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Under supervision, the Hospital Laboratory Technician 1 perform repetitive, technical laboratory procedures that require special training and skill typically with theoretical background in one scientific field. Incumbents usually perform duties of limited variety and work under close technical supervision, in their initial assignments. They are responsible to receive, label, and process specimens received for analysis in the Clinical Laboratories, to input patient data into the computer, answer telephone inquiries regarding test information and results, and accession (enter) specimens. To maintain, troubleshoot and operate (TLA) Total Lab Automation system. To monitor and operate TUG sample delivery system. Must be able to perform all tasks well without supervision in an efficient and accurate manner to ensure good patient care.
Responsibilities
Task A: Receiving 1. Greet individuals bringing specimens to the lab. 2. Input patient data into the computer systems. i.e.Sunquest. 3. Process work in the following order: a. STATs b. Process Immediately c. Routine Racks d. Urine and Body Fluids e. Research/Budget 4. Receive and sort STAT, pre-op, or routine specimens coming to the Clinical Laboratories, whether from sources within UCSF or referred from external physicians or institutions, and whether directly chargeable for patient care or research purposes. 5. Check for proper patient identification on both specimen and requisition and for clear test requests (i.e., a valid, offered test). 6. Obtain and verify information and specimen collection requirements from Laboratory Manual, consulting supervisor, Laboratory Residents, or technologists only when information needed is not found in the Lab Manual or related readily available sources by laboratory policy, including but not limited to the Synonyms lists and monthly TL (Test Library) change memoranda. 7. Resolve any discrepancies or labeling problems by telephone, involving the laboratory Medicine sections or Resident as appropriate. 8. Place blood samples and requisitions in racks for computer entry and labeling, setting aside specimens requiring special processing or handling (including the issuance of temporary patient unit numbers) in individual cups for follow-up. 9. Process specimens referred from outside institutions only if they are accompanied by proper authorization form. If authorization is not available, process specimens to the point where the specimen may be safely held in a stable condition until the problem can be resolved - specimen quality must be maintained! Standards: 1. Respond immediately and in a courteous and professional manner to anyone delivering specimens or needing assistance. 2. Maintain reasonable speed during sorting. Routine specimens should be sorted for entry within 10 minutes after arrival in Clinical Laboratories. 3. Resolve any problems by contacting physician or nursing unit in a timely manner. 4. Notify supervisor if problems cannot be resolved within 15 minutes (more rapidly if urgency is made clear by contact with physician or nursing unit). 5. Notify physician/unit immediately whenever quantity of specimen is insufficient for analysis so that a new specimen can be obtained and submitted in a timely manner. 6. Alert supervisor of any Specimen Labeling Problem in a timely manner. 7. Process STATs within 15 minutes after reaching the Reception desk. 8. Specimens requiring immediate processing must be handled within 15 minutes in order to maintain sample integrity.
Task B: Labeling: 1. Label specimens with appropriate computer-generated labels. Beware of the particular risk of incorrectly labeling a sample when specimens collected at multiple times or from several sites are submitted together. 2. Prepare pour-off vials for aliquoting, as necessary. 3. Verify correct computer entry of tests by checking orders on the labels against requisitions. In case of discrepancies, notify the floor supervisor or the ordering unit. 4. Flag specimens clearly to the analytical sections, facilitate sharing of specimens (e.g., between Chemistry and Hematology or between Hematology and Microbiology) when only a small sample has been submitted. 5. Initial requisition in the appropriate box upon completion of labeling. Standards: 1. Label specimens and aliquots correctly. 2. Maintain reasonable speed on a steady basis in order to complete labeling of a rack. 3. No more than one rack should be waiting to be labeled to ensure a continuous flow of specimens to the aliquoting workstations. 4. Detect and correct discrepancies between request forms and computer-generated labels.
