chapter 1

PREPARED BY ETHOPIAN UNIVERSITIES
MEDICAL LABORATORY SCHOOLS WITH
CDC- ETHIOPIA and ASCP
1
Chapter – One
1. The laboratory

Objectives
After completion of this chapter, the student will be
able to:
 Define laboratory.
 Explain the role of medical laboratory services.
 State the laboratory rules, ethics, professional
code of conduct and polices.
3

Outlines
1.1: General overview
1.2: Classification of laboratories
1.3: Structure of laboratory services
1.4: Role of clinical laboratory services
1.5: Function & use of different medical
laboratory department/units
1.6: Role of medical laboratory personnel
4

1.1: General overview
Defn
: Laboratory – is a place that is equipped with
different materials and supplies for performing
diagnostic, experimental or research activities.
Medical laboratory (clinical laboratory) is special
place which is equipped with various biomedical
instruments and chemicals for performing laboratory
tests from biological specimens (Whole blood, serum,
plasma, urine, stool, sputum etc.)
5

History of medical laboratory science
Medical laboratory sciences have existed as a part of
healthcare for almost one hundred years.
Initially laboratory physicians (pathologists) and/or
academic researchers trained individuals to perform
procedures under their supervision.
6

History of …
 In the 1950s and 1960s, the knowledge in the
biological and clinical sciences increased.
 The development of automation and more
sophisticated laboratory techniques, relevance in the
delivery of health care created the need for well
defined and academically organized medical
laboratory science program.
7

History…
By the 1980s many degree granting institutions had
established curricula in medical laboratory science.
The professional requirements of medical laboratory
science advanced from “non formal qualification” in
the 1940s and 1950s, to bachelor’s degree, followed
by the master’s degree and doctoral degree programs
in the last 30 years.
8

History ….
Today, medical laboratory science is a well
developed body of knowledge that includes portions
of basic and medical sciences, medical techniques
and research methods.
This facilitates and ensures the production of
quality medical diagnostic testing.
9

1.2: Classification of laboratories
WHO classify laboratory into 4- levels based on risk
levels.
What is risk group?
Risk group I
 - Low individual & low community risk.
(A pathogen is unlikely to cause disease.)
10

Classification …
Risk group III
 High individual & low community risk
 A pathogen that usually produces human
disease but does not ordinarily spread from one
infected individual to another.)
 E.g. Brucella, clostridium botulism
12

Classification …
Risk group IV
 High individual & community risk
 A pathogen that usually produces serious human
diseases & may be readily transmitted from an
individual to another directly or indirectly
within the community.
 No effective prophylaxis or treatment
13

Classification…
1.Basic lab. (Level 1 and level 2 laboratories)
 It is the simplest kind.
 It is adequate for work at the PHC and hospital
diagnostic lab.
 It is adequate for work with organisms in risk
group 1 and 2
i.e. Low risk.
14

Classification …
2. Containment lab –( level 3)
 More advanced and it is used for work with infectious
organisms e.g TB, salmonella – risk group -3.
 The principle is to remove those organisms having
particularly hazards from the basic lab.
 The objective is to expose as few people as possible to
the risk of infection.
15

Classification …
It is a separate room with controlled access by
authorized staff only
 It should be fitted with a microbiological safety
cabinet.
Its ventilation should be arranged.
16

Classification ….
3. Maximum containment lab (level 4)
 intended for work with viruses.
 Risk group-4 demand maximum precautions for the
most strict safety.
 These labs are usually separate buildings with strictly
controlled access through decontaminant showers.
 All air from rooms is filtered before discharge to the
atmosphere
17

1.3: Structure of laboratory services
A medical Laboratory service must be integrated with the health
care system
- This makes the need care accessible by the community served
along the network
This Networking consists of:
A. community-based health center lab:-
I). comprehensive health centers lab.
 investigation controlling and preventing major disease in a
community.
18

Structure of…
staffed by lab personnel
Promote health by health education
 Able to perform basic tests.
ii). Maternity health units (MCH)
Staffed with nursing staff trained by MLT and responsible
in :
 Screening for anemia and proteinuria.
 Collecting blood for antibody screening or parasite
19

Structure of …
B. District Hospital laboratories (DHL)
 In addition to the work stated above the laboratories
have an important role in:
 Supervising the work of community-based health
center lab.
 Testing referred specimens
20

Structure of …
DHL…
has facilities for clinical investigations and
epidemiological surveys.
Specimen collection and transportation system .
Patients attending health center to benefit from
the facilities of DHL.
 Epidemics to be investigated rapidly
21

