GLOVES – the single most important safety device in the lab

Tags

, , , , , , , , ,

Nitrile gloves, just one choice

The conversation about gloves is an important one and one I’m passionate about.  So many of us remember back in the day how we coverslipped and changed stain lines bare-handed.  How many of us old-school HTs have thyroid issues that started with xylene exposure?!   

Unfortunately there really is not a single glove type that meets our needs with an ‘excellent’ rating in an affordable product allowing full dexterity.  Also, what you have on your hands PRIOR to gloving can reduce the protection.  These include soaps and lotions that can contribute to breaking down the glove faster than if you gloved with perfectly clean skin. 

We’d all love to have a glove that guarantees no skin contact for the duration of the time we need to wear them. FORTUNATELY—there are practices you can do to increase your own protection with gloves rated ‘good’.  Double gloving is one option; however this impedes movement and increases mechanical stress on your hands. If this is your best option, try two sizes—larger one the outer glove (obviously).   If you elect to single-glove, pick at least a  ‘good’ rating and change them frequently—even set a repeat timer based on the permeation rate of the glove type for the solvent and change slightly before the threshold is crossed. 

PVA Food Service Gloves

Any time your gloves swell or pucker, they’ve absorbed the material with which you are working. They are then holding the chemical directly against your skin!  Gloves are cheap compared to long-tem health consequences for repeat chemical exposure.  It is rare to be compensated for these types of illnesses from any employer, plus your quality of life is reduced, probably forever. Really—we’d rather be healthy than have our employer pay for treatment!! Protect yourself to the best of your ability.  No company I’ve ever worked for had issues with glove consumption: re-glove often!!  Make sure your SOP gloving policy allows for re-gloving in chemical processes (vs biohazardous processes) without handwashing to make it easy for your people to protect themselves.

Never use for aromatic hydrocarbon solvents

Take a look at the charts on the links below (I just checked them– no malware attached).  There are dozens of charts like this and a few conflicts on the ratings between charts so test for yourself. There are more chart if you search the internet or your glove providers can usually help.  

Glove composition and chemical composition vary by manufacturer so the differences in the charts are easily explained and support doing your own tests with the products you have in your lab.  Make sure you’re protecting yourself from the chemicals that are in the bottle—don’t assume — read the MSDS.

Supported Polyvinyl Alcohol (PVA) is best rated but they are clumsy and bulky—not good for our technical use but GREAT for recycling and waste management tasks. They’re re-usable and can be shared for waste handling.  Most of the regular tan ‘exam’ type gloves are like sponges—save them for water-based processes.  The cheap food industry PVA work at a ‘fair to good’ level on most charts and can be changed frequently to give similar protection without the bulk. They aren’t fitted so they’re a little sloppy.  Nitrile are more expensive, but also more comfy, consistently rated ‘good’ but they pucker within about 15-20 minutes of high exposure to xylene(s) such as hand coverlipping.  Any time you change manufacturers, test again. 

 

Keep yourself safe and healthy on the job—pick gloves that work and change them often!!

http://www.allsafetyproducts.biz/page/74172

 http://www.ansellpro.com/download/Ansell_7thEditionChemicalResistanceGuide.pdf

http://www.allsafetyproducts.biz/page/74172

 
 
 

EVERY lab can use Micro Tissue Arrays.

Tags

, , , , , , , , , , , ,

 
Video credit: IHC World www.ihcworld.com

We read about Micro Tissue Arrays in the current literature.  It seems like a cool idea for research labs and other non-clinical applications.  If you haven’t thought how they might help in your routine everyday processes…consider they might save you time,  simplify complex decision-making and reduce re-work in the routine clinical path lab.

How much time do you spend each day managing control slides? Have a big IHC menu? Lots of specials? Time spent keeping QC tissue blocks organized, slides cut, matching the QC slide to the antibody and deciding to mount the patient section on the control or double the reagent cost and run two: we do it every day and it adds up.  Ever grab the wrong control and have to start all over again again?  Yeah, me too.

Wouldn’t it be AWESOME to just reach for ONE slide for all your routine specials?  Or ONE out of maybe THREE choices for your entire IHC antibody menu?  Watch the video at the top–these aren’t difficult to construct and once mapped, reading them is a breeze. 

The molds come in different sizes (# & diameter of the plugs) and assuming your cutters know their stuff, you’ll produce HUNDREDS of perfect, proven control slides from each block stocking your stain techs for weeks in even the highest volume situations.

Thanks to IHC World for the quality video and photos. 

Drop me a comment (upper right) with your experiences and thoughts — good idea or just another neat way to play with paraffin?

