Pub Date : 2018-06-04DOI: 10.29074/ASCLS.118.000349
D. Bourne, Samer Andrew Farraj, J. Rhees
ABSTRACT Monoclonal anti-CD38 is used in the treatment of patients with multiple myeloma (MM) who are refractory to proteasome inhibitors and immunomodulatory drugs. CD38 is highly expressed on malignant cells in MM; however, because CD38 is also expressed on red blood cells (RBCs), the drug interferes with a variety of blood compatibility tests that utilize the indirect antiglobulin test (IAT). Dithiothreitol (DTT) or trypsin may be employed to remove CD38 molecules from the RBC membrane prior to testing in order to circumvent the drug’s interference. However, numerous blood group antigens are also destroyed by DTT and trypsin, which could lead to the inability to detect certain clinically significant alloantibodies in pretransfusion compatibility testing. This study was undertaken to investigate the usage of various protocols for mitigating the drug’s interference in pretransfusion testing and strategies for providing blood products to patients undergoing anti-CD38 drug therapy in hospitals in the United States. ABBREVIATIONS Antihuman Globulin (AHG) Daratumumab (DARA) Dithiothreitol (DTT) Food and Drug Administration (FDA) Immunofixation Electrophoresis (IFE) Indirect Antiglobulin Test (IAT) Immunohematology Reference Laboratory (IRL) Laboratory Information System (LIS) Monoclonal antibody (mAb) Multiple Myeloma (MM) Red Blood Cell (RBC) Serum Protein Electrophoresis (SPEP) Index terms: CD38, Antibodies, Multiple Myeloma, Blood Banks, Blood Group Antigens
{"title":"Current Practice of Mitigating Monoclonal Anti-CD38 Interference in Pretransfusion Compatibility Testing","authors":"D. Bourne, Samer Andrew Farraj, J. Rhees","doi":"10.29074/ASCLS.118.000349","DOIUrl":"https://doi.org/10.29074/ASCLS.118.000349","url":null,"abstract":"ABSTRACT\u0000Monoclonal anti-CD38 is used in the treatment of patients with multiple myeloma (MM) who are refractory to proteasome inhibitors and immunomodulatory drugs. CD38 is highly expressed on malignant cells in MM; however, because CD38 is also expressed on red blood cells (RBCs), the drug interferes with a variety of blood compatibility tests that utilize the indirect antiglobulin test (IAT). Dithiothreitol (DTT) or trypsin may be employed to remove CD38 molecules from the RBC membrane prior to testing in order to circumvent the drug’s interference. However, numerous blood group antigens are also destroyed by DTT and trypsin, which could lead to the inability to detect certain clinically significant alloantibodies in pretransfusion compatibility testing. This study was undertaken to investigate the usage of various protocols for mitigating the drug’s interference in pretransfusion testing and strategies for providing blood products to patients undergoing anti-CD38 drug therapy in hospitals in the United States.\u0000\u0000ABBREVIATIONS \u0000Antihuman Globulin (AHG)\u0000Daratumumab (DARA)\u0000Dithiothreitol (DTT)\u0000Food and Drug Administration (FDA)\u0000Immunofixation Electrophoresis (IFE)\u0000Indirect Antiglobulin Test (IAT)\u0000Immunohematology Reference Laboratory (IRL)\u0000Laboratory Information System (LIS)\u0000Monoclonal antibody (mAb)\u0000Multiple Myeloma (MM)\u0000Red Blood Cell (RBC)\u0000Serum Protein Electrophoresis (SPEP)\u0000Index terms: CD38, Antibodies, Multiple Myeloma, Blood Banks, Blood Group Antigens","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129116161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This retrospective study evaluated the ability to predict certification by the American Society for Clinical Pathology (ASCP) Board of Certification (BOC), using an overall score cutoff of 60% on a university comprehensive exam. The study also evaluated overall and content area scores (Blood Bank, Chemistry, Hematology, Immunology, Laboratory Operations, Microbiology, and Urinalysis and Other Body Fluids) for correlation between the university and BOC exams. Overall university exam scores ranged from 35-86% (percentage of correct answers) for students completing both exams from 2006-2015 (n = 152). BOC exam scores ranged from 287-755 (scaled from 0-999, with 400 required to pass). The overall correlation between scores was 0.65. Content area correlations ranged from 0.00 (Immunology) to 0.55 (Microbiology) for students completing both exams from 2012-2015 (n = 51). A receiver operating characteristic curve resulted in an overall university exam score cutoff of 55% showing the highest sensitivity and specificity for predicting success. Using the hypothesized 60% cutoff, one student showed a false positive result. All students scoring above 67% on the comprehensive exam passed the certification exam. In general, this study indicates that there are large variations when comparing results between comprehensive and certification exams. ABBREVIATIONS: ASCP - American Society for Clinical Pathology; BOC - Board of Certification; BOR - Board of Registry; GPA - grade point average; MLS - medical laboratory science/scientist; NAACLS - National Accrediting Agency for Clinical Laboratory Sciences; ROC - receiver operating characteristic; SD - standard deviation
