Johns 1

CMLT 2015 – SGHS BWK

Clinical Chemistry – Eric Johns (~80 hours)

The skills needed to function in the Clinical Chemistry department include the following: READING, organization, specimen management, computer literacy, interdependence, troubleshooting. One needs to be able to operate under stressful situations.

Day 1: Monday – January 5, 2015 Read procedure manuals, Vitros® 5600 Manual, Miscellaneous bench manual, immunology manual for H. pylori

and Mono test Reviewed training operations guide Started on study questions

Day 2: Tuesday – January 6, 2015 Watched Vitros® 5600 CD-ROM Training guide Introduced to specimen process:

o Tubes and different color of tubes o Specimen types o Specimen cups (micro/bullets, etc.) o Quest samples

Shown QC board, storage tracking, label reprint Introduced to Vitros® 5600, Roche® 9180 AVL Electrolyte Analyzer, Advanced Instruments, Inc.® Osmomoter,

and manual chemistry tests Completed Study Questions

Day 3: Wednesday – January 7, 2015 Ran QC on AVL, Osmometer, and Acetest Shown Reagents: Microslides, Microtips, and Microwells; how to load Ran samples and was explained condition codes

Day 4: Thursday – January 8, 2015 Ran QC on AVL, Osmometer, and Acetest Operated the Vitros® 5600 analyzer, AVL, and Osmometer

Day 5: Friday – January 9, 2015 Ran QC on AVL, Osmometer, and Acetest Operated the Vitros® 5600 analyzer, AVL, and Osmometer Had study questions checked for accuracy

Day 6: Monday – January 12, 2015 Ran QC on AVL, Osmometer, and Acetest Operated the Vitros® 5600 analyzer, AVL, and Osmometer

Day 7: Tuesday – January 13, 2015 Ran QC on AVL, Osmometer, and Acetest Had Middleware, PathNet Millennium, and their interface explained Had auto-verification explained Had Protocol for calling critical values and appropriate documentation procedure explained Had guidelines for running Quality Control explained Had processes of diluting samples, maximum dilutions, and reflex testing explained Had process of running urine samples explained, including appropriate pH range for specific analytes and how to

correct pH if outside range Operated the Vitros® 5600 analyzer, AVL, and Osmometer

Johns 2

CMLT 2015 – SGHS BWK

Day 8: Wednesday – January 14, 2015 Ran QC on AVL, Osmometer, and Acetest Completed Chemistry Practical #1 on Vitros® 5600 and AVL Completed Chemistry Practical #2 on Vitros® 5600 and AVL Operated the Vitros® 5600 analyzer, AVL, and Osmometer

Day 9: Thursday – January 15, 2015 Ran QC on AVL, Osmometer, and Acetest Operated the Vitros® 5600 analyzer, AVL, and Osmometer

Day 10: Wednesday – January 16, 2015 Ran QC on Acetest Completed Practical and Examination on Vitros® 5600, AVL, and Osmometer

Hematology – Eric Johns (~72 hours)

Day 1: Tuesday – January 20, 2015 Performed daily maintenance on microscope (Olympus® BX43) Read Hematology Procedure Manual Section 1 – LH 780

Day 2: Wednesday – January 21, 2015 Performed daily maintenance on microscope Performed 30 WBC Differentials Reviewed Kodachromes – CAP Surveys

Day 3: Thursday – January 22, 2015 Performed daily maintenance on microscope Performed 20 WBC Differentials Performed Reticulocyte Count Read Hematology Procedure Manual Section 2 – Differential, Bench Procedures, Biological Fluids, Maintenance,

QC Performed Sed Rate procedure

Day 4: Friday – January 23, 2015 Performed daily maintenance on microscope Performed Sed Rate and Micro-Sed Rate procedures Performed Sickledex® procedure Operated Beckman Coulter® LH 780 + LH Slidemaker, Siemens Hematek™ 2000 Performed procedures for Leuco-tic®, Thrombo-tic®, and body fluid counts on hemacytometer

Day 5: Monday – January 26, 2015

Operated Beckman Coulter® LH 780 + LH Slidemaker, Siemens Hematek™ 2000 Day 6: Tuesday – January 27, 2015

Operated Beckman Coulter® LH 780 + LH Slidemaker, Siemens Hematek™ 2000 Performed Eosinophil stain on urine sample

Day 7: Wednesday – January 28, 2015

Operated Beckman Coulter® LH 780 + LH Slidemaker, Siemens Hematek™ 2000 Assisted with three bone marrow aspirate slide preparations Performed Reticulocyte Count

Day 8: Thursday – January 29, 2015

Operated Beckman Coulter® LH 780 + LH Slidemaker, Siemens Hematek™ 2000

Johns 3

CMLT 2015 – SGHS BWK

Day 9: Friday – January 30, 2015

Took Hematology examination Phlebotomy – Eric Johns (~40 hours) This rotation requires humanitarianism and strong interpersonal communication to convey a positive customer service approach to the patients in need. Day 1: Monday – February 2, 2015

Inpatient care: Observed proper procedure for introduction, verification of identifiable information, site selection and preparation, order of draw, and labeling of tubes

Day 2: Tuesday – February 3, 2015

Inpatient care: Observed proper procedure for introduction, verification of identifiable information, site selection and preparation, order of draw, and labeling of tubes

Introduced to use of butterfly system, syringe, and Vacutainer™ system Day 3: Wednesday – February 4, 2015

Inpatient care: Observed proper procedure for introduction, verification of identifiable information, site selection and preparation, order of draw, and labeling of tubes

