Labs – The Importance and Best Practices

Labs – The Importance and Best Practices

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Rochelle Colby (left) and Jennifer Jameson who work in the Lab at Cancer Treatment Centers of America in Tulsa were presenters at the 2017 Association of Oklahoma Nurse Practitioners Conference in Midwest City last week and discussed “Labs: What does that really mean?” The presentation was a general overview of what happens in the laboratory and pathology and it was geared towards what Nurse Practitioners would find useful in their day-to-day general practice.

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It is estimated that 70% of all health care decisions affecting a diagnosis or treatment plan for a patient involve a pathology investigation (or laboratory test)*. Decisions on an individual’s diagnosis, treatment and subsequent therapeutic monitoring are often dependent on a range of pathology-based results, which can affect imaging and radiation, pharmacy, surgery, nutrition, oncology and clinical care.
Medical Technologist Jennifer Jameson and Medical Laboratory Scientist Rochelle Colby, who are both certified by the American Society for Clinical Pathology and work in the on-site Laboratory at Cancer Treatment Centers of America® in Tulsa (CTCA Tulsa), recently presented at the 23rd Annual Association of Oklahoma Nurse Practitioners Conference in MidWest City about the importance of labs. The following are some of the best practices and highlights they shared:
Results are only as good as the specimens
“It’s important to know that lab results are only as good as the specimens that we get,” explained Jameson, who has worked in microbiology for 23 years. “That’s why it’s critical to use two patient identifiers and write them on the specimen container, including date, time and the collector’s initials. Even the tube types that carry the specimens and the way they are transported make a difference – some tests can be temperature dependent, sensitive to light exposure or need to be in a preservative within minutes.”
Multiple steps help to prevent errors
“There are multiple steps in the collection process, all in place to prevent errors,” added Colby, who serves as the lead hematology tech at CTCA Tulsa. “Safeguards are in place, like proficiency testing, inventory control, temperature logs, quality control, test records and preliminary positive test monitoring. Each step includes elements of quality assurance.”
For example, when gathering blood work, there are issues when the tubes are under filled or over filled. “Under filling can cause a dilution of the plasma, resulting in underestimation of clotting factor levels,” said Colby. “Over filling by 120% may also give erroneous results.”
Antibiotic resistance is a real issue
“An estimated 50% of antibiotic use in humans is unnecessary and inappropriate,” said Jameson. “The most recent estimates show that antibiotic-resistant bacteria cause more than 2 million illnesses and 23,000 deaths annually in the US.” Antimicrobial resistance is an increasingly serious threat to health at the patient, community and global level. Jameson notes that the rate of resistance is increasing faster than new antimicrobials are being discovered. For example, Methicillin was introduced in 1960 and resistance was detected in 1962; Levofloxacin was introduced in 1996 and resistance was detected in 1996.* These highlights show the importance of good laboratory practices and why they are important to keep in mind.
*Sources: Centers for Disease Control and Prevention. The Clinical Biochemist Reviews

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