Cooling clamp on a microtome – really? What will they think of next??!!

Tags

, , , , , , , , ,

Image

http://www.leica-microsystems.com/biosystems/products/total-histology/sectioning/rotary-microtomes/details/product/leica-rm-coolclamp/

We all know about using cooling plates and wet ice to get the best uniform sections.  Leica–also a familiar standard in the field–introduced a new feature on their microtomes.  The clamp includes a refrigeration mechanism that keeps the blocks cold.  Not sure why one would need this and wonder about having just one more thing to adjust and break while cutting irreplaceable tissue biopsies.

Obviously I have an opinion…what you you guys think?  Please post your thoughts–love to see if I’m the only ‘old school’ or if this really is another bell and whistle no one needs…

H and E Stain – joining the dinosaurs?

Tags

, , , , , , , , , ,

An article from today’s Dark Daily:

New Way to Look at Tissue Biopsies: Beckman Institute Researchers Develop Low Cost, High-Speed and Stain-free Optical Technology That Could Displace Existing Histopathology Methodologies

Published: March 9 2012  by Pamela Scherer McLeod 
Pathologists would gain new tool to diagnose cancer faster and more accurately, based upon stain-free analysis of tissue

Reading tissue biopsies with a new stain-free method could eventually help pathologists achieve faster and less subjective cancer detection. Should this technology prove viable, it would also displace many of the longstanding tissue preparation methodologies used today in the histopathology laboratory.

Credit a research team from the Beckman Institute at the University of Illinois (UI) Christie Clinic and at the UI campuses in Urbana and Chicago, with developing this new technology.

They call the technique Spatial Light Interference Microscopy (SLIM). According to a story reported by Futurity.org, the technique uses two beams of light.

New Technology Could Help Pathologists Detect Cancer Earlier

In the Proceedings of the National Academy of Sciences, the scientists stated the new technology offers answers to some of the most elusive questions in contemporary biology: how cell growth is regulated and how cell size distributions are maintained. “SLIM can be so valuable for greatly improving the chances of early detection and treatment of cancer,” declared study leader Gabriel Popescu, Ph.D., Quantitative Light Imaging Laboratory, Department of Electrical and Computer Engineering at the Beckman Institute.

The reason for Popescu’s optimism is SLIM’s capabilities using optical interferometry, or interference patterns, to make accurate measurements of waves at the molecular level. This enables the technique to work with great sensitivity.

Shown above are multi-modal images of prostate biopsy slides of a 5+4 Gleason grade, or high grade tumor. The top row of images are done with standard histological staining. The bottom row of images are done with the stain-free Spatial Light Interference Microscopy (SLIM). (Credit: Shamira Sridharan of www.Futurity.org)

According to Mustafa Mir, a graduate student in Electrical Engineering and a first author of the project paper, SLIM is capable of measuring mass with a sensitivity of one femtogram, or one thousandth of the mass of a cubic micron of water.

“What that means is that only a small number of molecules arranged in a certain way are enough to give us the optical signal that something is going to happen here,” Popescu explained.

The technology works through a combination of phase-contrast microscopy and holography. It does not need staining or any other special preparation of the tissue to be analyzed. It is also completely non-invasive. This means that scientists can visualize nanoscale structures quantitatively and study ongoing cell function in situ.

“Ideally, we would like to detect cancer at the single-cell level,” Popescu stated. This would enable scientists to find a cell that looks abnormal early on, allowing treatment where the process is still reversible. “We know that the disease starts at the nanoscale, at the molecular level, and we think we have the proper tool to catch these early events,” he added.

With Current Staining Method, Pathologists Disagree 20% of the Time

SLIM offers revolutionary advantages over current staining technology. Its optical maps report morphological properties of tissues and cells that cannot be recovered by common stains, including hematoxylin and eosin, Futurity reported. This provides objective evaluations of structural data such as tumor margins that can be difficult for pathologists to assess with current methodologies.

“A significant advantage over existing methods is that we can measure all types of cells… while maintaining the sensitivity and the quantitative information that we get,” Mir stated in a story by MedGadget.

According to Popescu, use of SLIM technology, along with a fluorescent reporter, could have broader implications in understanding the effects of cancer treatments and other forms of therapy on the fundamental process of cell growth. “By using [the combined technologies], we were also able to differentiate how the cells regulate their growth in different stages of their lifecycle,” he stated.

“We think that the most important advantage of SLIM is that it provides quantitative, objective information,” Popescu observed in Futurity. “Right now, in the clinic, the diagnosis is subjective; it’s a human that does it. There are studies showing that two pathologists agree on a diagnosis only four out of five times.”

