CHAPTER ONE

LABORATORY
CHAPTER ONE
THE LABORATORY

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 Objectives
 After completion of this chapter, the student will be able to:
1. Define laboratory.
2. Identify and enumerate the different kinds of medical
laboratories.
3. Explain the role of medical laboratory services.
4. State the laboratory rules, ethics, professional code of
conduct and polices.

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Outlines
1.1: General overview
1.2: Classification of laboratories
1.3: Structure of laboratory services
1.4: Role of clinical laboratory services
1.5: Function & use of different medical laboratory
department/units
1.6: Role of medical laboratory personnel
1.7: Laboratory rules and policies

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1.1: General overview
 Defn: Laboratory – is a place that is equipped with different
instruments, equipments, chemicals etc for performing either
experimental works or research activities
 Medical laboratory is part of the laboratories that is
equipped with various biomedical instruments and chemicals
for performing different lab diagnostic activities by using
biological specimens. (Whole blood, serum, plasma, urine,
stool, sputum etc). It is also called clinical laboratory science

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History
 Medical laboratory sciences have existed as a part of
healthcare for almost one hundred years.
 Initially laboratory physicians (pathologists) and/or academic
researchers trained individuals to perform procedures under
their guidance.
 In the 1950s and 1960s, the explosion of knowledge in the
biological and clinical sciences, the development of
automation and more sophisticated laboratory techniques
and its relevance to the delivery of health care, created the
need for well defined and more academically organized
medical laboratory science program.
 By the 1980s many degree granting institutions had
established curricula in medical laboratory science.
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History…
 The professional requirements of medical laboratory science
advanced from “no formal qualification” in the 1940s and
1950s, to bachelor’s degree, followed by the master’s
degree and doctoral degree programs in the last 30 years.
 Today, medical laboratory science is a well developed body
of knowledge that includes portions of basic and medical
sciences, medical techniques and research methods.
 This facilitates and ensures the production of quality medical
diagnostic testing.

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1.2: Classification of laboratories

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Classification of laboratories cont’d
 Risk group III
 High individual & low community risk

 A pathogen that usually produces human disease but

does not ordinarily spread from one infected individual to

another.)
 E.g. Brucella, clostridium botulism
 Risk group IV
 High individual & community risk

 A pathogen that usually produces serious human

diseases & may be readily transmitted from an individual

to another directly or indirectly within the community.
 No effective prophylaxis or treatment

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Classification of laboratories cont’d
1.Basic lab. (Level 1 and level 2 laboratories)
 It is the simplest kind.
 It is adequate for work at the PHC and hospital
diagnostic lab.
 It is adequate for work with organisms in risk group 1 and 2
i.e. Low risk.
2. Containment lab –( level 3)
 More advanced and it is used for work with infections
organism E.g. TB, salmonella – risk group -3
 The principle is to remove from basic lab those organisms
which are particularly hazards.
 The objective is to expose as few people as possible to the
risk of infection

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Classification of laboratories con’d
1.It is a separate room with controlled access by authorized

staff only
2. It should be fitted with a microbiological safety cabinet.
3. Its ventilation should be arranged.
3. Maximum containment lab (level 4)
 intended for work with viruses.
 Risk group-4 for which the most strict safety precautions
are
necessary.
 These labs are usually separate buildings with strictly
controlled access through decontaminant showers.
 All air from rooms is filtered before discharge to the
atmosphere
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1.3: Structure of laboratory services
A medical Laboratory service must be integrated with the health
care system which exists in the country.
- This is function as a network, which could be accessible and
provide a service that is needed by the community.
This Networking consists of:
A. community-based health center lab:-
I). comprehensive health centers lab.
 investigation controlling and preventing major disease in a
community
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Structure of laboratory services cont’d
 staffed by lab personnel
 Promote health by health education
 Able to perform basic tests.
ii). Maternity health units (MCH)
Staffed with nursing staff trained by MLT and responsible in :
 Screening for anemia and proteinuria.
 Collecting blood for antibody screening or for
examination of parasites

