Question:
Describe about the Laboratory – Professional Work Experience of Royal Prince Alfred Hospital, Sydney?
The clinical experience relates to the learning and skills acquired during the professional tenure at Royal Prince Alfred Hospital, Sydney. The experience in Central Specimen Reception (CSR), Biochemistry Laboratory, Blood Bank and Anatomical Pathology departments of the hospital provided an insight of the various clinical perspectives in context to the methodology adopted during numerous medical investigation processes executed within the hospital premises. The preliminary intent of these laboratory processes relates to the evaluation and identification of the potential disease mechanisms and their manifestations with respect to the etiology and prognostic factors.
The execution of various laboratory interventions in the role of clinical analyst provided an opportunity to understand the criteria, requirements, context, protocols and risk factors associated with the clinical investigation methods practiced within the hospital confinement. Additionally, the clinical experience provided opportunities to evaluate the ethical concerns, health insurance protocols, revenue cycle management and safety parameters in context to the operational processes related to the health care system.
The biochemistry laboratory department caters the requirements for conducting various clinical investigative services following the physician’s recommendation. The antibody screening procedures, including immunoassays in the lab employed to investigate the etiology in context to the infectious processes invading the human body. The major challenge encountered in proceeding with the enzymatic and antibody identification protocols relates to the selection of the pure antigen to acquire specificity in the antiglobulin analysis (Wild, 2005:p. 153). The learning outcome pertaining to the immunoassay protocol includes the acquisition of the skills related to storage and purification of the specimen for efficient processing to obtain accurate results from the sample analysis. The hematological investigative procedures including antigen typing rendered in the blood bank assists in evaluating Rh profile of the individuals in context to the studied specimen (Ochei & Kolhatkar, 2000:p.359). The patterns of Rh antibodies of the studied population determine immunochemistry of the blood samples helpful during the blood transfusion processes. The ABO and RH grouping methods learned during the tenure in hospital attribute to analyzing the serology in context to the haemolytic conditions of the patients (Lockyer, 1982:p.37). The management of the clinical record pertaining to the analysis of hematological studies and discrepancy management between the outcomes of the ABO and Rh (D) analysis are some of the key skills acquired while working in the blood bank. The execution of master titration procedures acquired in immunohaematological evaluation for determining haemolytic conditions include the techniques warranting careful dilution of samples and use of appropriate pipette under optimal conditions for precisely conceiving the titration measurements to confirm or rule out haemolytic abnormality (Sood, 2006:p.17). The cold agglutinin-screening exam in the blood banks assists in identifying the pathophysiology of anaemia and cold agglutinin disorder patterns among the affected patients (Hillyer, 2007:p.564). The capacity to efficiently explore and analyze the functionality of the complement systems on the blood cells membranes and clinically correlating the findings with the probability of the haemolytic condition proved to be the potential learning outcome of this laboratory evaluation protocol. The mechanism of step down units in blood bank refers to rendering supporting services in cases of urgently required blood transfusions. The compatibility testing methodology employed in identifying the cross matches between blood samples to determine the potential candidates for blood transfusion (Blaney & Howard 2013:p.188). The greatest challenge encountered during the compatibility testing includes the identification of potential matches in emergency conditions. Additionally, the quality control measures to retain the precision of the compatibility testing outcomes require following the Unites States Food and Drug Administration standards in the identification of agglutination vs. lack of agglutination patterns in the hematological samples. The precise analysis from the compatibility testing assists the clinicians in preventing administration of incompatible blood transfusions leading to severe fatalities or life threatening morbidities among the affected patients. Therefore, the skills acquired during the compatibility testing facilitate to minimize the health risk among patients requiring blood transfusions for treating various haematological conditions. The techniques including antibody adsorption and elution are clinically significant in determining the hematological disorders and selection of patients for blood transfusions (Shaz et al, 2013:p.136). The Rh phenotyping techniques practiced at the blood bank and biochemistry lab of the hospital assists in analyzing the sensitivity and specificity patterns of the blood samples in context to various antigens tested during the phenotypic analysis (Whitlock, 2010:p.115-118). This methodology further assists in determining the autoimmune manifestations and hematological incompatibilities among the patients requiring immunological analysis.
