AETCOM MODULE -1
2. General Principles of Laboratory Diagnosis
of Bacterial diseases
EXERCISE 2.2: DEMONSTRATE RESPECT FOR PATIENT
SAMPLES
Competency:
MI 8.11- Demonstrate respect for patient samples sent to the laboratory for the
performance of laboratory tests in the detection of microbial agents causing
infectious diseases
Specific Learning objectives:
At the end of the module students should be able to Describe and apply professional
and moral values related to patients’ clinical sample at the sample reception and
processing stage.
Identify the routine events in sample collection, transportation and storage that are
disrespectful to clinical sample.
Identify the ways to rectify them and demonstrate respect to patients’ sample
Describe and demonstrate application of ethical principles and medico legal issues in
laboratory results
In the given situation/case scenario, identify the events that show disrespect/breach in
confidentiality to the clinical sample /data and suggest ways to rectify them.
1. SAMPLE CASE SCENARIOS
BIOPSY SAMPLE OF A CRITICAL PATIENT GETTING REJECTED
BECAUSE IT WAS COLLECTED IN A FORMALIN SALINE.
Biopsy sample collected in formalin saline will not allow bacteria to grow and
culture of the sample will not yield any growth.
Biopsy sample requiring culture should be sent fresh and not in formalin.
In the situation where single specimen is only available, then a piece of it should
be removed in a sterile manner and sent for culture saving the rest of the
specimen for histology.
Make sure it is indicated on the requisition form that microbiology and histology
are performed on that one piece of biopsy sample.
Corrective Action
Request for fresh sample without formalin saline.
Clear instructions to be written in the request form regarding sample type,
amount, collection procedure, preservative if any required and its transportation
and storage protocol.
2. SAMPLE CASE SCENARIOS
LEFT OVER SERUM SAMPLE GETTING USED FOR RESEARCH
WITHOUT INFORMED CONSENT
Informed consent: The process of educating a person about the test and
obtaining permission to carry out testing is called “Informed Consent”
“Informed” means that the person has enough information to make an educated
decision about testing.
“Consent” refers to a person’s voluntary agreement to have the test done.
Failure to obtain informed consent is a crime. It is a medical malpractice and the
doctor can be charged with negligence.
Corrective Action:
Informed consent is mandatory and has to be obtained and documented before it
is used for research work.
3. SAMPLE CASE SCENARIOS
SAMPLE IS ACCOMPANIED WITH REQUEST FORM WITH
INCOMPLETE INFORMATION/WRONG PATIENT CREDENTIALS.
Laboratory request forms provide information about the laboratory test being
requested for.
They carry information such as the credentials of the patient, laboratory number,
doctor’s name, doctor’s signature and provisional diagnosis details.
Omission of information on the form may lead to laboratory errors.
These types of errors put the patient at the risk of transfusion-related death,
medication errors, misdiagnosis and mismanagement and reports delay.
A hospital should have proper policy and training for all staff handling and filling
the request form.
Corrective Action:
The sample will be rejected and will not be tested further.
Complete and correct information should be provided.
After receiving the proper and correct request form, the sample will be received
and processed further.
4. SAMPLE CASE SCENARIOS
UNDUE DELAY IN TESTING AND REPORTING OF A SAMPLE
REQUIRING EMERGENCY TESTING
Physicians rely on accurate laboratory test results for proper disease diagnosis
and for guiding the therapy. It is important that clinical decisions are based on
information derived from laboratory test results.
Undue delay results in delayed diagnosis and treatment, which can lead to serious
harm to the patients, or even death. Such delays in treatment can also become the
basis of medical malpractice suit.
The turnaround time (TAT) is defined by most laboratories is the time interval
between the specimen received in the laboratory to the time of reports dispatched
with verification. TAT is a metric used to monitor the efficiency and productivity
of the laboratory.
Corrective Action:
All the emergency tests should be processed and reported immediately.
Undue delays in testing and reporting should be avoided.
The importance of prioritizing the specimen as relevant to the clinical situation
should be discussed, documented and followed.
