lab 1 - LABORATORY GUIDELINE IN THE LABORATORY Flashcards
SAFETY STANDARDS AND AGENCIES
-U.S. Department of Labor, Occupational Safety and
Health Administration (OSHA)
-Clinical and Laboratory Standards Institute (CLSI)
-Centers for Disease Control and Prevention (CDC)
-College of American Pathologists (CAP)
-The Joint Commission (TJC)
A nonprofit educational organization that
provides a forum for the development,
promotion, and use of national and
international standards
Clinical and Laboratory Standards Institute (CLSI)
Step by step procedure in SOPs
Clinical and Laboratory Standards Institute (CLSI)
Normal values with each laboratory tests
Clinical and Laboratory Standards Institute (CLSI)
Different manner of reporting of each
laboratory tests
Clinical and Laboratory Standards Institute (CLSI)
Part of the US Department of Health and
Human Services Public Health Service
Centers for Disease Control and Prevention (CDC)
Public health information is mandated by the
Centers for Disease Control and Prevention (CDC)
focuses on Emerging and notifiable infectious disease to
a certain country or community
Centers for Disease Control and Prevention (CDC)
Provide information to the public, what
would be the transmission of a certain
infectious disease, signs, symptoms, and how
would be the virulent factor of this pathogen
Centers for Disease Control and Prevention (CDC)
Different levels of organism that we may
encounter in the laboratory, different
classifications right we have the level one
level two level three and level four and with
the classifications of organism we have an
appropriate way on how to handle this kinds
of organism
Centers for Disease Control and Prevention (CDC)
Head of the laboratory, they
have an a specialization for the anatomical
and clinical pathology
Pathologist
Classification of laboratories
- Has designated area and proper
ventilation, and humidity.
Primary
Secondary
Tertiary
The Joint Commission (TJC)
In line with the different facilities
The Joint Commission (TJC)
Give the criteria in terms of maintaining the
facilities and adequacy of the working area on
each tab type or classification of laboratory.
The Joint Commission (TJC)
Staff must wear ____ and be additionally
protected from contamination by infectious agents.
laboratory coats
five general safety practices
- Staff must wear laboratory coats and be additionally
protected from contamination by infectious agents. - Food and drinks should not be consumed in work
areas or stored in the same area as specimens.
Containers, refrigerators, or freezers used for
specimens should be marked as containing a
biohazard. - Specimens needing centrifugation are capped and
placed into a centrifuge with a sealed dome. - A gauze square is used when opening rubber
stoppered test tubes to minimize aerosol production
(introduction of substances into the air). - Auto dilutors or safety bulbs (orange or blue) are
used for pipetting. Pipetting of any clinical material by
mouth is strictly forbidden.
Specimens needing centrifugation are __ and __ into a centrifuge with a sealed dome.
capped;
placed
A ____is used when opening rubber
stoppered test tubes to minimize aerosol production
(introduction of substances into the air).
gauze square
_____ are
used for pipetting. Pipetting of any clinical material by
mouth is strictly forbidden
Auto dilutors or safety bulbs (orange or blue)
Universal precautions instituted by the cdc in 1985 to protect health care workers from exposure to what blood borne pathogens?
blood borne pathogens, primarily
hepatitis B virus (HBV) and HIV
which causes
Syphilis
Typhoid
Dengue
____ were instituted by the
CDC in year ___ to protect health-care workers from
exposure to blood-borne pathogens,
Universal precautions (UP); 1985
the guideline of UP or universal precautions recommended
-?
-?
-?
-Wearing gloves when collecting or handling
blood and body fluids contaminated with
blood
-Wearing face shields when there is a danger of
blood splashing on mucous membranes
- Disposing of all needles and sharp objects in
PUNCTURE RESISTANT CONTAINERS
without recapping
Fishing technique
A modification of universal precautions
Body Substance Isolation (BSI)
Not limited to blood borne pathogens and considers
all body fluids and moist body substances to be
potentially infectious
Body Substance Isolation (BSI)
Disadvantage of the guideline is that it does not
recommend handwashing after removing gloves
unless visual contamination is present
Body Substance Isolation (BSI)
Protection of healthcare workers for those
transmissible infection.
Standard Precautions
Assumes every person in the health care setting is
potentially infected or colonized by an organism that
could be transmitted
Standard Precautions
Applies to all blood and body fluids, mucous
membranes, and non-intact skin and stresses
handwashing.
