LABORATORY MANAGEMENT Flashcards
5 HIERARCHY OF CONTROLS (from most to least effective)
ELIMINATION
SUBSTITUTION
ENGINEERING CONTROLS
ADMINISTRATIVE CONTROLS
PPE
Removes hazard at the source
Preferred solution to protect workers
because no exposure can occur
Elimination
using a safer alternative to the source of
the hazard
effective substitutes reduce the potential
for harmful effects and do not create new
risks
SUBSTITUTION
reduce or prevent hazards from coming
into contact with workers.
Can include modifying equipment or the
workspace, using protective barriers,
ventilation, and more.
Can cost more than administrative
controls or PPE. However, long-term
operating costs tend to be lower,
especially when protecting multiple
workers.
Engineering
Controls
Establish work practices that reduce the
duration, frequency, or intensity of
exposure to hazards.
Administrative
Controls
Equipment worn to minimize exposure to
hazards
PPE
Might seem to be less expensive than
other controls, but can be costly over
time.
PPE
Biological hazards are disease producing agents (pathogens) that can be transmitted to individuals through various routes of exposure (modes of transmission). Exposure to these hazards may result in acute or chronic health conditions.
BIOHAZARDS
5 COMMON MODES OF TRANSMISSION
- BLOOD AND BODY FLUIDS
- FECAL-ORAL
- CONTACT
- SMALL PARTICLE AEROSOL (AIRBORNE)
- More than one mode: contact,
and/or droplet spray
EXAMPLES OF PATHOGENS: BLOOD AND BODY FLUIDS
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus
(HIV)
EXAMPLES OF PATHOGENS: FECAL-ORAL
Hepatitis A Virus (HAV)
Hepatitis E Virus (HEV)
MODE OF TRANSMISSION:
Herpes Simplex Viruses (HSV)
Human Papilloma Virus (HPV)
Cytomegalovirus (CMV)
Vancomycin Resistant
Enterococcus (VRE)
Methicillin Resistant
Staphylococcus Aureus (MRSA)
Clostridium difficile (C. difficile)
CONTACT
EXAMPLES OF PATHOGENS: AIRBORNE
Mycobacterium Tuberculosis
More than one mode: contact,
and/or droplet spray
Severe Acute Respiratory
Syndrome Coronavirus 2 (SARSCoV-2)
Herpes Zoster Virus (HZV)
Influenza virus (Flu)
Measles (Rubeola virus)
CHAIN OF INFECTION
MICROORGANISM
RESERVOIR/SOURCE
PORT OF EXIT
MOT
PORT OF ENTRY
SUSCEPTIBLE HOST
bacteria, virus, fungus, parasite
microorganisms
habitat for organisms to grow: human, animal, air, food, soil, water, equipment
reservoir/source
SECRETION (SALIVA)
EXCRETION (URINE, FECES)
PORT OF EXIT
CONTACT, DROPLET, AIRBORNE, VECTOR, FORMITES
MODE OF TRANSPORT
MUCOSA LINING, OPEN WOUND, ORAL, RESPIRATORY TRACT, URINARY TRACT
PORT OF ENTRY
VERY YOUNG & ELDERLY, WITH CHRONIC DISEASE, MALNOURISHED, IMMUNOCOMPROMISED
SUSCEPTIBLE HOST
Agents that have no known potential for infecting healthy people
BSL1
Microorganisms associated with human diseases that are rarely serious and for which preventive or therapeutic interventions are often available.
BSL2
Material that may contain viruses not normally encountered in a clinical laboratory and mycobacteria
BSL 3 WITH RISK BASED
ENHANCEMENTS
dangerous and exotic agents that pose a higher risk of aerosol transmitted laboratory infections and life-threatening disease for which effective treatments are limited.
BSL4
- Controlled access
- Hand washing sink
- Sharp hazards warning policy
- Personal protective equipment
- Laboratory bench
- Autoclave
BSL1
- Controlled access
- Hand washing sink
- Sharp hazards warning policy
- Physical containment device
- Personal protective equipment
- Laboratory bench
AUTOCLAVE
BSL2
*Air tight when disinfecting
* Self-closing, double-door access
* Controlled access
* Personal shower out (risk-based
enhancement)
* Sharp hazards warning policy
* Hand washing sink
* Sealed penetrations
* Physical containment device
* Powered air purifying respirator
(risk-based enhancement)
* Laboratory bench
* Autoclave
* Exhaust HEPA filter (risk-based
enhancement)
* Effluent decontamination system
(risk-based enhancement)
BSL 3 WITH RISK BASED
ENHANCEMENTS
- Air tight
- Self-closing, double-door access
- Controlled access
- Sharp hazards warning policy
- Hand washing sink
Sealed penetrations
Physical containment device
Positive pressure protective suit
Laboratory bench
Autoclave
Chemical shower out
Personal shower out
Supply and exhaust HEPA filter
Effluent decontamination system
BSL4
Most important means of preventing the spread of infection
HAND WASHING
If hands are visibly soiled, wash hands with soap and water for ___
mins
1-2 MINS
If hands are not visibly soiled, wash hands for at least ___. or use
____ hand cleaners
30 secs
alcohol based
*CDC Guidelines: During hand washing, thoroughly clean between your fingers and under your fingernails for at least _____. And rinse your hands in a _____ position to prevent recontamination.