{"title":"Correlation of University Comprehensive and National Certification Exam Scores for Medical Laboratory Science Students","authors":"Sarah B. Pelton","doi":"10.29074/ascls.30.4.240","DOIUrl":"https://doi.org/10.29074/ascls.30.4.240","url":null,"abstract":"This retrospective study evaluated the ability to predict certification by the American Society for Clinical Pathology (ASCP) Board of Certification (BOC), using an overall score cutoff of 60% on a university comprehensive exam. The study also evaluated overall and content area scores (Blood Bank, Chemistry, Hematology, Immunology, Laboratory Operations, Microbiology, and Urinalysis and Other Body Fluids) for correlation between the university and BOC exams. Overall university exam scores ranged from 35-86% (percentage of correct answers) for students completing both exams from 2006-2015 (n = 152). BOC exam scores ranged from 287-755 (scaled from 0-999, with 400 required to pass). The overall correlation between scores was 0.65. Content area correlations ranged from 0.00 (Immunology) to 0.55 (Microbiology) for students completing both exams from 2012-2015 (n = 51). A receiver operating characteristic curve resulted in an overall university exam score cutoff of 55% showing the highest sensitivity and specificity for predicting success. Using the hypothesized 60% cutoff, one student showed a false positive result. All students scoring above 67% on the comprehensive exam passed the certification exam. In general, this study indicates that there are large variations when comparing results between comprehensive and certification exams. ABBREVIATIONS: ASCP - American Society for Clinical Pathology; BOC - Board of Certification; BOR - Board of Registry; GPA - grade point average; MLS - medical laboratory science/scientist; NAACLS - National Accrediting Agency for Clinical Laboratory Sciences; ROC - receiver operating characteristic; SD - standard deviation","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115158915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. J. Behan, Kristen H. Coffey, Michele Promo, Teresa Brooks, J. J. Van Der Like
Literature is scarce regarding medical laboratorians and their attitudes about interprofessional interactions with other healthcare providers. We investigated learning and attitudes in a joint project that brought Clinical Laboratory Sciences (CLS) students and Nursing students together. The nursing and CLS faculty created a simulated post-partum patient who developed deep vein thrombosis followed by pulmonary embolism. The patient was heterozygous for the Factor V Leiden mutation. The simulations occurred in two venues. The patient scenario occurred at the student Nursing Skills and Simulation Learning Center “SIM lab” at the bedside of the patient experiencing symptoms of deep vein thrombosis and pulmonary embolism, with the nursing students responding to the patient's distress. CLS students collected blood from the patient during the crisis. The laboratory scenario occurred in the CLS teaching laboratory. CLS students performed real time PCR on the patient for the Factor V Leiden mutation, and instructed the nursing students how to interpret the results. Learning gains were measured by survey after the 2 events. Retention of learning was measured 6 weeks after the second event took place. All students showed sustained learning about venous thromboembolism, its risk factors, and genetic mutations that predispose towards thrombophilia. Students' attitudes about interprofessional education and each other's professions were surveyed before and after the experience. Students valued the experience and 87% of them responded that they are interested in pursuing more interprofessional education training opportunities. ABBREVIATIONS: IPE - Interprofessional Education, VTE - Venous Thromboembolism, DVT - Deep Vein Thrombosis, PE - Pulmonary Embolism. NSSL - Nursing Student Simulation Lab, CLS-Clinical Laboratory Sciences
