Nature of the Clinical Laboratory ACCORDING TO INSTITUTIONAL CHARACTERISTICS

CLINICAL LABORATORY INSTITUTION-BASED FREE STANDING

- An essential component of the health institution ‣ Operates within the

premises or part of an ‣ Not part of an established
- Main task: To provide accurate and reliable
institution such as a institution
information to medical doctors for the diagnosis, hospital, school, medical
prognosis, treatment and management of clinic, medical facilities, for ‣ Most common example:
overseas and seafarers, etc. free-standing outpatient
diseases.
clinical laboratory
- Involved in research community, outreach, ‣ Most common example:
hospital-based clinical lab
programs, surveillance, infection control in the
hospital and community settings, information
dissemination, and evaluation of the applicably of
ACCORDING TO OWNERSHIP
current and innovative diagnostic technologies.
- A place where specimens collected from GOVERNMENT- OWNED PRIVATELY - OWNED

individuals are processed, analysed, preserved ‣ Owned, wholly or partially, ‣ Owned, established and
and properly disposed. by national and local operated by an individual,
government units corporation, institution,
- A medical technologist/ clinical laboratory association or organization
‣ Examples:
scientists plays a very significant role in the ‣ Examples:
Clinical and anatomical
performance of the laboratory. - St. Luke’s Medical
laboratories of DOH-run
government hospitals:
CLASSIFICATIONS OF CLINICAL LABORATORIES Center
- San Lazaro Hospital - Makati Medical Center
- Jose R. Reyes
ACCORDING TO FUNCTION Memorial Medical - MCU-FDTMF Hospital
Center - UERMMMCI
CLINICAL PATHOLOGY ANATOMIC PATHOLOGY
- UP-PCH
‣ Diagnosis and treatment of ‣ Diagnosis of diseases LGU- hospital based
diseased performed through through microscopic clinical laboratories:
laboratory testing of blood examination of tissues &
& other body fluids organs - Ospital ng Maynila
Areas of the ff. : Areas of the ff. : Medical Center
- Sta. Ana Hospital
- Clinical Chemistry - Histopathology - Bulacan Medical
- Immunohematology - Immunohistopathology
Center
& Blood banking - Cytology
- Medical - Autopsy
microbiology - Forensic Pathology
- Immunology &
serology ACCORDING TO SERVICE CAPABILITY
- Hematology
- Parasitology PRIMARY CATEGORY
- Clinical microscopy
- Toxicology ‣ Licensed to perform basic, routine laboratory testing,
- Therapeutic drug urinalysis, stool examination, hematology, cbc, blood typing
monitoring and gram staining (if hospital based)
- Endorcrinology
‣ Equipment requirements – microscopes, centrifuge,
haematocrit centrifuge
‣ Space Requirement – at least 10 square meters

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 Laws on the Operation, Maintenance, and
ACCORDING TO SERVICE CAPABILITY
Registration of Clinical laboratories in the Philippines
SECONDARY CATEGORY
REPUBLIC ACT NO. 4688
(hospital and non-hospital based)
‣ Licensed to perform laboratory tests being done by the - An act regulating the operation and maintenance
primary category clinical labs along with the following: of clinical laboratories and requiring the
- Routine clinical chemistry test like blood glucose registration of the same with the department of
concentration
- Blood urea nitrogen (BUN) health, providing penalty for the violation thereof,
- Blood uric acid (BUA) and for other purposes.
- Blood creatinine
- Cholesterol determination ADMINISTRATICE ORDER NO. 59 S. 2001
- Gram staining, KOH and crossmatching (if
hospital based)
- Rules and Regulation Governing the
‣ Minimum requirements – microscopes, centrifuge,
Establishment, Operation and Maintenance of
haematocrit centrifuge, semiautonimated chemistry
analyzer, autoclave, incubator and oven Clinical Laboratories in the Philippines
‣ Minimum space requirement – 20 square meters
BHFS/HFSRB – Health Facilities and Services
TERTIARY CATEGORY Regulatory Bureau
(hospital and non-hospital based)
CHD – Center for Health Development
‣ Licensed to perform all the laboratory tests in the
secondary category plus: - Issues a valid license to operated based on
compliance with the minimum licensing
- Immunology and serology requirements
- Microbiology, bacteriology and mycology
- Special clinical chemistry (clinical enzymology,
antimicrobial drug monitoring, markers) SECTIONS IN THE LABORATORY
- Special hematology (bone marrow studies, special
staining for abnormal blood cells, red cell CLINICAL CHEMISTRY
morphology) Immunohematology and blood
banking - Intended for the testing of blood and other body fluids

