MT6316 CHAPTER 10-11 Flashcards
Secondary effects of a laboratory accident are?
loss of reputation
A safety program must have a written?
Procedure and policy
Laboratory Safety Programs plan to/for?
- plans for preventing sickness and injury to personnel
- Plans to prevent damage or destruction of physical assets.
What are the objectives of a safety program?
- Safety skills and attitude of all personnel
- Surveillance program for promptly identifying hazards
- Plans for promptly correcting all hazards
- Laboratory safety efforts with the over all hospital safety program.
An Employee Health Program includes?
- pre-employmentphysicalexamination
- Periodic inspection of above in most instances reassessments are made yearly
- Written reports of all work-related illnesses and accidents
- Employee health records for the total period of employment.
A general safety program includes periodic inspections done by who and for what purposes?
by director or designee for purposes of indicating interest and concern
A general safety program includes the consideration of periodic programs by?
outside persons with expertise in special areas of laboratory safety.
A general safety program includes the hiring of?
full or part-time safety officer
T or F: It is okay to work alone in the laboratory
F, a second person should be within call.
here are two types of chemical hazards, which are?
External
Internal
EXTERNAL OR INTERNAL CHEMICAL HAZARD: result of caustic or corrosive substance
external
EXTERNAL OR INTERNAL CHEMICAL HAZARD: result of the toxicity of substances
internal
There are [how many] main routes by which chemicals enter the body.
three
What are the three main routes by which chemicals enter the body?
Inhalation
Absorption through skin
Ingestion
This is the major route of entry when working with solvent
Inhalation
Absorption through skin may produce what type of poisoning?
systemic poisoning
Route of entry due to poor hygiene practices
Ingestion
Programs for Handling Chemicals include?
- Prescribed containers and adequate storage space
- Permanent container labels
- Policies for transporting
- Instruction for dispensing, transferring and disposing
“Treat all body fluids _________”
infectious
The major routes by which laboratory staff acquire work-related infections are?
- percutaneous inoculation
- contact between mucous membranes and contaminated material
- accidental ingestion.
If there is a biological spill, apply what to the spill?
Absorbent towel and disinfectant
How much time is adequate for the disinfection of the biological spill?
20mins
If laboratory personnel becomes contaminated with biological hazards due to splashes or spills, immediate steps to take include?
- Clean exposed skin or body surface with soap and water, eyewash (for eye exposures) or saline (for mouth exposures).
- Apply first aid and treat as an emergency.
- Notify supervisor, safety officer, or security desk.
- Follow appropriate reporting procedures.
- Report to physician for treatment or counselling.
T or F: After use, gloves must be disposed of in the contaminated waste.
T
Protect eyes and other mucous membranes from projection by using face shield
Goggles
T or F: Contact lenses are able to offer protection from splashes
F, not able
Reduce laboratory workers’ respiratory exposure to airborne highly dangerous pathogens
Masks
For the use of masks, use what kind of respiratory with what during specimen collection and handling?
fit-tested particulate respirators with adequate filtering
Examples of fit-tested particulate respirators with adequate filtering?
EU FFP2, US NIOSH-certified N95
What PPE is compulsory in all instances?
Laboratory coats
What should one be aware of in the use of lab coats?
composition of fabrics, as some might be highly flammable.
What are the types of gloves and their corresponding purpose?
- rubber gloves (hazardous liquids)
- lead gloves (radioactive materials)
- surgical gloves (pathogens)
- insulated gloves (hot and cold objects)
- heavy leather gloves ( certain animals)
Basic PPEs include?
Clothing
Gloves
Safety shoes
Hard helmet
Safety eye glasses
Respirators
Facemasks
Program for Handling Biological Materials includes instructions and policies regarding?
- collecting transferring, storing and disposing of all specimens
- isolating test procedures
- washing and the care and cleaning of work surfaces
- cleaning and/or disposing of specimen
A significant source of potential injury to laboratory staff, thus making training in specific safety procedures imperative.
Laboratory equipment
Examples of Laboratory equipment involved in Mechanical or Physical Hazards?
autoclaves, centrifuges, compressed gas cylinders and fume hoods.
In the context of Mechanical or Physical Hazards, what is important to alleviate these hazards?
safety training and precautions
Safety Equipment in the laboratory include?
- Fire extinguisher
- Safety showers
- Eye washes
- Safety shields
How many types of fire extinguishers are there and what are these types?
these are of three general types
a. water type
b. dry chemical type
c. carbon dioxide type
Instructions for proper disposal of sharps are?
- Avoid needle recapping.
- Put sharps in a puncture-resistant, leak-proof sharps container.