{"title":"Pride and Prejudice and Learning: An Interprofessional Experience with CLS and Nursing Students","authors":"K. J. Behan, Kristen H. Coffey, Michele Promo, Teresa Brooks, J. J. Van Der Like","doi":"10.29074/ascls.30.4.233","DOIUrl":"https://doi.org/10.29074/ascls.30.4.233","url":null,"abstract":"Literature is scarce regarding medical laboratorians and their attitudes about interprofessional interactions with other healthcare providers. We investigated learning and attitudes in a joint project that brought Clinical Laboratory Sciences (CLS) students and Nursing students together. The nursing and CLS faculty created a simulated post-partum patient who developed deep vein thrombosis followed by pulmonary embolism. The patient was heterozygous for the Factor V Leiden mutation. The simulations occurred in two venues. The patient scenario occurred at the student Nursing Skills and Simulation Learning Center “SIM lab” at the bedside of the patient experiencing symptoms of deep vein thrombosis and pulmonary embolism, with the nursing students responding to the patient's distress. CLS students collected blood from the patient during the crisis. The laboratory scenario occurred in the CLS teaching laboratory. CLS students performed real time PCR on the patient for the Factor V Leiden mutation, and instructed the nursing students how to interpret the results. Learning gains were measured by survey after the 2 events. Retention of learning was measured 6 weeks after the second event took place. All students showed sustained learning about venous thromboembolism, its risk factors, and genetic mutations that predispose towards thrombophilia. Students' attitudes about interprofessional education and each other's professions were surveyed before and after the experience. Students valued the experience and 87% of them responded that they are interested in pursuing more interprofessional education training opportunities. ABBREVIATIONS: IPE - Interprofessional Education, VTE - Venous Thromboembolism, DVT - Deep Vein Thrombosis, PE - Pulmonary Embolism. NSSL - Nursing Student Simulation Lab, CLS-Clinical Laboratory Sciences","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125870637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) are genetic elements that function with CRISPR-Associated (Cas) proteins as an adaptive immune system to foreign genetic material in prokaryotic organisms. The CRISPR-dCas9 system is modified to suppress gene transcription. Methicillin-Resistant Staphylococcus aureus (MRSA) is a dangerous human pathogen that is resistant to beta-lactam antibiotics. This is due to the mecA methicillin resistance gene coding for penicillin binding protein 2A (PBP 2A), which inhibits the activity of beta-lactam antibiotics. Two CRISPR-dCas9 systems were designed to target the promoter region of mecA in MRSA to suppress transcription of the gene. A cefoxitin disk diffusion test showed that the target on the coding strand significantly reduced antibiotic resistance in MRSA, whereas the target on the noncoding strand did not. An oxacillin microbroth serial dilution was used to confirm disk diffusion results. The CRISPR system targeting the coding strand was the only one to reduce antibiotic resistance and thus was chosen for continued testing. mecA gene expression levels were analyzed using Reverse Transcriptase Quantitative Real-Time Polymerase Chain Reaction (RT-qPCR). Results showed that mecA gene expression in the CRISPR-treated sample was reduced to 0.230 fold of the value in the control, representing a 77% decrease in gene transcription. The 77% decrease in gene expression was not enough to make MRSA clinically susceptible to betalactam antibiotics. ABBREVIATIONS: BLAST - basic local alignment search tool, bp - basepairs, Cas - CRISPR-associated, cDNA - complementary DNA, CLSI - Clinical Laboratory Standards Institute, Cq - quantification cycle, CRISPRs - clustered regularly spaced short palindromic repeats, E.coli - Escherichia coli, M-MLV RT - Moloney Murine Leukemia Virus Reverse Transcriptase, MIC - minimum inhibitory concentration, MRSA - methicillin-resistant Staphylococcus aureus, NCBI - National Center for Biotechnology Information, PAM - protospacer adjacent motif, PBP 2A - penicillin binding protein 2A, RT-qPCR - reverse transcriptase quantitative real-time polymerase chain reaction, tracr - trans-activating CRISPR, UDG - uracil DNA glycosylase