Popescu described the ability to actually predict information about the outcome of the patient as the Holy Grail of the research. As an example, he noted SLIM’s potential to help determine the likelihood of recurrence following surgery. “This, right now, is actually a 50/50 guess,” he observed.

According to Popescu, SLIM’s highly automatic procedure, together with the low cost and high-speed associated with the absence of staining, could make “a significant impact in pathology at a global scale.”

Of course, it will take years before tissue analysis solutions incorporating Spatial Light Interference Microscopy (SLIM) are ready for daily use by  anatomic pathologists. Yet, it is the pipeline of transformative technologies like that which promise to give Clinical laboratory professionals new capabilities to diagnose disease more accurately and earlier. In turn, this improves the value that laboratory medicine brings to physicians, patients, and payers.

—Pamela Scherer McLeod

Read more: New Way to Look at Tissue Biopsies: Beckman Institute Researchers Develop Low Cost, High-Speed and Stain-free Optical Technology That Could Displace Existing Histopathology Methodologies | Dark Daily http://www.darkdaily.com/new-way-to-look-at-tissue-biopsies-beckman-institute-researchers-develop-low-cost-high-speed-and-stain-free-optical-technology-that-could-displace-existing-histopathology-methodologies-030912#ixzz1oe5evQMp

An interesting shift: TOO MANY JOBS…?!?!

Tags

, , , , , , ,

 We ALWAYS have jobs…temp and permanent hire.  It’s been a LONG time since we’ve had THIS many.  Take a look, don’t forget our REFER-A-FRIEND bonus program.  And as always, this isn’t the complete list–call if you need something specific and we’ll search for you….

1.Pennsylvania

A. Private Small Reference Lab: 2 HISTOTECHS, 1 PA/GROSSER: A newly remodeled private lab has two day shift openings for full service including specials and IHC.  Two Histotechs to work together as well as a possible PA or Grosser to fill out the team.  They have an aid and it’s one of those jobs where you do it all and get the kudos you deserve.  An ‘old-school’ lab and one worth exploring if you’re looking for a long-term career opportunity. GREAT DOCS!

 B. Large reference facility: 1 HISTOTECH: A routine Histotech position.  Good pay and a possible career path with a large private company

C. Large reference facility: 1 HISTOTECH: Routine histology near one of the nicest cities in which to raise a family (my hometown!)

2. Florida

Gulf Coast Hospital: 1 SUPERVISOR and 2 HISTOTECHSAll day-shift for a private community hospital rebuilding their team. 

IF YOU DON”T HAVE A FLORIDA LICENSE–CALL ANYWAY.  An opportunity to move into a facility that cares enough to stand up for their techs and get them the pay and the environment to do the best work for their patients!  I like the lab manager–she had a great plan for this group!

3. Ohio

Private Hospital Facility: 3 HISTOTECHS: One handling the autopsy suite and some histology, the other two will fill out the Histology team.  They are rebuilding their team with an eye toward making it the best place in the area to work. 

4. Texas

A. Private medium-sized reference lab: 1 LEAD, 1 GROSSER, 2 HISTOTECHS: Multiple positions including a lead that might also serve as lead grosser, a grossing tech and several Histotech positions with several start times.  They have been a great place to work and with new management, are back on track again.

B. Private small reference lab: 1 HISTOTECH and possibly 1 IHC TECH: Lovely newly remodeled private reference facility outside a major city.  Nice management, routine work and a good pay rate…nice place to raise a family, too.

C. Large reference lab: PA or QUALIFIED/EXPERIENCED GROSSING HISTOTECH: They aren’t quite sure of the shift (evenings or early AM) but this is a career facility with promotion from within.  Very nice facilities, good pay and benies.

5. Colorado

Private medium reference facility: 2 HISTOTECHS: A NICE PLACE TO WORK….our temps convert to permanent at this place!  Can’t get a better compliment than that.  They’re growing and need more qualified help.  They do work with students and train but new experienced techs bring in new ideas.  I’ve benched with this supervisor–she’s a straight shooter–you know what is expected and how you’re doing.  Good pay–BEAUTIFUL city. 

6. ALL OVER THE COUNTRY:

HISTOTECHS, PATHOLOGIST’S ASSISTANTS: Seeking multiple HISTOs & PAs for a large number of temp and permanent openings…there just aren’t enough of you guys!

Call  281.852.9457  Email your resume for a call-back: admin@fullstaff.org

Fax and Alternate Phone: 800.756.3309

Travel temp – weighing the options

Traveling as a tech has good things and bad things, both.  The good things include the ability to say when, have some control over where, a little about what (shift, job description, facility type), and you can take time off between assignments. 