- Label the container “Sharps”
NEVER USE BOXES for the disposal of?
*sharps
*biohazardous materials that have not been autoclaved
*liquid wastes
*chemically contaminated laboratory glassware or plasticware
*chemical containers that cannot be disposed of as regular solid waste.
Liquids with [low/high] flash points may ignite if they are near __________
Low
heat sources
What are the types of heat sources involved in the ignition of liquids with low flashpoints?
hotplates, steam lines or equipment that might produce a spark or heat.
A small laboratory fire is considered to be one that is extinguishable within how long?
1–2 minutes.
First line fire extinguishing technique is to cover the fire with?
inverted beaker or wet paper towels
If the technique to cover the fire with an inverted beaker or wet paper towels is not successful, what is the last resort?
Fire extinguisher
How many classes of fire hazards are there?
4 (A,B,C,D)
A Fire Prevention Program includes?
- Physical facilities and operational practices that satisfy fire code.
- Instructions for handling and storing combustibles; container labels with “flash points”.
- Instructions for operating all heat-generating equipment
- Well-conceived and rehearsal plans in event of fire that are closely coordinated with hospital efforts
Label combustibles container with?
Flashpoints
Sources of radiation in the laboratory include?
a. radioactive isotopes
b. x-rays
c. ultraviolet sources
Require special precautions, and dedicated benches with specific bench covers for manipulation of radio-labeled elements are needed.
Radiochemicals
Radiochemicals require?
Appropriate protection ((PlexiglasTM, lead)
Ensuring quality and safety during laboratory processes is a major concern for laboratory managers
Laboratory Liabilities
As a Laboratory Director, it is important to?
- design and plan laboratory facilities
- assess all potential risks and apply basic concepts of organization
- consider the organization of the laboratory when developing new activities or new diagnostic techniques
As a Quality Manager (or designated safety officer), it is necessary to?
- Develop basic safety rules and organization, and ensure that personnel are trained
- know the basics of safety and biosafety management issues
- know how to perform an extensive risk assessment when developing
new activities - conduct laboratory safety audits.
As a laboratorian, it is important to?
- be aware of basic safety rules and processes;
- understand the basics of safety and biosafety management issue with toxic chemicals, biological samples, physical hazards and interacting with patients.
Injury Liabilities of the Laboratory include?
- Laboratory equipment
- Storage of compressed gasses
- Needles and sharps
- Exposure to toxic chemicals and radioactive materials pose a real threat to the health and safety of laboratory staff.
- Laboratory acquired infections
- Aerosols contamination
- Biological and chemical spills
- Laboratory fires
Defined as a deviation or an imbalance between what “should be” and what “actually is” happening
The problem
The problem is answered by the question, _________
“what is wrong that needs correction”.
Categories of a Problem are?
- Causality-based problems
- Meaning-based problems
Has well defined boundaries and elements are connected primarily through cause and effect.
Causality-based problems
Causality-based problems have what kind of relationship?
Linear
What kind of problem: the laboratory intercom’s failure to work properly
Causality-based problems
Boundaries are poorly defined
Meaning-based problems
Rarely are linked directly by cause and effect and the nature of their connections depends on the meaning attached to each elements.
Meaning-based problems
What kind of problem: the financial proceeds of the laboratory is declining
Meaning-based problems
In Meaning-based problems, the elements to include are not _____, they must be _____
Given
Chosen
Employers allow or encourage employees to share or participate in organizational ______
Decision making
What kind of problem solving involves the employers allow or encourage employees to share or participate in organizational decision-making?
Participative Problem Solving
A manager may choose to make the decision alone or request input from an individual with specific expertise or experience in the subject matter
Unilateral Problem Solving
Seven Steps of Problem Solving
- Find the problem
- Diagnose
- Develop alternative solutions
- Evaluate alternative solutions
- Select the best solution–the decision point
- Implement the solution after developing a plan
- Evaluate feedback and take corrective action where needed to ensure the problem is solved.
Source for finding problem include?
- Failure to meet objectives
- decreased production or quality of service - lowered employee morale
- diminishing income
- rise in incident reports
- Employees, peers and supervisors
A manager need only be alert to the __________ and prepared to investigate their _________.
existence of problems
causes.
The manager’s investigation must be based on?
based on fact, and not the result of opinion, misinterpretation, or bias
To assure a good diagnosis of the problem, you should?
- Define the problem in writing briefly and accurately
- Gather as much data as possible to determine the cause/s
- Identify the specific cause to reduce work later on
- Identify known constraints and barriers that would preclude some solutions
When gathering information for problem diagnosis, it is important to work with?
facts, not opinions.
