laboratory automation and point of care testing
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Laboratory Automation and Pointof Care Testing
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80% or more of the information a physician
relies on comes from laboratory results
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Benefits of Automation
Reduction of medical errors
Improved safety for laboratorians
Faster turn-around-times
Partially alleviates staff shortage
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Steps In Automated Analysis
1. Specimen collection and processing
2. Specimen and reagent measurement anddelivery
3. Chemical reaction phase
4. Measurement phase
5. Signal processing and data handling
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Specimen Collection and Processing
Barcoding
Types of specimens used in lab testing Whole blood
Serum or plasma
CSF
Urine
Stool
Joint fluids or various other body fluids
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Specimen & Reagent Measurementand Delivery
Random Access analyzer
All determinations done on one patient beforegoing to next
Do not have to perform all tests available, can
choose which tests
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Chemical Reaction Phase
Mixing
Wet or dry reagents
Separation
Incubation
Reaction Time
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Measurement Phase
Various methodologies to measure the
analytes in lab CLIA 88 mandates that when using a
moderate or high complexity automated
instrument you must run 2 controls every 8
hours of operation or once per shift whenpatient specimens are being analyzed
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Signal Processing and Data Handling
Hard copy
Visualize on computer monitor Autoverification
Interfaced with LIS
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Automated Analyzers
Choice of instrument based on several
factors: Volume of tests
Level of staffing
Cost of analyzer
Size of lab
Maintenance and operation costs
Turn-Around-Time Throughput
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Point of Care Testing
at the bedside or
near the patient
Reduced turn-around-
time
Cost
Maintenance of QC andQA
Connectivity to
Patients record
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Testing Complexity
Waived tests
S
imple, non-detrimental Moderate Complexity
More complex, usually automated (blood counts, routine
chemistry)
High complexity
Usually non-automated, complicated, require judgment
(micro, and blood bank)
Provider Performed Microscopy (PPM)