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NSCMLT Standards of Practice

 

STANDARDS OF PRACTICE

 

 

 

Date Approved: April 2013

Section: Position Statement

 

 

Effective Date: June  2015

Date to be reviewed: April 2016

 

 

 

 

STATEMENT:

 

Medical laboratory technologists (MLT) work in various clinical settings including but not limited to: hospitals, private laboratories, research facilities, colleges, universities, point of care testing settings and industry.

  

Medical laboratory technology is a demanding career. Due to new technological advancements, technologists must change and adapt their working roles and responsibilities. Medical laboratory technologists continually advance their learning and knowledge of their profession as it moves forward to meet with changes in healthcare.

 

This standard of practice (SOP) is a guide to the knowledge, skills, judgment and attitudes that are needed to practice safely and competently within the scope of practice set out by the Nova Scotia College of Medical Laboratory Technologists (NSCMLT). The standards are based on the premise that the medical laboratory technologist is responsible for and accountable to their work. 

 

The standard of practice are the minimum standards of practice that all licensed MLT’s must meet in Nova Scotia. NSCMLT recognizes that not all MLT’s perform each of these roles as part of their daily work. However, when a MLT does perform a specific role, then they must meet all of the standards of practice associated with the role. 

 

 

Who are Medical Laboratory Technologists?

 

 

General Medical Laboratory Technologist

 

General medical laboratory technologists are highly skilled healthcare professionals working in various areas of laboratory technology including; histology, hematology, transfusion science, immunology, parasitology, virology, tissue bank, clinical chemistry, molecular and microbiology. They are involved with the various aspects of collection, preparation and analysis of specimens received in the laboratory. This analysis aids in the diagnosis, preventions and treatment of disease. 

 

Diagnostic Cytotechnologist

 

Cytotechnologists are highly skilled health care professionals who are able to aid physicians with cancer detection and disease diagnosis in all body sites. Cytotechnologists prepares specimens for analysis, grossing, immunohistochemistry, molecular, and flow cytometry, process and screen cell smears, Analyzes routine, special and ancillary stains and techniques such as Papanicolaou, H&E, telepathology, flow cytometry, FISH, PCR and EM, male fertility specimens, fine needle aspiration biopsies and body fluids for cancerous or precancerous changes and other pathologies. The results have direct impact on patient care and implications for follow-up care.  

 

 Clinical Genetics Technologist

 

Clinical geneticists are highly skilled health professionals with a skill set that is constantly evolving.  They help patients and families by utilizing cutting edge technology in areas such as prenatal diagnosis, congenital abnormalities, inherited disorders and hematologic and other malignancies enabling physicians to diagnose, treat and monitor a patient’s condition. Results have direct impact on patient care, family counselling and future medical care.  Clinical Genetics Technology involves the detailed analysis of the human genome using FISH, banded metaphase chromosomes and molecular genetic techniques on a variety of human tissues.  

 

  

STANDARDS OF PRACTICE

 

Medical laboratory technologists comprehend and adhere to all professional, legal, and ethical requirements governing the practice of the profession.  MLTs possess in-depth scientific knowledge of the theory, techniques, and clinical application of medical laboratory technology.

 

Fundamental Competencies

The MLT uses a client-centered approach to provide safe and comprehensive medical laboratory services and to facilitate the effective delivery of services to clients.

 

 MLTs shall:

  • Act in compliance with the Medical Laboratory Technology Act, Regulations and NSCMLT Bylaws
  • Have an in-depth scientific knowledge of the theory, techniques, and clinical application of medical laboratory technology
  • Apply fundamental competencies to tasks and respond to problems as they arise according to protocols of the profession
  • Maintain competence
  • Enhance knowledge, skill and application of relevant medical laboratory procedures
  • Recognize and practice within the limits of their competence
  • Recognize and work within the limits of their competence when accepting responsibility for assignment and or delegation

Safe Work Practices

The MLT practices in accordance with current provincial and federal safety legislation for the protection of clients and the environment.

