Lecture Clinical procedures for medical assisting (4/e): Chapter 14 – Booth, Whicker, Wyman

CHAPTER

14
Laboratory and
Equipment Safety

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­2

Learning Outcomes
14.1 Describe the purpose of the physician’s office
laboratory.
14.2 List the medical assistant’s duties in the
physician’s office laboratory.
14.3 Identify important pieces of laboratory
equipment.
14.4 Operate a microscope.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­3

Learning Outcomes (cont.)
14.5 Identify the regulatory controls governing
procedures completed in the physician’s
office laboratory.
14.6 Identify measures to prevent accidents.
14.7 Describe the goal of a quality assurance

program in a physician’s office laboratory.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­4

Learning Outcomes (cont.)
14.8 Identify the medical assistant’s recordkeeping responsibilities.
14.9 Describe correct waste disposal procedures.
14.10 Describe the need for quality assurance and
quality control programs.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­5

Learning Outcomes (cont.)
14.11 Maintain accurate documentation, including
all logs related to quality control.
14.12 List common reference materials to consult
for information on procedures performed in
the physician’s office laboratory.
14.13 Communicate with patients regarding test
preparation and follow-up.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

14­6

Introduction
• Laboratory testing –
integral part of patient
care
• Medical assistant
must know
– Common laboratory
equipment
– Safety in the
laboratory

• CLIA ’88 – impact on
laboratory setting
– Quality assurance
– Quality control
procedures
– Required record
keeping

– Steps to prevent
accidents
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­7

Role of Laboratory Testing in Patient Care
• Analysis of blood, urine, and other

body fluids
– Regular monitoring to
identify diseases or
other problems
– Confirm initial diagnosis
– Determine and monitor
dosage of a medication
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­8

Role of Laboratory Testing

(cont.)

• Kinds of
laboratories
– Reference
laboratory
• Owned and operated
by an organization
outside the practice

– POL
• Quicker turnaround
• Eliminates need for
patient travel to other
test location

• Have technological
resources beyond the
POL
Some managed care companies require their
subscribers to use a specific reference laboratory.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­9

Role of Laboratory Testing (cont.)
• Purpose of POL
– Accurate and timely processing of routine
tests
– Reporting test results to physician
– Tests
•
•
•
•

Chemical analysis
Hematologic tests
Microbiologic tests
Urinalysis

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­10

Apply Your Knowledge
Compare a reference laboratory and the POL.
ANSWER: A reference laboratory is a lab facility usually run by an
organization separate from the practice. It has technologies
beyond the POL. Patients have to travel to this facility. A POL
provides quicker turnaround on results but is limited in the
testing that can be performed. Patients are able to have testing
done during an appointment without leaving the office.

Super!
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­11

Medical Assistant’s Role
• Processing tests done in POL
– Preparing the patient
– Collecting the sample
– Completing the test
– Reporting the results
– Communicating information about the
test
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­12

Medical Assistant’s Role (cont.)

• Additional
responsibilities
– Understand
regulations
– Accident prevention
– Waste disposal
– Housekeeping and
maintenance
– Quality assurance and
control

– Record keeping
– Inventory and order
equipment and
supplies
– Use reference
materials
– Screen and follow-up
results

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­13

Apply Your Knowledge
What are the duties of a medical assistant related
to testing done in the POL?
ANSWER: The medical assistant duties may include preparing
the patient, collecting the sample, running the test, reporting the

results, and, once the physician has reviewed the results,
communicating the results to the patient.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­14

Use of Laboratory Equipment
• You may routinely
use the following:
–
–
–
–
–

Autoclave
Centrifuge
Microscope
Electronic equipment
Equipment used for
measurement

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­15

Use of Laboratory Equipment

(cont.)

• Autoclave – sterilizes surfaces of
instruments and equipment
• Centrifuge – spins and separates
specimen into its component parts

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­16

Use of Laboratory Equipment

(cont.)

• Optical microscope
– Uses light,
concentrated through
a condenser and
focused through the
object, to project an
image
– Compound
microscope – two
lenses magnify the
image created by
condensed light
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

14­17

Microscope
• Oculars

• Objectives

– Eyepieces
• Monocular
• Binocular

– Contain a
magnifying lens –
magnify image 10
times (10X lens)

– Contain another
magnifying lens
– Moved under
ocular when
needed
– Three objectives
• Two dry
• One oil-immersion

Microscope

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

14­18

Microscope (cont.)
• Arm and focus
controls
– Arm – attaches
oculars and objectives
to body
– Focus controls – used
to focus the object

• Stage and substage
– Stage – platform for
slide
– Substage – condenser

• Specimen slides/
coverslip

• Light source
– Under stage and
substage
– Adjustable intensity

Microscope

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

14­19

Parts of the Microscope
5.Eyepiece
s

1.Arm

2.Fine
3.Coarse
Adjustment
Adjustment
4.Base

6.
7.Nosepiec
Objective
es
8.Slide
9.Clips
Stage
10.Condense
11.Iris
r
12.Light
Source
Back

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

14­20

Use of Laboratory Equipment (cont.)
• Using an optical microscope
– Operate correctly
– Care and maintenance
• Clean after each use
• Store under plastic cover
• Move by holding arm and supporting
the base

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­21

Use of Laboratory Equipment (cont.)
• Electronic equipment
and software
– Used to create and
maintain clinical data
– More accurate, safer,
and more efficient than
manual methods

• Equipment used for
measurement
–

–
–
–

Pipettes
Flasks or beakers
Hemocytometer
Thermometers

– Photometer –
measures light
intensity

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­22

Apply Your Knowledge
Matching: ANSWER:
D Measures light intensity
___

A. Focus controls

C Platform for slide
___

B. Hemocytometer

E Contains magnifying lens
___

C. Stage

G One is an oil-immersion
___

D. Photometer

F Condenser to concentrate light E. Ocular
___
A Move body tube up and down F. Substage
___
B Calibrated to count cells
___

G. Objective

Nice
Job!

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­23

Safety in the Laboratory
• Primary concern
• OSHA

– Protection of employees in the workplace
– Specific guidelines
– General duty clause
• If no specific guidelines
• Workplace free from recognized hazards

– Enforces guidelines from CDC

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­24

OSHA Guidelines
• Standard Precautions
• Hazard communication standards
• OSHA Bloodborne Pathogens Standard
• Hazardous Waste Operations and

Emergency Response Final Rule
• Needlestick Safety and Prevention Act

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


14­25

Standard Precautions
• Assume that all blood, blood
products, human tissue, and body

fluids are contaminated
• PPE guidelines
– Gloves
– Eye protection

• Use equipment appropriately
• Proper biohazard disposal
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.