Structure of…
C. Regional (hospital) laboratories
 In addition to the work stated above the laboratories
 It assists and supervise the DHL.
 Analyses referred samples and perform range of
specialized tests .
 Investigate epidemic and do more clinical and public
health diagnosis
 Organizing refresher courses and trains lab technicians
22

Structure of …
D. Central (hospital) and public health laboratories
 In addition to the work stated above the laboratories
• It assists and supervise the RHL
• Analyses referred samples and perform a range of more
advanced tests
• Investigate epidemic and do more clinical and public
health diagnosis
• Trains lab technicians by organizing refresher courses.
23

Summary of laboratory service network
24
N.BTherearealso
privatehospital,clinic
&diagnostic
laboratories

1.4 The Function of Medical Laboratory in a
Health Care System.
 Laboratory has an important role in:
I. Providing quality health care service
II. Achieving efficiency and cost effectiveness in health
care system
III. Achieving good health planning and management in
health care system
25

Medical Laboratory and …
i. The role of laboratory in providing quality health care
1. Laboratory investigation increase the accuracy of
diagnosis.
 Many infectious disease and serious illness can be
diagnosed correctly
 E.g. error in diagnosis of malaria is high when diagnosis
is on clinical symptoms only. 26

Medical Laboratory and ...
2. Laboratory has essential role in screening for ill health and
assessing response to treatment.
 Assess a patients response to drug therapy.
 Screen individuals with infectious disease. E.g. TB, STIs
 Screen whole blood and blood product for transfusion
transmitted pathogen.
 Screen pregnant women for anemia, infections which
may transmitted to newborn and others.
•Screen- test for the present or absence of a disease.
27

Medical Laboratory and...
3. The laboratory is needed to work with other in reducing
infection in the community and investigating epidemics
rapidly.
Detecting source of infection,
identifying carries contact tracing
Participating in epidemiological surveys
On site testing and collection and dispatch of
specimens when an epidemic occurs
Participating in health education 28

Medical Laboratory and...
ii. The role of laboratory in achieving efficiency and cost
effectiveness in health care system.
1. The laboratory reduce the expenditure of money on
drugs.
Drugs can be used more selectively and only
when needed.
Drug resistance can be identified more rapidly
and monitored.
29

Medical Laboratory and…
iii. The role of laboratory in achieving good health
planning and management
1.Reliable laboratory test result with relevant patient data,
provide information on the health status of a community,
health pattern and disease trend.
This information is needed to establish health care priority and
plan:
Health care program.
Training of health personnel and delivery of health
service.
Treatment schedule and change in drug usage. 32

2. public heath laboratories provide accurate epidemiological
information for health planning
cause of the disease in the community.
prevalence and incidence rate of infectious
disease.
33

With out reliable lab support:
 Patients less likely to receive the best possible care.
 Resistance to essential drugs will to continue to
spread.
 The source of disease may not be identified correctly.
 Epidemics and spread of major communicable
diseases will not be checked reliably.
 Valuable financial and human resource may not use
properly.
34

 Indications (importance) of requesting lab
examinations are:
To make a diagnosis of pathogen.
Confirm a clinical impressions.
To rule out (R/o) a disease and diagnosis.
To provide prognostic information.
To screen for disease.
35

Medical laboratory and…
 To provide therapeutic guidance so that:
Drugs can be used more selectively.
 Patterns of emerging drug resistance can be
identified.
Side effects and progress are monitored.
36

1.5: Function & use of different medical laboratory
department/units
 Hematology- deals with examination of the constituent
of blood, blood forming tissue and clotting processes.
 Clinical chemistry – deals with measurement of various
bio-chemicals changes in serum and body fluids.
 Immunohematology- deals with blood banking and
transfusion medicine.
37

Function & use of …
 Medical microbiology - deals about medically
important microorganisms, performing different
diagnostic and research activities on microorganisms
Microbiology includes the following sub disciplines
Bacteriology: is a science dealing with bacteria.
Virology :is the study of virus and viral disease.
Mycology: is the study of fungi.
Parasitology: is the study of parasites.
Immunology: study about immune system.
38

Function & use of …
 Urinalysis and body fluid analysis- deals with the
analysis of their constituents.
 Serology- is the study of antigen and antibody and
their interaction in vitro.
39

Function and use of …
Molecular biology: is the branch of biology that seeks
to understand the molecular basis of life. In particular,
it relates the structure of specific molecules of
biological importance—such as proteins, enzymes,
and the nucleic acids DNA and RNA—to their
functional roles in cells and organisms.

40

1.6: Role of medical laboratory personnel
Introduction:
 Medical laboratory is a health profession its goal is to resolve
patients’ problem presented to the physician by performing
laboratory analysis.
 Roles:
1. Diagnosing of diseases
 Errors occur when diagnosis of diseases depend on
clinical symptoms alone.

