MLT 280 - Clinical Practicum I

1. Correlate test results with the appropriate disease state(s) or condition(s).
2. Analyze quality control data to evaluate the accuracy of patient results while following proper quality control and quality assurance procedures.
3. Identify appropriate laboratory procedures used for diagnosing a patient’s disease state, state those test principles, and predict expected test results.
4. Demonstrate ability to follow verbal and written instructions to accurately complete testing on patient and control samples while following universal precautions and safety rules at all times in the laboratory.
5. Demonstrate appropriate Medical Laboratory Technician behavior with regards to attendance and punctuality, cooperation with personal and patients, attitude and ethics, acceptance of criticism, professional appearance, and adaption to a changing environment.

Course Objectives

1. Demonstrate proper collection and handling of specimens for tests.
2. Evaluate specimens for quality.  Demonstrate corrective actions needed for improper specimens.
3. Log in and label specimens accurately.
4. Prepare a daily worksheet or generate a computer worksheet using laboratory technology to analyze and report patient results.
5. Demonstrate safe technique in handling and disposing of infectious materials.
6. Perform and evaluate quality control (QC) for all hematology procedures. Demonstrate proper corrective actions needed if QC values are outside established limits.
7. Operate each hematology and coagulation instrument according to laboratory procedure to obtain accurate QC and patient results.
8. Demonstrate an understanding of the daily maintenance routines for each piece of hematology and coagulation instrumentation.
9. Explain the functions of and the blood parameters provided by each hematology and coagulation instrument. Recognize when values are outside the linearity of each instrument.
10. Describe the reagents used on each hematology and coagulation instrument and their functions.
11. State the formulas and normal ranges and calculate the MCV, MCH, and MCHC.
12. Perform a differential on a Wright stained blood smear, correctly identifying all normal and abnormal cells and morphology. Recognize possible pathological relationships of the abnormal cell types.
13. Evaluate cell histograms or scattergrams and predict pathophysiological causes of any abnormality.
14. Perform a body fluid manual cell count.
15. Perform and explain the principle of an erythrocyte sedimentation rate. Evaluate the results and explain the factors that might interfere with an accurate result.
16. Perform a reticulocyte count. State the normal values and explain the formula used to correct the reticulocyte count for hematocrit.
17. Perform and calculate a manual WBC and Platelet count.
18. Perform and read a spun hematocrit.
19. Perform a seminal fluid analysis.
20. Perform, list the reagents used, and evaluate the results of the following coagulation tests: PT, APTT, Thrombin time, Fibrinogen, D-Dimer.
21. Describe types of urine specimens and the diagnostic use for each type.
22. Follow guidelines for the proper storage, labeling and handling of urine specimens.
23. Describe collection techniques employed to obtain types of urine specimens.
24. Demonstrate safe techniques in the handling and disposal of infectious materials in the urinalysis department.
25. Record and monitor quality control for procedures and instruments in the urinalysis department.
26. Demonstrate an understanding of daily maintenance routines and corrective actions, if necessary in the urinalysis department.
27. Correlate urine color and clarity with substances that can indicate a pathologic process.
28. Describe the chemical principles employed to measure the substances detected by urinalysis reagent strips.
29. Recite the significance of positive results for substances detected by urinalysis reagent strips.
30. Differentiate between pathologic and nonpathologic formed elements detected in urinary sediment.
31. Describe the screening techniques used in the urinalysis department to detect metabolic disorders.
32. Apply clinical phlebotomy theory to the proper collection of capillary and venous blood specimens.
33. Explain the proper collection, transport and identification of each sample type for chemistry analysis according to fasting state, temperature, speed of analysis, etc.
34. List the criteria for rejecting chemistry specimens for specific analysis for reasons such as lipemia, hemolysis, prolonged light exposure, etc.
35. Demonstrate and follow the lab procedure for record keeping and reporting normal patient results and panic values results in the chemistry department.
