IHMR-Bangalore Compiled By Dr Ratnesh Pandey

1. IHMR-Bangalore Compiled By Dr Ratnesh Pandey 3 M LABORATORY SERVICES

2. 3 M LABORATORY SERVICES • MANAGING • MONITORING & • MASTERING

3. Outline • Introduction • Defining Lab & Lab Services • Types of Lab • Lab Services • Importance of Lab Services • Lab Equipment • Lab Information System • Lab Services • Lab Medicines • Lab Safety • Planning • Staffing • NABL • Research & Training • Policies • Procedures • Role of Administration • Conclusion

4. A medical laboratory  is a placewhere tests are done on clinical specimens and samples in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease • Laboratory Services include testing of materials, tissues or fluids obtained from a patient or clinical studies to determine the cause and nature of disease

5. Haematology • Histopathology • Cytology • Routine Pathology • Bacteriology • Mycobacteriology • Virology • Mycology • Parasitology • Immunology • Serology • Biochemical analysis • Hormonal assays

6. What are Laboratory Services all about? Laboratory Services play a critical role in the detection, diagnosis and treatment of disease. Samples are collected and examination and analysis of body fluids, tissue and cells are carried out. Main services are: • To Perform diagnostic tests • To Identify organisms, like E-coli bacteria • To Count and classify blood cells to identify infection or disease • To Operate complex diagnostic equipment • To Perform immunological tests to check for antibodies • To Type and cross-match blood samples for transfusions • To Analyze DNA

7. Services we provide.. Microbiology Parasitology Virology Haematology Coagulation Clinical Biochemistry Toxicology Immunohaematology/Blood bank

8. Urinalysis Histopathology Cytopathology Electron microscopy Genetics Cytogenetics Surgical pathology Immunology/Serology

9. Lab equipments and LIS

10. Planning for equipments • Basic instruments and equipments should be made available • All vital equipment should be in duplicate or have an alternative arrangement • Selecting the best instrument for the laboratory is a very important part of equipment management

11. Following element should be considered during management program in laboratory: 1) Selection and purchasing 2) Installation 3) Calibration and performance evaluation 4) Maintenance 5) Troubleshooting 6) Service and repair 7) Retiring and disposing of equipment

12. Lab equipments Basic equipments for all types of routine investigations are: 1) Colorimeter/Photoelectric colorimeter: Its a device that measures the absorbance of particular wavelengths of light by a specific solution 2) Centrifuge: Is a piece of equipment, generally driven by an electric motor that puts an object in rotation around a fixed axis, causing denser substances to separate and by which lighter objects will tend to move on top 3) Water Bath:A device for regulating the temperature of anything subjected to heat, by surrounding the vessel containing it with another vessel containing water which can be kept at a desired temperature

13. Continued…………………………. 4) Microscope- Mono Ocular/binocular: Is an instrument used to see objects that are too small for the naked eye 5) Hot air oven: Are electrical devices used in sterilization 6) Autoclave: Is a device used to sterilize  equipment and supplies by subjecting them to high pressure saturated steam at 121 °C for around 15–20 minutes depending on the size of the loads 7) Ph-meter:  is an electronic instrument used for measuring the pH (acidity or alkalinity) of a liquid

14. Lab equipments • Incubator: Is a device used to grow and maintain of course   microbiological cultures or cell cultures 9) Automated biochemistry analyzer: Is an instrument designed to measure different chemicals and other characteristics in a number of biological samples quickly, with minimal humanassistance 11) Enzyme-linked immunosorbent assay(ELISA) -Reader : Uses one sub-type of heterogeneous, solid-phase enzyme immunoassay (EIA) to detect the presence of a substance, usually an antigen, in a liquid sample or wet sample

15. Continued…….. 12) Microtome: Is a tool used to cut extremely thin slices of material, known as sections. Its used in microscopy, allowing for the preparation of samples for observation under transmitted light or electron radiation 14) Wax melting bath:  Its a device used for electric melting of glues, vinyl compounds , waxes etc. with bottom valve discharge. Heaters are positioned such that melter may be used 1/3, 2/3 and full capacity without overheating contents 15) Hot plate: A hot plate is a portable self-contained tabletop small appliance that features one, two or more gas burners  or electric heating elements

16. LIS • A lab information system ("LIS") is a class of software that receives, processes, and stores information generated by medical laboratory processes. These systems often must interface with instruments and other information systems such as hospital information systems (HIS) • A LIS is a highly configurable application which is customized to facilitate a wide variety of laboratory workflow models • It is a complete management system that handles all business functions from patient management, results generating, to physician decision making

17. Lab information system

18. Key Features • The lab machines including the auto analyzers are interfaced with the hospital information system and their complete operations are automated without human intervention • HL7 standards incorporates the ability to receive data from other lab machines • Sample management system creates barcodes and tracks the samples of blood, saliva, urine etc.

