Clinical Laboratory Science Research Articles

Exploring the Relationship Between Value Perception and Turnover Among Clinical Laboratory Scientists

Exploring the Relationship Between Value Perception and Turnover Among Clinical Laboratory Scientists

Comparative cross-sectional assessment of knowledge, attitude and practice among university students and employees towards the use of the microbiology laboratory equipment

Background: Continuous evaluation of students and employee’s knowledge and attitude in clinical laboratories is mandatory to ensure a high level of competency, proper practice and to assess the need for training, which shall be reflected on the quality of laboratory results. The aim of the present study was to evaluate the knowledge, attitude, and practice in microbiology laboratories among employees (at King Fahd Hospital of the University) and clinical laboratory students (at Imam Abdulrahman Bin Faisal University) Methods: This was a cross-sectional survey of 30 2nd year students, 26 3rd year students, 24 4th year students in the Clinical Laboratory Sciences department, and 30 employees. Participants completed a survey comprising 30 questions to assess their knowledge and attitude towards the use of equipment and practice in the microbiology laboratory. Results: The results indicated that there was no significant difference between the average scores of all levels of students regarding their knowledge (p = 0.85, 0.999, and 0.869), attitude (p = 0.883, 0.996, 0.853), and practice (p=0.633, 0.325, 0.858) in the microbiology laboratory. Employees scores (knowledge;5.03±2.646, attitude; 12.03±4.89, and practice; 7.7±6.11) were quite poor, as indicated by the lower average results than that of students (knowledge; 5.65±3.08, attitude; 13.25±5.33, and practice; 13.46±5.7). Conclusions: It is concluded that the knowledge, attitude, and practice of students and employees in the microbiology laboratory needs to be meticulously monitored and improved to ensure high achievement of learning outcomes and better overall performance in the laboratory. This may be achieved through using frequent quizzes and continuous education programs.

Sosialisasi Fungsi Vitamin dan Penggunaan Cairan Antiseptik Berbasis Alkohol dalam Pencegahan Covid 19 di Panti Asuhan Yatim Piatu Ar-Rodiyah Tembalang Semarang

The Covid-19 pandemic (Corona virus) is a pandemic transmitted by the corona virus that attacks humans, especially children and the elderly. The transmission of Covid-19 can be through droplets; therefore, it is necessary to prevent it through health protocol, namely clean and healthy living habits, including using masks, washing hands, maintaining distance, and increase body immunity, The purpose of community service is to provide education about the function of vitamins, and how to use an alcoholic-based antiseptic solution for children Ar-Rodiyah Tembalang Orphanage, Semarang. This activity was carried out by lecturers, D4 Health Analyst students and S2 Clinical Laboratory Science students at Universitas Muhammadiyah Semarang on January 31, 2021. The target of this activity was 51 children aged 8-20 years. The results of the implementation of community service at the Ar-Rodiyah orphanage Semarang were distributing 2 posters about the function of vitamins, and how to use an alcoholic-based antiseptic solution, then during the meeting an explanation of the material and the function of vitamins, and how to use an alcoholic-based antiseptic solution and questions and answers was delivered during the meeting. The conclusion from this community service increase knowledge of orphans about function of vitamin from 30 to 80 and knowledge to use alcohol-based antiseptic fluids correctly can increase from 45 to 90. The orphaned children also really hoped for sustainability of this community service activity with other counseling material.

Development of Histopathological and Cytopathological Techniques as Clinical Laboratory Sciences

Development of Histopathological and Cytopathological Techniques as Clinical Laboratory Sciences

Nursing and Clinical Laboratory Science Cocurricular Interprofessional Education Simulation

Nursing and Clinical Laboratory Science Cocurricular Interprofessional Education Simulation

Uncertified Facility (BSL 2 plus): Its Journey through Life for Preparations and Setting up, Compliance with Biosafety Regulations, Implementation, and Registration of the Facility with the Ministry of Health, Singapore