Role of medical laboratory ……..
2. Treating of diseases
Antibiotic sensitivity testing
Monitoring of patients response to treatment
3. Screening of diseases
 Detection of in apparent infections
4. Control of epidemics
Early detection of pathogens
43

Role of medical laboratory …
5. Surveillance & provision of health information
Source identification
Water supply testing
Carrier identification
Risk factor assessment
6. Controlling field trials
New drug/vaccine testing
Vaccine potency test
44

7. Management of finance, equipment and supplies
8. Ensuring a reliable and quality lab practice
Best possible service to patients
User confidence
Effectiveness and efficiency
Accountability
Optimal use of resources
45

 Therefore, the physician or other health professional
is dependent up on the skill and ability with which
the laboratory personnel perform his/her duties.
 You as a lab. Technologist holds life and death in
your hands, because the information you give to the
physician influences the medical treatment a patient
receives.
46

Role of medical laboratory …
47

1.7: Laboratory rules, ethics and policies
 Ethics-moral principle or rules of behavior that
govern or influence a person’s behavior.
 Rule-a statement of what, should or must be done in
particular circumstance.
 Code of conduct -a set of professional standards
agreed on by members of a particular profession.
49

Laboratory rules……
Code of conduct for medical laboratory personnel
 Should include those practices and attitudes which
characterize a professional and responsible lab officer.
 Adopting it helps to remind medial laboratory personnel of
their:
 Responsibility to patients.
 Duties to up holds professional standards and.
 Need to work with complete integrity.
50

Laboratory rules…
1. Place the wellbeing & service of the patient above
your own interest.
2. Be loyal to your profession by maintaining high
standard of work & striving to improve professional
skill & knowledge.
3. work scientifically & with complete honesty.
4. don’t misuse your professional skill or knowledge for
personal gain. 51

Laboratory rules…
5. Never take anything from your place of work that does
not belongs to you.
6. Don’t disclose to a patient or any other unauthorized
person the result of your investigation.
7. Treat your patient with strict confidentiality.
8. Respect & work in harmony with other members of
your staff or health center team.
9. Be any time courteous, patient, considerate to the sick
& their relatives.
52

Laboratory rules…..
10. Follow safety procedures & know how to apply
first aid.
11. Don’t drink alcohol or unprescribed drugs that
would interfere to your work performance during
laboratory working hours.
12. Use laboratory equipment with care.
13. Don’t waste reagents & other supplies.
14. Safeguarded the dignity & privacy of the patient.53

Laboratory policies
 Laboratory policies are those decisions which are
taken in consultation with other medical staff to
enable a laboratory to operate reliably and effectively
in harmony with other departments.
 These policies usually cover:
A. Laboratory hour and emergency work.
54

B. Range of tests to be performed and those to be referred
to higher level.
Range of tests to be performed depend on
 The number of material resources
 The availability of material resources
 The types of health institution
Referral of specimen
55

Laboratory rules….
C. Collection of Specimen
Correct collections of specimens are essential for
reliable test results.
During receiving specimens observe certain details to
insure that appropriate specimens are collected.
The containers should be labeled with patients name
I.d number, date and time of collection
A fully completed, request form should accompany
each specimen with the detail mentioned above. 56

D. Work load capacity of the laboratory
It should be matched to the:-
 Number of a staff and their level of training.
 The size of the laboratory.
 The availability of laboratory facilities.
 The available man power.
57

E. Delivery of results
Laboratory staff should provide valid result of tests.
Result should be clearly and neatly written.
58

laboratory rules …
 To ensure the validity and accuracy of test results the
following points should be taken in to consideration:
 The result before they leave the laboratory must be
checked by the most experienced member of the
laboratory technical staff.
 Any unexpected result should be investigated and
repeated if necessary.
 Reference values (normal range) should be included in
the reports. 59

Summary Question
1. Discuss about the history of medical laboratory
service
2. What is the role of medical laboratory personnel?
3. State laboratory rules, ethics and professional code of
conduct.
60

Reference
1. Linne Jean Jergenson, Basic techniques of medical
laboratory 4th
ed. 2000.
2. WHO, Manual of basic techniques for a health laboratory
2000.
3. Chees brough M.District Laboratory manual for tropical
courtiers, Cambridge Univerity press, 2000 (Vol ).
4. Chees brough M.District Laboratory manual for tropical
courtiers, Cambridge Univerity press, 2000 (Vol II).
5. Seyoum B. Introduction to medical laboratory technology
students lecture note series 2002.
6. www.CDC.gov
61

Next : will be on : Lab
equipment and wares
End of slide
62

chapter 1

More Related Content

What's hot

Similar to chapter 1

chapter 1

Editor's Notes