hct

• Histopathology


  The study of the pathology of the cells and tissue
• Histopathology Section/Department


  • Only found in tertiary level laboratory
  • Part of the anatomic pathology (rather than clinical pathology)
  • Uses special machines and performs complex procedures to produce output— finished slides ready for pathologists to examine
• Histopathology Workflow Process


  1. Operation

  2. Specimen Reception

  3. Gross Examination

  4. Tissue Processing

  5. Microscopic Examination & Results Reporting
• Tissue Processing


  The different steps - fixation, dehydration, clearing, infiltration or impregnation, embedding, trimming, section cutting, staining, coverslipping, and labeling
• Histopathology Specimens


  • Tissue (Solid) - Biopsy
  • Body Fluids (Liquid) - Cytology
  • Autopsy
• Specimen Reception/Accessioning


  • Specimens submitted to the Histopath laboratory must be entered into the surgical pathology database via accessioning process
  • Identification should include patient's complete name, date of birth, gender, specimen type, hospital number, and other demographic data
• Criteria for rejection of specimen include discrepancies between the requisition and specimen labels, leaking specimen container, no clinical data or history, and inappropriately identified specimen
• Tissue Fixation


  • A fixative preserves the tissue by preventing autolysis and putrefaction
  • The proper ratio of fixative to tissue is 10:1
  • Preliminary tissue fixation happens when 10% buffer neutral formalin is added upon specimen arrival in the lab

  
• Identifying all hazards in and emanating from the laboratory is the first step in risk management, pertaining to both personal and environmental health and safety
• Untoward Accidents in the Laboratory

  • 40% Histopathology Department
  • 33% Microbiology Department
  • 20% Hematology Department
  • 7% Other Departments
• The histopathology section has its own distinct hazards as this section has a different environment, equipment and procedures from the other sections in the lab
• There are minor issues that can still interfere during microscopic examination
• Risk Management and Safety in Histopath Laboratory


  Identifying all hazards in and emanating from the laboratory is the first step in risk management
• Risk management pertains to both personal and environmental health and safety
• The histopath section has its own distinct hazards as this section has a different environment, equipment and procedures from the other sections in the lab
• Identifying all potential hazards in and eliminating them from the lab is the first step in risk management
• This pertains to both personal and the environment
• Untoward Accidents in the Laboratory

  • 40% Histopathology Department
  • 33% Microbiology Department
  • 20% Hematology Department
  • 7% Other Departments
• Risk Management Flow


  1. Identify hazards and risks

  2. Evaluate Risks

  3. Determine controls

  4. Implement controls

  5. Review the effectiveness of controls
• Hierarchy of Controls


  The mitigating actions that can be taken regarding the risks in the lab
• Elimination


  • The MOST EFFECTIVE CONTROL. If we can eliminate the risk then it is effective.
• Substitution


  • If we determine one part of our procedure or our machine to be very risky, we try to change it with something that is less risky.
• Engineering Controls


  • Changing your workspace, materials, equipments, and machines to ensure that there is minimal risks/to mitigate risks.
• Administrative Controls


  • Deals with procedures. There are steps that we can list down that we have to follow so that we will minimize our exposure to the risks involved.
• Personal Protective Equipment (PPE)

  • The LEAST EFFECTIVE CONTROL. In the lab, we are always at risk of contamination, biological contamination, and infectious material, we prepare PPE and wear them to protect us from that kind of hazard.
• Laboratory Environment


  • There must be adequate fresh air inside the laboratory
  • There must also be sufficient space for equipment and supplies
  • There must also be smooth flow of traffic / easy communication
• Why must there be fresh air inside the lab? Since, of course, histopath handles a lot of chemicals, we need to make sure that there is very good ventilation and we also need to make sure that there are exhaust fans.
• That is also why the histopath laboratory is in another area or it is the furthest section in the laboratory.
• Equipment may malfunction due to poor maintenance, and poor quality reagents can result in poor processing of tissues or inaccurate staining results.
• Maintenance of refrigerating and heating elements.
• Well-grounded electrical outlets with stable voltage and emergency power supply in case of brownouts.
• No eating, no smoking, no applying of cosmetics in the lab.
• We must use our personal protective equipment.
• We should wear gloves, and lab gowns during tissue processing, goggles to protect our eyes in case of splashes and face masks to prevent breathing in of fumes during staining.
• Include facilities such as showers in case of the need of flushing our eyes, body, or clothing in case that we are splashed with biological material.
• Periodic evaluation to assure proper functioning of equipment at all times.
• There must be a copy of the operating manual.
• Never attempt to set up a major piece of equipment without approval from the manufacturer.
• You must be trained first before doing anything to the machine
• In Case of Machine Acquisition, Take Note of the Following

  • Name of Equipment /Instrument /Manufacturer /Model number/serial number/ Date Purchased
  • Record of preventive maintenance performed, as prescribed by the manufacturer
  • Maintenance Date/date of inspection/validation/performance evaluation
  • Daily Temperature Monitoring /recording for all temperature controlled equipment
  • Record of service calls and repairs performed (Date of Last Repair)
  • Calibration Date (quarterly calibration)
  • Record of Cleaning (daily/weekly/monthly)
  • Copy of operating manual