An uncertified facility is a facility not certified, as defined in the Biological Agents and Toxins Act (BATA) in Singapore, but has met the requirements of the Ministry of Health to possess First and Fifth Schedule biological agents and toxins. This type of facility is also known as a Biosafety Level 2 Plus (BSL 2+) facility. Registration as an uncertified facility or a BSL 2+ facility requires a certain process and procedure to be sought with the Biosafety Branch of the ministry. This review, shares first-hand knowledge on the journey to achieving registration of the authors’ facility. The procedure involved considerable preparation, setting up facility requirements, biosafety precautions, procedures and practices, and training and competence of laboratory users. The ministry conducted a thorough onsite facility audit to ensure that the facility requirements and biosafety procedures and practices were in place. It then issued an approval letter of possession for the first-time use of biological agents and registered the laboratory as an uncertified facility. The expectation is that the comprehensive information shared may be of great benefit to other facilities with similar interests. Copyright Ⓒ 2021 The Korean Society for Clinical Laboratory Science. All rights reserved.

Comparative cross-sectional assessment of knowledge, attitude and practice among university students and employees towards the use of the microbiology laboratory equipment

Background: Continuous evaluation of students and employee’s knowledge and attitude in clinical laboratories is mandatory to ensure a high level of competency, proper practice and to assess the need for training, which shall be reflected on the quality of laboratory results. The aim of the present study was to evaluate the knowledge, attitude, and practice in microbiology laboratories among employees (at King Fahd Hospital of the University) and clinical laboratory students (at Imam Abdulrahman Bin Faisal University) Methods: This was a cross-sectional survey of 30 2 nd year students, 26 3 rd year students, 24 4 th year students in the Clinical Laboratory Sciences department, and 30 employees. Participants completed a survey comprising 30 questions to assess their knowledge and attitude towards the use of equipment and practice in the microbiology laboratory. Results: The results indicated that there was no significant difference between the average scores of all levels of students regarding their knowledge (p = 0.85, 0.999, and 0.869), attitude (p = 0.883, 0.996, 0.853), and practice (p=0.633, 0.325, 0.858) in the microbiology laboratory. Employees scores (knowledge;5.03±2.646, attitude; 12.03±4.89, and practice; 7.7±6.11) were quite poor, as indicated by the lower average results than that of students (knowledge; 5.65±3.08, attitude; 13.25±5.33, and practice; 13.46±5.7). Conclusions: It is concluded that the knowledge, attitude, and practice of students and employees in the microbiology laboratory needs to be meticulously monitored and improved to ensure high achievement of learning outcomes and better overall performance in the laboratory. This may be achieved through using frequent quizzes and continuous education programs.

Comparative cross-sectional assessment of knowledge, attitude and practice among university students and employees towards the use of the microbiology laboratory equipment.

Background: Continuous evaluation of students and employee's knowledge and attitude in clinical laboratories is mandatory to ensure a high level of competency, proper practice and to assess the need for training, which shall be reflected on the quality of laboratory results. The aim of the present study was to evaluate the knowledge, attitude, and practice in microbiology laboratories among employees (at King Fahd Hospital of the University) and clinical laboratory students (at Imam Abdulrahman Bin Faisal University) Methods: This was a cross-sectional survey of 30 2 nd year students, 26 3 rd year students, 24 4 th year students in the Clinical Laboratory Sciences department, and 30 employees. Participants completed a survey comprising 30 questions to assess their knowledge and attitude towards the use of equipment and practice in the microbiology laboratory. Results: The results indicated that there was no significant difference between the average scores of all levels of students regarding their knowledge (p = 0.85, 0.999, and 0.869), attitude (p = 0.883, 0.996, 0.853), and practice (p=0.633, 0.325, 0.858) in the microbiology laboratory. Employees scores (knowledge;5.03±2.646, attitude; 12.03±4.89, and practice; 7.7±6.11) were quite poor, as indicated by the lower average results than that of students (knowledge; 5.65±3.08, attitude; 13.25±5.33, and practice; 13.46±5.7). Conclusions: It is concluded that the knowledge, attitude, and practice of students and employees in the microbiology laboratory needs to be meticulously monitored and improved to ensure high achievement of learning outcomes and better overall performance in the laboratory. This may be achieved through using frequent quizzes and continuous education programs.