20 secs
downward
Worn to protect the clothing and skin of
health
Protect workers from contamination
Should be put on first
lab gown
Worn to protect against splashes and
inhalation of droplets containing
pathogens from infective patients.
mask, googles, face shields
Worn to protect healthcare workers from contamination by patient body substances
gloves
DONNING
1.Gown should be put on first
2.Mask should cover both nose
and mouth
3.Gloves should be pulled over the
gown cuff
DOFFING
1.Gloves are removed first.
2.Gown should be pulled from the
shoulders towards the hands
3. Mask should be removed
Decontamination of Body Fluid Spills
✓ _______
✓ Recommended contact time is _____
5.25% NaCL or 10% chlorine bleach (1:10 dilution)
15 minutes
enclosed workspaces with a ventilated hood that is designed to contain pathogenic microorganisms during microbiological processes.
Biosafety Cabinets
Class I and II Biosafety cabinets are used for Biosafety levels __ and __
I and II
Class III BSCs are most suitable for work with hazardous agents that require Biosafety Level __OR __
3 OR 4
the most basic biosafety cabinet that provides
protection to the environment and the laboratory personnel.
CLASS 1
It doesn’t provide protection to the product as the unsterilized room air is drawn over the work surface.
CLASS 1
cabinets protect the operator and the environment from the aerosol but not the sample.
CLASS 1
provide both kinds of protection (of the samples and the environment) since makeup air is also HEPA- filtered.
CLASS II
5 TYPES OF CLASS II BIOSAFETY CABINETS
TYPE A1
TYPE A2
TYPE B1
TYPE B2
TYPE C1
The type A1 cabinets have a minimum inflow
velocity of ____
75ft/min
This type of cabinet is not as widely used as it is not safe to work with hazardous chemical substances.
CLASS II TYPE A1
The type A2 cabinets have a minimum inflow
velocity of
100 ft/min.
Because of the chances of the release of
hazardous chemicals into the environment, _____ cabinets are also not extensively used.
CLASS II TYPE A2
These cabinets have a dedicated duct system
which allows the release of the contaminated air
out of the facility.
CLASS II TYPE B1
In the case of Type B1 cabinets, ___ of the air is recirculated, whereas the remaining ___ is exhausted out of the facility
40%
60%
All of the contaminated airflow (100%) in these cabinets is externally exhausted which means the air drawn into the cabinet is 100% exhausted into the atmosphere.
Because none of the air is recirculated, these
cabinets are the best to be used for tasks involving the release of chemical vapors.
CLASS II TYPE B2
expensive, and their use is limited to toxicology laboratories where protection against hazardous chemicals is imperative.
CLASS II TYPE B2
Similar to Type B cabinets in their working mechanism, but these are designed to reduce operating costs add flexibility to the laboratories.
the cabinets provide protection to the
environment, the operator, and the workstation or
the biological material.
CLASS II TYPE C1
Are leak-tight, totally enclosed but ventilated
cabinets, where all air that either enters or leaves through the facility pass through a HEPA filter.
CLASS III
CLASS III CABINETS ARE ALSO TERMED AS ____
GLOVE BOXES
These cabinets can be used for all four Biosafety levels (1, 2, 3, and 4). But these are the most important for the manipulation of biological materials in the Biosafety level 4.
