General Lab Checklist

General Clinical Rotation

Objectives, Expectations, and Competency Checklist

GENERAL COMPETENCY CHECKLIST

ASCP BOC Exam Content

OBJECTIVES:

After completion of coursework and this clinical experience, the MLS student will be able to:

GENERAL LABORATORY

1. Gain clinical exposure and practice of skills and theory learned in the previous clinical laboratory science courses in a general laboratory setting.
2. Relate the demands and responsibilities and duties of the MLS and other staff in a general service laboratory.
3. Observe basic management and supervision skills practiced in a general service laboratory.
4. Perform selected management procedures as directed by the laboratory manager.
5. Learn flexibility by adapting to different expectations and styles of laboratory management and supervision practices.
6. Develop independent and interdependent work skills by assuming responsibility for own work and work area and working closely with others.
7. Perform selected test procedures in all areas of the laboratory.
8. Perform and report urinalysis to include chemical, physical and microscopic characteristics.
9. Perform and report CBC to include differential and histogram evaluation.
10. Perform and report PT and APTT tests and other hemostasis tests as available.
11. Perform and report routine chemistry tests using appropriate instrumentation.
12. Perform blood collections as directed.
13. Observe, and perform as appropriate, routine maintenance on lab instruments and equipment.
14. Participate in quality assurance practices as directed.

URINALYSIS/BODY FLUIDS

1. Work independently with minor supervision
2. Explain the basis for selecting the appropriate specimen for the test desired and how to determine the suitability of the specimen.
3. Perform and/or correctly report the specimen’s
   1. appearance
   2. color
   3. specific gravity
   4. volume
   5. pH
4. Use reagent strip test systems to perform and accurately interpret the presence and /or concentration of:
   1. glucose
   2. ketone
   3. bilirubin
   4. urobilinogen
   5. protein
   6. hemoglobin
   7. occult blood
   8. nitrite
   9. leukocyte esterase
5. Detect abnormal color reactions and identify the cause(s).
6. Perform confirmatory test for: (if applicable)
   1. bilirubin
   2. ketones
   3. reducing substances
   4. protein
7. Identify, differentiate, and grade microscope sediment including the following:
   1. WBC
   2. RBC
   3. casts
   4. crystals
   5. bacteria
   6. yeasts
   7. mucus
   8. epithelial cells
   9. parasites
   10. spermatozoa
8. Perform screening test and or/quantitative test for:
   1. porphyrins
   2. fat
   3. urobilinogen
   4. amino acids and metabolites
9. Establish and maintain a complete quality control program.
10. Use, maintain and update the procedure manual.
11. Correlate urinalysis data with other laboratory data and the clinical status if the patient.

 PHLEBOTOMY (if applicable at your facility)

Following didactic instruction and student laboratory practice, the MLS student will demonstrate proficiency as follows in a clinical situation:

1. Demonstrate patient identification procedure and specimen labeling without error.
   1. Properly identify patients. Label tubes completely and legibly, initial request forms, and clock-in specimens as required.
   2. Explain procedure for special collections, STAT specimens, and times collections.
2. Effectively use several types of blood drawing equipment including vacutainers, syringes, microcontainers, microlance, and other collecting systems.
   1. Demonstrate correct venipuncture technique using syringes and vacutainers.
   2. Demonstrate correct skin preparation and puncture techniques for:
      1. Newborns-chemistry specimens, hematology specimens, blood gases, blood cultures, bleeding times.
      2. Other patients- capillary punctures, venipuncture, blood cultures, special testing ( i.e. blood alcohol)
3. Identify specimen collection problems, i.e. insufficient blood ratio to anticoagulant, hemoconcentration, I.V. contamination, heparin lock, etc.
4. Explain the action of anticoagulants used in specimen collection.
   1. Explain the procedures for handling tubes with anticoagulants and/or other additives, and list the proper color-coded stoppers and capillary tubes used for routine tests.
5. Accurately collect appropriate specimens for tests ordered and transported to the laboratory within the appropriate time limits.
   1. Keep collection tray stocked, neat, and clean.
   2. Utilize collection trays in the prescribed manner.
   3. Display efficiency in routine blood collection and delivery to the laboratory.
   4. Perform venous and capillary collections as directed by laboratory personnel.
6. Display professional behavior and attitude toward patients, personnel, and visitors.
7. Demonstrate a confident manner, consideration for patients, and cooperation with the medical staff and nursing personnel.
8. Demonstrate proper procedure for collecting specimens under all conditions, including emergencies, STATS, isolation, interfering I.V.’s, timed tests, etc.
9. Demonstrate understanding and compliance with patient isolation procedures.
10. Demonstrate proper procedure for handling hazardous specimens and blood collection apparatus.
11. Demonstrate knowledge of significant vascular anatomy.
12.  Determine the effects of various I.V lines, heparin lock, etc., on certain laboratory tests.
13. The student will observe all ethical standards of the profession regarding the treatment of patients.

EXPECTATIONS (of Texas State MLS students)

• Review the objectives for the General Laboratory rotation before you go on the rotation (and, it doesn’t hurt to take them with you to check off what you’ve done or haven’t done).
• Take your Clinical Chemistry and Hematology textbooks with you and use them when you’re looking up information about specific tests; have a notebook handy to jot down important things so you don’t have to be told more than once
• This rotation will expose you to several areas of the clinical laboratory and include phlebotomy. If you haven’t reviewed phlebotomy techniques, take a look at the Medtraining programs. The urinalysis and peripheral blood programs are also helpful for this rotation.
• If you haven’t notified your rotation site, be sure to do so early to let them know you are coming and to find out what time you are to be there, where to park, clothing, and any other concerns you have.
• Be ON TIME, wear your scrubs if you have them (you can also take a lab coat, but many places will provide that), take your student TX State name tag, student handbook/review book, notify your lab contact and us if you are not going to make it because of sickness, emergency, etc.
• ON THE JOB-Observe universal precautions at all times; be attentive and proactive in your learning; ask if you don’t understand something but try not to “nag” (in other words, you shouldn’t have to ask “does this test require serum or plasma” 5 times J); Show interest and enthusiasm; do not get caught up in lab/office politics/personnel feuds/etc.
• Every clinical site is a little different; try to be intuitive with the “workflow” and culture of the lab; you only have an opportunity to be there 3 weeks so try to fit in
• This is YOUR opportunity to network with future employers and all of our sites communicate with each other about you and your peers….so, treat this like a 3-week interview!
• Learn from the different MLS and MLT professionals that you are around. Many of them have years of practical experience and “tricks of the trade” that are hard to show in a teaching lab on campus.
• Do not be afraid of repetition. The more experience you have with chemistry instrumentation and evaluating quality control data, the better. This is important. It will help you on your rotation exam and on your certification exam.
• Stay for the entire “shift”; be courteous and grateful to our clinical sites as we rely on them for future rotation; YOU are representing not only yourself but TEXAS STATE and the MLS program.