Synergistic efficacies of thymoquinone and standard antibiotics against multi-drug resistant isolates.

Objectives:To explore the antibacterial activity of thymoquinone (TQ), a quinone extracted from Nigella sativa.Methods:This study was conducted from May 2019 to March 2020 at the Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia. The antimicrobial activity, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) of TQ were determined using an agar well diffusion method and broth microdilution assays, and the synergistic effect was evaluated using antibiotics in parallel. The disruptive effect of TQ on bacterial cell membranes was determined using scanning electron microscopy. The antivirulence properties of TQ, which include adherence and biofilm formation, were also investigated using adherence and biofilm formation assays, respectively.Results:Thymoquinone demonstrated bactericidal efficacy against 4/14 bacterial strains, with MIC range of 1.04-8.3 µg/mL and and MBC range of 10.41–66.66 µg/mL. Thymoquinone showed synergism against Klebsiella pneumoniae, Staphylococcus epidermidis (American Type Culture Collection 12228), Staphylococcus aureus, and Staphylococcus epidermidis in combination with the tested antibiotics. Thymoquinone inhibited bacterial adhesion by 39%-54%, 48%-68%, and 61%-81% at 0.5 × MIC, 1 × MIC, and 2 × MIC, respectively. The tested bacterial strains significantly inhibited biofilm formation after treatment with various concentrations of TQ for 24 and 48 hours.Conclusion:The combinatory effect of TQ with antimicrobials should be considered when developing new antimicrobial therapy regimens to overcome multidrug-resistant.

The Doctorate in Clinical Laboratory Sciences: A New Curriculum to Enhance the Connection of the Laboratory to Health Care Providers

This report discusses the need for a Doctorate in Clinical Laboratory Sciences program and describes a curriculum to train Doctorate in Clinical Laboratory Sciences students. The Doctorate in Clinical Laboratory Sciences program was developed to help reduce diagnostic errors in patient care by enhancing connections between the clinical laboratory and health care providers. Data are presented from program implementation in 2016 to 2017 academic year to 2019 to 2020 regarding the faculty and student demographics, program statistics (eg, admissions and attrition rates), and effectiveness. Perceptions of program effectiveness were obtained via surveys from 28 faculty physicians who supervised Doctorate in Clinical Laboratory Sciences students during clinical service rotations. Another survey assessed the preferred type of practice after graduation of 33 students. Over the 4-year period, the program had a 50% rate of admission and a 21.8% attrition rate. As of December 2020, 15 students graduated from the program. The majority (69%-82%) of physician faculty who completed the survey agreed that Doctorate in Clinical Laboratory Sciences students contributed positively at clinical rounds. Approximately two-thirds of students reported a preference to lead a Diagnostic Management Team or serve as an advanced practice provider in a Diagnostic Management Team with leadership provided by an MD/DO or PhD. This report provides useful information for other institutions that may want to establish similar Doctorate in Clinical Laboratory Sciences programs. Early data suggest that our program effectively trains doctoral-level advanced practice medical laboratory scientists, who may play an important role in improving patient safety by reducing diagnostic errors and providing value-based, optimal patient care.

Overutilization and Underutilization of Thyroid Function Tests are Major Causes of Diagnostic Errors in Pregnant Women.

