PRINCIPLES OF

MEDICAL TECHNOLOGY
PRACTICE 1
 UNIT 2
CLINICAL LABORATORY
 OUTLINE
• General overview
• Classification of medical laboratories
• Laboratory Sections
• Information flow in the clinical laboratory
• Three phases of laboratory testing
• Laboratory policies
 LEARNING OUTCOMES
At the completion of this chapter the students should be able to:
• Identify and differentiate the classification of clinical Laboratory
settings
• Explain the roles, functions and services offered by the different
sections of the laboratories.
• Justify and explain various information on a laboratory requisition.
• Identify the different phases of laboratory testing.
 CLINICAL LABORATORY
▪ facility
▪ specimens (whole blood, serum, plasma, urine, stool, etc) from
the human body
▪ collected, processed, examined or analyzed
▪ Prevention, diagnosis & treatment
CLINICAL LABORATORY
CLASSIFICATION OF CLINICAL LABORATORY

DEPARTMENT OF HEALTH
Administrative Order no. 2007 -0027

A. Based on Ownership
1. Government
2. Private
B. Based on Function
1. Clinical Pathology
2. Anatomical Pathology
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Function)
Clinical Pathology:
1. Clinical Chemistry 7. Immunohematology
2. Hematology 8. Cytogenetics
3. Microbiology 9. Endocrinology
4. Clinical Microscopy 10. Toxicology
5. Immunology 11. Therapeutic drug
6. Molecular Biology monitoring
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Function)
Anatomical Pathology :
1. Surgical Pathology
2. Immunohistopathology
3. Cytology
4. Autopsy
5. Forensic Pathology
6. Molecular Pathology
 CLASSIFICATION OF CLINICAL LABORATORY

C. Based on Institutional Character:

1. Institution-based
2. Freestanding
D. Based on Service capability
1. General Clinic laboratory
2. Special Laboratory
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Service capability)

1. General Clinical Laboratory

a. Primary Category
b. Secondary Category
c. Tertiary Category
d. Limited Service capability
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Service capability)

1. General Clinical Laboratory

a. Primary Category
1. Routine hematology (CBC)
2. Qualitative platelet determination
3. Routine urinalysis and fecalysis
4. Blood typing – for hospital based

* minimum of 10 square meters in floor area

CLASSIFICATION OF CLINICAL LABORATORY
(Based on Service capability)
1. General Clinical Laboratory
b. Secondary Category
1. Routine Clinical Chemistry
2. Quantitative platelet determination
3. Cross matching
4. Gram staining
5. KOH staining for fungal disease

*minimum of 20 square meters in floor area

 CLASSIFICATION OF CLINICAL LABORATORY (Based
on Service capability)

1. General Clinical Laboratory

c. Tertiary Category
1. All secondary lab services
2. Special chemistry (Cardiac markers)
3. Special Hematology (coagulation tests)
4. Immunology/Serology (HIV, hepa profile, tumor markers)
5. Microbiology – culture and sensitivity

* Minimum of 60 square meters in floor area

CLASSIFICATION OF CLINICAL LABORATORY
(Based on Service capability)

1. General Clinical Laboratory

d. Limited Service capability
a. Dialysis centers
b. Social hygiene clinics
CLASSIFICATION OF CLINICAL LABORATORY (Based
on Service capability)

2. Special Clinical Laboratory

a. Assisted reproduction technology laboratory
b. Molecular and cellular technology
c. Molecular pathology, Forensic pathology and Anatomic
laboratory
CLASSIFICATION OF CLINICAL LABORATORY

E. National Reference Laboratory

1. Confirmatory testing
2. Surveillance
3. Resolution of conflicting results
4. Training and research
5. Evaluation of diagnostic kits and reagents
 NATIONAL REFERENCE LABORATORY
1. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
 NATIONAL REFERENCE LABORATORY
2. San Lazaro Hospital STD-AIDS Cooperative Center Laboratory
(SACCL)
 NATIONAL REFERENCE LABORATORY
3. EAST AVENUE MEDICAL CENTER
 NATIONAL REFERENCE LABORATORY
4. NATIONAL KIDNEY AND TRANSPLANT INSTITUTE
 NATIONAL REFERENCE LABORATORY

5. LUNG CENTER OF THE PHILIPPINES

CLASSIFICATION OF CLINICAL LABORATORY

F. Satellite Testing Sites

▪ Testing site owned by a licensed laboratory but situated in a location
some distance from the main laboratory.
CLASSIFICATION OF CLINICAL LABORATORY
G. Mobile Clinical Laboratories
▪ laboratory testing unit
▪ moves from one testing site to another testing site
▪ has a temporary testing location
▪ shall have a base laboratory
▪ permitted to collect specimen only
▪ operate within a 100-km radius from its main lab
LABORATORY SECTIONS

A. SPECIMEN PROCESSING
 LABORATORY SECTIONS
B. HEMATOLOGY SECTION
Hematology Section
 LABORATORY SECTIONS
C. COAGULATION SECTION
 LABORATORY SECTIONS