Task C: Separation and Aliquoting of Specimens other than Urine 1. Centrifuge specimens and separate cells and/or plasma where appropriate. Operate equipment properly and safely, balancing centrifuge loads using beam balance and setting the equipment to the correct speed. 2. Add buffers or preservatives to samples or carry out other special processing as required. 3. Aliquot the correct amounts of specimens into the appropriate cups, vials or tubes for testing. 4. Maintain a continuous flow of specimens for aliquoting by organizing your workload efficiently. 5. Provide the correct number of aliquots (tubes) for analysis and correctly label them with the proper sample number. 6. Determine whether the amount and quality of the specimen meets the requirements for testing. If our requirements are not met, communicate this fact to nursing units, physicians' offices, or referring laboratories, noting the time and name of the person to whom you gave this message in the telephone log book. Then enter the appropriate test comment into the computer noting the problem and the action taken (usually a request for a new specimen). Note the problem on the requisition and file in the Problem folder to enter the comments. 7. Place the specimens in racks or cups as appropriate for storage and store specimens according to the computer labels to maintain sample integrity. 8. Package specimens for send-out to Referral laboratory when assigned to that rotation or when the send-out person is not available. 9. File requisitions in bin for scanning. Standards: 1. Immediate processing must be completed within 30 minutes after a specimen has been received in Clinical Laboratories. 2. Make the proper cups for the appropriate tests with the correct additives, and process, package for send-out and store specimens in accordance with label and Laboratory Manual instructions. 3. Notify physician/unit in a timely manner if quantity or quality of specimen is inadequate for testing so that remedial action can be taken. 4. Package send-out specimens for next routine pickup in a timely manner. 5. Operate centrifuges only with a balanced load and at the proper speed. 6. Report equipment malfunction or any potential hazard noted (e.g., frayed electric cord) in a timely manner.
Task D: Aliquoting of Urine Collections: 1. Verify the labels against the requisition to detect any entry errors, and alert floor supervisor of problems. 2. Check that the proper preservative was added to verify proper collection. 3. Measure all timed urine collections. Perform a quality control check on electronic scale and immediately report any discrepancy to supervisor before urine is processed. We employ the weight of the collection as an accurate substitute for urine volume. Pour the sample into one of our own containers if it has been collected in a nonstandard container. Zero (tare) the electronic scale with an empty collection container by pressing the grams button. Record the scale reading in grams as the urine volume in mL. 4. Aliquot urines into the proper tubes or containers. 5. Handle the specimen as directed by the lab manual instructions. 6. Initial requisition in appropriate "Aliquot" box upon completion of task. 7. Write Urine Volume and Hours of Collection on Urine Volume worksheet. 8. Review Volume/Hrs of Collection on worksheet on daily discard specimens more than 7 days old from storage refrigerator. 9. Resolve problem arising from improper handling of specimen; notify supervisor. Standards: 1. Routine urines received in the laboratory by 0900 hrs are weighed, results are recorded, and aliquots made by 1000 hrs. 2. Aliquots should be available for testing within 30 minutes of receiving worksheets. 3. Measure urine volumes (weights) accurately. 4. Aliquot specimens correctly. 5. Write all results on Volume/Hrs worksheet by 1030 hrs. 6. Accurately transcribe (enter) Hrs of Collection into the computer. 7. Process all routine urines received. 8. Notify Supervisor if unable to complete tasks in a timely manner.
Task E: STAT Processing: After computer entry sort STAT specimens with labels and transport them to the appropriate testing sections. Verify test ordered against requisition during the sorting of labels with specimens. Follow instructions (posted on label printer) for processing STAT and routine orders on the same specimen. Initial requisition upon completion of sorting task in the "label" box (actual labeling of STAT specimens is performed within the testing section). Standards: Deliver specimens within 15 minutes of entry to the testing section.
Task F: Responses to Inquiries/Communications: 1. Communicate non-technical information (such as collection instructions and turnaround times, test results, etc.) obtained from the Laboratory Manual, the in- and out-patient price files, the laboratory computer and requisitions. Supervisor and technical staff should be consulted WHEN INFORMATION IS NOT AVAILABLE in these sources. All communications and responses, whether in person or by telephone, should be given accurately and clearly in a professional and courteous manner as you would yourself wish to be treated. Keep in mind that everyone has the common goal of helping the patient. 2. Answer any telephone extensions in your work area in a timely manner if the need arises. Standards: 1. Adhere to the hospital's house and telephone standards established by the Hospital. Identify yourself, our unit, and offer, "May I help you?" Attempt to answer phones not on an answering device before the third ring.