The failure to order the correct diagnostic test at the right time is one of the major contributing factors of diagnostic error. Excessive testing can lead to added economic burden and addressing underutilization is precarious as clinicians often fail to order the tests that would improve diagnosis, prognosis, and management. A retrospective analysis of errors in test orders of thyroid function testing (TFT) in 321 pregnant women suspected of clinical and subclinical thyroid disorders was performed. Test selection was evaluated, and determinations were made about the extent of overutilization and underutilization of TFTs in reviewing each individual patient case by a Doctorate in Clinical Laboratory Science (DCLS) scholar. About 77% (247 cases) of the cases were found to have errors associated with test ordering for TFT. Of the cases reviewed, 18% cases were associated with overutilization, 53% of the cases were associated with underutilization, and 7% were associated with both (overutilization and underutilization). The annual cost burden because of ordering unnecessary tests was estimated to be approximately $13,000. The cost burden from errors resulting from not ordering a test would be of much greater magnitude but was difficult to estimate because underutilization has a ripple effect and may cause prolonged hospital stays, unnecessary medical bills, and delayed/ missed diagnosis leading to poor outcomes for patients. This study evaluated whether proper utilization of TFT were made at maternal health clinic locations of a large academic medical center in pregnant women to diagnose thyroid disorder and reported the issue of wastage of resources in the clinical laboratory. The study findings show significant errors in ordering of TFT for pregnant women in more than 75% of the cases that was based on evidence-based review of patient cases.

Body Mass Index and Its Association with Genetically Transmitted Traits.

Background Body mass index (BMI) is a metric widely used to measure the healthy weight of an individual and to predict a person's risk of developing serious illnesses. Study the statistical association between genetically transmitted traits and BMI might be of interest. Objectives The present study designed to extend the inadequate evidence concerning the influence of some genetically transmitted traits including ABO blood type, Rh factor, eye color, and hair color on BMI variation. Methods A total of 142 undergraduate female students of the Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia, were participated to investigate the possible linkage between genetic traits and BMI variations. Height and weight are collected from participants for BMI measurement. ABO blood type and Rh factor were determined by antisera. Results Out of 142 female students, 48 were categorized in the first tertile (T1: less than 19.8 kg/m2), 50 were categorized in the second tertile (T2: between 19.8 and 23.7 kg/m2), and 44 were categorized in the third tertile (T3: greater than 23.7 kg/m2). Chi-square analysis shows that there were no associations of genetic traits including hair color, eye color, ABO blood type, and Rh blood type with BMI. However, a significant association between hair color and BMI was observed using multinomial logistic regression analysis. Conclusions Our data provides a more robust prediction of the relative influence of genetic effects such as hair color on BMI. Future studies may contribute to identifying more association between genes involved in hair pigmentation and BMI variation.

Developing The Next Generation Of Clinical Laboratory Scientist Supervisors: A Study Of Supervisory Competencies In Clinical Laboratory

Abstract Introduction/Objective Developing the next generation of clinical laboratory scientist (CLS) supervisors who are competent and comprehensively prepared to meet the industry’s healthcare demands can be challenging. When a CLS is promoted to a supervisory position and then found to be incompetent due to the lack of experience, skills, knowledge and/or abilities. To identify the root cause of this phenomena a comprehensive review of the literature explored management competency theories and concepts (Katz’s three-skills approach, the Peter principle, Sandwith’s competency domain model, and National Center for Healthcare Leadership’s health leadership competency model). The management competency theories provided the foundational theoretical framework for this study. Methods Quantitative and qualitative data was used to address the research questions. A modified Tipton’s instrument/survey was used. The survey used demographic, open-ended, and Likert-type questions. Results This study had a total of 247 participants, who self-identified as CLS supervisor or manager, and completed an online survey. The results showed an increased competency level due to experience, continuous learning, mentors, formal education, leadership programs and delegation of tasks. The majority of the participants did not feel that the College of American Pathologists regulatory standard of a general CLS supervisor was sufficient to produce a competent CLS supervisor. Training and education was recommended to help transition CLS practitioner into the role of CLS supervisor. Other recommendations include mentors, succession planning, career ladder/leadership programs, experience, and support. Conclusion In order to develop the next generation of CLS supervisors, who are comprehensively prepared to meet the industry’s healthcare demands, healthcare organizations are going to need to employ evidence-based human resource management strategies. Human resource management strategies, such as training and development programs, leadership programs, mentor programs, and succession planning, should include administrative and interpersonal domain knowledge, skills, abilities and experience

Effects of Blackboard Resources Utilization on Students’ Performance in Molecular Biology Course

