Clinical laboratory science : journal of the American Society for Medical Technology最新文献

A survey of members of the American Society for Clinical Laboratory Science (ASCLS) in 2012 examined laboratory administrators' views on retention incentives and older Clinical Laboratory Professionals (CLP). Results indicated that retention strategies currently in place are not concordant with the ones CLP think are important. Further, with the exception of ergonomic equipment, administrators reported low feasibility for the workplace changes favored by practitioners. While all administrators attributed positive traits to older CLP, older administrators held more favorable views. Administrators perceived older CLP as productive, having a high level of technical skills and loyal. The combination of technical competence and work ethic make retention of older CLP attractive to laboratory administrators and advantageous for combatting workforce shortages. This study highlights the discordance between the retention incentives valued by CLP and those viewed as feasible by administrators. Findings should be used by administrators to refine incentive packages that better reflect the desires of CLP.

The Clinical and Laboratory Standards Institute guidelines require special processing of whole blood specimens with hematocrits greater than 55% due to the possibility of spurious prolongation of routine coagulation studies (PT, aPTT). As samples with hematocrits above 60% are rare at our institution, our study seeks to determine the effect of relative citrate excess on routine coagulation studies in samples with hematocrits of 60% to determine whether special processing is necessary. A calculated volume of 3.2% citrate was added to 1 mL aliquots of 40 whole blood samples in citrated tubes from adult patients to simulate a hematocrit of 60%. A dilutional control was created by adding an equivalent volume of saline to a separate 1 mL aliquot. Routine coagulation studies (PT, aPTT) were run on both samples on the STA Compact Analyzer in accordance with manufacturer instructions. While a paired Student's t-test demonstrated a clinically significant change in both PT and aPTT with the addition of citrate (p = 0.0002 for PT and p = 0.0234 for aPTT), clinical management would not have been altered by any observed change. More interestingly, we observed a shortening of 27/40 PTs and 23/40 aPTTs rather than the expected prolongation. Based on our data, no adjustment of citrate volume appears to be necessary in samples with hematocrits less than or equal to 60%.

In order to contribute to improved healthcare quality through patient-centered care, laboratory professionals at all levels of practice must be able to recognize the connection between non-analytical factors and laboratory analysis, in the context of patient outcomes and quality improvement. These practices require qualities such as critical thinking (CT), teamwork skills, and familiarity with the quality improvement process, which will be essential for the development of evidence-based laboratory science practice. Performance tasks (PT) are an educational strategy which can be used to teach and assess CT and teamwork, while introducing Medical Laboratory Science (MLS) students at both baccalaureate and advanced-practice levels to the concepts of quality improvement processes and patient outcomes research. PT presents students with complex, realistic scenarios which require the incorporation of subject-specific knowledge with competencies such as effective team communication, patient-centered care, and successful use of information technology. A PT with assessment rubric was designed for use in a baccalaureate-level MLS program to teach and assess CT and teamwork competency. The results indicated that, even when students were able to integrate subject-specific knowledge in creative ways, their understanding of teamwork and quality improvement was limited. This indicates the need to intentionally teach skills such as collaboration and quality system design. PT represent one of many strategies that may be used in MLS education to develop essential professional competencies, encourage expert practice, and facilitate quality improvement.

A 20-month-old infant presented to the emergency department with diarrhea and vomiting of six days duration. Blood, stool and urine specimens were collected for both bacteriological culture and parasitic workup. Concurrent infections with both Shigella sonnei and Vibrio cholerae were determined to be the cause of the infectious diarrhea. This case illustrates the importance of the microbiology laboratory in detecting infrequently seen enteric pathogens. We will also review the pathogenesis and laboratory diagnosis of Vibrio cholerae and Shigella sonnei.

Alcohol is the most widely abused substance in the United States and its pathology is responsible for more pathological conditions than all other forms of drug use combined. Alcohol dependence is associated with a number of adverse individual and societal consequences and high rates of morbidity and mortality. Alcohol use and abuse have a significant pathological effect on the brain, fetus, liver, heart, pancreas, and immune system. Cancer risks have also been attributed to alcohol use and abuse. Assessing acute and chronic alcohol consumption is critical to effective treatment but unfortunately currently available clinical laboratory testing procedures lack the ability to inform alcohol treatment providers about use and abuse.