Task G: Send-Outs: Process test sent out to a Referral (Send-Out, Outside) Laboratory when assigned that responsibility. Package specimens according to the instructions on the computer-generated label with the aid of the Laboratory Manual as needed. Give top priority to all drug and toxicology specimens so they are ready for the next scheduled courier pickup. Any test requiring prior approval must be referred to the laboratory resident before it is submitted to a Reference Laboratory, but it should be processed up to the point where it can be safely held (e.g., a specimen requiring immediate processing and approval should immediately be processed while awaiting a decision whether it will or will not be approved. Standards: 1. Complete send-out work in an accurate and timely manner to meet the pickup schedule. 2. Notify supervisor of any problem related to the specimens in a timely manner. 3. Processing specimens correctly.
Task H: Computer Usage: Use the basic computer functions (Sunquest GUI Order Entry, General Lab, Smart and Laboratory Inquiry) required to retrieve patient data and resolve specimen identification problems. Standards: 1. Perform the above tasks as necessary in a timely manner. 2. STATs must be processed immediately; input patient data and STAT test requests accurately.
Task I: Computer Crashes: Process specimens when the computer system is not functioning, following instructions in the written internal crash plan, processing specimens correctly without aid of computer labels and forwarding them to the proper testing sections, and writing patient/test information on all pour-off tubes. Standards: 1. Be familiar with the written internal crash plan and follow it with minimal supervision. Follow these instructions except where given prior approval to do otherwise by your supervisor. 2. Hand-write all requisitions and labels legibly.
Task J: Additional Unspecified Duties: Perform additional duties or projects as assigned. Standards: 1. Complete the assigned task properly within the agreed upon time. Errors - Definitions and Significance Errors in processing laboratory specimens can be highly dangerous to patients and even if not may be extremely disruptive to the patient, the individuals caring for the patient, and the laboratory staff. 1. Major errors can potentially misdirect diagnosis or treatment. These include mixing up samples from different patients, mixing up two different specimens from the same patient, using the wrong specimen additive, and similar mistakes, as well as errors which may require a patient to repeat an invasive diagnostic procedure (e.g., failure to properly preserve or store a CSF which results in the patient undergoing another spinal tap). 2. Other serious errors may cause inconvenience, even great inconvenience, to a patient but do not yield an incorrect result and therefore are not likely to lead directly to improper management of the patient. These are primarily errors of omission or of additional unwarranted laboratory testing, such as failing to make a pour off for an ordered test, entering orders for tests which were not requested, failing to enter orders for tests which were requested, or excessive delay in processing resulting in the test missing the scheduled run. Erroneous entry of charges to budget accounts are also serious because they waste the time and resources of personnel inside and outside the laboratory in tracking down and correcting the problem. Such errors often can be corrected without requiring another patient sample.
Task K: Total Lab Automation Duties: "Track Master" Function as a "Track Master" operator of the automation track system. Sorts through samples and identifies correct labeling format before loading to track input lanes or BIM (Bulk Input Module). Identifies QNS sample and not load to automation line. Receives in lab system manually and delivers samples to departments. Identifies blood bank sample tubes and not load to automation line. Delivers sample tubes to Blood Bank department and alerts blood bank personnel if automation line accidentally receives blood bank specimens. Investigates sample that does not have download to the automation line. Investigates samples and troubleshoots samples that go to automation Priority Output Error lanes or unknown (no test download) lane. Sends samples for archiving to storage module. Pulls samples from storage module. Standards: 1. Process sample tubes from Priority Output Error lane or unknown lane by investigating sample trace logs within 15 minutes. 2. Proficient in reading sample trace logs to help in troubleshooting problem samples. 3.