{"title":"Suppression of Antimicrobial Resistance in MRSA Using CRISPR-dCas9","authors":"K. Wang, M. Nicholaou","doi":"10.29074/ascls.30.4.207","DOIUrl":"https://doi.org/10.29074/ascls.30.4.207","url":null,"abstract":"Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) are genetic elements that function with CRISPR-Associated (Cas) proteins as an adaptive immune system to foreign genetic material in prokaryotic organisms. The CRISPR-dCas9 system is modified to suppress gene transcription. Methicillin-Resistant Staphylococcus aureus (MRSA) is a dangerous human pathogen that is resistant to beta-lactam antibiotics. This is due to the mecA methicillin resistance gene coding for penicillin binding protein 2A (PBP 2A), which inhibits the activity of beta-lactam antibiotics. Two CRISPR-dCas9 systems were designed to target the promoter region of mecA in MRSA to suppress transcription of the gene. A cefoxitin disk diffusion test showed that the target on the coding strand significantly reduced antibiotic resistance in MRSA, whereas the target on the noncoding strand did not. An oxacillin microbroth serial dilution was used to confirm disk diffusion results. The CRISPR system targeting the coding strand was the only one to reduce antibiotic resistance and thus was chosen for continued testing. mecA gene expression levels were analyzed using Reverse Transcriptase Quantitative Real-Time Polymerase Chain Reaction (RT-qPCR). Results showed that mecA gene expression in the CRISPR-treated sample was reduced to 0.230 fold of the value in the control, representing a 77% decrease in gene transcription. The 77% decrease in gene expression was not enough to make MRSA clinically susceptible to betalactam antibiotics. ABBREVIATIONS: BLAST - basic local alignment search tool, bp - basepairs, Cas - CRISPR-associated, cDNA - complementary DNA, CLSI - Clinical Laboratory Standards Institute, Cq - quantification cycle, CRISPRs - clustered regularly spaced short palindromic repeats, E.coli - Escherichia coli, M-MLV RT - Moloney Murine Leukemia Virus Reverse Transcriptase, MIC - minimum inhibitory concentration, MRSA - methicillin-resistant Staphylococcus aureus, NCBI - National Center for Biotechnology Information, PAM - protospacer adjacent motif, PBP 2A - penicillin binding protein 2A, RT-qPCR - reverse transcriptase quantitative real-time polymerase chain reaction, tracr - trans-activating CRISPR, UDG - uracil DNA glycosylase","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115474213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Index to Volume 30, Numbers 1 Through 4","authors":"","doi":"10.29074/ascls.30.4.270","DOIUrl":"https://doi.org/10.29074/ascls.30.4.270","url":null,"abstract":"","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129413631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The NIH identified that most microbial infections are biofilm-associated. Bacterial biofilm formation in human infection is of great concern to public health, as it has been associated with increased antimicrobial resistance, decreased effectiveness of host response, chronicity of infection, and medical device-associated disease. The pathogen, methicillin-resistant Staphylococcus aureus (MRSA), warrants special attention since it has been a frequent culprit in hospital- and community-acquired infections, is known to form biofilms in vivo, and is notoriously resistant to antimicrobics. This study sought to inhibit biofilm formation and/or reduce MRSA viability using the phytochemical cinnamaldehyde, which has been widely studied as an antimicrobial agent as well as a quorum sensing inhibitor. Clinical MRSA isolates from area hospital laboratories were assessed for cinnamaldehyde effect using a: (i) microplate assay for quantitative spectrophotometric evaluation of crystal violet-stained biofilm adherent to microwells; and (ii) viable bacterial count assay for colony forming unit (CFU/ml) enumeration. Results indicated that cinnamaldehyde inhibited MRSA biofilm formation in a concentration-dependent manner with significance (p<0.01) at 50 and 100 μM. Colony counts of MRSA were also significantly (p<0.01) reduced in a concentration-dependent manner. Taken together, these results indicate that cinnamaldehyde inhibits MRSA biofilm formation at early time points and reduces cell viability. Since an early effect of cinnamaldehyde was noted in this study, in the future, expanded kinetic studies will be assessed to ascertain cinnamaldehyde effects at the different steps of biofilm formation. ABBREVIATIONS: MRSA – methicillin-resistant S. aureus, MSSA – methicillin-susceptible S. aureus, TSB – tryptic soy broth