  

 MLTs shall:

  • Apply Routine Practices and Additional Precautions to ensure safety of one-self, healthcare professionals, patients and the community
  • Use protective equipment
  • Use appropriate hygiene and infections control measures
  • Use safety devices (fume hood, pipettes)
  • Handle and dispose of sharps safely in compliance with safety guidelines
  • Use approved methods for disinfection and sterilization of equipment
  • Respond to emergencies and incidents appropriately
  • Apply spill containment and clean up procedures
  • Report all incidents in a timely manner
  • Follow WHIMIS, fire safety protocol and existing legislation 
  • Follow safety protocols as set out by employer
  • Use appropriate ergonomic principles
  • Use expertise to store, dispose, transport and handle dangerous goods.
  • Maintain inventory of hazardous reagents and discards appropriately if no longer in use

Communication/Interaction

 

MLTs shall:

  • Demonstrate and practice effective communications skills 
  • Work effectively within the healthcare team
  • Demonstrate basic patient care skills
  • Demonstrate time management skills
  • Recognize barriers to effective communication
  • Respect the rights of colleagues and patients
  • Demonstrate collegiality
  • Collaborate with other health professionals to ensure best practice and patient centered care
  • Contribute to conflict resolution
  • Documents issues and takes appropriate action
  • Promote  and implement interdisciplinary work practice
  • Encourages students

Pre-Analytical

 

MLTs shall:  

  • Follow workplace protocol
  • Receive specimens and verify adequacy of specimens
  • Ensure and recognize when relevant specimen information is required for correct interpretation/testing
  • Instruct patients on collection storage and transport of specimens to lab
  • Prepare specimens for transport
  • Collect, label and deliver specimens
  • Coordinate and prioritize workflow 
  • Register patient/specimens information using appropriate LIS/HIS
  • Comply with guideline for storage and disposal of specimens
  • Prepare specimens for analysis
  • Uses sound judgment to assess quality and suitability of specimens for interpretation/testing
  • Understand theory of the laboratory procedures being performed
  • Verify patients are properly identified, registered or has a unique identifier before any specimen is obtained, including during emergencies and unknown patients. 
  • Ensure all laboratory personnel who perform laboratory tasks are properly trained and supervised in accordance with laboratory standards.

Specimen Analysis and Reporting

 

MLTs shall:

  • Evaluate, interpret, validate and report test results
  • Correlate test results
  • Perform additional techniques to aid diagnosis or makes recommendations as required
  • Understand relationship between analysis, diagnosis, clinical information and treatment
  • Recognize need for further testing
  • Understand and interpret reference intervals, critical values, linearity limits and technique limits of analysis and responds accordingly
  • Understand reasons for unexpected test results and possible interactions
  • Able to take corrective action if errors occur and documents as required
  • Understand the principles to perform analytical techniques
  • Where required follow irreplaceable specimen policy

Post Analysis 

 

MLTs shall:

  • Refers results to appropriate authority/individual if required
  • Ensure policy and procedures are current
  • Communication of laboratory analysis
  • Ensure laboratory reports remain confidential and retained in accordance with provincial policy and established legislation

 

Equipment and Reagents

 

MLTs shall:

  • Prepare stains and stock solutions
  • Prepare media and working solutions
  • Reconstitute reagents according to manufacturer’s instructions and store reagents
  • Use reagent preparation equipment
  • Operate and maintain lab equipment as directed
  • Maintain logs and updates documents
  • Make adjustments and preventative maintenance to equipment
  • Maintain inventory
  • Monitors instrument performance
  • Able to troubleshoot problems, recognizes malfunction in equipment, analyzers and reagents and takes corrective action

Quality Management

 

 MLTs shall:

  • Ensure accuracy of patient data
  • Apply QA principles following procedures and taking corrective action as needed
  • Maintain appropriate documentation
  • Document appropriately as per lab requirements
  • Monitor supplies for expiry dates
  • Demonstrate awareness of key performance indicators
  • Participate in external and internal QA programs
  • Assist in updating procedures and protocols
  • Participate in workflow analysis
  • Take appropriate action when QA/QC issues occur
  • Maintain standards for quality control
  • Follow QA/QC protocols
  • Monitor QA/QC programs and takes appropriate corrective action as needed
  • Evaluate new methods and validates the procedures
  • Ensure QC data is retained in accordance with established policy and legislation
  • Ensures that unlicensed personnel for whom they are responsible, are delegated, only tasks that are appropriate to their training and consistent with legislation, regulations and policies
  • Ensures that unlicensed personnel working under their supervision are competent

Professionalism/Professional Responsibilities

The MLT is accountable to the client, the public, employer, and the regulatory College and practices in accordance with legislative requirements and the College Standards of Practice.