The experience in anatomical pathology department of the hospital relates to acquiring skills and competence in undertaking gross histopathological analysis of the surgical specimen. The surgical pathological services rendered in the anatomical pathology department include various tissue biopsies, microanalysis of the tissue samples, microtomy protocols, immunofluorescence staining, embedding technique (frozen section), decalcification, tissue processing, staining of samples, waste disposal, Faxitron X-Ray and urgent specimen analysis. The clear understanding in terms of practicing hygiene and protective measures in the pathology department highly warranted for reducing any risk pertaining to health challenges and inadvertent conditions at the workplace. Indeed, provision of proper ventilation within operational premises and air monitoring protocols requiring strategic execution to ascertain risk free processing of the tissue samples within the confinements of the pathology department. The tissue biopsy techniques warrant execution of the correct sampling protocols and recommended staining procedures to ascertain the precision of study outcomes from the sample analysis (WSAVA Liver Stadardization Group, 2006:p.12-14). The most important challenge in context to the histopathological analysis related to proper handling of the specimens, accurate numbering and delivery to the correct destination. Indeed, mishandling or improper care of the specimens may result in haemolysis leading to inaccurate outcomes (Hopkins, 2009:p.10-11). Furthermore, retrieving blood cultures in improper timings by inefficient staff predisposes them to contamination, thereby leading to the generation of imprecise outcomes affecting the clinical diagnosis. Indeed, the clinical skills pertaining to tissue sectioning or microtomy based on acquisition of advanced techniques for affectively detaching the study sample though the cutting instrument for microscopic analysis (Suvarna et al, 2008:p.125). Adequate knowledge of the sampling technique and application of various microtome devices and section adhesives clinically warranted to ascertain precision in rendering the study samples for their consequent analysis. The skills related to immunofluorescence staining are helpful in facilitating preparation of cell culture and hematologic smears for their methodological analysis in context to generating accurate study outcomes (Bancroft, 2008:p.582). The embedding technique practiced in the pathology department adopted to fixate the tissue specimen in a recommended medium (including formaldehyde and paraffin) and subsequently freezing the study sample in terms of frozen section for analysis (Peters, 2010:p. 38). The embedding technique requires execution in such a manner to prevent any scope of contamination of sample during the dispensing and pre-freezing processes. However, the decalcification procedure in the pathology laboratory performed while employing Stewart’s fluid for the cross sectional analysis of the study specimen (Culling, 194:p.66). The intent of undertaking tissue decalcification procedure relates to attaining enhancement in staining reactions for generating precision in context to the outcomes of the sample analysis. The utility of the Faxitron X-Ray modality in the anatomical pathology department practiced with the intent to undertake the radiological analysis of the human musculoskeletal structure for evaluating underlying fractures or other structural bony abnormalities (White & Folkens, 2005:p.353).
In fact, the health and safety parameters while working in the laboratory environment in hospital attributed to practicing protective measures in context to handling of the study samples and avoiding any possible exposure of tissue fluids to the potential employees for avoiding predisposition of the laboratory staff toward various disease challenges. Furthermore, the work premises including laboratory and pathology departments and blood banks vigilantly monitored by occupational safety and health protocols to ascertain health and safety of the laboratory staff during the operational hours (Hill & Finster, 2010). The legal policies related to the regulation of the hazardous waste products in the hospital premises executed stringently to ascertain implementation of adequate disposal mechanisms for preventing prevalence of communicable diseases and toxic pathophysiological manifestations among the healthcare workers. Additionally, the employees working in the radiology department governed by the radioactive materials jurisdiction act to avoid exposure of the injurious radiations, while rendering investigation services within the operational confinements. The effective implementation of the policies and procedures recommended by the Centers for Disease Control and Prevention (CDC) in the hospital’s departments ensures the prevention of unwanted exposure of tissue specimen, infectious organism or other etiological factors to the healthcare workers within the operational premises. The proactive approaches in context to the execution of necessary remedial action in emergencies and epidemics following the state federal laws devised for the entire hospital departments with the intent to prevent the risk of injuries and infections following the inadvertent circumstances. The implementation of guiding principles for handling the study specimen with desirable care and caution to avoid the predisposition of any untoward event during specimen storage and transport by the hospital workers ensures the effective utilization of protective strategies by the hospital administration in efficiently tackling the health concerns of the workers.