{"title":"Cinnamaldehyde Inhibits MRSA Biofilm Formation and Reduces Cell Viability","authors":"Marco Rossi, R. Heuertz","doi":"10.29074/ascls.30.4.214","DOIUrl":"https://doi.org/10.29074/ascls.30.4.214","url":null,"abstract":"The NIH identified that most microbial infections are biofilm-associated. Bacterial biofilm formation in human infection is of great concern to public health, as it has been associated with increased antimicrobial resistance, decreased effectiveness of host response, chronicity of infection, and medical device-associated disease. The pathogen, methicillin-resistant Staphylococcus aureus (MRSA), warrants special attention since it has been a frequent culprit in hospital- and community-acquired infections, is known to form biofilms in vivo, and is notoriously resistant to antimicrobics. This study sought to inhibit biofilm formation and/or reduce MRSA viability using the phytochemical cinnamaldehyde, which has been widely studied as an antimicrobial agent as well as a quorum sensing inhibitor. Clinical MRSA isolates from area hospital laboratories were assessed for cinnamaldehyde effect using a: (i) microplate assay for quantitative spectrophotometric evaluation of crystal violet-stained biofilm adherent to microwells; and (ii) viable bacterial count assay for colony forming unit (CFU/ml) enumeration. Results indicated that cinnamaldehyde inhibited MRSA biofilm formation in a concentration-dependent manner with significance (p<0.01) at 50 and 100 μM. Colony counts of MRSA were also significantly (p<0.01) reduced in a concentration-dependent manner. Taken together, these results indicate that cinnamaldehyde inhibits MRSA biofilm formation at early time points and reduces cell viability. Since an early effect of cinnamaldehyde was noted in this study, in the future, expanded kinetic studies will be assessed to ascertain cinnamaldehyde effects at the different steps of biofilm formation. ABBREVIATIONS: MRSA – methicillin-resistant S. aureus, MSSA – methicillin-susceptible S. aureus, TSB – tryptic soy broth","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134618837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Massive transfusion protocols have been developed to provide the best patient outcomes by administering the correct ratio of blood components and pharmacological agents available in today's market. Adults, obstetrical, and pediatric patients all have different needs during a massive hemorrhage. Patient outcomes, utilization of resources in a cost-effective manner, and education can all impact how this is accomplished. Through a literature review, this article outlines assesses the presence (or absence) of standard massive transfusion protocols for different patient populations in non-metropolitan areas where resources such as blood components can be difficult to obtain. ABBREVIATIONS: AABB – organization formerly known as the American Association of Blood Banks), RBCs - packed red blood cells, APTT - activated partial thromboplastin time, FDA - Food and Drug Administration, FFP - fresh frozen plasma, TRALI - transfusion acquired acute lung injury, TACO - transfusion associated circulatory overload, TXA - Tranexamic acid, rVIIa - Recombinant factor VIIa, PCCs - Prothrombin Complex Concentrates, PPH - postpartum hemorrhage
{"title":"Managing Massive Transfusions in diverse Patient Populations in a Non-Metropolitan Area","authors":"Shauna M.M. Sturgill, L. Gillard","doi":"10.29074/ascls.30.4.258","DOIUrl":"https://doi.org/10.29074/ascls.30.4.258","url":null,"abstract":"Massive transfusion protocols have been developed to provide the best patient outcomes by administering the correct ratio of blood components and pharmacological agents available in today's market. Adults, obstetrical, and pediatric patients all have different needs during a massive hemorrhage. Patient outcomes, utilization of resources in a cost-effective manner, and education can all impact how this is accomplished. Through a literature review, this article outlines assesses the presence (or absence) of standard massive transfusion protocols for different patient populations in non-metropolitan areas where resources such as blood components can be difficult to obtain. ABBREVIATIONS: AABB – organization formerly known as the American Association of Blood Banks), RBCs - packed red blood cells, APTT - activated partial thromboplastin time, FDA - Food and Drug Administration, FFP - fresh frozen plasma, TRALI - transfusion acquired acute lung injury, TACO - transfusion associated circulatory overload, TXA - Tranexamic acid, rVIIa - Recombinant factor VIIa, PCCs - Prothrombin Complex Concentrates, PPH - postpartum hemorrhage","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130838201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In an effort to reduce the incidence of transfusion-transmitted infections (TTI) and septic transfusion reactions (STR) from bacterially-contaminated platelet products, the Center for Biologics Evaluation and Research (CBER) department of the Food and Drug Administration (FDA) recently published draft guidance in March of 