 

 MLTs shall:

  • Be aware of the legal and ethical requirements of laboratory work as it relates to patients’ rights and standard of care
  • Recognize unprofessional conduct and takes appropriate action
  • Clarify the roles and responsibilities of the profession to other healthcare teams as required
  • Exercise rights to refuse to participate in potentially dangerous procedures
  • Comply with legislation, the Medical Laboratory Technology Act and Regulations
  • Seek appropriate guidance when asked to perform beyond scope of practice
  • Participate in training of co-workers and students
  • Demonstrate ability to adapt to the changing needs of the profession
  • Maintain confidentiality of all patient and laboratory information
  • Put patients welfare and care standards above all other considerations
  • Act in accountable and ethical manner
  • Understand and comply with the code of professional conduct of the CSMLS 
  • Make independent professional judgments
  • Maintain clinical skill competence
  • Assist with professional development of staff
  • Promote and work to improve the profession
  • Participate in teaching, managing and supervising as required
  • Participate in lifelong learning in the profession and complies with TeKnowledge 

Research Initiatives

The MLT integrates and applies the principles, techniques, and methodologies of evidence based medical laboratory science to professional practice.

 

 MLTs shall:

  • participates in research activities in the lab
  • Supports evidence based work in practice
  • Develops and assesses new technologies, techniques and procedures
  • Initiates research and leads formal projects
  • Reviews and critically appraises current literature to make appropriate recommendations for the lab
  • Contributes to research design and development
  • Follows ethics review standards in research design

MLT Manager and Directors shall also

  • Ensures the lab conforms with applicable laws, regulations, and accreditation policies that ensure the MLT practice safely, effectively and ethically
  • Develop and implement practice models based on measurement and improvement in the quality that labs provide
  • Organize staff and workflow to enable MLT’s to fulfill standards of practice and to optimize patient care
  • Establish job descriptions that hold MLT’s accountable for professional performance consistent with standards of practice, including measurable performance indicators
  • Facilitates staff to work within and comply with their professional, ethical and legal obligations
  • Ensure MLT access to required information and resources to ensure best practices
  • Supports and encourage engagement by MLTs in continuous professional development
  • Intervenes when an MLT is not practicing in accordance to the NSCMLT standards of practice for MLTs and reports to the NSCMLT 
  • Support staff that report violations of practice, legal and ethical obligations by self or other healthcare professionals to their employer or NSCMLT
  • Manage errors, incidents and unsafe practices
  • Develop and implement policies and procedures that minimize errors, incidents, and unsafe practices
  • Promote a healthy nonviolence workplace where all are treated respectfully
  • Creates practice environments that support consultation and inter-professional practice among members of the healthcare teams

MLT Educators shall also

  • Promote a safe learning environment free of violence, harassment and discrimination
  • Promote a learning environment in which everyone is treated with respect
  • Facilitate learning of safe practice and quality management as it applies to  medical laboratories
  • Role model the development of professionalism, team work and effective interpersonal skills
  • Provide education in regard to professional, ethical and legal obligations
  • Facilitate learners to develop skills on how to address unethical, unsafe or illegal practices or behaviours of peers or colleagues
  • Implement educational activities that assist the learner to develop and enhance required competencies
  • Maintain an appropriate professional relationship with learners
  • Provide a learning environment that promotes legal, safe and accurate lab testing
  • Promote professional accountability and intervenes when learners or MLT’s are not practicing in accordance with the NSCMLT Standards of Practice for MLT’s
  • Provide appropriate supervision of learners and supports their ability to provide safe competent laboratory results
  • Promote a learning environment to contribute to ongoing demonstration and evaluation of competencies
  • Encourage learners to engage in continuous learning and professional development and promote inter-professionalism
  • Provide ethical, non-biased, evaluation of competency
  • Aid in the progression of the scope of practice by contribution of literature, presentations or engagement in national and provincial bodies
  • Preceptors are considered educators in that they educate students how to follow standard operating procedures, perform methods,  analyze results and report results

 MLT’s holding Research or Knowledge Translation Occupations

  • Promotes research environments that support and facilitate research utilization, professional accountability, client safety and advance practice
  • Communicates evidence-informed research findings to MLT’s, other healthcare professionals, clients, stakeholders and public
  • Promotes and practices the principles of evidence-based decision making,  knowledge translation and exchange
  • Advances MLT practice through communicating evidence based research and best practice findings
  • Practices ethical research practices according professional, institutional and legal policy

 

 

Developed by the NSCMLT Professional Practice Committee

 

References:

College of Registered Nurses Nova Scotia Standards of Practice 2012

 

Nova Scotia College of Pharmacist Standards of Practice 2014

 

 

RELATED DOCUMENTS: 

 

DATE DEVELOPED: April 2013

 

REVIEWED DATES:  April 2015