Standard Precautions
To help prevent nosocomial infections, the CDC in 1994
implemented two levels of precautions.
what are those 2 level?
The FIRST LEVEL is Standard Precautions
The SECOND LEVEL is Isolation Precautions/
Transmission based Precautions
The level that is the Formerly Universal Precautions
FIRST LEVEL - Standard Precautions
This level Specifies precautions to use in caring for all
patients regardless of diagnosis or
presumed infection status.
FIRST LEVEL - Standard Precautions
the level that focuses Protection of healthcare workers,
okay for those a transmissible
infection
SECOND LEVEL-s Isolation Precautions/
Transmission based Precautions
Specifies precautions to use for patients
either suspected or known to be infected
with certain pathogens transmitted by
airborne, droplet, or contact routes.
SECOND LEVEL - Isolation Precautions/
Transmission based Precautions
Precautions that are based on how the
infectious agent is transmitted.
SECOND LEVEL - Isolation Precautions/
Transmission based Precautions
epidemiology check which part aspect of the disease?
Level of transmission
Incubation period of that particular
disease
Signs and symptoms
Level of the fatality
are used less often and only with
patients who have specific infections
Isolation precautions
Are to be used for patients known or suspected to be
infected or colonized with highly transmissible or
epidemiologically significant pathogens that require
special precautions in addition to standard
precautions.
TRANSMISSION-BASED PRECAUTIONS/ ISOLATION
PRECAUTIONS
The occurrence and pattern of
a specific disease
Epidemiology
3 isolation precautions
airborne, droplet, and contact
an isolation precaution for
patients known or suspected to be infected with
microorganisms transmitted by droplet nuclei
(particles SMALLER than 5 m).
airborne precautions
an isolation precaution for
patients known or suspected to be infected with
microorganisms transmitted by droplet nuclei
(particles LARGER than 5 m).
droplet precautions
an isolation for nuclei that is generated when a patient talks, coughs, or sneezes and
during certain procedures such as suctioning.
droplets precautions
an isolation when
a patient is known or suspected to be infected or colonized with
epidemiologically important microorganisms that can be
transmitted by direct contact with the patient or indirect
contact with surfaces or patient-care items.
SAFE WORK PRACTICES FOR INFECTION CONT
coontact precaution
The use of ______ is an approach
to infection control that prevents occupational
exposures to bloodborne pathogens
CDC Standard Precautions
requires laboratories to have a personal
protective equipment (PPE) program.
Selection and Use of Gloves
Facial Barrier Protection and Occlusive Bandages
Laboratory Coats or Gowns as Barrier
OSHA
Hands should always be washed at the which
times
- before patient contact, when gloves are removed
- prior to leaving the work area
- Whenever the hands have been knowingly contaminated
- Before going to designated break areas, and before
and after using bathroom facilities.
how to Remove gloves properly.
(a) Grasp the outside edge near the wrist. Peel away from the
hand, turning the glove inside out. Hold the glove in opposite
gloved hand
Pinch the center palm
(b) Hold the contaminated glove in the gloved hand while
removing the second glove.
.(c) Slide the ungloved finger under the wrist of the remaining
glove. Peel off from inside, creating a bag for both gloves, and
then discard
Types of safety hazard
Biological
Sharps
Chemical
Radioactive
Electrical
Fire/explosive
Physical
source of biological hazards
Infectious agents
possible injury for biological hazard
Bacterial, fungal,
viral, or parasitic
infectious
source of sharp hazard
needles, lancets, broken glass
possible injury of sharp hazards
Cuts, punctures, or
blood-borne
pathogen exposure
source of chemical hazard
preservatives and reagents
source of radioactive hazard
equipment and radioisotopes
possible injury of chemical hazard
exposure to toxic, carcinogenic, or caustic agents
possible injury of radioactive hazzard
radiation exposure
possible injury of electrical hazard
burns or shock
source of electrical hazard
ungrounded or wet equipment: frayed cords
source of fire or explosive hazard
bunsen burners, organic chemicals
possible injury of fire/explosive
burns or dismemberment
source f physical hazard
wet floors, heavy boxes, patients
a type of hazard encountered in Nuclear medicine
radioactive
possible injury of physical hazard
falls, sprains, or stains
ergonomic positions are related to which hazard?
physical hazard
All of the majority of the laboratory
tests for that particular section of
the laboratory are done through
that particular radio isotopes.