2016. Entitled, “Bacterial Risk Control Strategies for Blood Collections Establishments and Transfusion Services to Enhance the Safety and Availability of Platelets for Transfusion,” the new guidance recommends either the use of rapid bacterial testing at point-of-issue on days four or five of stored platelets or the use of pathogen reduction technology (PRT) at the time of platelet collection. A literature review demonstrates that both methodologies effectively reduce the incidence of TTI and STR without compromising the efficacy of the platelet product. However, the use of PRT has further-reaching implications. Utilizing amotosalen in the presence of ultraviolet (UV) light, PRT intercalates with nucleic acids. Not only does this render bacteria inactive, it also inactivates viruses and protozoa. This effectively eliminates the need for some viral testing, and reduces the risk of TTIs due to new and emerging pathogens. The use of PRT, therefore, proves to be the superior option for both transfusion services and blood collection centers, with implications for future use with additional blood products such as whole blood. ABBREVIATIONS: TTI - transfusion-transmitted infections, STR - septic transfusion reactions, CBER - Center for Biologics Evaluation and Research, FDA - Food and Drug Administration, AABB - organization formerly, the American Association of Blood Banks, TS - transfusion services, PRT - Pathogen-Reduction Technology, PGD - Pan Genera Detection, CMV - cytomegalovirus
{"title":"Pathogen Reduction in Platelets: A Review of the Proposed Draft Guidance","authors":"J. Tracy","doi":"10.29074/ascls.30.4.263","DOIUrl":"https://doi.org/10.29074/ascls.30.4.263","url":null,"abstract":"In an effort to reduce the incidence of transfusion-transmitted infections (TTI) and septic transfusion reactions (STR) from bacterially-contaminated platelet products, the Center for Biologics Evaluation and Research (CBER) department of the Food and Drug Administration (FDA) recently published draft guidance in March of 2016. Entitled, “Bacterial Risk Control Strategies for Blood Collections Establishments and Transfusion Services to Enhance the Safety and Availability of Platelets for Transfusion,” the new guidance recommends either the use of rapid bacterial testing at point-of-issue on days four or five of stored platelets or the use of pathogen reduction technology (PRT) at the time of platelet collection. A literature review demonstrates that both methodologies effectively reduce the incidence of TTI and STR without compromising the efficacy of the platelet product. However, the use of PRT has further-reaching implications. Utilizing amotosalen in the presence of ultraviolet (UV) light, PRT intercalates with nucleic acids. Not only does this render bacteria inactive, it also inactivates viruses and protozoa. This effectively eliminates the need for some viral testing, and reduces the risk of TTIs due to new and emerging pathogens. The use of PRT, therefore, proves to be the superior option for both transfusion services and blood collection centers, with implications for future use with additional blood products such as whole blood. ABBREVIATIONS: TTI - transfusion-transmitted infections, STR - septic transfusion reactions, CBER - Center for Biologics Evaluation and Research, FDA - Food and Drug Administration, AABB - organization formerly, the American Association of Blood Banks, TS - transfusion services, PRT - Pathogen-Reduction Technology, PGD - Pan Genera Detection, CMV - cytomegalovirus","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115960127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An interprofessional education simulation project was created for Clinical Laboratory Sciences students to promote patient safety skills. Hand hygiene and patient identification were addressed in the scenario. CLS students participated in two IPE SIM experiences spaced six weeks apart. All students were educated by nursing faculty on careful hand hygiene (HH) when entering and exiting a patient's environment. Students were separated into two groups. The control group had no further education. The intervention group were instructed on the WHO 6-step HH process, and rehearsed on the steps. Students took pre and post-simulation quizzes on knowledge of HH. There was no significant difference in the quiz test scores between the two groups. Students' actual HH was video recorded prior to entering the patient environment and again as they exited. The intervention group demonstrated a significant and sustained increase in pre-patient HH times compared to the control group. ABBREVIATIONS: IPE SIM- Interprofessional Education Simulation, HH- Hand Hygiene, WHO- World Health Organization, ID- Identification. HAI- Healthcare Acquired Infections, CLS-Clinical Laboratory Sciences
