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Molecular Medicine: Current Aspects

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Review Article

Current Review on Infamous Practices in Medical Laboratory Science Profession

Nosa Terry Omorodion, Achukwu PU, Gabriel Uzoma Umeh, Wilson Ogbonna Ajanwachuku, Esohe Amanda Igharo

Correspondence Address :

Nosa Terry Omorodion
Health Services Department
University of Benin
Benin City, Nigeria
Tel: 08136742270
Email: terry.omorodion@uniben.edu

Received on: October 17, 2017, Accepted on: November 28, 2017, Published on: December 06, 2017

Citation: Nosa Terry Omorodion, Achukwu PU, Gabriel Uzoma Umeh, et al. (2017). Current Review on Infamous Practices in Medical Laboratory Science Profession

Copyright: 2017 Nosa Terry Omorodion, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract
Infamous: Well known for some bad quality or deeds. Infamous practices could mean a lot of disreputable qualities Infamous practices therefore, means dishonorable, disreputable practices by professionals. Impact of Laboratory Testing Error on Patient Health Medical diagnosis and therapy greatly depend on laboratory test results, and test result errors expose patients to a significantly higher risk of inaccurate diagnosis and improper treatment. A CMS study of waived testing laboratories indicates that incidents of failure to follow manufacturers' instructions may occur in as many as 60,000 laboratories and that this may potentially harm patients.

Keywords: Infamous, Practices, Laboratory
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Introduction
Infamous: Well known for some bad quality or deeds. wicked, abominable, outrageous, disreputable, ill-fame, discreditable, shameful, dishonorable, scandalous, heinous, vile, unspeakable. Infamous practices could mean a lot of disreputable qualities Infamous practices therefore, means dishonorable, disreputable practices by professionals [1]. Skill is often seen as an attribute of individuals. It is not just knowledge but the "ability to do something well". Skill almost invariably entails invention and is contextual. Since skill is hard to measure people often use "years of schooling" as a substitution for skill possession. But this view can be very misleading [2]. A medical Laboratory scientist is that person who studied medical laboratory sciences and has been licensed to carry out medical laboratory test or diagnosis [3].
Due to the complexity of laboratory medicine and its significance in quality patient care, it is Important that laboratory personnel possesses the necessary qualifications, to ensure they are professionally competent. Licensure and certification programs not only set minimum standards for medical laboratory personnel working in clinical laboratories; they also help ensure quality laboratory testing and proper patient care.

Licensure vs. Certification


There are two types of occupational regulation: licensure and certification. The two terms are often confused with each other but they are not interchangeable. Certification by governmental entities is also sometimes confused with certification by nongovernmental (private) organization. Certification is defined as being a less restrictive form of occupational regulation than licensure. Health care personnel can be certified without being "licensed," as is the case with many clinical laboratory personnel.
Licensure is the most recognized type of occupational regulation. Licensure refers to the right given by a governmental agency or individual to engage in a legally defined occupational scope of practice. Licensure can address the preservation of a licensee's skill through continuing education and/or proficiency requirements. It can also "provide a universal standard for entry-level personnel" [4].
It is an established fact that laboratory operations, including testing, have a major role in evaluating and handling patient health. The mandatory employment of certified laboratory workforces would have ensured that individuals with adequate training were doing that laboratory testing. Technicians only requires a high school diploma to perform moderately complex testing such as performing blood types on patients needing blood transfusions, drug screens and complete blood counts with a microscopic white blood cell differential. These individuals are not trained to catch leukemia cells on a blood smear. These are life-altering services that must be correct. With children, misdiagnosis can lead to advanced disease progression and in some cases increased rates at which diseases are transmitted, more hospital admissions, longer hospital stays, increased healthcare costs and an overall negative impact on public health. Rapid, accurate laboratory testing decreases healthcare costs. Important, and often critical, medical decisions are made based on the results of laboratory tests. Inaccurate tests lead to unnecessary treatments and reduce patient confidence. Simply put, patients get treated correctly and more quickly with accurate laboratory tests. In turn, patients are released from hospitals faster, and patients treated outside the hospital require less costly treatment. Inaccurate tests are a particular concern for vulnerable populations such as children and the elderly.
In our global world, emerging and reemerging diseases are arriving at our doorstep more than ever. Clinical laboratories and qualified, licensed personnel are needed as with the recent and Ebola outbreak, measles and healthcare associated infections such as MRSA and Clostridium difficile (C. diff). We play a vital role in potential bioterrorism and pandemic (influenza) threats from influenza and other infectious diseases [5]. While most hospitals and clinics in the Nigeria can be trusted to hire suitably educated and certified laboratory professionals, there is a concern that medical laboratories are beginning to hire non-certified workers in response to a growing shortage of qualified laboratory personnel. This issue is about public safety, quality health care and increased health care cost. There is no guarantee that your medical laboratory tests are being performed by qualified medical laboratory personnel. A lack of licensing denies access to scholarships and other funding provided for other higher education students, such as for the radiographers' shortages that are very similar to our own.