New people and places have their attraction. Some of my friends are from assignments nearly twenty years ago– and they’re all over the country!  Going new places and spending time learning a new city can be fun.  And you learn so much: I can do most any kind of Histology with any equipment and solve problems sixteen different ways.

One unexpected benefit is you can remain detached from the politics & drama in the labs that have a lot of that stuff going on.  That’s one thing that marks a great traveler in one who remains above the fray.  And if it is a less-than-lovely environment, it is easier as you know you’re going to move on pretty soon and can simply count down the days. 

Oh! Hotels and housekeeping! Don’t forget the lovelies that give us new linens, tidy up after us and vacuum once a week, usually there is a gym and a pool, so all we have to do is work and relax. 

The bad things include you can’t take extra time off mid-assignment to explore: we’re there to work.  Rarely is there overtime, we often do the basics like embed and cut, as that’s the most valuable use of our time. 

Time away can take a toll.  If you have to work without big breaks in between assignments you can lose contact with friends, and being away from family for extended periods gets old.  Really old.

The money isn’t all that much different if you calculate the cost of benefits and the time off without vacation pay.  Then add the total freak between assignments when it feels like there won’t be another job anytime soon!   

So it’s simply a choice.  Weigh the pros and cons in light of your life situation.  In this economy having a full time job with stability and full benefits including vacation time is good.   If you’re in-between jobs or are able to incorporate a little uncertainty into your life’s plan, maybe being a traveler is for you.   

Anyone else have comments or content to add–we’d love to hear from you!

Love to cut?

Cutting.  The core of our work. As a bench tech I suspect you get to cut and embed every day.  Would you be surprise that when taken out of a lab for a long period of time, you might MISS cutting and embedding?

 I don’t get to cut every day like I used to – and yes – I really miss it!  I think it’s part of why retired techs take part time and PRN work.  We miss the art of making those beautiful sections from GI to full large-mold colon slides. 

Just sayin.

A new batch of Job Openings…

Temporary Tech in: Colorado & Pennsylvania

Supervisors in: Texas, Florida, California

IHC specialists in: California, Louisiana

Routine Histology, entry through experienced positions in:  Tennessee, Pennsylvania, Ohio, Michigan, California, Colorado, Louisiana, Texas, Florida, Washington and several others.

Call for more information!  800.756.3309

What the heck is ISO and what does it mean to us?

Tags

, , , , , , , , , , , , , ,

We all know that change is part of working in clinical labs.  There’s a big one in the works.  The article, below, is specific to cytology but through the content we can get an idea of the impact for all of Pathology in the near future.

*********************************

ISO 15189

Globally recognized technical competence and quality management standards are a noble step for cytology.

By Nelson Barayuga, MBA, MT/CT(ASCP) (Original content from Advance Magazine for Laboratory Professionals, Posted on: January 30, 2012)

Laboratory medicine is constantly evolving, not only with diagnostic innovations but also in adapting practices that reflect the constant need for quality in both the local and international environment.

The laboratory does not lag in these business developments and to be accredited with technical competence and quality management standards that are globally recognized is a noble step towards improving patient care.

Overview and Purpose
The International Standardization Organization (ISO) is the world’s largest developer and publisher of International Standards. The ISO provides the standards for business, government and society. It is a network of the national standards institutes of 163 countries, one member per country, with a Central Secretariat in Geneva, Switzerland, that coordinates the system.

ISO is a non-governmental organization that forms a bridge between the public and private sectors. Therefore, the ISO enables a consensus to be reached on solutions that meet both the requirements of business and the broader needs of society.1

ISO was born from the union of two organizations–the International Federation of the National Standardizing Associations (ISA), established in New York in 1926; and the United Nations Standards Coordinating Committee (UNSCC), established in 1944.1

The ISO was established in 1947 and has since then published more than 18,500 international standards. Most of the earlier standards have been in business, where many of its member institutes are part of the governmental structure of their countries, or are mandated by their government. Other members have their roots uniquely in the private sector, having been set up by national partnerships of industry associations. 1

The work of the ISO stems from international agreements and are published as international standards. Medical laboratories now have the opportunity to comply with these published international standards and obtain recognition for quality of their products and services.

Laboratory medicine has embraced this challenge with the clinical side being in the forefront of the program. Cytology will always be a close follower. With the increasing scope of molecular diagnostics and automation, this will definitely bring cytology to another level of service quality.

As laboratory practitioners, we have to remember ISO accreditation is in addition to and not a replacement for the Clinical Laboratory Improvement Amendments (CLIA) requirements

Demonstration of Competence
ISO 15189 was first published in 2003 (and later withdrawn and revised in 2007) and is commonly referred to as ISO 151898:2007. It specifies requirements for quality and competence particular to medical laboratories.

