LESSON 8: NATURE OF THE CLINICAL LABORATORY

The Clinical Laboratory

 It is an essential component of health institutions

 Main Task: To provide accurate, reliable information to medical doctors for the diagnosis,
prognosis, treatment, and management of diseases.

 70%

 Decisions performed by medical doctors are based on laboratory test results.

 MLS plays a very significant role in the performance of laboratory testing and ensuring the
reliability of laboratory results.

MANUAL LESS LABORIOUS

TAXING SHORTENED TURNAROUND
TIME
LABOR- INTENSIVE PRODUCE MORE
TIME-CONSUMING RELIABLE RESULTS

It also actively involved in

 Research

 Community outreach programs

 Surveillance

 Infection control in the hospital and community settings

 Information dissemination

 Evaluation of applicability of current and innovative diagnostic technologies

CLASSIFICATIONS OF CLINICAL LABORATORY

ACCORDING TO FUNCTION

Clinical Pathology

 Concerned with the diagnosis and treatment of diseases performed through laboratory testing
of blood and other body fluids.
Anatomic Pathology

 Concerned with the diagnosis of diseases through microscopic examination of tissues and
organs.

ACCORDING TO INSTITUTIONAL CHARACTERISTICS

Institution-based

 A clinical laboratory that operates within the premises or part of an institution.

Free-standing

 A laboratory that is not part of an established institutions.

ACCORDING TO OWNERSHIP

Government Owned

 Clinical laboratories owned by national or local government units.

Privately-Owned

 Clinical laboratories are owned, established and operated by an individual, corporation,

institution, association, or an organization.

ACCORDING TO SERVICE CAPABILITY

Primary Category

 Licensed to perform: Basic to routine laboratory testing.

 Routine urinalysis, routine stool examination, routine hematology or complete blood count that
includes hemoglobin, hematocrit, WBC and RBC count, WBC differential count and qualitative
platelet count, blood typing and Gram staining (if hospital—based)

 Equipments: Microscope, Centrifuge, Hematocrit Centrifuge

 Space Requirement: At least 10 square meters

Secondary Category

 License to perform: All tests done by Primary Category + Routine Clinical Chemistry, Gram Stain
(HB), KOH Mount (HB), Crossmatching (HB)

 Blood glucose concentration, blood urea nitrogen, blood uric acid, blood creatinine, cholesterol
determination.
  Equipments: Microscope, Centrifuge, Hematocrit Centrifuge, Semi-automated chemistry
analyzers, autoclave, incubator, oven.

 Space Requirement: At least 20 square meters

Tertiary Category

 Licensed to perform: All test done by Secondary Category Plus

 Immunology and Serology

 Microbiology, Bacteriology, Mycology

 Special Clinical Chemistry

 Immunohematology and Blood Banking

 Equipments: All equipment in Secondary + Automated Chemistry Analyzer, Biosafety Cabinet

Class 2, Serofuge

 Space Requirement: At least 60 square meters

 Immunology and serology

 NS1-Ag for dengue, rapid plasma reagin, Treponema-pallidum particle agglutination test

 Microbiology, Bacteriology, Mycology

 Differential staining techniques, culture and identification of bacteria and fungi from specimens,
anti-microbial susceptibility testing

 Special Clinical Chemistry

 Clinical enzymology, therapeutic drug monitoring, markers for certain diseases.

 Special Hematology

 Bone marrow studies, special staining for abnormal blood cells, red cell morphology

 Immunohematology and Blood Banking

 Blood donation program, antibody screening, and identification preparation of blood

components.
National Reference Laboratory

 Laboratory in a government hospital designated by the DOH to provide special diagnostic

functions and services for certain disease.

FUNCTIONS:

 Referral Services

 Provision of confirmatory testing

 Assistance of research activities

 Implementation of external quality assurance program

 Resolution of conflicts regarding test results

 Training of medical technologists on certain specialized procedures

5 NRL-EQAS (National Reference Laboratory- External Quality Assessment Services)

National Kidney and Transplant Institute (NKTI)

 Hematology and Coagulation

Research Institute of Tropical Medicine (RITM)

 Microbiology

 (Identification and antibiotic susceptibility testing)

 Parasitology

 (Identification of ova and quantitation of malaria)

Lung Center of the Philippines

 Clinical Chemistry

 (For testing 10 analytes, namely glucose, creatinine, total protein, albumin, blood urea nitrogen,
uric acid, cholesterol, sodium, potassium and chloride)

East Avenue Medical Center (EAMC)

 Drugs of abuse (methamphetamine acid and cannabinoids)

San Lazaro Hospital STD-AIDS Cooperative Center Laboratory (SACCL)

 Infectious immunology hepatitis B surface antigen (HBsAg), human immunodefiency virus (HIV),
hepatitis C virus (HCV)