Ex. MIR, CT scan, and PET scan
which hazard is it related?
radioactive hazard
this would be a specific term for safe handling the
blood and other biological substances that is very risk
for us
BIOSAFETY
A term used to describe the safe handling of biological
substances that pose a risk to health.
BIOSAFETY
Biological hazards can be encountered in a healthcare
setting on a daily basis
true or false
true
Healthcare personnel must be able to recognize them
in order to take the precautions necessary to
______ or ____ exposure to them
eliminate or minimize
For the protection of ourselves to not be harmed
BIOHAZARD
Anything harmful or potentially harmful
to health is called a biohazard (short for
biological hazard)
BIOHAZARD
biohazard should be identified by what?
by a biohazard symbol
Most laboratory specimens have the
potential to contain infectious agents, they are
considered _____.
biohazards
solution used for potentially infectious agents
Sodium hypochlorite solution - Household
bleach (1:10 dilution)
The most likely source of infection in serological
testing is through _____
contact with patient specimens
The chain of infection requires a continuous link
between three elements:
what are those?
a source, a method of
transmission, and a susceptible host
The ultimate goal of biological safety is to ____
prevent
completion of the chain by preventing
transmission.
Strict adherence to guidelines published by these two agencies is essential
Centers for Disease Control and Prevention (CDC)
and the Occupational Safety and Health
Administration (OSHA)
All biological waste, must be placed in
appropriate containers labeled with
the biohazard
symbol
all biological waste, except _____, must be placed in
appropriate containers labeled with the biohazard
symbol
urine
Any supplies contaminated with BLOOD AND BODY FLUID must also be disposed of in containers clearly marked
with the biohazard symbol or with what color coding?
with red or yellow
color-coding
RED sharps; YELLOW infectious
Contaminated non-disposable equipment, blood
spills, and blood and body fluid processing areas must
be disinfected.
The most commonly used disinfectant is a ______
prepared weekly and stored in a plastic, not a glass,
bottle
1:10
dilution of sodium hypochlorite (household bleach)
how do we disposed urine?
URINE is poured within the sink and use running water to drain
The term _____is applied to
any infectious microorganism present in blood and
other body fluids and tissues
blood-borne pathogen (BBP)
Most common BBP in immunology and serology:
Hepatitis C, Hepatitis B and HIV.
The best defense against HBV infection is
vaccination
Vaccination consists of a series of three equal intramuscular injections of vaccine: what are those?
an initial dose, a second dose 1 month after the first, and a third dose 6
months following the initial dose
The vaccine also protects against ____-since it can
only be contracted concurrently with HBV infection
HDV
the success of immunization and proof of immunity against HBV are can be determined after how many months since the last vaccination dose.
There will be a blood test done that will detect the presence of the hepatitis B surface antibody (anti-HBs) in the serum
1-2 months
In which sample we can see the HBV?
present in blood and other body fluids such
as urine, semen, cerebrospinal fluid (CSF), and saliva.
TRUE OR FALSE
HBV can’t survive up to a week in dried blood on work
surfaces, equipment, telephones, and other objects
In a healthcare setting, it is primarily transmitted
through ____ (a Single ____ can transmit
HBV) and other sharps injuries and Contact with
contaminated equipment, objects, surfaces, aerosols,
spills, and splashes
needlesticks
In nonmedical settings, it is transmitted primarily
through ____
sexual contact and sharing of dirty needles.
has
become the most widespread chronic bloodborne
illness in the United States.
HEPATITIS C VIRUS (HCV)
Hepa variant that has No vaccine is currently available.
HEPATITIS C VIRUS (HCV)
Found to be the primary cause of non-A, non-B hepatitis.
HEPATITIS C VIRUS (HCV)
is found primarily in blood and serum, less
frequently in saliva, and seldom in urine and semen.
HCV
It can enter the body in the same manner as HBV. However, infection primarily occurs after large or
multiple exposures
HCV
attacks the body’s immune system, causing AIDS
by leaving the body susceptible to opportunistic
infections.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
caused by organisms that
would not ordinarily be pathogens to a normal healthy
individual.