It is to be used by medical laboratories in developing their quality management systems and assessing their own competence, and to be used by accreditation bodies in confirming or recognizing the competence of medical laboratories.

As the standard is about competence, accreditation is the formal recognition of a demonstration of that competence. Unique to CLIA’s approach to accreditation using peer review, ISO 15189 accreditation is to be carried out by a third party organization, and not by the peers (first party) nor by the patients (second party); thus being independent of those parties involved.

Not to be confused with and earlier laboratory-related standard published in 1999, ISO 17025 is the main standard used by testing and calibration laboratories. While it is an excellent standard for research and industrial laboratories, ISO 17025 does not fully address the needs of the medical laboratory. To provide an appropriate process to measure both technical competence and quality management, ISO 15189 was proposed and published. ISO 15189 is actually based upon ISO 17025 as well as ISO 9001.

Practical Applications
Standards ensure the characteristics of products and services we want and expect are met: these include laboratory results that reflect quality, environmental friendliness, safety, reliability, efficiency and interchangeability–all at an economical cost.

When products and services meet our expectations, we tend to take this for granted and be unaware of the role of standards. However, when standards are absent, we soon notice. We soon care when products turn out to be of poor quality, do not fit, are incompatible with equipment that we already have, are unreliable or dangerous.1

To meet the growing interest of recognition, the College of American Pathologists (CAP) initiated ISO 15189 accreditation in 2008.

ISO 15189 and Cytology
As more laboratories strive for accreditation, one may not help but wonder how this may influence the regulations and quality assurance practices already in place.

We already have the guidelines and oversight from CLIA ’88. These standards will not be replaced but rather supplemented by ISO 15189. With our current strict and thorough national standards, it is assuring to expect laboratories will meet these international requirements. However, we do have to understand that the third party will always have the discretion of implementing more stringent guidelines as it deems necessary.

Accreditation to ISO 15189 is voluntary, but the benefit for the profession and the services offered to patient care are paramount. Could international standards mean international business? Possibly, if construed in its literal definition. Can laboratory work be subjected to international testing practices? Again possibly, with considerations of digital imaging and remote access technology.

Aside from meeting international standards of quality and competence, business interaction among the countries that recognize the accreditation is a natural development that is made possible. It is speculative, but whenever the need arises and economic practicality is met, it is hard not to imagine such arrangements.

It is interesting to see the extent of laboratory participation of other countries that may want to establish reciprocal ties. Does a global economy mean an increase in distant (international) laboratory testing? Again, speculatively, yes to certain assays and procedures.

Oftentimes, when our laboratory products and services are reliable, accurate and timely, it is because they meet standards. This is what we generally strive for with all of our laboratory services. This time, with ISO 15189, we have the instrument to apply and practice this concept locally as well as internationally.

Where does this take cytology? Our role to patient care is foremost, and it is definitely a step that takes our services to another level of technical competence.

Nelson Barayuga is laboratory supervisor, NSLIJ Plainview and Syosset Hospitals, New York.

References 

  1. International Organization for Standardization, Available at: http://www.iso.org. Last accessed Jan. 14, 2012.
  2. American National Standards Institute. Available at: http://www.ansi.org. Last accessed Jan. 14, 2012.
  3. College of American Pathologists. Available at: http://www.cap.org. Last accessed Jan. 14, 2012

How does the weekend go?

Tags

, , , ,

I love how at the end of each workday in Histology, all the specimens are grossed, your blocks are cut and slides are turned out or on an overnight IHC run.  When you load the processors you have a pretty good idea what tomorrow (or like today how Monday) is going to go. 

I still bench in a lab pretty frequently but not every day.  I’m usually in an office under a phone headset and duct-taped to my computer.  I miss having a stack of flats or a tray of blocks at the end of the day and the satisfaction of ‘I did that’.  Nowadays my day is a reflection of who I talked with: is  the search for their next career step going well…or how close are we to finding that perfect fit for the people in that lab working short for the second quarter in a row. 

I do think about how stressful being in a job that doesn’t fit can be.  I’ve had a few of those along the way.  I also think about how tired you get working short day after day–we’ve ALL been there. 

So rather than being measured by a stack of slides or a box of blocks, my day at Full Staff is measured by this question:  where did we make a REAL difference today?  My day is about people and service.  Sometimes that means sitting at my desk on a beautiful Saturday afternoon because Suzanne and Erick need to get back to work and the guys in Ohio have been working short since before Thanksgiving.  It feels good–

–the privilege of making a difference.