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Introduction In this issue ... |
• CPA Guidance on the Accreditation of Managed Pathology Networks • Universal Precautions • CPA Annual Conference |
CPA SUPPORT WEBSITE
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CPA’s current website has information about the company structure, contact details, accredited laboratories and EQA Schemes, newsletters, and documents and publications. We have now created a support website and this can be accessed either via the current website, or by typing in www.cpa-uk.co.uk/support This website has been introduced to provide a quick and easy way to pass on up-to-date information to all interested parties. It is useful for applicants currently preparing for a visit and for assessors planning a visit in the near future. |
The CPA Professional Advisory Committee meets on a monthly basis and there are often decisions taken at those meetings that will impact on future assessments. Some of the decisions become CPA policy, once endorsed by the Board of Directors. Please take the time to view this site and, if you are preparing for an assessment, please look for up-to-date information before your visit. |
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DIARY DATES CPA Assessor Training Courses Two-day courses for assessor training will be held in Birmingham on the following dates:
13/14 January 2004
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CHRISTMAS AND CPA Central Office will be closed as follows: |
CPA Guidance
on the Accreditation of Managed Pathology Networks
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1. The Department of Health has published Draft Guidance on Modernising Pathology Services. |
> There shall be a single Annual Management Review (A11) |
Universal
Precautions
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When doing on-site assessments in blood science laboratories (mainly Biochemistry, Haematology and Immunology) CPA assessors are finding laboratories that claim to be using “Universal Precautions” for handling specimens. They mean by this that all specimens, both high and low risk (with regard to the presence of blood borne viruses) are handled with the same “high” standard of precautions (to prevent inadvertent infection of laboratory staff). This is particularly relevant to laboratories that still perform numerous manual techniques with a high level of specimen handling. Such an approach has many benefits, and at least two are often quoted: |
However, the concern is that some laboratories have not properly thought through the issues. The recently published latest edition of “Safe working and the prevention of infection in clinical laboratories and similar facilities” rightly cautions against universal precautions unless they are properly defined. It says, “The use of the term ‘universal precautions’ is not helpful with regard to the measures needed for handling biological agents, as it is not clearly defined. Adopting universal precautions may result in a standard of practice which is not high enough. The precautions needed must be based on an assessment of the risks involved…” (p17). Several basic questions need to be answered before universal precautions are introduced: 1. Have full risk assessments been performed and recorded? 2. Has the laboratory carefully defined what their universal precautions are? 3. When can the universal precautions be used? 4. Are there situations when the universal precautions may be inappropriate? The risk assessment needs to look at such issues as: 1. Specimen storage, testing and disposal, and decontamination of equipment. 2. Are there particular implications for unqualified staff e.g. reception staff and MLAs? 3. Are there particular areas of risk? e.g. tube breakage in the centrifuge; does the method produce aerosols; are sharps involved? These issues should already have been highlighted anyway in the laboratory’s basic risk assessments, but need re-evaluating in the light of a universal precautions policy. 4. Will the policy be applied just within one department, the whole of pathology, or the whole Trust? If applied just within pathology, the policy can be invisible to those outside. If applied to the whole Trust there will be significant |
communication and training issues involving clinicians, phlebotomists and porters. If applied to the whole Trust, will high-risk samples cease to be labelled with yellow high-risk stickers? 5. What training issues will there be, especially for unqualified staff? 6. Are there situations where the universal precautions are not appropriate and how will high-risk specimens therefore be handled in those situations? The implementation of universal precautions can have many benefits, and in many situations can be done by introducing fairly simple manoeuvres – e.g. gloves and goggles to be worn at all times when handling specimens or dilutions thereof, all centrifugation to be done in sealed centrifuge buckets, and avoid the use of sharps. Laboratories are advised to think carefully though, before stating to a CPA assessor that they are using universal precautions for handling their specimens, unless they have done the necessary groundwork. Inspectors should and will ask for the written risk assessment and compare this with the highest standards of care necessary in their experience. This article is not intended to be an exhaustive discussion on the subject and laboratories are recommended to read some of the following articles. References 1. “Safe working and the prevention of infection in clinical laboratories and similar facilities” 2nd edition 2003, published by the Health Services Advisory Committee. 2. National Committee for Clinical Laboratory Standards: Clinical Laboratory Safety: Approved Guideline NCCLS Document GP17-A. Wayne, PA, NCCLS 1996 In America the Occupational Safety and Health Administration, and the National Institute for Occupational Safety and Health (a functional unit of the CDC) have published similar guidelines. Mr Ray Russell, Senior Chief Biomedical Scientist Lancashire Immunology Service, Royal Preston Hospital |
CONFERENCE 2004
Date: Thursday 25 March 2004
Venue: RIBA, 66 Portland Place, London W1B 1AD
Registration: 10.00am - 10.30am
Full details of the programme will be posted on the CPA website at www.cpa-uk.co.uk.
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Session 1 – Increasing burdens in Laboratory Medicine |
Registration Fee: Ł130 (to include coffee, lunch and tea)
The Conference is usually oversubscribed and booking is essential.
Royal College of Pathologists and IBMS CPD applied for.