Day 4: Thursday – February 5, 2015

Inpatient care: Observed proper procedure for introduction, verification of identifiable information, site selection and preparation, order of draw, and labeling of tubes

Day 5: Friday – February 6, 2015

Outpatient care: Observed proper procedure for introduction, verification of identifiable information, site selection and preparation, order of draw, and labeling of tubes

Immunology/Serology – Eric Johns (~40 hours) Day 1: Monday – February 16, 2015

Read Immunology procedure manuals, Sebia® IFE manual Completed Immunology study questions Observed ANA QC and setup Performed RPR testing

Day 2: Tuesday – February 17, 2015

Observed/assisted with bone marrow aspirate Performed RPR testing

Day 3: Wednesday – February 18, 2015

Observed/assisted with bone marrow aspirate Observed/performed ANA QC, setup, and identified positive and negative results Performed RPR testing

Day 4: Thursday – February 19, 2015

Took Immunology examination

Johns 4

CMLT 2015 – SGHS BWK

Urinalysis/Coagulation – Eric Johns (~40 hours) Day 1: Monday – February 23, 2015

Read Urinalysis and Coagulation procedure manuals Completed study questions Reviewed Kodachromes

Day 2: Tuesday – February 24, 2015

Observed/assisted with QC and loaded samples on AUTIONTM AX-4280 and Iris® iQ200 analyzers Observed/assisted with QC and loaded samples on Diagnostica Stago STA Compact coagulation analyzer Performed Sudan III lipid procedure Performed wet prep procedure Performed drug screen by urine cups Performed hCG screens Performed 20 manual urinalysis procedures by strip and microscope

Day 3: Wednesday – February 25, 2015

Performed QC and loaded samples on AUTIONTM AX-4280 and Iris® iQ200 analyzers Loaded samples on Diagnostica Stago STA Compact coagulation analyzer Performed wet prep procedure Performed drug screen by urine cups Performed hCG screens

Day 4: Thursday – February 26, 2015

Performed QC and loaded samples on AUTIONTM AX-4280 and Iris® iQ200 analyzers Performed QC and loaded samples on Diagnostica Stago STA Compact coagulation analyzer Performed wet prep procedure Performed drug screen by urine cups Performed hCG screens Performed drug screen by card

Day 5: Friday – February 27, 2015

Took Urinalysis/Coagulation examination Microbiology – Eric Johns (~80 hours) Day 1: Monday – March 2, 2015

Observed logging-in specimens, media storage Demonstrated Rapid Strep A Antigen screen Demonstrated RSV Antigen screen Demonstrated Influenza A & B Antigen screen

Day 2: Tuesday – March 3, 2015

Specimen collection Media selection Isolation and colony count streaking Culture incubation Performed Rapid Strep A Demonstrated Giardia/Cryptosporidium antigen testing Read/Reported Gram Stains

Johns 5

CMLT 2015 – SGHS BWK

Day 3: Wednesday – March 4, 2015 Demonstrated/discussed colony morphology/hemolysis, oxidase test, Catalase/Staph latex/Coagulase tests,

Indole-spot test, Strep grouping (A-G), TSI/LIA/Urea/Motility media, API 20E, N/H panel, XV test, Vitek system, Salmonella serotyping

Demonstrated/discussed MIC’s-Vitek, Kirby-Bauer, E-test, C MRSA screen Demonstrated/discussed Blood cultures, Genital cultures, Group A culture, Group B cultures, Throat cultures

Day 4: Thursday – March 5, 2015

Demonstrated/discussed Bile esculin/6.5% NaCl/P disk, CAS test, E.coli O157:H7 test Demonstrated/discussed C VRE screen Demonstrated/discussed Urine cultures

Day 5: Friday – March 6, 2015

Demonstrated/discussed Body fluids, Cath tips, Wound cultures Demonstrated/discussed Vanco screen/D test/Beta lactamase Took Microbiology media examination

Day 6: Monday – March 16, 2015

Demonstrated/discussed Cryptococcal antigen, Mycology Biohazard/safety, Mycology specimen collection, Mycology Media/selection, KOH/India ink prep, Calcofluor white stain

Read Mycobacteriology resources Day 7: Tuesday – March 17, 2015

Read Mycobacteriology and Mycology resources Day 8: Wednesday – March 18, 2015

Demonstrated/discussed antigen testing for Rotavirus, C.difficile toxin Demonstrated/discussed Yeast ID/Mold ID Discussed cellophane tape prep-pinworm

Day 9: Thursday – March 19, 2015

Read Mycobacteriology and Mycology resources Day 10: Friday – March 20, 2015

Took Microbiology examination

Immunohematology – Eric Johns (~80 hours) Day 1: Monday – March 23, 2015

Introduction to Blood components, Tube typing, Gel System, Gel Typing procedures Day 2: Tuesday – March 24, 2015

Performed Tube typing Day 3: Wednesday – March 25, 2015

Antibody screens, Type and Screens Day 4: Thursday – March 26, 2015

Antibody identification

Johns 6

CMLT 2015 – SGHS BWK

Day 5: Friday – March 27, 2015 Antigen typing DAT – in vivo sensitization Elution testing

Day 6: Monday – March 30, 2015

Crossmatching Transfusion reaction investigation/workup

Day 7: Tuesday – March 31, 2015

Typing units Observed issuance of blood

Day 8: Wednesday – April 1, 2015 Discussed ORTHO ProVue® Newborn profiles, Rhogam studies

Day 9: Thursday – April 2, 2015

Took Blood Banking practical Day 10: Friday – April 3, 2015

Took Blood Banking examination