Opportunistic infections
HIV infection has a poor ___ and is of great
concern to healthcare workers
Poor ____because we have different stages of
HIV like acute stage (fever for 2 to 4 weeks),
latent stage (3 to 20 years asymptomatic) and
late stage (AIDS).
prognosis
HIV can be isolated from
blood, semen, saliva,
tears, urine, cerebrospinal fluid, amniotic fluid,
breast milk, cervical secretions, and tissue of
infected persons
The number-one personal safety rule when handling
needles is to _____
never manually recap one
Devices available for needle disposal:
needle holders that become a sheath
needles that automatically re-sheath or become blunt
Needles with attached sheathes.
All sharps must be disposed of in _____
puncture-resistant,
leak-proof containers labeled with the biohazard
symbol
The Occupational Exposure to Bloodborne pathogens
Standard became law on what year
1991
the regulation to protect heath care workers from blood borne pathogens are monitored and enforced by what agency?
OSHA
It requires all employers to have a written Bloodborne
Pathogen Exposure Control Plan and to provide
necessary protection, free of charge, for employees.
The Occupational Exposure to Bloodborne pathogens
Standard
Specifics of the OSHA standard include the following:
Requiring all employees to practice universal
(standard) precautions.
Providing lab coats, gowns, face shields, and gloves
to employees and providing laundry facilities for non-disposable protective clothing
Providing sharps disposal containers and prohibiting recapping of needles.
Prohibiting eating, drinking, smoking, and applying cosmetics in the work area.
Labeling all biohazardous materials and containers.
Is the immunization for HBV free?
yes
OSHA’S EXPOSURE CONTROL PLAN
Categories of Exposure:
category I, II, III
WHAT IS THE CATEGORY I in categories of exposure
- daily exposure to blood and body fluids
WHAT IS THE CATEGORY III in categories of exposure
no exposure to blood and body fluids
WHAT IS THE CATEGORY II in categories of exposure
regular exposure to blood and body fluids
The disinfectant of choice for bloodborne pathogens
is
sodium hypochlorite (household bleach freshly
diluted 1:10)
In chemical hazards, Preparing reagents must be in ?
under a fume hood
true or false
Chemicals should NEVER be mixed together, unless
specific instructions are followed, and must be
added in the order specified
true
Describes hazards, safe handling, storage, and
disposal hazardous chemicals
MATERIAL SAFETY DATA SHEET (MSDS)
Each MSDS contains basic information about the
specific chemical or product
list them up
trade name, chemical name and synonyms,
chemical family, manufacturer’s name and
address, emergency telephone number for
further information about the chemical,
hazardous ingredients, physical data, fire
and explosion data, and health hazard and
protection information.
Describes the effects of overexposure or exceeding
the threshold limit value of allowable exposure for an
employee in an 8-hour day.
MATERIAL SAFETY DATA SHEET (MSDS)
Describes protective personal clothing and equipment
requirements, first aid practices, spill information and
disposal procedures.
MATERIAL SAFETY DATA SHEET (MSDS)
Hazardous chemical waste should be disposed of as per the current ___ regulations
EPA - Environment protection agency
They also trach the disposal of hazardous
chemical waste aside EPA
Local regulations and the Department of
Transportation
Many kits used in testing contain ____, which
can be disposed of by flushing down the drain with
plenty of water to avoid buildup in plumbing
sodium azide
is encountered in
the clinical laboratory when
procedures using radioisotopes,
such radioimmunoassay are
performed.
Radioactivity
Radiation is bad for pregnant
women; _____ (may lead to birth defects of
the fetus)
teratogenic
Disposal of radioactive waste is regulated by the
_____
Nuclear Regulatory Commission (NRC)
what should we do r before unplugging the
equipment or moving the equipment using a non-conductive glass or wood object
turn off the circuit breaker
what to do When a fire discovered?
remember RACE
R - rescue
A - alarm
C - contain
E - extinguish/evacuate
class A fire
CLASS A - Ordinary combustible, solid materials
(paper, wood
Class B fire
Flammable liquids/gasses and combustible
petroleum products
Class D
- Combustible/ reactive metals (Mg, Na, K
Class C fire
- Energized electrical equipment
Class B extinguishers
Use foam, dry chemical, or carbon dioxide
to smother the fire
Class E
Detonation
Class A extinguishers
Use soda and acid or water to cool the fire
Class ABC (multipurpose) extinguisher
Use dry chemical reagents to smother the
fire.
They can be used on class A, B, and C fires.
Class K extinguishers
Use a potassium-based alkaline liquid
specifically formulated to fight high
temperature grease, oil, or fat fires by
cooling and smothering them without
splashing
Some class K extinguishers can also be used on class A, B,
and C fires
