What’s the buzz on specimen collection and transport?

May 1, 2010
Two words: color coding

Color-coding in labs is extremely useful when
used to distinguish between different types of testing. Color provides a
visual clue that works faster than text alone. By adding color coding to
barcode labels, you can speed up storage and retrieval time, eliminate
human errors, and reduce the risk of lost samples for overall increased
employee efficiency and productivity. Effective color-coded labeling is
as much about risk management, legal compliance, maintaining privacy,
preserving anonymity, and safeguarding information security as it is
about everyday convenience and employee productivity. Without accurate,
durable labeling in specimen collection, there may be dire ramifications
—such as a lawsuit, damage claim, audit, or other unwelcome business
situations. The retrieval of a bar-code color-coded sample or document
mitigates the risk of illegal and malicious disclosure. Laboratory
technicians find exactly what they need to correctly perform and record
their testing.

George Scholl
Business Development Specialist
Electronic Imaging Materials
Maker of Durable Laboratory Barcode Labels

Labels at the bedside

Printing bar-coded specimen labels at the bedside is a
trend that has been slow to catch on. Labs are beginning to realize positive
patient-identification systems that print bar-coded labels at the bedside are
more than just label printers for test tubes. These systems not only improve
patient safety for blood, they also can be used for anatomic-pathology samples,
improve turnaround time, improve quality assurance, and streamline all specimen
collection not just phlebotomy. Positive patient-identification systems will
also help healthcare facilities use IT in a “meaningful way,”giving them an
opportunity for incentive payments from Medicare and Medicaid.

Gregory Francis

President

Korchek Technologies

Maker of CareChek XP-Specimen Collection

Old favorite, bar codes, lead lab specimen ID to future

Bar codes, in use since 1970, have labs quickly learning these could be
the epicenter for streamlining lab processes and progressing into the
future of patient safety, therapy development, and workplace efficiency.
Durable barcoded labels provide clear, readable identification that
withstands processing — coupled with automated scanning of a specimen
—labs can benefit from chain-of-custody tracking, immediate LIMS/LIS
data input, and a significant reduction of errors due to manual entry.
Bar coding also promotes the LEAN processing technique of work-cell
single-piece flow specimen handling, which improves efficiency by
eliminating waste from batch-and match errors and reduces the time spent
waiting for batches to finish. Unique specimen ID and bar coding promote
database sharing initiatives by standardizing information and
patient/participant information. There is no gray area — bar codes
protect patients and identify specimens to eliminate waste, advance R&D,
and improve efficiencies in the lab.

Nicole Nelson, MBA

Market Manager – Lab and Healthcare

Brady Corp

Provider of automated specimen ID and tracking solutions

More flexibility in tissue processing

Outreach laboratories are becoming more aware of the
liability and exposure involved with specimen transportation every day. By
being held accountable for the safety of all specimens, labs are now seeing
the importance of electronically tracking specimens — especially
irreplaceable specimens. One lost biopsy not only can result in the loss of
profits but also can expose a lab to a legal nightmare. Manually tracking
specimens is no longer considered to be efficient or accurate as technology
has greatly increased productivity and helped optimize outreach programs.
More and more, labs are now seeing the value in streamlining their logistics
department by electronically tracking specimens.

Dave Taylor, President

Taylor Data Systems
Maker of Medical Courier Elite

Five rights of laboratory testing

Our solutions support our commitment to what we believe to be
the Five Rights of Laboratory Testing. This involves making certain the
right patient has the right test performed at the right time, for the
right indicators, ultimately leading to the right diagnosis. That
commitment also means producing solutions that help automate the
specimen-collection process and ensure accurate patient identification
and specimen labeling. This, in turn, enables more efficient collections
to support LEAN initiatives, reduce medical errors, and improves patient
safety. With the ever-changing laboratory environment, the marketplace
is constantly responding to meet the laboratory’s needs so that the goal
of zero errors can be successfully and more readily met.

