Put It on the Board, 1/18

Create PDF

Some safety issues more gray than black and white

Most laboratory safety rules are free from ambiguity. Anyone who handles specimens must wear personal protective equipment, for example. Some issues are less clearly defined, though, and require a deeper dive into the guidelines.

That is where Dan Scungio, MT (ASCP), SLS, CQA(ASQ), comes in.

As laboratory safety officer for Sentara Healthcare, he maintains safety programs at sites throughout Virginia and northern North Carolina. In his consulting work as Dan the Lab Safety Man, Scungio digs into regulations to answer safety questions for an international audience of laboratory personnel via his website and presentations.

Scungio

Scungio took some of the most commonly asked laboratory safety scenario questions to the October 2017 Global Summit on Best Practices in Preanalytics, organized by Greiner Bio-One North America. The trickiest part about the presentation, he says, was telling his audience of safety officers, managers, and other laboratory personnel that not every question has a clear-cut answer.

“Laboratorians tend to like to think in terms of black and white. We just want a definitive answer,” Scungio says. But “sometimes you have to look for your own answer based on your own laboratory and situation.”

For example, regulatory agencies and organizations say little about whether phlebotomists should wear lab coats when drawing blood, he says. “OSHA says, ‘You need to wear gloves,’ and they don’t really talk about lab coats for phlebotomy,” he says. The CAP also does not specifically address a dress code beyond gloves for blood collection, he adds.

Scungio dug deeper and found an OSHA letter of interpretation, which says that phlebotomists do not need to wear lab coats during venipuncture. “But that is not really the end of the story,” he says.

A 2008 study reveals that nearly 75 percent of the 180 phlebotomists who responded to a survey reported having experienced blood spatter above their glove line while drawing blood.

“I’ve drawn blood a lot in my career and never had that issue. But this is a high percentage of phlebotomists saying it happened,” Scungio says, adding that the study was performed by a lab coat manufacturer.

Having phlebotomists wear lab coats raises other questions. “Should we wear the same lab coat from patient to patient? Because now you’re wearing personal protective equipment, and we certainly don’t wear gloves from patient to patient,” Scungio says. “We don’t even use the same tourniquet from patient to patient anymore, or the same needle hubs.”

His advice to laboratorians is to perform a risk assessment at their site based on the safety issues staff have experienced. “You have to make that determination for yourself,” he says.

Emergency eye washes and showers are another popular topic. The CAP and OSHA say that for hazardous chemicals, an eye wash must be no more than 55 feet or 10 seconds of travel distance from the hazard, Scungio says. “If you have a door in the way of that 55 feet and 10 seconds and it opens toward you while you’re traveling, that’s considered an obstruction. That’s not allowed,” he adds.

OSHA also requires a shower, depending on the amount of hazardous chemical in the laboratory. Curiously, no regulation addresses having an eye wash or shower for bloodborne pathogens, “but you would want that if you have an exposure,” Scungio says.

“I always talk about face protection as the bottom line,” he says. “If you’re using face protection when you should be, you shouldn’t have to worry about needing an eye wash.”

Regarding the issue of gloves and microbiology, “We’re probably 50/50 with compliance in this across the country, based on labs I work with,” Scungio says. While there is no clear regulation—OSHA’s letter of interpretation on the subject says glove use is “strongly encouraged”—Scungio sees no room for indecisiveness.

“They plate cultures with their gloves on because they’re handling specimens. If you’re handling those plates with gloves on, you certainly should handle them with gloves on the very next day when you’re taking them out of the incubator to look at them. You can’t have it both ways. Either the surface is contaminated or it’s not.”

More often than not, a regulation will address a laboratory safety question. “If you can’t find it in black and white, and none of your resources is able to help you, then make the determination based on what is the best safety practice,” Scungio says.

The 2018 Global Summit on Best Practices in Preanalytics will be held Oct. 15–18 in Charlotte, NC. —Amy Carpenter Aquino
[hr]

Siemens acquires Fast Track Diagnostics

Siemens Healthineers has signed an agreement to acquire Luxembourg-based Fast Track Diagnostics, a global supplier of diagnostic tests. The acquisition increases the menu of the Siemens Healthineers Versant kPCR Molecular System by more than 80 assays and syndromic panels, Siemens said in a Dec. 15 statement.

Fast Track’s tests are real-time PCR kits that target respiratory infections, gastroenteritis, meningitis, hepatitis, and other conditions.

Through the acquisition, Siemens Healthineers will now include Fast Track’s sites in Luxembourg, Malta, and India, as well as its workforce of about 80 employees.
[hr]