‣ Minimum equipment requirements – those seen in to quantify essential soluble chemicals including
secondary category laboratories along with automated waste products useful for the diagnosis of certain
chemistry analyzer, biosafety cabinet class II, serofuge
diseases.

‣ Minimum space requirement – at least 60 square - Most common specimen: blood (serum or plasma)
meters and urine
NATIONAL REFERENCE LABORATORY - One of the most busiest section in the lab; in
majority of tertiary level lab, this section is fully
‣ A laboratory in a government hospital designated by the automated
DOH to provide special diagnostic functions and services for
certain diseases - Important activities that med tech performs:
‣ These functions include:  Internal Quality Assurance (IQA)
- referral services
 Continuous Quality Improvement (CQA)
- provision of confirmatory testing
- assistance for research activities  participation in National External Quality
- implementation of External Quality Assurance Assurance Program (NEQAP) important activities
Programs (EQAP)
- Resolution of conflicts regarding tests of different that med tech performs
labs Training of medical technologists

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MICROBIOLOGY
- Subdivided into 4 sections:
 Bacteriology
 Mycobacteriology
 Mycology
 Virology
- Specimens usually submitted – blood, other body
fluids, stool, tissues and swabs from different sites in
the body
- Tests includes:
 Microscopic visualization after staining
 Isolation and identification of bacteria and fungi
using different culture media and biochemical
tests
 Antibacterial susceptibility testing (AST)
HEMATOLOGY AND COAGULATION STUDIES
- Deals with the enumeration of cells in the blood and
other body fluids
- Tests include:
 Complete blood count (CBC)
 Hemoglobin and hematocrit determination
 WBC differential count
 Red cell morphology and cell indices
 Platelet count
- Coagulation studies – testing for the determination
of various coagulation factors
CLINICAL MICROSCOPY
- 2 major areas:
1. for routine and other special examinations in
urine – macroscopic, microscopic examination
and chemical examination in urine
2. for the examination of stool or routine
fecalysis – detection and examination of
parasitic worms and ova
BLOOD BANK/ IMMUNOHEMATOLOGY
- Two main activities: blood typing and compatibility
testing
- Screening and identification of antibodies as well as
the blood components used for transfusion
- Considered as the most critical in the clinical lab
BLOOD BANK/ IMMUNOHEMATOLOGY
(Hospital-based clinical lab)
- blood donation activities prompt other activities such
as donor recruitment and screening, bleeding of
donor and post-donation care
IMMUNOLOGY AND SEROLOGY
- Analyses of serum antibodies
- Tests include (but not limited):
 Hepatitis B profile tests
 Serological test for syphilis
 Tests for hepatitis C and Dengue fever
ANATOMIC PATHOLOGY – SECTION OF
HISTOPATHOLOGY/ CYTOLOGY
Activities performed include:
 Tissue processing (removed surgically as in
biopsy and autopsy
 Cutting into sections
 Staining
 Preparation for microscopic examination by a
pathologist
SPECIALIZED SECTIONS OF THE LABORATORY
IMMUNOHISTOCHEMISTRY
- Combines anatomical, clinical and biochemical
techniques where antibodies (monoclonal and
polyclonal) bounded to enzymes and fluorescent dyes
are used to detect presence of antigen in tissue.
- Useful for diagnosing some types of cancer
MOLECULAR BIOLOGY AND BIOTECHNOLOGY
- DNA and RNA are identified and sequenced to
detect any pathologic conditions/disease processes.
- Most common technique – polymerase chain
reaction (PCR)
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LABORATORY TESTING CYCLE