Kelly Feist

Vice President of Marketing

Sunquest Information Systems

Maker of Sunquest Collection manager and SMART solutions

Mobile specimen tracking

The clinical laboratory industry looks to mobile software
products to help improve their specimen transport process, provide
higher quality service to their customers and reduce errors.  Labs,
physicians and patients need real-time information on the status of
specimens throughout the testing process. Mobile tracking can provide
visibility into when a specimen has arrived at the testing facility,
been picked up at the lab or collected by medical- specimen transport
organizations. Companies using mobile solutions gain a significant
advantage over their competitors. Offering proof of delivery, chain of
custody, sophisticated reporting, and the ability to track specimens in
real time makes these companies more attractive to hospitals, clinics,
and independent physicians. Clinics and labs are deploying mobile
solutions to drive productivity and efficiency, reduce costs, and
increase their competitive edge. Mobile software products delivered
through a SaaS-based model and packaged for the clinical laboratory
industry are cost-effective, low-risk, and effective in providing the
chain-of-custody visibility necessary to deliver high quality service.
These products are affordable, scalable, and easy to use, translating
into rapid ROI for the lab or clinic — and peace of mind for their
customers.

Rick Pontin
CEO
Airclic

Maker of Airclic’s Mobile Performance Platform

The Golden Rule of the lab

Technological progress in today’s laboratory offers
exciting promise for the future of diagnostic testing. While searching
for increased lab efficiencies, reduced overhead expenses, and maximized
profits, medical professionals remain ever mindful of The Golden Rule of
the laboratory: safety first. New and improved equipment and techniques
will continue to advance medical care while emphasizing safety as a
guiding principle. As diagnostic testing, collection, and transport move
into the 21st century, laboratories and their staffs need to heed this
Golden Rule and to promote safety education at every level, inside and
outside of the laboratory. Whatever it is, doing it the safe way is the
least expensive and most efficient way of all.

 Deidre Y. Bryan

Clinical Marketing Manager, N.A.

Owen Mumford

Maker of Unistik 3 Single Use Safety Lancets

Education is key for lab staff

Product manufacturers in the blood- collection industry now
have the opportunity not only to provide product training but also
educational information on proper handling to achieve a quality sample for
lab analysis. The role of the manufacturer has expanded to include
contributing to the education of laboratory staff on good preanalytic
techniques that follow Clinical and Laboratory Standards Institute’s (CLSI)
Standards and Guidelines for drawing specimens by venipuncture and proper
sample processing. This type of educational material has become an important
component of our partnership with our customers.

 Diane Ban
Product Manager, Preanalytics
Greiner Bio-One
Maker of VACUETTE QUICKSHIELD
Complete

PLUS

Reducing healthcare costs

We are continuously in contact with lab managers and staff —
the frontline of our industry and in prime position to communicate to
vendors the things which work best in the field and how we can help
facilitate their work. Their suggestions and comments allow us to continue
our pursuit of innovation. Committed to rapidly responding to customer
needs, we research, design and engineer, build, and test all of our products
in-house without subcontractors to delay our processes. In-house engineers,
software developers and microbiologists are responsible from R&D to final
laboratory testing. Because each lab functions differently, we want to
accommodate each laboratory in its unique situation. Complete automation of
specimen processing eliminates repetitive stress caused by opening,
sampling, and closing specimen containers numerous times each day, which can
lead to fatigue and work related stress and injuries. Automation in clinical
microbiology allows precious qualified staff to be redeployed from
repetitive lab tasks to functions that require judgment and interpretative
skills. Improving efficiencies in the laboratory helps identify infectious
agents faster, with greater precision and provides faster results to
physicians.

 Gabriela M.
Powers

Global Marketing Manager

Copan Diagnostics
Maker of

WASP, the walk-away specimen processor,
and its Gram SlidePrep module

Regulations and requirements for shipping

Under the Obama administration, there have recently been a
number of significant personnel changes within the U.S. Department of
Transportation, which regulates the shipment of all hazardous materials
within the United States. Many within the industry believe these changes
possibly point towards increasing monitoring, auditing, and enforcement as
it pertains to the shipment of all hazardous materials, which includes
infectious specimens. Based on current International Air Transport
Association (IATA) regulations and requirements, all patient specimens
shipped by air, whether infectious or exempt, are required to be properly
packaged according those regulations and requirements. With proper training
for all personnel involved in the shipping and transport of patient
specimens, and the use of appropriate shipping systems, the medical
laboratory will go a long way in minimizing the chances of rejected
patient-specimen shipments as well as the potential ramifications for
failure to adhere to regulations pertaining to such shipments.