The business processes inside the hospital premises pertain to the health insurance system, including the revenue cycle management processes operating with the intent of generative financial outcomes for the efficient functioning and success of the workplace. The efficient cash flow mechanisms indeed, implemented in context to medical coding, billing and denials handling structures to ascertain financial growth and prosperity of the health care system. The rendered services by the heath care providers, pathologists, radiologists, nurses and lab investigators adequately reimbursed with the effective implementation of the electronic database management systems in the coding and billing departments to facilitate the payment of health services to the potential providers and non-physician professionals engaged in rendering care and therapy to the patients. The social issues related to the healthcare industry pertain to rendering unbiased services and health provision to the individuals requiring medical attention in context to their health conditions. The other important issue pertaining to the diagnostic services in reputed hospitals corresponds to the potential cost for rendering these modalities for patients’ diagnostic evaluation. Indeed, the development of various diagnostic and therapeutic modalities requires organizing extensive clinical trials with the intent to devise strategic approaches in controlling the disease outcomes and epidemiological manifestations across the globe. The lack of awareness among the population in this regard creates the state of deficit during the execution of such studies in the controlled conditions. The important ethical issues in the healthcare sector related to the lack of homeostasis between the quality of care, safety and efficiency of the healthcare processes. Moreover, the inaccessibility of the impoverished people to obtaining qualitative healthcare services leads to increased cases of deaths, morbidities and epidemics across the globe. The sustained deficit of the healthcare professionals per unit of human population poses serious questions on the scalability of the healthcare sector in accomplishing the health requirements of the target population.
The significant challenge encountered while working inside the hospital premises across various departments related to the provision of adequate training mechanisms and awareness programs among the healthcare workers to improve the quality of healthcare services and wellness among the hospital employees. Indeed, these educational programs are highly warranted in any healthcare setting to establish benchmarks for stabilizing the quality and efficiency of healthcare services for the patients’ population. These potential issues tackled at the workplace while seeking consistent guidance and follow-ups from the fellow experienced colleagues in context to understanding the laboratory protocol and protective measures warranted to ensure safety and efficiency within the hospital’s confinements. The achievements during the entire tenure in the hospital related to the acquisition of skills and knowledge pertaining to multidisciplinary health investigation protocols and diagnostic modalities employed to restore health and wellness among the patients’ population. Indeed, the healthcare sector is an emerging industry associated with the prospects of further development in terms of enhancement of quality of care and therapy to the target population. Additionally, the great financial rewards affixed with the healthcare sector (including the medical laboratory technology discipline) makes it as the preferred career option among the students across the globe. Indeed, the interdepartmental professional experience with Royal Prince Alfred Hospital transformed the career profile by facilitating new heights in terms of enhanced competence followed by the acquisition of skills and experience during the entire tenure executed in the laboratory and pathology departments.
References
Bancroft, J 2008, Theory and Practice of Histological Techniques (6th edn.), Churchill-Livingstone, USA
Blaney, K & Howard, P 2013, Basic & Applied Concepts of Blood Banking and Transfusion Practices, Elsevier, Missouri
Culling, C 1974, Handbook of Histopathological and Histochemical Techniques (3rd edn.), Butterworth, Great Britain
Hillyer, C 2007, Blood Banking and Transfusion Medicine: Basic Principles & Practice, Churchil-Livingstone, Philadelphia
Hill, R & Finster, D 2010, Laboratory Safety for Chemistry Students, New Jersey
Hopkins, T 2009, Lab Notes: Guide to Lab and Diagnostic Tests, Davis, Philadelphia
Lockyer, W 1982, Essentials of ABO -Rh Grouping and Compatibility Testing, John-Wright, England
Ochei, J & Kolhatkar, A 2000, Medical Laboratory Science : Theory And Practice, Tata McGraw-Hill, New Delhi
Peters, S 2010, A Practical Guide to Frozen Section Technique, Springer, London
Shaz, B, Hillyer, C, Roshal, M & Abrams, C 2013, Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects (2nd edn.), Elsevier, USA
Sood, R 2006, Textbook of Medical Laboratory Technology, Jaypee, New Delhi
Suvarna, S, Layton, C & Bancroft, J 2013, Bancroft’s Theory and Practice of Histological Techniques (7th edn.), Churchill-Livingstone, UK
White, T & Folkens, P 2005, The Human Bone Manual, Elsevier, USA
Whitlock, S 2010, Immunohematology for Medical Laboratory Technicians, Cengage, USA
Wild, D 2005, The Immunoassay Handbook (3rd edn.), Elsevier, UK
WSAVA Liver Stadardization Group 2006, WSAVA Standards for Clinical and Histological Diagnosis of Canine and Feline Liver Diseases, Elsevier, Philadelphia
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