MLT 115 - Clinical Lab Fundamentals

1. Evaluate the clinical laboratory.
   1. Discuss the roles of Medical Laboratory Technicians and other laboratory personnel.
   2. Summarize the general functions of a clinical laboratory, as well as the functions of each main area in the lab.
2. Assess laboratory safety and quality control.
   1. Identify safety and precaution labels and signs.
   2. Disinfect work area.
   3. Wear appropriate personal protective equipment.
   4. Practice correct hand-washing technique.
   5. Dispose of biohazardous waste.
   6. Protect self, student-patient, and clinical patients from transmission of infectious disease.
   7. Perform appropriate error correction and documentation.
   8. Identify government agencies regulating laboratory results.
   9. Explain the use of quality control in the lab.
   10. Define accuracy and precision.
   11. Calculate standard deviations and coefficient of variation.
   12. Determine factors that affect procedures and results.
3. Calculate laboratory math, measurements, apparatus and principles.
   1. Name different types of glass, containers and receivers.
   2. Perform pipetting techniques.
   3. Perform unit conversions in standard and metric.
   4. Convert temperature from degrees Celsius to degrees Fahrenheit and vice versa.
4. Demonstrate absorbance spectrophotometry.
   1. Describe the principles of spectrophotometry.
   2. Operate the spectrophotometer to calculate unknown concentrations.
   3. Graph curves illustrating % transmittance v. concentration and absorbance v. concentration.
   4. Discuss the absorbance and transmittance of light and how it relates to Beer’s Law.
   5. Apply Beer’s Law in the calculations of solution concentrations.
   6. Convert % transmittance to absorbance using a conversion chart.
   7. Given a standard line, determine if the procedure follows Beer’s Law.
   8. State two methods which are used to determine if a procedure follows Beer’s Law.
   9. Define the following types of specimens used when performing procedures using the spectrophotometer: standard solutions, blank, and control specimen.
   10. Use a common procedure to determine the concentration of glucose in a specimen.
   11. Give the normal values for glucose levels in blood and other body fluids.
   12. Define diabetes mellitus; contrast Type I and Type II diabetes.
5. Demonstrate an understanding of quality assurance in blood collection.
   1. Recognize the importance of correct blood collection techniques in total patient care.
   2. List the factors that influence the integrity of a blood specimen.
   3. Describe the quality assurance of blood collection.
6. Examine equipment used in blood collection.
   1. Describe the purposes of various pieces of equipment and supplies.
   2. Differentiate among the various needle sizes as to gauge and purpose
   3. Discuss methods to safely dispose of contaminated needles.
   4. Identify the types of tubes by color code, and state the anticoagulant and additives present, mechanism of action, and special characteristics, and the purposes of each
   5. List the correct order of draw.
   6. Differentiate between serum and plasma.
   7. Define coagulation; and, state when an anticoagulant is used in blood collection.
7. Perform venipuncture techniques.
   1. List the required information on a requisition form.
   2. Describe correct patient identification.
   3. Describe patient preparation and the variables that can affect some lab tests
   4. Assemble venipuncture equipment and supplies.
   5. Process specimens for analysis
   6. Discuss post-venipuncture care of patient, labeling, and delivery of specimens to the lab.
   7. Collect blood from student-patients and donors using various methods of collection
   8. Identify the most common venipuncture sites; and, identify alternative sites and describe when they would be used.
   9. Explain how to determine site selection and the cleaning process.
   10. Describe proper needle position for a successful venipuncture.
   11. List reasons blood would be collected using a syringe or butterfly rather than collection it via venipuncture using evacuated tubes.
   12. List the steps in performing a venipuncture using a syringe or butterfly.
8. Perform dermal puncture techniques.
   1. State reasons for performing a dermal puncture.
   2. Identify acceptable and unacceptable sites for dermal puncture in adults, children, and babies.
   3. List the steps in performing dermal puncture.
   4. List the order of collection for dermal puncture specimens.
   5. Describe correct labeling of microspecimens.
   6. Describe the commonly used skin puncture devices for both finger sticks and heel sticks.
   7. Explain why the first drop of blood is wiped away when performing a dermal puncture.
9. Assess complications and trouble-shooting in blood collection.
   1. List steps taken when collecting blood from a patient with an intravenous (IV) line in place.
   2. Define the following: syncope, hematoma, petechiae, sclerosed veins.
   3. Discuss causes and prevention of the following complications in phlebotomy: fainting, bruising, petechiae, excessive bleeding, seizures, allergies, infections, pain, damaged veins.
