ANALYSIS OF URINE AND BODY FLUIDS SAFETY IN THE CLINICAL LABORATORY

1. Safety in the
Clinical
Laboratory
PREPARED BY:
LGG,RMT
ANALYSIS OF URINE AND
OTHER BODY FLUIDS

2. LABORATORY STANDARDS
● CLSI (Clinical Laboratory Standards Institute)
- Formerly NCCLS
- Publishes national and international standard documents on a variety
of laboratory testing procedures and policies for guidance on
achieving better testing outcomes.
QUALITY ASSESSMENT
❏ Variables Affecting the Quality of Laboratory Testing

3. LABORATORY STANDARDS
QUALITY ASSESSMENT
❏ Establishing a Quality Assessment Program o effective communication
● adherence to established policies
● accurate and thorough documentation practices
● use of delta checks
● timely verbal reporting of all critical values
❏ Performing Quality Control Tests
❏ Quality Control
● A set of procedures and practices to monitor the testing
process and verify the reliability, accuracy, and precision of
the test.
● You must monitor each test with standards and controls (at
least two levels)
● New tests must be validated

4. LABORATORY STANDARDS
QUALITY ASSESSMENT
❏ Participating in Proficiency Testing
● External proficiency testing is mandated by CLIA ‘88
● Unknowns from CAP or other approved lab
● Internal proficiency testing is also helpful for quality
● Establishing a Quality Assessment Program Ensures
SAFETY IN THE CLINICAL LABORATORY
● OSHA (Occupational Safety and Health
Administration)
- Worker safety issues
● CDC (Centers for Disease Control and
Prevention)
- Implements public health regulations,
monitors reportable diseases and trends,
categorizes lab tests

5. TYPES OF SAFETY HAZARDS
1. BIOHAZARDS - biological substances that pose a threat to the health of living
organisms, primarily that of humans. This can include medical waste or
samples of a microorganism, viruses, or toxins (from a biological source) that
can affect human health.
a. Chain of infection
- Source
- Mode of Transmission
- Susceptible Host
b. Proper Handwashing and Personal Protective Equipment (PPE)
UNIVERSAL PRECAUTIONS:
1. All patients considered as possible carriers of bloodborne pathogens.
2. Recommends wearing of gloves, face shields, proper disposal of sharps.
3. EXCLUDED: urine & body fluids not visibly contaminated with blood

6. TYPES OF SAFETY HAZARDS
BODY SUBSTANCE ISOLATION:
1. Modification from Universal Precaution.
2. Not limited to bloodborne pathogens
3. Personnel at all times should wear gloves
4. MAJOR DISADVANTAGE: does not recommend hand washing after removal of gloves
unless visual contamination is present.
STANDARD PRECAUTION
PATIENT-CARE EQUIPMENT
HANDWASHING
LINENS
ENVIRONMENTAL CONTROL
GLOVES
MASK, EYE PROTECTION & FACE SHIELD
PATIENT PLACEMENT
OCCUPATIONAL HEALTH & BLOOD BORNE PATHOGENS
GOWN

7. Personal Protective Equipment
1. Gloves
2. Fluid-resistant gowns
3. Eye and Face shields
4. Centrifuge using capped tubes or cover centrifuge when using
5. Special precautions to specimen submitted via suspicious containers
Handwashing
- Hand contact as number one method of infection transmission
Disposal of Biological Waste
1. Incineration - is the high-temperature burning (rapid oxidation) of a waste. It is also known as
controlled–flame combustion or calcination and is a technology that destroys organic constituents in
waste materials.
2. Autoclaving - 15 minutes in 121⁰c 15 psi
3. Pick-up by certified hazardous waste company

8. TYPES OF SAFETY HAZARDS
2. SHARP HAZARDS
- Discard sharps in puncture resistant containers located within work
area.
3. CHEMICAL HAZARDS
Chemical Spills
● Flush area with large amount of water
● Contaminated clothing should be removed immediately
● Do not neutralize chemicals
Chemical Handling
● Never mixed chemicals unless specified
● Wear goggles when preparing reagents
● Do not pipette by mouth

9. TYPES OF SAFETY HAZARDS
Chemical Hygiene Plan
OSHA also requires all facilities that use hazardous chemicals
to have a written chemical hygiene plan (CHP) available to
employees. The purpose of the plan is to detail the following:
1. Appropriate work practices
2. Standard operating procedures
3. PPE
4. Engineering controls, such as fume hoods and flammables safety cabinets
5. Employee training requirements
6. Medical consultation guidelines
Chemical Labeling
● Poisonous
● Corrosive
● Carcinogenic

10. TYPES OF SAFETY HAZARDS
Material Data Safety Sheets
- By law, vendors are required to provide these sheets to purchasers;
- Information contained in an MSDS includes the following:
1. Physical and chemical characteristics
2. Fire and explosion potential
3. Reactivity potential
4. Health hazards and emergency first aid procedures
5. Methods for safe handling and disposal
4. RADIOACTIVE HAZARDS
❏ Effects of radiation is cumulative
❏ Degree of exposure related to:
● Time
● Distance
● Shielding
❏ Wear measuring device to detect amount of accumulated radiation
❏ Post radioactive symbols on doors if so.

11. TYPES OF SAFETY HAZARDS
5. ELECTRICAL HAZARDS
❏ Continually observe for frayed cords and overloaded circuits
❏ Avoid unplugging equipments with wet hands or while cleaning.
❏ Remove source of electricity if electrical shocks are encountered or avoid
transfer of the current
6. FIRE/EXPLOSIVE HAZARDS
❏ Store flammable chemicals properly
❏ Compressed gas should be located away from heat
❏ Fire blankets must be present in the lab
❏ If person’s clothes are burning, wrap in blanket to smother the flames.

12. TYPES OF SAFETY HAZARDS
7. FIRE/EXPLOSIVE HAZARDS
❏ Store flammable chemicals properly
❏ Compressed gas should be located away from heat
❏ Fire blankets must be present in the lab
❏ If person’s clothes are burning, wrap in blanket to smother the flames
- The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires
that all health-care institutions post evacuation routes and detailed plans to follow in
the event of a fire.
- When a fire is discovered, all employees are expected to take the actions in the
acronym RACE:
● Rescue—rescue anyone in immediate danger
● Alarm—activate the institutional fire alarm system
● Contain—close all doors to potentially affected areas
● Extinguish—attempt to extinguish the fire, if possible;
● exit the area

13. TYPES OF SAFETY HAZARDS
- The NFPA classifies fires with regard to the type of burning material
- It also classifies the type of fire extinguisher that is used to control them.
- The multipurpose ABC fire extinguishers are the most common.
- It is important to be able to operate the fire extinguishers. The acronym PASS
can be used to remember the steps in the operation:
1. Pull pin
2. Aim at the base of the fire
3. Squeeze handles
4. Sweep nozzle side to side.

14. TYPES OF SAFETY HAZARDS
8. PHYSICAL HAZARDS
❏ Avoid running in rooms and hallways
❏ Watch for wet floors
❏ Bend knees when lifting heavy objects
❏ Keep long hair pulled back
❏ Avoid dangling jewelry
❏ Maintain clean and organized work area
❏ Wear closed toe-shoes

15. THANK YOU