MAGIC
IN MITCHELL: SDSCLS/SIOUXLAND CLMA CONVENTION
Plan to attend the
SDSCLS/CLMA annual meeting in Mitchell May 3-5, 2000. The agenda includes a
golf tournament, keynote address by Dave Glenn and a variety of workshops. The
Mitchell convention bureau will be providing tours to Cabelas, the Archeodome,
the Corn Palace and the Doll Museum. Registration packets will be arriving in
late March. If you have questions:
• e-mail: Kathi Baddi at viva@visionpharm.com
or
phone (605) 996-3356
• e-mail: Vicki Lehrman at lehrmanvd@dtgnet.com
or
phone (605) 995-2261
• e-mail: Mary Parr at mparr@santel.net or
phone
(605) 996-2031
Or visit
SDSCLS’s website.
AVERA
LABNET BUSINESS
DEVELOPMENT
OFFICE MOVING
On March 20, the
Business Development Office of the Avera Laboratory Network will be moving to
new quarters. The new address for Lori Murray and John Kangas will be:
Avera
Laboratory Network
Business
Development
3900
West Avera Drive
Sioux
Falls, SD 57108-5721
(605)
322-4650 or (800) 657-8095
Fax:
(605) 322-6666
REVISED
OSHA BLOODBORNE PATHOGEN COMPLIANCE
DIRECTIVE
The Occupational Safety
and Health Administration (OSHA) issued a new directive on November 5, 1999
designed to help minimize serious health risks faced by workers exposed to
blood and other potentially infectious materials. These risks include human
immunodeficiency virus (HIV), hepatitis B and hepatitis C. The directive guides
OSHA’s compliance officers in enforcing the standard that covers occupational
exposure to bloodborne pathogens and ensures consistent inspection procedures
are followed. It updates an earlier directive issued in 1992 and reflects the
availability of improved devices, better treatment following exposure and OSHA
policy interpretations.
Secretary of Labor Alexis M. Herman
said, ‘We must do everything we can to protect workers who may be at risk of
exposure to bloodborne diseases.
This directive doesn’t place new
requirements on employers but it does
recognize and emphasize the advances made in medical technology. And it reminds
employers that they may use readily-available technology in their safety and
health programs.”
The emphasis of the new directive is
the importance of annual review of employer’s bloodborne pathogens program and
the use of safer medical devices to help reduce needlesticks and other sharps
injuries. OSHA does not advocate the use of one particular medical device over
another. Exposure control plans must document evaluation of devices with new
technology designed to eliminate or minimize exposure and implementation of
such devices where appropriate. Evaluation and selection are the responsibility
of the institution. The directive also highlights basic work practices,
personal protective equipment and
administrative controls.
The engineering control emphasis is
a result of OSHA’s request last year for ideas and recommendations on ways to
better protect workers from
contaminated Sharps.
The directive also includes detailed
instructions to compliance officers on inspections of multi-employer worksites,
such as home health services, employment agencies, personnel services,
physicians and health care professionals in independent practices, and
independent contractors. Also included are decontamination requirements,
guidelines on hepatitis vaccinations and post exposure treatments, and employee
training.
The directive can be accessed from
the OSHA home page at http://www.osha.gov under the directives link.
Copies can also be obtained from the agency’s Publications Office by calling
(202) 693-1888.
Highlights OF OSHA’S COMPLIANCE
DIRECTIVE
CPL
2-2.44D ENFORCEMENT PROCEDURES FOR
THE
OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS
• Annual review of Exposure Control plan—
employers must ensure that their plans
reflect
consideration
and use of commercially available
safer
medical devices.
• Engineering Controls and Work Practices—
emphasizes
the use of effective engineering
controls,
to include safer medical devices, work
practices,
administrative controls and personal
protective
equipment.
• Emphasizes that employers should rely on
relevant
evidence in addition to FDA approval
to
ensure effectiveness of devices designed to
prevent
exposure to bloodborne pathogens.
• Multi-Employer Worksites—focuses on
employment
agencies, personnel services, home
health
services, independent contractors, and
physicians
in independent practice.
• Adds most recent guidelines from the Center
for
Disease
Control on vaccinations against the
Hepatitis
B virus. Incorporates CDC’s guidelines
on
post exposure evaluation and follow-up for HIS
and
the Hepatitis C virus.
• Requires effective training and education for
employees
whenever safer devices are
implemented.
•
Replaces and updates appendices.
INDETERMINATE
FETAL FIBRONECTIN RESULTS
Indetermine results on
fetal fibronectin can occur for several reasons. According to Adeza invalid
results can be caused by:
• Atypically high concentrations of fibronectin
due
to amniotic fluid. (The assay is intended
to
be used on women with intact fetal
membranes.)
• Interfering substances (Contraindications
include
soaps and lubricants)
• Damaged sample matrix.
Invalid
results occur infrequently. Recollect the fFN sample 24 hours after digital
exam. Repeatedly invalid tests can be referred to Adeza for further testing.
FROM
THE EDITOR...