All of these structural and design features provide maximum protection to the operator, the
environment
CLASS III
carcinogen
mutagenicity
reproductive toxicity
respiratory sensitizer target organ toxicity
aspiration toxicity
HEALTH HAZARD
flammables
pyrophoric
self-heating
emits flammable gas self-reactives
organic peroxides
FLAME
IRRITANT (skin and eye)
skin sensitizer
acute toxicity
narcotic effects
respiratory tract irritant
hazardous to ozone layer
EXCLAMATION MARK
GASES UNDER PRESSURE
GAS CYLINDER
SKIN CORROSION/BURNS
EYE DAMAGE
CORROSIVE TO METALS
CORROSION
EXPLOSIVES
SELF-REACTIVES
ORGANIC PEROXIDES
EXPLODING BOMB
OXIDIZERS
FLAME OVER CIRCLE
AQUATIC TOXICITY
ENVIRONMENT
ACUTE TOXICITY ( fatal or toxic)
SKULL AND CROSSBONES
An important source of information for workers,
lab personnel, emergency responders, and emergency medical
personnel
Safety Data Sheets (SDS)
Safety Data Sheets (SDS), formerly called ___
Material Safety Data
Sheets (MSDS)
In compliance with the new Hazard Communication Standard, SDS are divided into ____ sections
16
TRUE OR FALSE
Storage should be based solely on alphabetical order because incompatible chemicals may react chemically.
FALSE (should not be alpabetical order)
6 substance storage
flammable liquids
mineral acids
caustics
perchloric acid
air-reactive substances
heat-reactive substances requiring refrigeration
4 substances stored separately
flammable solids
organic acids
oxidizers
water-reactive substances
NFPA standard hazards identification system
BLUE- HEALTH
RED-FIRE
YELLOW- INSTABILITY
WHITE-SPECIFIC
CLASS OF FIRE: “A”
TYPE OF FIRE:
EXTINGUISHER:
ORDINARY COMBUSTIBLE
WOOD, CLOTH, PAPER
TYPE A
TYPE A-B
CLASS OF FIRE: “B”
TYPE OF FIRE:
EXTINGUISHER:
FLAMMABLE LIQUIDS
OILS, GASOLINE, PAINTS, GREASE
TYPE A-B
TYPE B-C
TYPE A-B-C
CLASS OF FIRE: “C”
TYPE OF FIRE:
EXTINGUISHER:
LIVE ELECTRICAL EQUIPMENT
ELECTRICAL WIRING, FUSE BOX
TYPE B-C
TYPE A-B-C
CLASS OF FIRE: “D”
TYPE OF FIRE:
EXTINGUISHER:
COMBUSTIBLE METALS
METALS
BUCKET OF SAND
CLASS OF FIRE: “K”
TYPE OF FIRE:
EXTINGUISHER:
COMMERCIAL COOKING EQUIPMENT
COMMERCIAL COOKING OIL APPLIANCES
WET CHEMICAL
Activities characterized by constant or excessive repetitive actions, mechanical pressure, vibrations, compressive forces or static postures for an extended period of time which may cause cumulative trauma disorders or work related MSD
ERGONOMIC HAZARDS
COLOR OF BAG: NON- INFECTIOUS DRY WASTE
BLACK
COLOR OF BAG: NON-INFECTIOUS WET WASTE (kitchen, dietary, etc.)
GREEN
color of bag: infectious AND PATHOLOGICAL WASTE
YELLOW
COLOR OF BAG: CHEMICAL WASTE INCLUDING THOSE WITH HEAVY METALS
YELLLOW WITH BLACK BAND
COLOR OF BAG: RADIOACTIVE WASTE
ORANGE
COLOR OF BAG: SHARPS AND PRESSURIZED CONTAINERS
RED
the organizing and controlling of the affairs of a business or a sector of a business or “working with and through people to accomplish a common mission.”
MANAGEMENT
4 LEADERSHIP STYLES
AUTHORITARIAN
DEMOCRATIC
CONSENSUS
LAISSEZ-FAIRE
autocratic; closed system; manager makes all decisions
without input from others
AUTHORITARIAN
participated; open system; manager makes decisions after polling staff
DEMOCRATIC
manager gets at least partial agreement from staff
CONSENSUS
free reign; manager leaves decision to staff, abdicates responsibility
LAISSEZ-FAIRE
5 MASLOW’S HEIRARCHY OF NEEDS
1.SELF-ACTUALIZATION
2.SELF-STEEM
3.LOVE AND BELONGING
4.SAFETY AND SECURITY
5. PHYSIOLOGICAL NEEDS
Styles can be plotted on a continuum from authoritative to democratic.
Tannenbaum and Schmidt theory
X theory relates to authoritative leader
Y theory relates to the democratic leader
Douglas McGregor’s X and Y theory
describes five types of management situations:
Blake and Mouton theory
Low concern for people and production
Impoverished management
Low concern for people, but high concern
for production
Authority-compliance
Medium concern for people and production
Middle-of-the-road management
High concern for people, but low
concern for production
Country club management
High concern for people and production
Team management
This theory indicates that the style used by the leader may vary
according to the situation
Fielder theory
Four leadership situations:
Hersey-Blanchard theory
4 SKILLS OF MANAGERS
ORGANIZATIONAL
PEOPLE
FINANCIAL
TECHNICAL
Conceptualize and apply management process,
systematize work flow, make decisions, and communicate with coworkers.