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Structure of laboratory services cont’d
B. District Hospital laboratories (DHL)
In addition to the work stated above the laboratories have an
important role in:
 Supervising the work of community-based health center lab.
 Testing referred specimens
 has facilities for clinical investigations and epidemiological
surveys
 Specimen collection and transportation system
 Patients attending health center to benefit from the facilities of DHL
 Epidemics to be investigated rapidly

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Structure of laboratory services cont’d
C. Regional (hospital) laboratories
 In addition to the work stated above the laboratories
 It assists and supervise the DHL

 Analyses referred samples

 Perform a range of specialized testes

 Investigate epidemic and do more clinical and public

health facilities
 Trains lab technicians by organizing refresher courses

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Structure of laboratory services cont’d
D. Central (hospital) and public health laboratories
In addition to the work stated above the laboratories
• It assists and supervise the DHL
• Analyses referred samples
• Perform a range of specialized testes
• Investigate epidemic and do more clinical and public
health facilities
• Trains lab technicians by organizing refresher courses

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1.4 Medical Laboratory and Its Function in a Health
Care System.
 Laboratory has an important role in improving the
 quality
 efficiency
 cost effectiveness
 planning and management of the health care system .
 They are divided into three :

I. providing quality health care service

II. achieving efficiency and cost effectiveness in health

care system.
III. achieving good health planning and management

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Medical Laboratory and Its Function in …………

A. The role of laboratory in providing quality health care

1.laboratory investigation increase the accuracy of disease
diagnosis.
 Many infectious disease and serious illness can be
diagnosed by using the laboratory.

 E.g. error in diagnosis of malaria is high when diagnosis

is on clinical symptoms only.

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Medical Laboratory and Its Function ………..
2. Laboratory has essential role in screening for ill health and
assessing response to treatment.
 Assess a patients response to drug therapy
 Screen individuals with infectious disease. E.g. TB, sexually
transmitted diseases
 Screen whole blood and blood product for transfusion
transmitted pathogen
 Screen pregnant women for anemia, infections which may
transmitted to newborn and others

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Medical Laboratory and Its Function ………..
3. The laboratory is needed to work with other in reducing
infection in the community and investigating epidemics rapidly.
 Detecting source of infection, identifying carries contact tracing
 Participating in epidemiological surveys
 On site testing and collection and dispatch of specimens when
an epidemic occurs
 Participating in health education
B. The role of laboratory in achieving efficiency and cost
effectiveness in health care system.
1. The laboratory reduce the expenditure of money on drugs.
 Drugs can be used more selectively and only when
needed
 Drug resistance can be identified more rapidly and

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monitored 19
Medical Laboratory and Its Function in ………

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Medical Laboratory and Its Function in ………..
C. The role of laboratory in achieving good health planning
and management
1.Reliable laboratory test result with relevant patient data,
provide information on the health status of a community,
health pattern and disease trend. This information is needed to
establish health care priority and plan:
 Health care program
 Training of health personnel and delivery of health service
 Treatment schedule and change in drug usage
2. public heath laboratories provide accurate epidemiological
information for health planning
 cause of the disease in the community
 prevalence and incidence rate of infectious disease

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Medical Laboratory and Its Function in ……
With out reliable lab support:
I. Patients less likely to receive the best possible care
II. resistance to essential drugs will to continue to spread
III. the source of disease may not be identified correctly
IV. epidemics and spread of major communicable diseases will
not be checked reliably
V. Valuable financial and human resource may not use
properly.

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Medical Laboratory and Its Function ………
 Indications (importance) of requesting lab examinations
are:
 To make a diagnosis of pathogen.
 Confirm a clinical impressions
 To provide prognostic information

 To provide therapeutic guidance so that:

 Drugs can be used more selectively
 Patterns of emerging drug resistance can be identified
 Side effects and progress are monitored.
 To screen for disease.

