Department of Clinical Laboratory Science by ay5aByO

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									         Department of Clinical Laboratory Science
   Presentation to ECU Program Prioritization Committee

Laboratory Tests
  Essential in diagnosis and treatment of disease
  Provide information that cannot be obtained from other sources (vital
  signs, symptoms, patient history, physical exam)
  Examples –
  Diabetes- diagnosis requires demonstration of elevated glucose or Hgb
  A1c blood levels
   Heart Disease- risk of heart disease assessed using blood cholesterol
  (Total, HDL, LDL cholesterol) and triglyceride levels
  Cancer- blood levels of tumor markers (CEA, PSA), presence of
  abnormal white blood cells on peripheral blood smear
  Infection- Bacterial, Viral, Fungal, Parasitic

  The Clinical Laboratory Professional
  A. Performs these laboratory tests
  B. Determines whether the results can be reported to the physician
  Four major departments of clinical laboratory
      Chemistry
      Hematology
      Microbiology
      Blood Bank (Immunohematology)

  The departments of the lab perform a diverse menu of tests.
  Each department has its own menu and own analytical techniques
  Students must learn four distinct bodies of knowledge to be competent
  practitioners




                                    1
Lab            Samples         Blood Collection      Analytical                    Potential
Department     Analyzed        Tubes Used            Techniques/                   Problems
                               (Anticoagulant )      instruments

Clinical       Plasma,       Green top (Heparin)     Spectrophotometry             Hemolyzed
Chemistry      Urine,        Red top                 Immunoassay                   samples
               Spinal Fluid,                         Chromatography                Blood collected
               other body                            Electrophoresis               above IV line
               fluids                                Automated analyzers used      Wrong blood
                                                                                   collection tube

Hematology     Whole           Purple top            Electrical impedance –        Clotted samples
               blood,          (Potassium EDTA)      cell counter                  Improperly filled
               plasma,         Blue top              Spectrophotometry             blood collection
               spinal fluid,   (Sodium citrate)      Flow cytometry                tube
               urine           Pink top              Special cell stains           Administration of
                                (Potassium EDTA)     Microscopy                    heparin just before
                                                     Urine reagent test strips     sample collection
                                                     Automated analyzers used      for coagulation
                                                     for most tests                test


Microbiology   Whole           Blood culture broth   Bacterial, fungal and viral   Improperly
               blood,          medium                culture                       collected samples
               plasma,                               Gram Stain and other          Contaminated
               urine, spinal                         stains                        samples
               fluid, wound                          Microscopy                    Delay in sample
               exudates,                             Spectrophotometry             transport to lab
               stool,                                Antibiotic/Antifungal
               respiratory                           susceptibility testing
               secretions                            Immunology tests for
                                                     Antigen and antibody
                                                     Molecular testing
                                                     Automated analyzers used
                                                     for some tests

Blood Bank     Whole           Pink cap tube         Agglutination tests
               blood,          (Potassium EDTA)      Automated analyzers used
               plasma, cord    Purple cap tube       for some tests
               blood           (Potassium EDTA)




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   Each body of knowledge includes:
       Analytical techniques used in the department
       Theory of tests performed in the department and their association
         with disease diagnosis and treatment
       Proper sample collection techniques
       Quality control mechanisms used to detect errors in the analytical
         process
       Potential problems and interferences that can cause erroneous test
         results
       How to evaluate test results and identify errors

The CLS faculty and the clinical affiliates work together to help the student
learn the bodies of knowledge and develop proficiency in the tasks required
of competent professionals.

Not every lab result produced by the lab is reported
Result can be inaccurate because:
   Problem with test system
   Problem with the patient sample




Image source: http://www.bd.com/vacutainer/urine



                                      3
      CLS Program – First Year

   First year is spent on campus, M-F
   Three hours of lecture in morning
   Three hours of lab in afternoon
   Courses taken in Fall, Spring and Summer semesters
   Instruction in laboratory techniques is carried out using state of the art
   instrumentation and real patient samples in two modern student
   laboratories.

      CLS Student Laboratories




   Instructional techniques used include:
    Lecture
    Analysis of patient case studies
    Case study presentations
    Computer-based tutorial programs using CLS Student lab and ECU’s
      Virtual Computing Lab
    Performance and evaluation of laboratory tests for each lab
      department

Students learn how to perform the analytical techniques used in the clinical
laboratory using the same equipment and reagents as the real lab.




                                       4
CLS Program- Second Year
  Students spend Tuesday-Friday in clinical rotations in one or more of the
  laboratories of the department’s clinical affiliates:
      Pitt County Memorial Hospital
      Carolina East Medical Center
      Nash Health Care System
      Cape Fear Valley Medical Center
      Wilson Medical Center
      Lenoir Memorial Hospital (Blood Bank only)
      Wayne Memorial Hospital
      Federal Medical Center in Butner, NC (Hematology only)

   Students apply the knowledge and laboratory techniques they have
   learned in a real world setting.

   Students also take on-campus courses on Mondays in Professional
   Practice Issues and Molecular Diagnostics


      Clinical Chemistry Laboratory

       Measures/detects analytes in fluid portion of blood – plasma
       Tests performed on automated analyzers
       Test and disease associations – see Clinical Laboratory Tests and
        Disease handout

   Hematology Laboratory
      Testing focuses on the cellular elements of the blood, coagulation
       proteins in the plasma, and analysis of urine.
      Tests:
       1. Blood cell counts (red blood cells, white blood cells, platelets)
       counting Assessment of blood cell morphology- peripheral blood
       smear, white cell differential
       2. Measuring blood levels of coagulation proteins

        3. Performing tests on urine samples
       Test and disease associations – see Clinical Laboratory Tests and
         Disease handout

   The Microbiology Laboratory


                                     5
 Clinical laboratory scientists perform tests to:
     Identify infectious organisms such as bacteria, fungi, parasites and
       viruses in patient samples
     Perform drug susceptibility tests
     Perform sterility surveys on hospital areas and equipment

 The analytical procedures used in Microbiology include traditional
 culture and new molecular techniques.

 Blood Bank
 Provides units of blood components for transfusion:
     Red blood cells
     White blood cells
     Platelets
     Fresh frozen plasma
     Coagulation factor concentrates


Tests:
      Blood type
      Cross match
      Transfusion reaction investigation




  The departments of the lab perform a diverse menu of tests.
  Each lab has its own menu and own analytical techniques
  Students must learn four distinct bodies of knowledge to be competent
   practitioners




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