Develop Alternative Solutions using what approach?
Brainstorming approach
Brainstorming approach includes what processes?
- List as many solutions as possible - but none of them should be evaluated
- Criticizing the suggestions
- to inhibit contributions, one of which could possibly be the basis of the best solution.
Evaluating an Alternative Solution involves a direct look at the?
Pros and cons
What may be appropriate in Evaluating an Alternative Solution?
cost-benefit analysis
In a cost-benefit analysis, what should be quantified and verified?
- financial aspect should be quantified
- the patient benefits verified
4 major types of decisions
- Considered decision
2 Operational decisions - Swallow hard decisions
- Ten-second decisions
What kind of decision: have a major effect on the total operation
Considered
What kind of decision: complicated and require considerable reflection
Considered
What kind of decision: require much interaction with others
Considered
What kind of decision: the routine kinds of things we do on day to day basis
Operational
What kind of decision: an excellent opportunity to develop as decision makers
Operational
What kind of decision: the kind that are often personally uncomfortable
Swallow hard
What kind of decision: usually deal with interpersonal relationships
Swallow hard
What kind of decision: Employees may not like the decision but they can understand why it was made.
Swallow hard
What kind of decision: dictated by external pressure
Ten-second
What kind of decision: an employee requesting an hour off that day
Ten-second
What kind of decision: primarily unilateral decisions
Ten-second
What kind of decision: managers must remember that he will be held accountable for the decision.
Ten-second
FINANCIAL MANAGEMENT OR PLANNING: utilization of funds
MANAGEMENT
FINANCIAL MANAGEMENT OR PLANNING: planning the procurement
MANAGEMENT
FINANCIAL MANAGEMENT OR PLANNING: controlling the financial operation to assure effective utilization of funds
MANAGEMENT
FINANCIAL MANAGEMENT OR PLANNING: setting of financial goals
PLANNING
FINANCIAL MANAGEMENT OR PLANNING: the determination of future financial requirements
PLANNING
FINANCIAL MANAGEMENT OR PLANNING: possible sources of funds
PLANNING
A systematic programming of organizational activities
Budget
Made based on their costs and on the amount of resources available.
Budget
A budget is a template for?
forecasting revenue and expenses for an organization.
An ongoing process that culminates annually with the expense projections for the coming year.
Laboratory Budgeting
Laboratory Budgeting are forecasts made in accordance with?
the chart of accounts
Laboratory Budgeting is divided into?
Quarters (3months)
The 3 month intervals in laboratory budgeting represents?
the best times for expenditure modification.
How to prepare budgets?
1.Historical
2.Growth Factor Projection
3.Zero-Based Budgeting
What budget prep: use data from previous year’s revenue and expenses
Historical
What budget prep: forecasting future revenues and expenses by factoring the desired growth projection.
Growth Factor Projection
What budget prep: tarting the budget process from zero figure and justifying and researching every cost that will be incurred before arriving to a final budget.
Zero-Based Budgeting
A Budget is divided into anticipated?
Income and expenses
Part of a budget that includes the charges that may be made for patient days, services rendered per patient day
Income/ Revenue
A part of the budget that involve personnel costs which amounts to about 70% of total expenses
Expenses/ Costs
Expenses/ Costs involves personnel costs which amounts to about how much of the total expenses?
70%
Expenses/ Costs also involved what kind of costs?
materials, leases and contracts and overhead costs.
Usually include interest on debts, utilities, phone, building maintenance and various other costs that cannot be allocated to a specific areas.
Overhead costs
What kind of costs pertain to salaries of permanent employees who are already working at the start of the fiscal year?
Personnel costs
In Personnel costs, what may be anticipated?
Additional personnel may be anticipated (or reductions may be planned)
Can be estimated on the basis of previous experience.
Supplies
What can be anticipated in Supplies?
new equipment is anticipated, and changes made in supplies
In the chart of accounts, what are the kinds of salaries?
a. exempt
b. non-exempt
In the chart of accounts, what are the kinds of Supplies and Equipment?
a. purchase
b. rental
c. lease
d. maintenance
e. depreciation
In the chart of accounts, what are the kinds of taxes?
a. payroll
b. sales
In the chart of accounts, what are the kinds of insurance?
a. general liability
b. workman’s compensation
c. group health
d. others
FINANCIAL ACCOUNTING STATEMENTS include?
1.Balance Sheet
2.Income Statement
3.Statement of Cash Flow
What kind of FINANCIAL ACCOUNTING STATEMENT: Statement of Financial Position, It shows the lab’s financial situation at a given point in time.
Balance sheet
A balance sheet contains the?