Abstract Introduction/Objective Molecular diagnostics utilizes structural and functional fundamentals of molecular biology and finds its scope in clinical education for disease diagnosis and monitoring, and evaluation of non-disease status. Time and financial constraints make molecular biology education challenging for both teachers and students. Advances in information technologies have helped teachers to provide a rich resource to students which if properly utilized is expected to generate better teaching-learning outcomes. However, the pattern of utilization of digital resources by students and its impact on their performance is still unknown. The aim of this study was to assess students’ behavior to Blackboard resource utilization and its impact on their performance in molecular biology course. Methods We conducted a retrospective cross-sectional study including all the 46 students (9 graduate and 37 undergraduate students; 14 distant and 32 regular students) enrolled for molecular biology course in the year 2017 and assessed the associations between blackboard resource visits and students’ final weighted total grades. Blackboard resource visit variables included “Tegrity” viewing duration, viewing times, and contents viewed (“My Grades”, “Announcement”, “Discussion”, “Contacts”, “Content Item”). Results Among all students, the most and least visited contents were “Content Item” (261 average hits) and “Contacts” (1.28 average hits), respectively with similar patterns of the visit among all student sub-categories. The longest average Tegrity viewing duration (25 hours) and the highest average Tegrity viewing times (56 hits) were noted among undergraduate distance students. The average grade was higher among graduate students than undergraduate students. The overall blackboard resource visit and the individual category visit among graduate and undergraduate students had no association with students’ final weighted scores. Conclusion Our findings have important implications for the utility of blackboard resources among graduate and undergraduate clinical laboratory science students. Similar assessments including students from many different years are recommended to generate more accurate evidence.

USING THE REQUIREMENTS OF TEACHING AND LEARNING STANDARDS TO ACHIEVE THE STANDARDS OF THE EDUCATION EVALUATION COMMISSION IN KSA: AN APPLICATION ON THE ACADEMIC PROGRAMS IN THE FACULTY OF APPLIED MEDICAL SCIENCES IN NAJRAN UNIVERSITY.

This study aimed to realize the extent of the fulfillment of the standard of teaching and learning according to the standards of the Education Evaluation Commission in KSA for the academic programs in the Faculty of applied medicine science - Najran University. These programs have already got the international accreditation from AHPGS in 2015 to 2020. Thus, the study has targeted the beneficiaries of this standard. These beneficiaries are students and the teaching staffs of the three programs (Clinical laboratory, physiotherapy and Radiation science programs) to disclose the differences of the fulfillment of this standard in the light of the variables of programs and categories (students and teaching staffs) in addition to the gender regarding the program of radiation science (track of male and female). The researchers have used the descriptive approach, the sample of the research are 37, 28 and 64 students, 16,17 and 9 teaching staffs from the programs of medical laboratory, physiotherapy and radiation sciences, respectively for the academic year 2018/2019 during the second semester. The researchers have used the questionnaire as a tool to collect data. Two questionnaires were designed. The first one is directed to the students in each program. This one contained 40 items, which distributed to 3 subjects. However, the second has directed to the teaching staffs, contained 49 items, which also distributed to 3 subjects. The most important results of this study is that the procedures regarding each sub-standard (study subjects) proved to be highly sufficient, especially from the teaching staffs’ point of view. The study has come out with some recommendations which will lead to fulfill the standard of teaching and learning well, among them the graduates’ characteristics should be announced, the targeted outcomes of learning from the students’ academic programs and the other service beneficiaries by various advertising means whether in paper or electronic, linking between the needs of labour market and the outcomes of the program through holding appropriate training agreements with the bodies in which students employed, promote the evaluation approaches used in the program to cope with the measurement of learning outcomes, the administration of the program should lay down appropriate mechanism to review the program and measure students’ acquirement of the outcomes of learning periodically and based upon the feedback from the evaluation process, care of integration of the students in the committees of organizing workshop and symposia and invite all students of the program, urging them to participate actively in these workshops. (Keywords: Academic standards, teaching and learning standard, Najran University)

An Effect of Big Five Personality Traits of Clinical Laboratory Science Students on Their Academic Satisfaction: Mediated Effect of Career Preparation