19. Continued………………………….. • Assures that the technicians complete all the pending tests • Generates automated results from various laboratory machines and updates patient records • Ability to handle large number of specimens without compromising on safety • Efficient tracking of specimens by usage of bar codes for the specimens

20. Benefits of Lab Information System Doctors • The lab results of critical patients would be notified instantaneously to the doctor • All the lab results would be submitted directly to the doctor Patients • No delay in the execution of doctors’ orders • No need to make repeat visits to collect the results • No mix-up of samples of different patients at the lab Lab Technician • Immediate receipt of the doctors’ orders to perform a lab test • Easier reporting of lab results of the patients

21. The functional components of the clinical Laboratory

22. FUNCTIONS OF THECLINICAL LABORATORY • Identify the chemical composition of blood and urine samples • Identify and count the different types of cells found in blood and other body fluids • Blood typing and determination of transfusion compatibility between blood donors and recipients • The culturing and identification of bacteria and viruses from sites of infection in the body

23. The functional components of the clinical Laboratory • A hospital laboratory work generally falls under the following divisions: • Hematology • Serology • Clinical Chemistry/Biochemistry • Urinalysis • Microbiology • Blood Bank

24. Hematology • Hematology :-The study of blood. This section counts and qualifies the different types of blood cells and other components found in blood

25. Serology • Serology - The study of serum for its antibody content. Certain microorganisms (antigens) stimulate the body to produce antibodies during an infection. In the Serology lab, the antibodies react with antigens in specific ways that can be used to confirm the identity of the specific microorganism

26. Clinical Chemistry/Biochemistry • Chemistry - Performs most chemical analyses including glucose,sodium, potassium, and cholesterol.

27. Urinalysis • Urinalysis - The study of urine for the purpose of medical diagnosis. Urine is initially examined for such characteristics as color, odor, and specific gravity (density relative to water). It is routinely tested for its acidity level, as indicated by its pH reading, and screened for glucose (sugar)

28. Microbiology • Microbiology - The study of microorganisms, including viruses, that can only be seen with a microscope.

29. Blood Bank • Blood Bank - Collects, tests, types and stores blood donations used for blood transfusions

30. Functional planning An important decision in planning for a new laboratory is the physical location in relation to other departments • Functional planning covers the following activity: • Determining services to be provided for inpatients/outpatients, for other departments, smaller hospitals and private practitioners • Determining area and space requirement to accommodate equipment, furniture and personnel in technical, administrative and auxiliary functions • Dividing the area into functional units, hematology, biochemistry, microbiology, histopathology, urinalysis etc • Determining the major equipment and appliances in each unit

31. Lab Safety and Rules of the Lab

32. Safety Symbols • Know safety symbols • They appear in your laboratory activities • They will alert you to possible dangers • They will remind you to work carefully

33. Protect YourselfEye Safety • Wear safety goggles when working with chemicals, flames, or heating devices • If you wear contact lenses let your boss or teacher know

34. Eye Safety • In case of emergency in which a chemical goes into one’s eye, use the eyewash station • Flush in water for 15 mins. and notify the teacher

35. Proper Attire • Keep all long hair tied back • Do not wear loose clothing that could catch on fire • Foot wear that completely covers the foot is required

36. Hand Safety • If a chemical spills on your skin, rinse with water for 15 minutes • Wash hands after every lab • Handle glassware, sharp tools and heated containers carefully

37. Sharp Objects • Always carry sharp objects with points and tips facing down • Never try to catch falling sharp instruments • Hold sharp instruments only by the handles

38. Electrical Safety • Only electrical plugs are to be placed into an electrical outlet • Unplug electrical equipment after use • Keep all electrical cords, wires, and appliances away from water

39. Physical Safety • Handle all equipment carefully • Do not place a cord wheresomeone can trip over it • Push all stools in out of the way • Keep books picked up out of walking isles

40. Heating Safety • Tie back hair and looseclothes when workingwith open flames • Never look into a container as you are heating it • Never point the end of a test tube being heated at yourself or others • Never heat in a closed container

41. Heating Safety • Never leave a heat source unattended • Heated metal and glass looks cool, use tongs or gloves before handling • Do not place hot glassware directly on lab desk or in cold water

42. Chemical Safety • Read all labels twice before removing a chemical from the container • Only use the type and amount of chemicalinstructed to use • Never touch, taste, or smell a chemical unless instructed by the teacher • Never mix chemicals unless instructed to do so

43. Chemical Safety • Transfer chemicals carefully! • Keep lids on chemical containers when not in use • When diluting an acid, pour the acid into water • Consider all chemicals dangerous

44. Don’ts… • Enter store room unless given permission • Take any chemicals from lab or store room • Touch any equipment, chemicals, or other materials until instructed to do so

45. Continued… • Eat or drink in the lab • Use lab glass-ware to eat or drink out of

46. Continued… • Engage in…. • practical jokes • horse play • rough house

47. In case of an emergency… • Know the locations of: • fire extinguisher • fire blanket • body shower • eyewash station • first aid kit

48. In case of an emergency… • Know the locations of: • fire extinguisher • fire blanket • body shower • eyewash station • first aid kit

49. In case of an emergency… • Know the locations of: • fire extinguisher • fire blanket • body shower • eyewash station • first aid kit

50. Remember to… • Stay at your work station • Maintain a clean work area • Read and follow all directions • Report any spills, accidents, or injury immediately • Clean and put away all equipment at the end of the lab period • Dispose of waste products according to instruction