QUALITY ASSURANCE IN CLINICAL LABORATORY

- Quality assurance (QA) – encompasses all

activities performed by the laboratory personnel to
ensure reliability of test results.
- It is an organized, systematic, well-planed and
regularly done with the results properly documented
and consistently reviewed
- 2 major components:
1. Internal Quality Assurance System (IQAS)
- day-to-day activities that are undertaken in order
to control factors or variables that may affect the
test results
2. External Quality Assurance System
(EQAS)
- System for checking performance among clinical
laboratories and is facilitated by designated
external agencies
- National Reference Laboratories (NRL) is the
DOH-designated EQAS

Designated NRL-EQAS:

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Professional organizations PROFILE
- Membership in a professional organization can also
- Assemblages of professionals within a particular build the career portfolio of a professional.
specialization or professional field that come - A professional society can also provide opportunities
together for the purpose of collaboration, networking, for speaking engagements, career specialization,
and professional development or advancement. publication in research journals, and even
scholarship and training programs abroad.
Benefits of Membership in Professional
Organizations TYPES OF PROFESSIONAL ORGANIZATIONS

 Professionalism
ACCREDITING ORGANIZATIONS
 Education
- Accredit curricular programs in educational
 Perks institution.
 Networking - An educational institution applying for
accreditation will then be visited by a technical
 Profile committee of experts from the accrediting
agency to verify its compliance to the standards
 Recognition
of quality education.
- Membership in this type of professional
PROFESSIONALISM organization is limited and is usually
institutional.
- Professionals must adhere to the set of rules or code
LOCAL ACCREDITING ORGANIZATIONS FOR
of ethics prescribed by the professional society.
MEDICAL TECHNOLOGY SCHOOLS

Philippine Accrediting Association of

EDUCATION PAASCU Schools, Colleges, and Universities
Philippine Association of Colleges
- It organize continuing professional development
PACUCOA and Universities Commission on
(CPD) activities for their members through Accredication
conventions, seminars, fora, workshops and other
activities of similar nature. CREDENTIALING/CERTIFYING
ORGANIZATIONS
PERKS - Provide certification examinations for
professionals.
- Usually come in the form of monetary discounts on - Certified professional are required to renew
registration fees for professional development their licenses within a specified duration.
- Not common in the Philippines due to the
activities of the organization. presence of a government professional
- These discounts are offered exclusively to members regulatory body (PRC)
INTERNATIONAL
of the organization. CREDENTIALING/CERTIFYING AGENCIES FOR
MEDICAL TECHNOLOGIST
NETWORKING AMT American Medical Technologist
American Society of Clinical
- Activities conducted by professional organizations ASCP Pathology
provide opportunities for building networks in the International Society for Clinical
ISCLT Laboratory Technology
field. National certifying Agency for
NCA Medical Laboratory Personnel
- Gatherings and other activities can be potential
avenues for creating long-term linkages and
connections with other professionals in the field.
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 PROFESSIONAL SOCIETIES
- Organizations that contribute to the continued
development of a specific group of professionals.
- Membership in a national society follows
membership in its local affiliate/chapter.
Local Professional Societies for Medical
Technologists
PAMET Philippine Association of
Medical Technologist, Inc.
Philippine Association of
PASMETH Schools of Medical
Technology and Public
Health. Inc.
BRAP BioRisk Association of the
Philippines
Philippine Blood Coordinating
PBCC
Council
Philippine Council for Quality
PCQACL Assurance in Clinical
Laboratories
Philippine Society of
PSM Microbiologist
Philippine Biosafety and
PhBB
Biosecurity Association
International Professional Societies for Medical
Technologists
American Society for Clinical
ASCP
Pathology
American Medical
AMT
Technologist
ASEAN Association for
AACLS
Clinical Laboratory Sciences
Asia Association of Medical
AAMLS
Laboratory Scientists
ASEAN Association of
AAMLT Medical Laboratory
Technologist
American Society for Clinical
ASCLS
Laboratory Science
International Association of
IAMLT
Medical Laboratory Science
International Federation of
IFBLS Biomedical Laboratory
Science
International Society for
ISCLT Clinical Laboratory
Technologist
PROFESSIONAL JOURNALS
- Publications containing scholarly studies on specific
professional fields.
- Sponsored by professional organizations, these journals
publish articles and reviews of books and past articles
and serve as a forum for new articles.
- It is significant for professionals, especially those
involved in education and research, to have their work
published in professionals’ journals. Journals help
disseminate such work to other practitioners in the field.
- Publishing research studies also contribute to the
credibility of an individual in a field of study.
- Some of the available professional journals for laboratory
professionals are:
 Philippine Journal of Medical Technology
 Asia-Pacific Journal of Medical Laboratory Science
 International Journal of Science and Clinical
Laboratory
 Laboratory Medicine
 Medical Laboratory Observer
 Clinical Laboratory Science
 Advances for Medical Laboratory Professionals
 American Journal for Clinical Pathology
 LabMedicine
PAMET
- Philippine Association of Medical Technologists, Inc.
- National professional organization of Registered
Medical Technologist (Philippines)
- Non-stock, Non-profit organization
- Founded: September 15, 1963
- Father of PAMET: Crisanto G. Almario
- Public Health Laboratory in Quiricada St., Sta. Cruz,
Manila.
- First national convention and election of officers:
September 20, 1964 at FEU
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PAMET
- First president: Charlemagne T. Tamondong 4. EXCELLENCE
- Nardito D. Moraleta: PAMET was incorporated and – Excellence is the high quality performance by
registered at the Securities and Exchange advocating and adhering to international standards
Commission (SEC) on October 14, 1969 with making services globally comparable competence
registration No. 39570
- First organizational meeting: September 15, 1963 5. UNITY
at the Public Health Laboratory in Sta. Cruz, Manila – Unity is the necessary linkage, support, involvement
and sharing that will increase the success and
advancement of every individual member and the
association in general