An Effect of Big Five Personality Traits of Clinical Laboratory Science Students on Their Academic Satisfaction: Mediated Effect of Career Preparation

In memory of Professor Rolf Neth October 6, 1926 – March 17, 2020

With great sadness, we learned of the passing of Professor Dr. med. Rolf-Dietmar Neth, the founder of the Wilsede meeting, on March 17, 2020, aged 93 in his home town Buchholz near Wilsede/Lüneburger Heide. Rolf Neth was born 6.10.1926. After the 2nd World War, Rolf Neth studied Medicine from 1949 to 1955 at the University of Göttingen. Then he was at the Max-Planck-Institut für Experimentelle Medizin (University Göttingen, 1956-1957), and promoted his skills in clinical and experimental hematology in St. George Hospital (1958-1959) in Hamburg. From 1960, his activity was connected with the pediatric clinics of Hamburg University where he became a Professor at the Children Hospital in 1972. From 1970 to 1980, Rolf Neth was occupied implementing new laboratory diagnostic approaches in the booming field of clinical hematology. Blood cancer treatment was developed, due to novel drugs invented to combat leukemic cells and rescue the small patients which 10-20 years ago had only zero chance to survive. Histo- and immunochemical diagnostics became routine tests for evaluation of clinical forms of leukemias and efficiency of their therapy. Since 1982, he coordinated laboratory hematology at the Department of Clinical Chemistry, University Hamburg, until retirement in 1992. Along with contribution to clinical laboratory science, Professor Neth, over 1973 to 2002, arranged a series of famous Wilsede Meetings "Modern Trends in Human Leukemia" dedicated to leukemia research and treatment. Rolf Neth and Robert Gallo decided time and topic of the meeting, and Rolf Neth proposed a place, i.e., a lonely village in the Luneburg heath, not far from his home. Hence, Leukemia and Viruses was selected as a specific topic for a meeting in Germany, because it was timely for convergence between clinical medicine and cancer biology. Rolf Neth organized the first Wilsede meetings himself for more than 20 years, until he passed these efforts to Wolfram Ostertag and Axel Zander. In the late 1990s, Carol Stocking and Boris Fehse took on this responsibility. Over last years, Wilsede meetings were arranged by Nicolaus Kröger and Boris Fehse. And as long as his health permitted, Rolf Neth came along to see how his baby was doing. He participated and assisted at any stage of the next meeting. We are thankful to have had the privilege of knowing and cooperating with Rolf Neth and to cherish his legacy by keeping the Wilsede tradition alive. He was married with Hanne-Lore Cohrs, 8.11. 1958, survived by his wife of 62 years Hanne-Lore, and four sons and several grandchildren.

Red Cell Alloimmunization and Autoimmunization in Multi-Transfused Thalassemia Patients in Sulaymaniyah Province-Iraq

Thalassemias are considered important health issues throughout Iraq, involving its Kurdistan region. This disorder, particularly its major form, needs lifelong regular transfusions. But this form of medical care is associated with various complications including red cell alloimmunization and autoimmunization. This study determined the frequency and associations of alloimmunization among multi-transfused patients with β-thalassemia major. The subjects were 204 patients who were registered at a thalassemia care center in Sulaymaniyah-Iraqi Kurdistan. The patients’ records were analyzed, their red cells were phenotyped for ABO/RhD antigens using the gel card method, and irregular antibody screening/identification was performed using the standard tube method. Alloantibodies were detected in 5.8% of the patients, while DAT was positive in 4% of the patients, which indicated autoantibodies. The identified alloantibodies were anti-E (2.4%), anti-C (1.4%), anti-e (1%), and anti-K (1%). A patient’s age at the start of transfusion (＞2 years) (P=0.042) and a positive history of transfusion reactions (P=0.003) were correlated with a significantly higher rate of alloantibody formation. From the results of our study, we conclude that measures to decrease the development of alloantibodies may incorporate matching for Rhesus and Kell systems and early induction of blood transfusions. Copyright Ⓒ 2020 The Korean Society for Clinical Laboratory Science. All rights reserved.