36. Demonstrate safe technique for handling and disposing of samples according to lab protocol in the chemistry department.
37. For each chemistry procedure, discuss how quality control (QC) is recorded, evaluated and what corrective measures are taken when the QC value falls outside the acceptable limits.
38. For each chemistry instrument used to perform chemical analysis, identify the type of analysis done, the machine, the primary operating components, and the function of each component.
39. Operate independently each chemistry instrument following the manufacturer’s recommendation for instrument performance.
40. For each test performed on a chemistry instrument, the student will demonstrate competency by: Describe the reagent and function, Describe reagent preparation and storage, Demonstrate sample preparation, if any, Program and/or calibrate the instrument, Produce valid patient results.
41. Demonstrate proper maintenance on each chemistry instrument by: Identify a functioning or malfunctioning instrument, Demonstrate ability to successfully troubleshoot instrumentation and return the instrument to normal use.
42. Identify the chemical tests composing the following profiles and discuss the pathophysiological significance of performing them: Electrolyte Profile (Lytes), Basic Metabolic Profile (BMP), Comprehensive Metabolic Profile (CMP), Hepatic Profile (LFT), Renal Function Profile (Serum tests & 24-hr Urine Creatinine), Cardiac Testing (Trop, CK, CK-MB), Iron Studies (Fe, Ferritin, TIBC, %Sat), Thyroid Studies (TSH, FT4, T4), Diabetes Studies (Fasting Glucose, HA1C).
43. Demonstrate performance of proper guidelines for collection, labeling and storage of blood specimens used in blood bank/immunology testing, and take necessary actions if specimens are unacceptable.
44. Demonstrate performance of laboratory policies for record keeping and reporting, including reading and grading agglutination reactions and hemolysis in the blood bank department.
45. Describe the basics of inheritance as it applies to blood groups, inheritance patterns, pedigree charts and gene frequencies in the blood bank department.
46. Describe the importance of the soluble A, B and H antigens and the importance of the A, B, H Se and Z genes in the blood bank department.
47. Name and list the sources of antisera, lectins and special testing reagents in the blood bank department.
48. Describe the Fisher-Race and Weiner theories of genetic control.
49. List and use 3 Rh nomenclatures in the blood bank department.
50. Describe Rh system antibodies, including reactivity and characteristics.
51. List the guidelines for prenatal testing in the blood bank department and administration of Rh immune globulin.
52. Name the major antigens in blood group systems other than ABO and Rh and the phenotypic frequency.
53. Discuss the antibodies associated with each blood group system including clinical significance, Ig class and serologic characteristics and special reagents used in identification.
54. Compare and contrast the direct and indirect antiglobulin tests, including their purpose, clinical significance, and procedure.
55. Interpret antibody reactions in a reagent red blood cell panel in the blood bank department.
56. Identify compatible and incompatible crossmatch reactions and the necessary steps in the resolution of incompatibilities.
57. Properly select group specific and nongroup specific blood for transfusion when necessary.
58. List indications and contraindications to transfusion with various blood components.
59. Describe medical history criteria prior to blood collection for protection of both the blood donor and recipient.
60. List the required tests performed on donor blood in the blood bank department.
61. Discuss serological/immunological techniques used for infectious disease testing of donor blood.
62. Discuss preparation, use, labeling, storage temperature, and shelf life for the following components: Whole blood, Red blood cells, Leukocyte-reduced red blood cells, Saline washed red blood cells, Frozen and thawed deglycerolized red blood cells, Fresh frozen plasma, Cryoprecipitate, Platelets, Granulocytes.
63. Recognize signs and symptoms of various types of transfusion reactions.
64. State the steps that must be taken by the blood bank when a transfusion reaction is suspected.
65. Describe the types, physiologic effects, and serologic effects of HDN and antenatal and postnatal tests for detection of HDN.
66. Demonstrate proper procedures when receiving and shipping blood and blood components, issuing blood and blood components and preparing blood and blood components for infusion in adults and infants.
