GLOVES – the single most important safety device in the lab

Tags

Anatomic, Clinical, equipment, Grosser, histology, process, Routine, safety, staining, xylene

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

 
 
 

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

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Career, Grosser, histology, histotech, Job, Laboratory, pathologists assistant, Search

 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

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

Tags

Assistant, Career, Clinical, Cytology, Diagnosis, Grosser, histology, histotech, HT(ASCP), Job, Laboratory, Permanent, Search, Temporary, Traveler

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.

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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