 David Creighton

Regulatory Specialist

Saf-T-Pak

Manufacturer of Infectious and Diagnostic Packaging and Compliance
Training

RFID tracking efficiencies offset enhancement’s costs

Tracking of lab samples is still relatively error prone. The
use of radio frequency identification (RFID) is gaining momentum as a
solution to eliminate the guesswork and ensure that samples leave a trail
that is easily followed when something goes wrong. RFID tags can be used
from the point of collection through sample storage and disposal. Tags have
been manufactured for healthcare -— able to withstand temperature, liquids,
and chemicals. Use of RFID tracking provides not only elimination of lost or
misplaced specimens but also enhanced visibility, identifying costly
bottlenecks and delays. These systems provide a snapshot of where a specimen
has been at any given time. Many labs have shied away from this technology
thinking that the cost is too high; however, not only has the cost come down
but also the efficiencies have been shown to completely offset the cost of
this enhancement.

 Peter Allison

CEO


Ambient ID

Maker of LabTrack Specimen Tracking System

Six tips for more successful cell cultures

By Ed Sullivan

For those who
perform cell-culture experiments, it pays to be meticulous. Even
seemingly minor handling techniques and lab equipment features can make
a difference in achieving success. It can be challenging to maintain
pure cell cultures and keep them healthy and growing properly. By their
very nature, these cell cultures are extremely fragile. Any laboratorian
who has had problems with cell-culture health, longevity, or
contamination knows how time consuming, costly, and frustrating this can
be. Some researchers are almost “superstitious”about trying new
cell-culture vessels or media, or even altering their techniques.

But not all cells types respond to growth conditions in the same way.
What is more, products are continually being developed that increase
convenience and efficiency in the research lab. The trick is to find
ways to maximize results while minimizing wasted time and money.

The following tips, compiled from interviews with experienced
researchers and innovative equipment manufacturers, can help increase a
lab’s success rate without relying on “luck.”

1. Choose the right growth surface

There is no universal growth surface on which all cells grow well. For
non-anchorage cells, be sure to select a vessel surface that is
hydrophobic in order to minimize attachment. Finding a surface for cells
that you wish to attach can be a bit trickier. For example, if cells
grow poorly on a traditional, negatively-charged cell-culture surface, a
specialty surface with a positive charge may be a viable alternative to
achieving necessary adhesion without laborious coatings.

Look for a vendor that offers flasks with color-coded surface options so
it is easy to differentiate them in the lab. Not only will color coding
help to prevent mix-ups among various cell cultures, it also serves as a
visual aid for quick and reliable identification of different growth
surfaces.

Be sure that your vendor uses high-grade materials and products that are
manufactured under stringent purity conditions, free of pyrogens and
cytotoxins. This is essential to achieving reliability and consistency
for experiments. Also make sure that vessel surfaces are as flat as
possible. This can provide better adherence where needed and minimize
“patchy”cell growth that could compromise the results.

2. Filter out potential contaminants

Contaminants corrupt cell cultures and the results. If proper care is
not taken, cell lines could be lost. Take the time and steps necessary
to filter and purify everything that will come into contact with the
cells. For proper filtration, choose a membrane such as polyethersulfone,
or PES, which is low in protein binding, low in extractables, and offers
a high flow rate. To make certain that media and any nutrients that
might possibly be used are free of mycoplasma, use a filter with a
0.1-micron pore size.

3. Cap carefully

Flasks with standard non-vented membrane caps are designed for use in
closed systems (e.g., Leibovitz L15 media), providing a liquid- and
gas-tight seal. Non-vented caps may be used in the vented position when
gas exchange is desired and in the closed position when gas exchange is
not desired.