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1.5: Function & use of different medical laboratory
department/units
 Hematology- deals with examination of the constituent of
blood.
 Clinical chemistry – deals with measurement of various bio-
chemicals changes in serum and body fluids.
 Medical microbiology - deals with microorganisms of
medically important, performing different diagnostic and
research activities on micro organisms and parasites .
Microbiology includes the following sub disciplines
 Bacteriology is a science dealing with bacteria
 Virology is the study of virus and viral disease
 Mycology is the study of fungi
 Parasitology: is the study of parasites.
 Immunology: study about immune system
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Function & use of different medical laboratory…….
 Immunohematology- deals with blood banking and transfusion
medicine.
 Urinalysis and body fluid analysis- deals with the analysis of
their constituent.
 Serology- is the study of antigen and antibody and their
interaction in vitro.
 Molecular biology :branch of biology that seeks to understand
the molecular basis of life. In particular, it relates the structure of
specific molecules of biological importance—such as proteins,
enzymes, and the nucleic acids DNA and RNA—to their
functional roles in cells and organisms.

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1.6: Role of medical laboratory personnel

Introduction:
 Medical laboratory is a health profession its goal is to resolve patients’
problem presented to the physician by performing laboratory analysis.
 Roles:
1. Diagnosing of diseases
 Errors occur when diagnosis of diseases depend on
clinical symptoms alone.
2. Treating of diseases
 Antibiotic sensitivity testing
 Monitoring of patients response to treatment
3. Screening of diseases
 Detection of in apparent infections
4. Control of epidemics
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Role of medical laboratory ……..
5. Surveillance & provision of health information
 Source identification

 Water supply testing

 Carrier identification
 Risk factor assessment
6. Controlling field trials
 New drug/vaccine testing

 Vaccine potency test

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Role of medical laboratory ……..
7. Management of finance, equipment and supplies
8. Ensuring a reliable and quality lab practice
Such a comprehensive commitment to quality is essential to
achieve –
 best possible service to patients
 user confidence
 effectiveness and efficiency
 accountability
 optimal use of recourses

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1.7: Laboratory rules, ethics and policies
 Ethics-moral principle or rules of behavior that govern or
influence a person’s behavior
 Rule-a statement of what, should or must be done in particular
circumstance.
 Code of conduct -a set of professional standards agreed on by
members of a particular profession
Code of conduct for medical laboratory personnel
 Should include those practices and attitudes which characterize
a professional and responsible lab officer.
 Adopting it helps to remind medial laboratory personnel of their
 Responsibility to patients
 Duties to up holds professional standards and
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 Need to work with complete integrity.
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 Laboratory rules……
1. Place the wellbeing & service of the patient above your own
interest.
2. Be loyal to your profession by maintaining high standard of
work & striving to improve professional skill & knowledge
3. work scientifically & with complete honesty
4. don’t misuse your professional skill or knowledge for
personal gain
5. never take anything from your place of work that does not
belongs to you
6. don’t disclose to a patient or any other unauthorized person
the result of your investigation
7. treat your patient with strict confidentiality

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Laboratory rules…..
8. Respect & work in harmony with other members of your
staff or health center team.
9. Be any time courteous, patient, considerate to the sick &
their relatives.
10. Follow safety procedures & know how to apply first aid.
11. Don’t drink alcohol or unprescribed drugs that would
interfere to your work performance during laboratory
working hours.
12. use laboratory equipments with care
13. Don’t waste reagents & other supplies.
14. Safeguarded the dignity & privacy of the patient.

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Laboratory rules…..
Laboratory policies
 Laboratory policies are those decisions which are taken in
consultation with other medical staff to enable a laboratory to
operate reliably and effectively in harmony with other
departments.
 These policies usually cover:

A. Laboratory hour and emergency work

B. Range of tests to be performed and those to be referred to
higher level.
 Range of tests to be performed depend on
 The number of material resources
 The availability of material resources
 The types of health institution
 Referral of specimen
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Laboratory rules….

C. Collection of Specimen
D. Work load capacity of the laboratory
E. Delivery of laboratory reports

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