67. Perform daily, weekly and quarterly quality control on reagents, and perform routine maintenance on blood bank equipment.
68. Perform immunology and serology assays using a variety of techniques.
69. Manage quality control for procedures and instruments in the immunohematology/immunology laboratory and know what corrective actions would need to be taken when established limits are exceeded.
70. Explain the proper collection, transport and identification of microbiology specimens.
71. List the criteria for rejecting specimens and corrective action to avoid such microbiology specimens.
72. Demonstrate performance of lab procedures for record keeping and reporting of significant results in the microbiology department.
73. Demonstrate safe technique for disposing of infectious material according to lab procedure.
74. Explain the microbiology quality control procedures for reagents, ID systems, media and equipment according to organisms and frequency of testing, how to evaluate the results of the QC and what action should be taken when values are not within established limits.
75. Perform and correctly interpret the results of staining procedures such as gram stain, acid fast stain, etc.
76. Demonstrate the proper inoculation and isolation procedures according to microbiology media, temperature, and atmosphere for each type of specimen submitted for microbiological analysis.
77. Recognize the colony characteristics of normal flora and pathogens from each type of body-site specimen submitted for microbiology analysis.
78. Discuss what colony counts are significant in midstream/clean catch urine vs. catheterized urine specimens from urology and non-urology patients.
79. Identify significant isolates from specimens containing normal flora or skin contaminants and specimens from sterile areas using laboratory flowcharts and methodology.
80. Perform antibiotic susceptibility testing on pure microbiology culture isolates.
81. Report microbiology culture and sensitivity results to a licensed care provider.
82. List the medically significant species of mycobacterium.
83. List the media used in the isolation and cultivation of mycobacteria.
84. Perform, interpret and explain the results of acid fast stains.
85. Explain the methodology and perform the digestion and concentration procedures on mycobacterium cultures.
86. Classify the mycobacterium into Runyon groups according to growth rate and pigmentation.
87. Identify and define the structures found on images of yeast and molds.
88. Describe, inoculate and interpret the media: SAB, mycoseal, cornmeal agar, potato dextrose agar and germ test tube medium.
89. Explain, perform and properly interpret the following stains for fungi: Gram, India ink, KOH preparation and Lactophenol cotton blue.
90. Describe the collection procedure, plating procedure and incubation of blood, urine, CSF, sputum and skin scrapings for microbiology culture.
91. Discuss and perform a microscopic examination (when available) using a saline, iodine, trichrome and iron hematoxylin stain.
92. Identify parasites from available clinical resources.
93. Maintain good clinical site attendance and punctuality by: Arriving on time, Beginning work promptly, Informing the instructor when leaving the area, Staying late when necessary to complete an assigned procedure, Limiting breaks to their allotted time.
94. Cooperate with clinical site personnel by: Maintaining a pleasant and professional attitude, Functioning well in a teacher/student setting, Showing respect and understanding of cultural diversity, Leaving the work area clean and neat, Replenishing supplies and reagents, Using reagents and supplies with economic discretion.
95. Demonstrate a professional attitude and ethical responsibility at clinical sites by: Being alert, attentive and paying attention to details, Completing required assignments, Finding work to keep busy when instructor is unavailable/busy, Showing empathy and respect for patients of all ages and cultural backgrounds, Taking appropriate actions to correct errors or resolve conflict, Maintaining professional composure, Handling and labeling specimens and materials appropriately and with accuracy.
96. Utilize constructive criticism at clinical sites by: Responding to suggestions and constructive criticism in a positive manner, Admitting to errors/mistakes and take steps to correct future errors.
97. Maintain a professional appearance at clinical sites.
98. Adapt to a changing clinical site environment by: Asking relevant questions, Following written procedures, Showing consistent attention to detail, Displaying confidence after instruction, Handling equipment appropriately and performing proper maintenance.
99. Follow standard precautions and lab safety regulations at clinical sites.