Assets (Cash, Receivables, Property, Equipment, Inventory).
What kind of FINANCIAL ACCOUNTING STATEMENT: Shows revenue generated and expenses incurred over a period of time.
Income Statement
What kind of FINANCIAL ACCOUNTING STATEMENT: Shows the inflow and outflow of cash. (Operations, Investments, Financing)
Statement of Cash Flow
Tools for fiscal decision making include?
- Laboratory workload reporting
- Depreciation/ Payback period
- Cost finding/ Cost-Revenue Analysis
Defined as one minute of technical, clerical, and aide time.
Workload unit
In actual practice, the average workload productivity in most laboratories is in the range of how many units per hour?
30 to 55 workload units per hour.
Components of Workload include?
- Direct Effort
- Indirect Effort
- Operational Needs
Refers to the personnel labor effort involved in direct patient specimen handling as it processes from specimen to result.
Direct Effort
List of tasks that staff members perform that isn’t directly related to the patient, specimen, or test results.
Indirect Effort
Non-procedural-based responsibilities that consume staffing resources.
Operational Needs
What is the difference between Operational Needs and Indirect Effort?
operational needs are further removed from the testing process and are more operational in nature.
What component of workload: Calibration, control, maintenance, stocking of supplies
Indirect Effort
What component of workload: Trainings, break/lunch, meetings
Operational Needs
What component of workload: answering phone calls, inquiries
Indirect Effort
Based on a 40-hour workweek
FTE, or full-time equivalent,
FTE, or full-time equivalent is based on the?
a 40-hour workweek
CAP workload unit is how long?
1 minute of technical, clerical and/or aide time
Productivity is measured through?
total workload units/ hour
Involves comparing current with previous productivity in (sections within the laboratory) ( with other comparable laboratories)
Productivity units
If a laboratory’s productivity consistently runs over ______, then the laboratory maybe understaffed and need additional personnel support.
60
The value of the equipment/ capital expense diminishes over an extended period of time and usage.
Depreciation
Determines how long will it take to recover cash outlays, or to recover their investment.
Payback Period
What is the equation for the straight line depreciation?
(Cost of equipment - Salvage Value) / Life expectancy of equipment
What is the equation for the payback period?
Purchase price of equipment / Annual income generated by the equipment
Cost for performing a particular procedure
Cost finding
Establishes its charges on the involved direct and indirect cost.
Cost finding
Cost finding is in consultation with?
fiscal staff of the hospital
In cost finding, who are needed to provide the indirect (or overhead) expense?
fiscal personnel
Two general types of costs?
a. direct costs
b. indirect costs
What type of cost: costs of materials supplies and personnel time
Direct
What type of cost: utilities, laboratory and institutional administrative expenses, building depreciation and janitorial services.
Direct
Constant overtime regardless of volume of determinations,
Fixed costs in a laboratory
Depreciations, supervisor salaries and rental charges are examples of?
Fixed costs in a laboratory
Costs (for items such as supplies and reagents) which will vary in a relationship to the volume of determinations.
Variable costs
Which is larger: Fixed cost or variable cost?
Fixed costs are much larger than variable costs since personnel costs usually account for 60 to 70% of the total budget of most hospitals.
Associated with physical assets, equipment, instruments that have a life span of more than 1 year and often depreciated over a 5 year period. Or may cost more than a set amount.
CAPITAL COSTS
Costs used for day-to-day operations.
OPERATING COSTS
General costs of doing business.
OPERATING COSTS
May also refer to costs to produce test results. Includes Direct and Indirect costs.
OPERATING COSTS
Related to all components associated with performing the test.
DIRECT COSTS
Not directly contributing to producing the test.
DIRECT COSTS
Overhead, administrative, other expense shared by many components in the lab are examples of?
DIRECT COSTS
Expenses that do not fluctuate when the volume of work changes on a daily basis.
FIXED COSTS
Rent, depreciation, taxes are examples of?
FIXED COSTS
Respond directly to any change in workload, will vary in relationship with volume of tests.
VARIABLE COSTS
Reagents, Supplies, Labor costs in cases of overtime, some overheads are examples of?
VARIABLE COSTS
A tool to determine the efficiency of management and to calculate the break- even point so the laboratory manager can set the charges that appropriately cover the costs as well as plan policy for future laboratory services.
Cost- Revenue Analysis
If the lab can expect to perform services that exceeds this point, it can EXPECT A?
PROFIT.
If the revenues cannot cover the associated costs, the Lab will expect a?
LOSS
What is the equation for breakeven?
Total fixed cost of the lab / (Revenue per test - Variable cost per test)