When there is no requirement for anaerobic conditions, vented caps with
a non-wettable hydrophobic membrane can be closed tightly to allow
regular gas exchange while keeping potential contaminants out. Using a
vented cap also eliminates the step of setting the cap to a vented
position, and prevents the liquid build up that sometimes forms around
the inside of plug seal caps, partially sealing them and inhibiting gas
exchange.

Look for quick-release caps for one-handed attachment or removal.
Generally, cell-culture flasks with traditional screw caps require one
or more turns to remove or replace the cap. A quick-release cap design
should require less than a full turn.

4. Do not disturb

Just like an infant, a cell culture does not like excessive noise or
movement. Make certain that the incubator is level, stable, and in a
location away from heavy foot traffic or vibrating, motorized
instrumentation, such as compressors, laminar flow hoods, or
centrifuges. Also make sure it has a rattle-free fan and that the
shelving allows for a uniform temperature profile. Bear in mind that
temperature fluctuations will more likely occur in the front of the
incubator, so keep more critical experiments toward the back of the
storage compartment.

“I believe that researchers experience this problem more often than you
might think,”says Pillari Ratnakar, PhD, veteran cell-culture
researcher. “I have seen instances where an incubator was placed next to
a centrifuge and a staff member thought there was a problem with the
culture vessel, incubator, or culture medium, for example. The real
problem was the agitation caused by the centrifuge equipment, and it
ruined the experiment by causing cells to form different circular growth
patterns on dishes.”

5. Be flexible

Cell scrapers are useful tools that allow laboratorians to remove cells
without using chemicals to dislodge them in preparation for experiments.
However, choosing the proper scraper design is critical. For example,
many cell scrapers have hard, inflexible blades that can cause more cell
damage than successful removal. To avoid such unnecessary or excessive
damage, consider using a cell scraper with a thin, flexible, non-toxic
blade material.

More advanced cell scraper designs can also include adjustable,
swiveling blades that are easier to use even in culture containers that
are difficult to access. This type of scraper blade can be aseptically
turned 90 degrees from the “scraper”position, ideal for use in flasks,
to the “lifter”position, which is useful for harvesting cells in
dishes.

6. Freeze cautiously

Once a cell culture has grown, remember that freezing and thawing are
critical for successful preservation and recovery. Follow an established
freezing protocol, and always use storage tubes that are specifically
designed for cryogenic use. Also, be sure to use cryo tubes that are
tested and certified to be completely free of potential contaminants
that would harm cell materials and cellular components during
preservation.

Freeze cells in a container at -80^0C with a cooling rate of 1^0C per
minute for several hours before transferring them to a liquid nitrogen
tank. Store the samples in the gas phase of the tank to prevent
contamination from frozen organisms in the liquid nitrogen, and to avoid
potential tube breakage due to liquid nitrogen entry and expansion
during thawing. When thawing, use a 37^0C water bath with cover.
Disinfect the tube before opening with 70% alcohol.

To avoid confusion or mixing of frozen samples, consider using a tube
system with color-coding. “Color coding on flasks makes it easy to
quickly discern between suspension and adherent cells, for instance,”according to Patrick McDonald, PhD, associate professor of Immunology at Universit’e de Sherbrooke in Qu’ebec. “This is a nearly foolproof system
that benefits everyone.”Some flasks also have uniquely shaped bases
that interlock with cryogenic racks, allowing easy, one-handed operation
of tubes and caps.

“Once you have successfully grown cells and are ready to store them long
term, you do not want to risk losing them during freezing,”advises Dr. Ratnakar.

Attention to detail is the name of the game in preparing and storing
cell cultures. Make careful decisions about techniques and equipment,
and continue to look for ways to increase efficiency, to avoid the
headache of lost cell lines and ruined experiments.

Ed Sullivan is a freelance writer who worked with Sarstedt., a
manufacturer of medical equipment/consumables, with its US-HQ in Newton,
NC.

Published: May, 2010

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