   4. Discuss causes and solutions for: failure to obtain blood, equipment failure, needle positions, and collapsed veins.
10. Evaluate specimen handling and processing.
    1. List factors that can cause a patient’s lab results to appear abnormal.
    2. Discuss appropriate handling of laboratory specimens.
    3. State the acceptable time between specimen collection and separation of cells from plasma or serum, and explain why this is necessary.
    4. Describe how to transport specimens to the lab when they must be kept warm, kept chilled, or are light-sensitive.
    5. List common reasons for specimen rejection; and, explain why the specimens are unable to be tested.
11. Discuss hematopoiesis.
    1. Describe the common blood cells, serum, and plasma, and their functions.
    2. Explain hemoglobin synthesis and structure.
    3. Identify forms of hemoglobin and derivatives.
    4. Describe methods of measurement and reference values.
    5. State the ratio of red marrow to yellow marrow.
    6. Discuss the role bone marrow plays in cells production from fetal life throughout adulthood.
    7. State the total adult blood volume in liters.
    8. State the life span of a red blood cell in days.
    9. State names, amino acid chains, and percentages in blood of normal adult hemoglobin.
    10. Define hemoglobinopathies, and list at least one (1) example of a hemoglobinopathy.
    11. List reasons for an increased and decreased hemoglobin value.
12. Explain hematocrit.
    1. Identify specimens to be used and methods of measurements.
    2. List reference values.
    3. List reasons for an increased and decreased hematocrit.
    4. State the reason for obtaining duplicate tubes for microhematocrit readings.
    5. State the ‘rule of 3’ as it pertains to RBC count, hemoglobin, and hematocrit.
13. Assess cell counts and RBC indices.
    1. Calculate Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), and Mean Corpuscular Hemoglobin Concentration (MCHC).
    2. List reference values for indicies.
    3. Relate indices to red blood cell morphology.
    4. Perform red blood cell, white blood cell and platelet counts.
    5. Calculate red blood cell, white blood cell and platelet counts.
    6. List reference values for cell counts.
    7. List reasons for increased and decreased numbers of red blood cells, white blood cells, and platelets.
    8. Define polycythemia, leukocytosis, leukopenia, absolute leukocytosis, thrombocytosis, thrombocytemia, and thrombocytopenia; and, list causes for these conditions.
14. Perform microscopic examination of peripheral blood.
    1. Prepare blood smears.
    2. Stain blood smears.
    3. Perform leukocyte differentials, including red blood cell morphology.
    4. Perform platelet estimate.
    5. Calculate corrected white blood cell count.
    6. List reference values.
    7. Define anisocytosis; and, correlate the red cell distribution width (RDW) with the amount of anisocytosis.
15. Evaluate hematological diseases states.
    1. Define anemias and leukemias.
    2. Recognize cell morphology in health and diseased states.
    3. Identify red cell and white cell disorders based on the differential, red cell indicies, and cell counts.
16. Demonstrate professional conduct.
    1. Demonstrate interpersonal communication skills with patients, other health care professionals, and the public.
    2. Practice confidentiality.
    3. Follow written and verbal instructions.
    4. Demonstrate ethical time management.
    5. Choose workplace-appropriate clothing and jewelry.
    6. Recognize the responsibilities of other laboratory and health care personnel, interacting with them with respect to their jobs and patient care.
    7. Recognize the need for continuing education as a function of growth and maintenance of professional competence.
    8. Maintain professional growth and competence through involvement in continuing education.
    9. Demonstrate workplace basic skills of listening, writing, leadership, and time management.
    10. Practice written and oral communication skills.
    11. Create team atmosphere in laboratory functions.
17. Demonstrate judgment and decision making skills.
    1. Analyze laboratory findings to recognize common procedural and technical problems.
    2. Evaluate laboratory findings to take corrective action.
    3. Analyze laboratory findings to check for sources of errors.
    4. Evaluate laboratory findings to recognize and report the need for additional testing.