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The TMC Lab Experience

The TMC Lab Experience. Tarrah Oliver, MT Donna Talker, Lab Manager. TMC Experience. Initiated May 10, 2016 Trained everyone Generalist MLT’s, MT’s, and students Ways to order the test: Initially, v erbal request from Providers

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The TMC Lab Experience

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  1. The TMC Lab Experience Tarrah Oliver, MT Donna Talker, Lab Manager

  2. TMC Experience • Initiated May 10, 2016 • Trained everyone • Generalist MLT’s, MT’s, and students • Ways to order the test: • Initially, verbal request from Providers • Lab Reflex, IM flag for platelets <120 (thrombocytopenia) • Later, became an orderable test on RPMS Photo by KiliiiYujan, 2019

  3. Results of Screen and Lab Reflex • ~300 patients screened (May 2016 to Present) • 9 patients scored 4 or 5 • 5 Ab positive - confirmed serologically • 4 Ab negative –chronic medical conditions that contributed to their scores (COPD, cirrhosis) • 8 were Lab Reflexed (88%)! • Recognized and ordered by the lab • No provider’s order needed • 6 transferred to UNM, 1 to RMCH for observation

  4. Performing the Screen • Takes about 30 mins to perform entire screen • Run CBC (complete blood count) • Smear and stain slide • Perform differential counts • Fill out worksheet • No extra time, materials, disruption in patient TAT Photo by KiliiiYujan, 2019

  5. Limitations • Providers ordering for asymptomatic patients, “I saw mouse droppings”, no flags in CBC • Lack of confidence in identifying Immunoblasts and Plasma cells from techs • Practice, practice, practice! • Annual competencies – one of each level • Hand delivering results to Providers • Couldn’t find them in hospital, patient transferred to another ward/Provider • Moved test to RPMS with the built-in comments and interpretation of scores

  6. Outcomes • All of our staff is trained to perform this screen • NO interruptions in TAT’s for STAT specimens • If CBC is abnormal, slide is made already. So if a request is added, all you need is the worksheet. • Lab has been a first responder when the flags are recognized • Helping patients get immediate treatment for prolonged life!

  7. Hantavirus Peripheral Screen - Community Outreach • 2016 • CDC came to TMC and learned about our Hantavirus 5-Point screen which was implemented. • 2017-2018 • Workshops developed with CDC support to share information with surrounding laboratories and public health organizations.

  8. Over 60 laboratorians trained and provided materials to implement the screen within their facilities.

  9. Contacts • Tarrah Oliver, MT • (928) 729-8852 • Tarrah.Oliver@fdihb.org • Donna Talker, Lab Manager • (928) 729-8841 • Donna.Talker@fdihb.org

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