Infamous Practices as it Affect Various Steps in Laboratory Practices

Pre-analytic

This the first step of laboratory diagnosis, if anything goes wrong here with the pre analytical stage, the scientist will have wrong results. A lot of errors could arise from the pre analysis of patient samples when the collection center is mount by an unskilled personnel in the area of medical laboratory practices. Pre analytical errors can arise from improper labeling of sample containers, wrong sample container, fixatives, and so on. All of this errors are bound to happen when the laboratory personnel is not licensed to practice, we have heard many cases of chemist, biochemist, microbiologist, doctors, pharmacist posing as a medical laboratory scientist. Some pharmacist having a small laboratory in their shops and performing laboratory test themselves, Hospital with laboratories being mounted by a none Medical Laboratory scientist, Pharmacist conducting laboratory diagnosis, chemist running laboratory test and issuing laboratory test result, nurses taking the job of a medical laboratory scientist, so many infamous and sharp practices putting the huge populations of Nigeria populace at risk of misdiagnosis.

Analytic errors

This includes machine malfunction, unqualified personnel handling analysis, the use of expired reagent, economizing reagent, improper storage of laboratory reagent for analysis and so on. Also the tech can fail to follow standard operating procedure or incorrectly identify or classify cells under the microscope.

Post-analytic errors

Errors transferring data to computer files, typing errors, physicians misread results.
Ways to minimize errors or infamous practices in medical Laboratory practices
1. By employing the services of a qualified personnel
2. Routine check of Medical Laboratory, Hospitals and Pharmacist for possible quackery
3. Implementation national external quality assessment program or control in all Laboratories, secondary and tertiary health facilities.

Practical implication of infamous practices and need for improvement

The clinical implications of sharp practices or infamous practices will lead to issuance of false positive or negative results to the clinician, which could lead to wrong treatment, Thereby resulting in death of the patient. There is urgent need to curb sharp practices for the sake of the patients. Proper regulatory body should be put in place to monitor infamous practices in the Medical Laboratory practices and the health sector in general.

Conclusion

Impact of Laboratory Testing Error on Patient Health Medical diagnosis and therapy greatly depend on laboratory test results, and test result errors expose patients to a significantly higher risk of inaccurate diagnosis and improper treatment. A CMS study of waived testing laboratories indicates that incidents of failure to follow manufacturers' instructions may occur in as many as 60,000 laboratories and that this may "potentially harm patients" [6]. Without adequate training of laboratory personnel, the likelihood of inaccurate test results increases [7]. A study of problems in laboratory testing in primary care estimates that more than 16 percent of incorrect test results affect patient care. 19 HCFA suggests that these patient care impacts include delays in receiving appropriate care and the possibility that inappropriate or harmful diagnoses or treatments could result in injury or death [8].
References
1. Rohde RE, Falleur DM, Ellis JR. Almost anyone can perform your medical laboratory tests - wait, what?. 2015.
2. SMITH R. Understanding the entrepreneur as socially constructed. 2006.
3. Farr, J. Michael; Laurence Shatkin. Best jobs for the 21st century. JIST Works. 2004;460.
4. Occupational Regulation: A Program Evaluation Report. Office of the Legislative Auditor. State of Minnesota. 1999;xii.
5. State-Mandated Licensure of Laboratory Personnel. LabMedicine. 2004;35(10);596-598.
6. Certificate of Waiver and Provider Performed Microscopy Procedures Pilot Project Overview. U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services. 2001.
7. Stull TM, Hearn TL, Hancock JS, Handsfield JH, Collins CL. Variation in Proficiency Testing Performance by Testing Site. JAMA. 1998;279(6):463-467.
8. Nutting PA, Main DS, Fischer PM, Stull TM, Pontious M, Boone DJ, Holcomb S. Problems in Laboratory Testing in Primary Care. JAMA. 1996;275:635-639.
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