{"title":"Promoting Patient Safety Through Interprofessional Education Simulation","authors":"Katie Cavnar, J. J. Van Der Like, L. Hobby-Burns","doi":"10.29074/ascls.30.4.228","DOIUrl":"https://doi.org/10.29074/ascls.30.4.228","url":null,"abstract":"An interprofessional education simulation project was created for Clinical Laboratory Sciences students to promote patient safety skills. Hand hygiene and patient identification were addressed in the scenario. CLS students participated in two IPE SIM experiences spaced six weeks apart. All students were educated by nursing faculty on careful hand hygiene (HH) when entering and exiting a patient's environment. Students were separated into two groups. The control group had no further education. The intervention group were instructed on the WHO 6-step HH process, and rehearsed on the steps. Students took pre and post-simulation quizzes on knowledge of HH. There was no significant difference in the quiz test scores between the two groups. Students' actual HH was video recorded prior to entering the patient environment and again as they exited. The intervention group demonstrated a significant and sustained increase in pre-patient HH times compared to the control group. ABBREVIATIONS: IPE SIM- Interprofessional Education Simulation, HH- Hand Hygiene, WHO- World Health Organization, ID- Identification. HAI- Healthcare Acquired Infections, CLS-Clinical Laboratory Sciences","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123895189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare professions face complex care environments with growing attention to the number of preventable hospital deaths. Interprofessional communication and teamwork are key elements in reducing medical errors, and are core competencies of interprofessional collaborative practice. Interprofessional education occurs when students from different disciplines learn together, and/or when faculty from one discipline instruct students in another. Simulated healthcare scenarios provide high-impact learning environments for students with many benefits. Simulation-interprofessional education has been used very little between Clinical Laboratory Sciences and BSN nursing students. The faculty from a growing university sought to improve student-learning outcomes through team-teaching and student role playing in simulation and science laboratories. Two IPE projects were undertaken. Both projects demonstrated increases in the cognitive, psychomotor and affective domains of learning. ABBREVIATIONS: IPCP – Interprofessional collaborative practice, IPE – Interprofessional education, CLS – Clinical Laboratory Science, BSN – Bachelor of Science in Nursing, NSSL – Nursing Skills and Simulation Learning Center, NAACLS – National Accrediting Agency for Clinical Laboratory Sciences
{"title":"Introducing Interprofessional Education to BSN and CLS Students Using a Simulated Healthcare Setting","authors":"K. J. Behan, J. J. Van Der Like","doi":"10.29074/ascls.30.4.224","DOIUrl":"https://doi.org/10.29074/ascls.30.4.224","url":null,"abstract":"Healthcare professions face complex care environments with growing attention to the number of preventable hospital deaths. Interprofessional communication and teamwork are key elements in reducing medical errors, and are core competencies of interprofessional collaborative practice. Interprofessional education occurs when students from different disciplines learn together, and/or when faculty from one discipline instruct students in another. Simulated healthcare scenarios provide high-impact learning environments for students with many benefits. Simulation-interprofessional education has been used very little between Clinical Laboratory Sciences and BSN nursing students. The faculty from a growing university sought to improve student-learning outcomes through team-teaching and student role playing in simulation and science laboratories. Two IPE projects were undertaken. Both projects demonstrated increases in the cognitive, psychomotor and affective domains of learning. ABBREVIATIONS: IPCP – Interprofessional collaborative practice, IPE – Interprofessional education, CLS – Clinical Laboratory Science, BSN – Bachelor of Science in Nursing, NSSL – Nursing Skills and Simulation Learning Center, NAACLS – National Accrediting Agency for Clinical Laboratory Sciences","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123878276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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