PRESIDENTS OF PAMET ADVOCACY

Charlemagne T. Emergence of
Tamondong Profession

Professional
Nardito D. Morales
Recognition

Felix E. Asprer Legislative Agenda

PAMET CORE VALUES Celebration of

Bernardo T. Tabaosares
1. INTEGRITY Profession

– Integrity is the strict adherence to a moral code, Angelina R. Jose Career Advocacy
reflected in transparent honesty, truthfulness,
Educational
accuracy, accountable of one’s actions and complete Venerable Oca
Enhancement
harmony in what one thinks, says, and does
2. PROFESSIONALISM Carmencita P. Acedera Image Building
– Professionalism refers to the positive traits and
Marilyn R. Atienza Proactivism
values, moral responsibility, social responsiveness
Norma N. Chang International Leadership
and behavioral outlook which makes one highly
respectable and credible Organizational
Agnes B. Medenilla
3. COMMITMENT Dynamism
– Commitment is the unconditional, unwavering and
Shirley F. Cruzada Interdisciplinary network
selfless dedication that one builds-in into the practice
of the profession characterized by initiative, creativity Leila M. Florento Global Perspectives

and resourcefulness to bring about quality health Romeo Joseph J. Ignacio Golden Celebration
care and service to the public
Rolando E. Puno Empowerment

