Reference no: EM133342833

Medical Technologist Laboratory Error

Marilyn is a supervisory medical technologist in the laboratory of a small clinic in the Midwest. Since the clinic does not employ phlebotomists to do blood draws, Marilyn performs this task, as well as all the analytical duties of a medical technologist. When asked the most frequent cause of analytical errors, she says preanalytical personnel practices, rather than equipment malfunction, are most often at fault.

"For example, one day a technologist found that the instrument we use for analyzing urine dipsticks was consistently reporting positive for leukocytes on every patient. She asked me if the instrument needed to be checked, and I couldn't find anything wrong with it, so I watched her perform a couple of analyses. The manual for the instrument emphasizes cleaning the work table daily after each use, and the technologist admitted that this hadn't been done. In fact, the work table hadn't been adequately cleaned for several days."

The technologist cleaned the work table before the next urine sample was tested, and no leukocytes were reported. "Apparently there was cross contamination from some previous urines with positive leukocyte readings. After that, the technologist made sure to clean the work table thoroughly and often. In the lab, we need to be especially careful about using the instruments according to manual instructions, and about preventing cross contamination of specimens."

From Marilyn's perspective as a laboratory supervisor, sloppy or inattentive work habits can cause inaccurate test results, which can alter a patient's course of medical treatment and cause unnecessary stress and sometimes legal action. Therefore, she generally observes the work habits of employees she supervises before assuming equipment malfunction.

From the technologist's perspective, she realized that urinalyses results were probably incorrect, and asked her supervisor for help. She was eager to correct any errors in preanalytical technique, and took steps to ensure her test results were accurate.

From the perspective of the patients who provided specimens for analysis, and the physicians who ordered the tests, employees who are vigilant and eager to improve job performance are the first line of defense against errors in medical diagnosis and treatment.

Questions:

1. What can happen if a laboratory result is incorrect due to technician error?

2. Because Marilyn is working in a laboratory that contains hazardous material, what should her training include?

3. Describe the Clinical Laboratory Improvement Act (CLIA) and how it is related to this case.