Determination of Antimicrobial Prescribing Practices in an Integrated Health System Emergency Department

Antibiotic stewardship utilizes interprofessional collaborative practices, including professionals from medicine, pharmacy, nursing, social services, and clinical laboratory science, to identify potential problems proactively. A tertiary care integrated health system's Emergency Department (ED) aimed to identify antimicrobials prescribed to the outpatient community as part of a proactive antimicrobial stewardship project. A pilot, prospective, snapshot of a tertiary community hospital's outpatient antimicrobial prescribing habits was conducted. All subjects were identified via a daily report of patients discharged from the ED over 30 days in the summer of 2017 and individually reviewed for prescribed antimicrobial(s). Exclusions were hospital admission, antimicrobial sensitivity, and antimicrobial courses less than five days or more than 14 days. The primary goal was determining the number of antimicrobial oral tablets/capsule prescriptions to adult outpatients within a 5 to 14-day treatment window. Secondary goals were to include the diagnosis, non-capsule/tablet antimicrobial, pediatric patients, and prescriptions outside the treatment window. Total number of antimicrobial prescriptions over the 30-day period was 653 in 5,520 individual visits. Total number of adults prescribed oral antimicrobials was 467 (15.6 daily). Patients were diagnosed with infections including urinary tract, cellulitis, soft tissue injury, abscess, upper respiratory, dental caries, gastrointestinal, sexually transmitted, otitis media/externa, pneumonia, viral, pyelonephritis, tick-borne, fungal, Bell's Palsy, and sepsis. The number of non-adult, non-oral, and outside window treatment antimicrobial prescriptions were 186 (6.2 daily). With an average 184 patients treated in the ED daily, approximately 11.8% received antimicrobial treatment on discharge. Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health. Areas of practice improvement were identified inadvertently as a result of this project. Potential future studies included seasonal variability, whether the patient obtained a prescription and complied with treatment, and differences between inpatient and outpatient antimicrobial prescribing practices.

Assessment of antinuclear antibodies by indirect immunofluorescence assay: report from a survey by the American Association of Medical Laboratory Immunologists.

The indirect immunofluorescence assay (IFA) using HEp-2 cell substrates is the preferred method by some for detecting antinuclear antibodies (ANA) as it demonstrates a number of characteristic staining patterns that reflect the cellular components bound as well as semi-quantitative results. Lack of harmonized nomenclature for HEp-2 IFA patterns, subjectivity in interpretation and variability in the number of patterns reported by different laboratories pose significant harmonization challenges. The main objectives of this study were to assess current practice in laboratory assessment of HEp-2 IFA, identify gaps and define strategies to improve reading, interpretation and reporting. We developed and administered a 24-item survey based on four domains: educational and professional background of participants, current practice of HEp-2 IFA testing and training, gap assessment and the perceived value of International Consensus on Antinuclear Antibody Patterns (ICAP) and other factors in HEp-2 IFA assessment. The Association of Medical Laboratory Immunologists (AMLI) and American Society for Clinical Pathology administered the survey from April 1 to June 30, 2018, to members involved in ANA testing. This report summarizes the survey results and discussion from a dry workshop held during the 2019 AMLI annual meeting. One hundred and seventy-nine (n = 179) responses were obtained where a significant number were clinical laboratory scientists (46%), laboratory directors (24%), supervisors (13%) or others (17%). A majority of respondents agreed on the need to standardize nomenclature and reporting of HEp-2 IFA results. About 55% were aware of the ICAP initiative; however, among those aware, a significant majority thought its guidance on HEp-2 IFA nomenclature and reporting is of value to clinical laboratories. To improve ICAP awareness and further enhance HEp-2 IFA assessment, increased collaboration between ICAP and the clinical laboratory community was suggested with emphasis on education and availability of reference materials. Based on these suggestions, future efforts to optimize HEp-2 IFA reading, interpretation and reporting would benefit from more hands-on training of laboratory personnel as well as continuous collaboration between professional organizations, in vitro diagnostic manufacturers and clinical laboratories.