D. CLINICAL MICROSCOPY
 LABORATORY SECTIONS

D. CLINICAL MICROSCOPY
 LABORATORY SECTIONS
E. PARASITOLOGY
 LABORATORY SECTIONS
F. CLINICAL CHEMISTRY
LABORATORY SECTIONS
G. CLINICAL MICROBIOLOGY
 LABORATORY SECTIONS
H. IMMUNOLOGY/SEROLOGY SECTION
 LABORATORY SECTIONS
SEROLOGY TESTS
▪ Pregnancy tests – detects B-HCG
▪ Dengue Test
▪ HbsAg – for hepatitis
▪ Bacterial Agglutination test
a. Widal test - Typhoid fever
b. Weil-Felix – non specific test for
typhus fever
LABORATORY SECTIONS
I. IMMUNOHEMATOLOGY/BLOOD BANK
LABORATORY SECTIONS
J. HISTOPATHOLOGY/CYTOPATHOLOGY
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory requisition
A form used by physician to document the tests that are to be
performed on patients.
Contains the following:
Patient’s demographic data: name, data, address, birth date
Patient Gender
Date & time of collection
Room number ( in-patient or out-patient)
Test slection
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory requisition
Contains the following:
Date and time of collection
Identification of the person who performed the collection,
name and signature of ordering physician
Source of specimen
Physician’s clinical Diagnosis
Additional comments
LABORATORY REQUEST FORM
 INFORMATION FLOW IN THE
CLINICAL LABORATORY

❖Laboratory Directory
Internal test number
Acronyms or abbreviations of the test
Type of specimen required
Specimen volume and the minimum
acceptable volume
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory Directory
Collection notes
Storage instruction of specimen
Stability of the specimen
Reference Ranges
Clinical Significance
Test schedule or testing interval/frequency
Method
 LABORATORY REPORTS
to transmit test results
Reference ranges
Date and time of the specimen collection
Name, address of the laboratory
Name and identification number of patient
Source of specimen
Date & time the report was generated
LABORATORY REPORTS
 THREE PHASES OF LABORATORY TESTING
A. PREANALYTICAL PHASE
▪ occurs first in the laboratory process
Patient preparation
Paper work and data entry
Specimen collection, processing, storage and
transportation.

Responsible Personnel
***Phlebotomist, laboratory technician
 THREE PHASES OF LABORATORY TESTING
B. ANALYTIC PHASE
▪ Considered the “actual” laboratory testing
or the diagnostic procedures, processes and products
Proper instrument maintenance
Reagent supplies
Quality control

Responsible Personnel
***Medical Technologist or Medical Lab Scientist
 QUALITY CONTROL
❖Ensure Accuracy, precision, reliability of the test procedure.
❖Validates the following:
Test reagents/ kits

Testing process

Training of the lab personnel performing the test

THREE PHASES OF LABORATORY TESTING
C. POST- ANALYTIC PHASE
❖Includes the following:
Review and analysis of results
Recording and reporting of test results
Storage and disposal of specimen
Releasing of results

Responsible personnel
***Medical Technologist, Section Supervisor, Chief Med.
Tech., office clerk or staff
 LABORATORY POLICIES
A. Laboratory hour and emergency work
▪ definite working hours
▪ outside regular working hours,organize a system
for testing urgent specimens.
 LABORATORY POLICIES
B. Range of tests to be performed and those to be
referred to higher level
1. the number of staff available
2. the availability of material resources
3. the types of health institutions (hospital or health
center)
 LABORATORY POLICIES

C. Referral of specimens (when necessary)

Example specimens for HIV detection and water
samples for bacteriological analysis
 LABORATORY POLICIES
D. Collection of laboratory specimen

URINE SAMPLE TRAY

CLEARLY LABELED SPECIMEN
 LABORATORY POLICIES

E. Workload capacity of a laboratory

- should matched to the number of staff
- their level of training
- size of the laboratory
- the availability of laboratory facilities
 REFERENCES
1. Department of Health , Administrative Order No. 2007
– 0027
2. Seyoum, Berhau (2006). Introduction to Medical
Laboratory Technology. Ethiopia Public Health Training
Initiative, The Carter Center, the Ethiopia Ministry of
Health, and the Ethiopia Ministry of Education.
3. Lieseke, C. and Zeibig, E. (2012). Essentials of
Medical Laboratory Practice. F.A Davis Company.
Philadelphia, USA.
 REFERENCES
INTERNET:
• https://www.encyclopedia.com/medicine/encyclopedias-almanacs-
transcripts-and-maps/medical-laboratories-0
Encyclopedia.com, Medical Laboratories

• https://www.limswiki.org/index.php/Reference_laboratory
Reference laboratory-LIMSWiki

• https://study.com/articles/Lab_Manager_Job_Description_Duties_and_Req
uirements.html
Lab Manager job description, duties and requirements. Study.com
 REFERENCES
INTERNET:
http://lcp.gov.ph/images/NEQAS_CC/1_Announcement.pdf
National Reference Laboratory for Clinical Chemistry

Department Order No. 393-E series 2000, Designation of National

Reference Laboratories and transfer of corresponding Equipment,
Instruments Supplies, Specimens, Records Form the Bureau of
Research and Laboratories To the designated Reference laboratories