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PASMETH microscope in green. Beneath the microscope is the
– Philippine Association of Schools of Medical year 1970.
Technology and Public Health, Inc. - The Circle represents the continuity of learning and
– National organization of recognized schools of the never-ending quest for excellence in the field of
medical technology and public health in the academe.
Philippines. - The four corners of the Diamond represents the four
– Established in 1970 objectives of the Association which are as follows:
– May 13, 1970: Dr. Narciso Albarracin (Secretary of  To encourage a thorough study of the needs and
the Department of Education), designated Dr. problems of Medical Technology and Public
Serafin Juliano (FEU) and Dr. Gustavo U. Reyes Health Education and to offer solutions to them.
(UST) to organize an association of deans/heads of  To work for the continuous development of
schools of medical technology and public health. Medical Technology and Public Health Education
– First Organizational meeting: UST on June 22, in order that the profession will be of maximum
1970. service to the country,
– First member school: UST, FEU, CEU, SJDEFI,  To take a united stand in matters which affects
PWU, MMC the interests of Medical Technology and Public
– First set of officers: Health Education, and
 President: Dr. Gustavo Reyes (UST)  To seek the advice, aid and assistance from any
 Vice President: Dr. Serafin Juliano (FEU) government or private entity for the fulfillment of
 Secretary/Treasurer: Dr. Velia Trinidad (CEU) the aims and purposes of the Association.
 Press Release Officer: Dr. Faustino Sunico - The Microscope represents the field of Medical
(SJDEFI) Technology and Public Health.
– Formally registered at SEC on October 6, 1985 - The year 1970 was the year the Association was
 Mr. Cirilo S. Cajucom (Committee on founded.
Legislation)
 Atty. Dexter Bihis (Legal counsel) ROSTER OF PASMETH PRESIDENTS
• Dr. Gustavo Reyes (1970-1973)
• Dr. Ibarra Panopio (1973-1974)
• Dr. Angelita Adeva (1974-1977)
• Dr. Elizabeth del Rio (1977-1980)
• Dr. Gustavo Reyes (1980-1981)
• Dr. Claro Cabrera (1981-1982)
• Dr. Elizabeth del Rio (1982-1983)
• Dr. Norma Lerma (1983-1984)
• Dr. Vivencio Torres (1984-1985)
THE PASMETH SEAL • Prof. Nardito Moraleta (1985-1988)
- The PASMETH Seal is circular with yellow lines in a • Dean Norma Chang (1988-1995)
• Prof. Rodolfo Rabor (1995-2000)
field of gold emblazoned with the words PHILIPPINE
• Dr. Nini Lim (2000-2002)
ASSOCIATION OF SCHOOLS OF MEDICAL • Dean Zenaida Cajucom (2002-2010)
TECHNOLOGY / PUBLIC HEALTH in black • Dr. Magdalena Natividad (2010-2012)
• Dean Bernard Ebuen (2012 to present)
encircling it. In the middle of the circle is a diamond-
shaped figure in yellow encasing a microscope in
black and the letters PASMETH across the
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 PHISMETS
- Philippine Society of Medical Technology Students
- National Organization of all medical
technology/medical laboratory science students
- Under the supervision of PASMETH
- First organized in 2002
 Dr. Zenaida Cajucom (PASMETH President)
- First PHISMET Adviser:
 Prof. Marilyn Bala (CHS)
 Prof. Nova Aida Cajucom (FEU-NRMF)
 Prof. Zennie Aceron (UST)
GREEN LETTERS
– Represent the color Health.
5 BUBBLES FROM A TEST TUBE
– Represent the 5 objectives embodied in the
Constitution.
15 INTERCONNECTED MOLECULES OUTSIDE A
TEST TUBE
– Signify the Unity of the 15 Board Schools
exploring various possibilities and aiming towards
the integral growth and holistic development of
Medical Laboratory Science Students. The

- Reorganized on November 6, 2006 at FEU-NRMF Microscope signifies Medical Laboratory Science.

 Dir. Magdalena Natividad (Head) Students.

 Dean Bernard Ebuen (Chair of the committee MICROSCOPE

on student development) – Signifies Medical Laboratory Science

- First Medical Technology Student congress:

February 24, 2009 at OLFU Valenzuela
 Attended by more than 500 students
- First PHISMETS leadership Training Seminar:
ATI-CAR Benguet State Uniersity in La Trinidad
Benguet on May 13, 2010

3 CIRCLES
- symbolizes the continuous active involvement of
Luzon, Visayas and Mindanao in the national
transforming venue of Medical Laboratory Science
Students.
LAUREL
– symbolizes Nature and the continuation of Life
every year.