For those of us that
find getting away to workshops and seminars difficult, ASCLS, CLMA and other
professional organizations offer on-line courses in a variety
of subjects. You can keep informed
in the comfort of your own home.
This issue of Labnews marks my final issue as editor.
I will continue to act as the Avera
McKennan reporter for the newsletter. The last year and a half have been a real
learning experience for me. I’d like to thank everyone for their help and
support. Lori Murray and Pam Hegge will take over as co-editors. I’m sure
they’ll do a great job. Please give them your support.
CONTINUING
EDUCATION OPPORTUNITY
Dr.
Henry Travers presented a videoconference on Blood Bank Technology in February.
A videotape of the conference is available by contacting Lori Murray, Avera
Laboratory Network Sales Representative.
LABNEWS
SURVEY
Watch your mail for a
survey from the Avera Laboratory
Network Labnews. New editors Lori Murray
and Pam Hegge want to hear from you! Help us improve Labnews for the new millennium!
DID
YOU KNOW?
Sufferers of
erythropoietic porphyria may have been the basis for the werewolf legend.
Patients with this rare genetic disorder have red teeth caused by the deposit
of porphyrins. Porphyrin accumulation in the skin causes photosensitivity.
Excess hair growth (hypertrichosis) is characteristic of porphyria. In late
stages of the disease, victims become violently insane.
AVERA
PACE CLINICAL ENGINEERING SERVICES
Avera PACE Clinical Engineering
Services provides testing and repair services on diagnostic and clinical
equipment for facilities that do not have the expertise or in-house staff. CES
has been providing biomedical outreach services to the 4-state region for over
6 years. CES
provides on-site service or, if the item is transportable, service in the shop
located in Sioux Falls. Utilizing the Avera Laboratory Network courier service
for transportation of lower end lab equipment such as centrifuges and
microscopes provides for an economical way to have equipment repaired. To
utilize the courier service, items must weigh less than 50 pounds, be carefully
packaged in a sealed box and be clearly labeled Clinical Engineering Services
with a return address. Inside the box include a brief description of the
problem you are experiencing with the unit and the phone number of a contact.
Shop rates are $50/hour for general medical devices. CES also offers service on
diagnostic and anesthesia equipment. Contact Dean Karli, Equipment Service
Manager at Avera PACE (800) 657-8095 for more information.
CLIENT
SERVICES STARS
Susan Bies has
been with Avera Sacred Heart for 8-1/2 years. Susan is a MT (ASCP) with a BS
from Mt. Marty College in Yankton, SD. She did her internship at St. Luke’s
Hospital in Sioux City, IA. Susan enjoys working with patients and other
laboratorians. She strives to make sure the services her facility provides are
compassionate and of high quality.
Susan is a
native of Scotland, SD. She and her husband Marc have been married for 15 years
and have 3 children, Joshua, Betsy and Jacob. Susan’s hobbies include walking,
exercising, playing the piano, reading and doing cross stitch. The family keeps
busy with sports and music events.
HOMOCYSTEINE
AT AVERA MCKENNAN
Beginning Friday, March 17, Avera
McKennan Laboratory will offer homocysteine in-house. The assay will be
performed twice weekly. Fasting EDTA plasma is the specimen of choice.
Heparinized plasma or serum may be used. Specimens should be drawn on ice and
spun ASAP. Homocysteine levels are stable for two weeks at 2-8 C. If testing
will be delayed, freeze at -20C. Expected values are 4.4-12.4 umol/L.
Elevated
levels of homocysteine have been associated with an increased risk for
cardiovascular disease. Elevated levels in renal patients are mainly due to
impaired removal of homocysteine from the blood by the kidney. Severely
elevated concentrations of total homocysteine are found in subjects with
homocystinuria, a rare genetic disorder of the enzymes involved in the
metabolism of homocysteine.
MEDICARE
PART B LOCAL MEDICAL REVIEW
POLICY
Subject: Prostatic
Specific Antigen (PSA)
Description:
PSA is a tumor marker for
adenocarcinoma of the prostate. It is useful in predicting residual tumor in
postoperative phase of prostate cancer. Three to six months after radical
prostatectomy, PSA is reported to provide a sensitive indicator of persistent
disease. Six months following introduction of antiandrogen therapy, PSA is
reported as capable of distinguishing patients with favorable response from
those in whom limited response is anticipated.
Indications
and Limitations of Coverage and/or Medical Necessity:
PSA is not in itself a diagnostic
test, but serves as a marker in following the progress of most prostate tumors
once a diagnosis has been established. This test is also an aid in the
management of prostate cancer patients and in detecting metastatic or
persistent disease on patients following treatment.
Reasons
for Denial:
PSA testing performed for
indications other than those listed in the model policy will be considered not
medically necessary or reasonable and will result in denial of payments. PSA
performed for the purpose of screening is an exclusion from the Medicare
program and therefore, non-covered.
Documentation
Requirements:
Documentation of medical necessity
must be retained by the ordering physician in the patient’s medical record. The
physician’s documentation should have history and physical and progress notes
that supports the medical necessity of the test and clearly shows the
evaluation and management of the patient’s disease.
Source: clma.org/healthcare