ORGANIZATIONAL
Understands basic theories of human needs and work motivation.
PEOPLE SKILLS
Effective use of and accounting for the monetary assets of the company.
FINANCIAL SKILLS
Involve the synthesis of the first three skills above and the
management of physical resources (supplies, equipment, facilities) into the operational parameters (products and services)
TECHNICAL SKILLS
4 FOUNDATION OF MANAGEMENT PROCESS
VISION
MISION
GOALS
OBJETIVES
a descriptive picture of a desired future state, long-term
VISION
organization’s purpose
MISION
organization’s desired outcomes, intermediate term and broad
GOALS
directives that describe how a goal will be achieved ; should be SMART
OBJECTIVES
SMART meaning
SPECIFIC
MEASURABLE
ACHIEVABLE
RELEVANT
TIME-BOUND
The concept of management as a continuous process of interacting functions, each dependent on the success of the other
MANAGEMENT PROCESS
4 MAIN FUNCTIONS OF MANAGEMENT PROCESS
PLANNING
ORGANIZING
DIRECTING
CONTROLLING
act of overseeing all activities and tasks that must be accomplished to maintain a desired level of excellence.
QUALITY MANAGEMENT
provides both a management philosophy for organizational development and a management process for improvement of quality in all aspects of work.
TOTAL QUALTY MANAGEMENT
FIVE-Q FRAMEWORK
QUALITY LABORATORY PROCESS
QUALITY CONTROL
QUALITY ASSESSMENT
QUALITY IMPROVEMENT
QUALITY PLANNING
includes analytical processes and the general policies, practices and procedures that define how all aspects of the laboratory are done (Quality Assurance)
QUALITY LABORATORY PROCESS
Emphasizes statistical control procedures, but also includes non-statistical check procedure such as linearity checks, reagents and standard checks and temperature monitoring
QUALITY CONTROL
concerned primarily with broader measures and monitoring of
laboratory performance (TAT, patient ID, test utility).
QUALITY ASSESSMENT
a structured problem solving process to help identify the root cause of a problem and a remedy for that problem.
QUALITY IMPROVEMENT
provides the planning to eliminate problems identified by QI
QUALITY PLANNING
PDCA cycle stands for what?
plan
do
check
act
a set of methodologies and tools used to improve business
processes by reducing defects and errors, minimizing variation, and increasing quality and efficiency.
SIX SIGMA
The goal of Six Sigma is to achieve a level of quality that is nearly perfect, with only ____ defects per million opportunities.
3.4
The Six Sigma Methodology comprises five data-driven stage, THESE ARE:
Define
Measure
Analyze
Improve
Control
___ IS designed to reduce waste, increase efficiency, and improve customer satisfaction; often used in clinical laboratories to improve turn around time (TAT)
LEAN
a standard that requires labs to develop a robust, reliable quality management system (QMS) to establish their competence. Management by objective (MBO)
ISO 15189: 2022
Targets organizational and employee performance by aligning goals and objectives throughout the organization, including timelines, tracking, and feedback in the process
MANAGEMENT BY OBJECTIVE (MBO)
process whereby the best process in one organization is modified to fit similar processes in another organization
BENCHMARKING
7 QUALITY TOOLS
Cause -and -effect diagram
Check sheet
Control chart
Histogram
pareto chart
scatter diagram
stratification
Identifies many possible causes for an effect or problem and sorts ideas into useful categories.
CAUSE AND EFFECT DIAGRAM
CAUSE AND EFFECT DIAGRAM IS ALSO CALLED AS?
ISHIKAWA OR FISHBONE DIAGRAM
A structured, prepared form for collecting and analyzing data; a generic tool that can be adapted for a wide variety of purposes
CHECK SHEET
Graph used to study how a process changes over time. Comparing current data to historical control limits leads to conclusions about whether the process variation is consistent (in control) or is unpredictable (out of control, affected by special causes of variation)
CONTROL CHART
The most commonly used graph for showing frequency distributions, or how often each different value in a set of data occurs.
HISTOGRAM
A bar graph that shows which factors are more significant.
PARETO CHART
Graphs pairs of numerical data, one variable on each axis, to look for a relationship.
SCATTER DIAGRAM
A technique that separates data gathered from a variety of sources so that patterns can be seen
STRATIFICATION