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UNDERSTANDING PHLEBOTOMY  Capillary puncture, involving the collection of
PHLEBOTOMY: A HISTORICAL PERSPECTIVE blood after puncturing the skin with a lancet
- Hippocrates stated that disease was the result of
excess substances in the body THE ROLE OF THE PHLEBOTOMIST
- Venesection was an important method that was  Point-of-care testing (POCT) compliance is now
believed at the time to remove these excess highlighted taking into account all modern
substances advances in laboratory technology
- Phlebotomy came from the Greek words phlebos and  Work responsibilities are also adapted to the
tome, meaning vein and incision, respectively modern setting, making healthcare professionals
- Early evidences of phlebotomy were seen, such as: cross-trained into a number of techniques and
 Crude tools discovered from the Stone Age skills, including phlebotomy
which were used to puncture vessels and drain  Quality assurance demands the highest standards
excess blood be maintained and appropriate procedures
 Paintings in a tomb in 1400 BC Egypt depicting followed
the application of a leech to a patient  There is a standardized education curriculum
 Barber-surgeons in the early Middle Ages being followed for those interested in the
- Phlebotomy was considered to be a major knowledge, skills, and standards of practice for the
therapeutic process in the early 17th and 18th phlebotomy profession
centuries, within which the lancet became the most
prevalent medical instrument
- Cupping involved the application of a heated suction
apparatus (the cup) to draw blood to the skin surface,
and parallel incisions are then made by a lancet or a
fleam
- Fleams were used in general phlebotomy to open an
artery or a vein to remove large amounts of blood
- Leeches were used for more localized bleeding
(Hiruto medicinalis)

PHLEBOTOMY TODAY
- Today’s objectives of phlebotomy has drastically
changed, and is performed to: THE CAPACITIES OF A PHLEBOTOMIST
 Obtain blood for diagnostic purposes and to 1. Certification – a voluntary process by which an
monitor prescribed treatment agency gransts recognition to an individual who

 Remove blood for transfusions at a donor center has met the prerequisites in a certain technical

 Remove blood for therapeutic purposes, such as area

treatement for polycythemia vera 2. Licensure – the act of granting a license; in the

- Accomplished by one of two procedures: healthcare setting, is an official document granted

 Venipuncture, which is the collection of blood by by a national agency that gives legal permission

penetrating a vein with a needle and syringe or for a person to work in a particular health

other collection apparatus profession

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 3. Continuing Education – updates the knowledge
or skills of participants and is generally geared to
a learning activity or a course of study for a group
of health professionals
THE PHLEBOTOMIST IN THE HEALTHCARE SETTING
1. Recognizes diversity – a phlebotomist who is
culturally aware provides more rewarding
interpersonal experiences, specifically recognizing:
 Beliefs and values that shape’s a person’s
approach to health and illness
 Health-related needs of patients and their
families depending on their environment
 Knowledge of health-related customs and
traditions
 Attitude toward seeking help from healthcare
providers
2. Professionalism – the conduct and qualities that
characterize a professional
- First impressions are important for a phlebotomist
- A person performing phlebotomy is required to
display attitudes, personal characteristics, and
behavior consistent with accepted standards of
professional conduct, such as:
 Self-confidence – trust in one’s own personal
judgment
 Integrity – personal feeling of “wholeness”
deriving from honesty and consistency of
character
 Compassion – a human emotion prompted by
others’ experiences and concerns and is
considered to be one of the greatest virtues by
major religious traditions
 Self-motivation – initiative to follow through
tasks and consistently strives to improve and
correct behavior
 Dependability – working hard and showing
constant, reliable effort and perseverance
 Ethical behavior – should know and follow the
policies designed to regulate what should be
done in the healthcare setting (primum non
nocere)
PATIENTS’ RIGHTS
- Patients must be informed of these when care is
initiated
3. Confidentiality – protection of the patient and the
practitioner especially in the dissemination of their
information to health information systems
COMMUNICATION SKILLS
- Highlights phlebotomy as a people-oriented
profession
- Effective healthcare communication must follow the
communication process, and must minimize
communication barriers whenever possible
- Active listening is needed for phlebotomists
- Nonverbal communication composes 80% of
language, and is also evident in the phlebotomist
 Kinesics – characteristics of body motion and
language; concept of kinesic slip
 Proxemics – study of an individual’s concept and
use of space
 Appearance – the impression a phlebotomist
makes, which is a key for future interaction with
patients
 Touch – patients respond favorably when touch
conveys a thoughtful expression of caring
EFFECTIVE COMMUNICATION IN HEALTHCARE
1. Empathy – identifying with the feelings or
thoughts of another person
2. Control – the way people like to think that they
can influence certain factors in their lives
3. Respect – positive feeling for a person and in
specific demonstrating that positive feeling
4. Trust – unquestioning belief by the patient that
health professionals are performing their job
responsibilities as well as they possibly can
5. Telephone communication – following proper
telephone etiquette
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