MLT Safety Exam

Bloodborne pathogens

Infectious agent spread through blood-blood (or similar) transmission
• EX: HIV, HBV

Occupational exposure: Needlestick or cut with a contaminated sharp object or contact with blood, tissues, blood-containing body fluids, body fluids to which Standard Precautions apply, or a concentrated virus.

Exposures may involve:

• Mucous membranes or nonintact skin

• Skin affected with dermatitis

• Prolonged contact

• Contact involving an extensive area

Most exposures do not result in infection

• Likelihood: Depends on several factors

• Concentration of virus in blood or sample

• Duration of contact (longer → more likely)

• Worker: Cuts or abrasions, breaks in skin

• Worker: Immune status (vaccinations)

Antiseptics

Used on living tissues
Exs: Soaps, iodine, chlorhexidine, mouthwash

Disinfection

Kills most organisms on surfaces
• 99.9% of viruses, bacteria
• 30-60 second contact with bleach, lysol

Sterilization

Kills all organisms including spores
• Mycobacterium, fungal spores
• Autoclaves: High temps and pressure
• Steam sterilizers: 30m, 121C & 15psi
• Pre-vacuum: 10m, 133c, 30psi

Decontamination

Eliminates many/most pathogenic microorganisms, except spores, on inanimate objects

Engineering control

Work practice control

Class A fuel

Ordinary combustibles such as trash, paper, wood and textiles

Class B fuel

Flammable liquids

Class C fuel

Electrical equipment

Class D fuel

Combustible metal

1. Identification
2. Hazard Identification
3. Ingredient information
4. First-Aid measures
5. Fire Fighting Measures
6. Accidental Release (Clean-up)
7. Handling & Storage
8. Exposure control / PPE
9. Physical & Chemical Properties
10. Stability & Reactivity
11. Toxicological Information

What information is included in the SDS?

Ecological Information
Disposal considerations
Transport Information
Regulatory Information
Other Information

What SDS information is optional?

Quality control

• Statistical measures used to predict the reliability and validity of test results
• Based on use of samples with known values run in parallel with patient samples
• If results are not within acceptable limits, patient results are not reported

Proficiency testing

• Program to monitor & evaluate accuracy & reliability of the analytical testing process
• Includes written quality control procedures
• Required under clia 88
• Not required for waived test category

PHI

Licensure

Mandatory for practice

Certification

Voluntary to prove competency

Regulatory agency

Legislation

Accreditation

Professional organization

CMS

• Federal agency within the US Dept of Health & Human Services (HHS)
• Administers Medicare, works with states for Medicaid & CHIP
• Oversight of related legislation (ex: HIPPA & CLIA’88)

CLIA 88

Established requirements for certification of laboratories & personnel

Regulation covers ALL diagnostic testing labs, including Physician’s Office Labs (POLs)
• Exempt: Research & Educational labs

Established Minimum educational standards for Laboratory Technicians
• Established the associate’s degree as the minimum entry-level technician
• Other personnel requirements (EX: Laboratory must be overseen by M.D.)
Proficiency testing, QC & QA Program minimum standards

Organizational Requirements
• Must be certified by CMS, OR a private certifying or state regulatory agency approved by CMS
• GA: State Dept of Community Health (GADCH)
Lab classification criteria
• Performed test complexity (Method)
• Risk of harm of an erroneous result
• Amount of interpretation / judgement needed
• Availability for home use

HIPAA

Patient Bill of Rights

CDC

Establishes Infection Control Standards for OSHA, supports lab standards through research, innovations, & monitoring

FDA

Monitors testing and administration of all Blood Products (Regulation of all Blood Banks: Non-profit, Private, & Corporate)

CAP

a primary laboratory accrediting organization and an internationally recognized program that utilizes
teams of practicing laboratory professionals as
inspectors

JC or TJC

evaluating and accrediting hospital laboratory services since 1979 and freestanding laboratories since 1995

COLA

NAACLS

the premier agency for international accreditation and
approval of educational programs in the clinical
laboratory sciences and related disciplines

OSHA

Establishes Safety Standards for business & industries operating within the US

Hazard communication standard

Requires that the chemical manufacturer, distributor, or
importer provide SDSs, formerly material safety data sheets
(MSDSs), for each hazardous chemical to downstream users
to communicate information on these hazards

Chemical hygiene plan

Exposure control plan

GA Department of Community Health

ASCP

AMT

AABB

• PATIENT ID (Full Name and DOB or MRN)
• IMPROVE COMMUNICATION
• INFECTION PREVENTION

Joint Commission Natl. Patient Safety Goals – What are the 3 goals in the lab?

Regulatory agency

Responsible for implementation of Legislation and oversight and Guidance

• Signal word
• Hazard pictograms
• Hazard statement
• Precautionary statement for each category / class

What’s on manufacturer labels?

Inhalation
Percutaneous inoculation
Mucus membranes
Ingestion

What are the routes of transmission in Lab infections

Inhalation

Aspiration of aerosols

Percutaneous inoculation

Needlesticks, cuts, or abrasions

Mucus membranes

Contact with contaminated surfaces (rubbing eyes)

Ingestion

Eating, applying cosmetics

• Patient Identification

• Phlebotomy-associated negative effects

• Specimen Identification

• Order Entry

• Specimen Integrity

• Effective use of laboratory

Preanalytical

Verification of accuracy of results

• Abnormal Results

Analytical

Communication of results

• Timely Manner

• Way RAV for Critical results

Effective use of test results

Outcomes of lab testing

Postanalytical