Chapter 6: Laboratory and Pharmacy Services

1. Chapter 6: Laboratory and Pharmacy Services

2. Clinical Laboratory Technologists • History of the Profession • Late 1800s, early 1900s: establishment of first clinical labs • World War I: technicians took on pathologists’ & bacteriologists’ duties • 1928: Board of Registry (BOR) created by ASCP • Graduates of BOR exam known as “medical technologists” • 1933: American Society for Clinical Laboratory Science (ASCLS) formed • 1973: National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) formed • Name changed to “clinical laboratory technologists” recently

3. Clinical Laboratory Technologists (cont’d) • Education • Bachelor’s in medical technology or a life science is standard • Associate’s degree required by CLIA for advanced lab personnel • Programs offered by universities & hospitals • Academic classes & clinical experience (3+1 or 4 + 1 program) • Master’s & doctoral programs available • 215 accredited programs

4. Clinical Laboratory Technologists (cont’d) • Course Work • Anatomy & physiology • Immunology • Microbiology • Statistics • Hematology • Chemistry • Urinalysis • Quality assurance & improvement • Safety & government regulations & standards • Communication & teamwork skills • Ethics & professionalism • Educational techniques • Research design & practice • Laboratory operations

5. Clinical Laboratory Technologists (cont’d) • Licensure, Registration, and Certification • Licensure or registration • Required by some states • Requires bachelor’s degree & passing exam • Certification • Optional, but advantageous • General & specialized • Offered by several organizations

6. Clinical Laboratory Technologists (cont’d) • General Duties • Prepare specimens, perform tests on them, & interpret results • Use complex instruments & equipment • Check for accuracy • Ensure proper function of equipment • Monitor lab process for quality control • Train subordinates in new techniques • Design & develop research experiments

7. Clinical Laboratory Technologists (cont’d) • Specialties • Clinical chemistry • Microbiology • Blood bank • Immunology • Cytotechnology • Molecular biology

8. Clinical Laboratory Technologists (cont’d) • Personal Characteristics • Responsible • Reliable • Thorough • Accurate • Good problem-solving skills • Capable of working well under pressure • Able to focus on complex tests • Communication skills • Capable of working independently

9. Clinical Laboratory Technologists (cont’d) • Employment Opportunities and Trends • >172,000 jobs • Most jobs in hospitals • 14% growth from 2008 to 2018 • Growth due to: • More tests required for growing population • Development of new tests

10. Clinical Laboratory Technologists (cont’d) • Professional Organization: ASCLS • Represents all lab personnel • Advocates for lab occupations • Monitors legislation • Acts as liaison to Congress & federal & state agencies • Emphasizes standards setting, continuing education, & personal & professional development • Membership benefits: online courses, workshops, conferences, national meeting, etc.

11. Clinical Laboratory Technicians • History of the Profession • Emerged in the 1960s • Developed due to: • New technologies, need for new tests • Need to free up medical technologists • Increasing popularity of 2-year community & junior colleges • 1966: Allied Health Personnel Training Act—provided funding • 1969: educational programs guidelines published & first exam • 1973: entry-level competencies approved

12. Clinical Laboratory Technicians (cont’d) • Education • Most have either: • Associate’s degree from community or junior college • Certificate from hospital, vocational or technical school, or military • A few are trained on the job • CLIA requires associate’s degree for advanced lab personnel • 196 accredited programs

13. Clinical Laboratory Technicians (cont’d) • Course Work • Laboratory methodologies • Specimen collection, processing, & analysis • Use of lab results in diagnosis & treatment • Communications • Quality assessment • Lab safety & regulations • Information processing • Ethical & professional conduct • Professional development

14. Clinical Laboratory Technicians (cont’d) • Licensure, Registration, and Certification • Licensure or registration • Required in some states • Requirements vary by state • Certification • Optional, but advantageous • Offered by several organizations

15. Clinical Laboratory Technicians (cont’d) • Work Responsibilities • Collect & prepare specimens for testing • Conduct & monitor tests • Analyze results of tests • Record findings on computer or paper • Report problems to supervisor • Care for instruments & equipment • Cross-match blood • Care for specimens • Train new employees

16. Clinical Laboratory Technicians (cont’d) • Personal Characteristics • Accuracy • Good judgment • Analytical skills • Responsibility • Precision • Eye for detail • Ability to work independently • Ability to work under time pressure • Teamwork skills • Communication skills

17. Clinical Laboratory Technicians (cont’d) • Employment Opportunities and Trends • Rapid growth: 14% between 2008 & 2018 • Setting distribution: • 45% in hospitals • 15% in medical & diagnostic labs • 14% in physician’s offices • 8% in educational services

18. Clinical Laboratory Technicians (cont’d) • Professional Organization: AMT • Nationally & internationally recognized certification program • Includes clinical laboratory technicians & technologists & others • Promotes personal & professional growth & leadership skills • Benefits: • Continuing education opportunities • Annual convention • State society meetings & seminars • Professional journal • Online programs & career center

19. Laboratory Assistants • History of the Profession • Emerged in 1950s due to shortage of medical technologists • State medical associations promoted training programs • 1960s & 1970s: development of educational & certification standards • 1962: development of a model training program • 1963: first certified laboratory assistants graduated • 1967: exam made a requirement for certification • 1973: ASMT approved entry-level competencies

20. Laboratory Assistants (cont’d) • Education • HS diploma or equivalent required • Many are trained on the job • Some complete formal training program • Only a few accredited programs • Programs: • Last about 18 months • Lead to a certificate • Some combine training with phlebotomist & EKG training • Include both course work & practical experience

21. Laboratory Assistants (cont’d) • Course Work • Laboratory assistant skills • Introduction to health care • Medical terminology • Laboratory administrative skills • Anatomy & physiology • Medical laboratory safety • Phlebotomy • Computer applications • Interpersonal & communication skills

22. Laboratory Assistants (cont’d) • Licensure, Registration, and Certification • Licensure or registration required in some states • Certification • Certified Medical Laboratory Assistant (CMLA) credential • Some programs prepare student for phlebotomist certification • Optional, but advantageous • No professional organization for this occupation

23. Laboratory Assistants (cont’d) • Work Responsibilities • Collect & label samples • Set up routine tests • Prepare materials for analysis • Perform low- to moderate-complexity tests • Maintain storage system for specimens • Deliver samples for testing • Recognize & report errors • Maintain equipment & supplies • Enter patient data into computer • Answer phones • Process test orders • Report results • Do billing

24. Laboratory Assistants (cont’d) • Personal Characteristics • Strong organizational skills • Eye for detail • Ability to work both independently & as part of a team • Interpersonal & communication skills • Ability to work well under time pressure • Ability to work quickly & accurately

25. Laboratory Assistants (cont’d) • Employment Opportunities and Trends • Shortage of personnel due to: • Competition for qualified staff • Lower compensation for lab work compared to other fields • Increased opportunities due to: • Aging baby boomers • Low awareness of lab occupations

26. Pharmacists • History of the Profession • Colonial America: doctors, apothecaries, & wholesale druggists • Before Civil War: apothecaries trained by apprenticeship • 1821: first professional association & first college of pharmacy • After Civil War • Pharmacy education shifted to state universities • Albert B. Prescott: shifted focus to academic study • State boards began licensing pharmacists • 1900: pharmacy school association formed (later called AACP) • 1920s: AACP adopted basic curriculum

27. Pharmacists (cont’d) • Education • PharmD degree required • 116 accredited programs • Entrance to program requires: • At least 2 years of undergraduate work • Most programs require PCAT • Programs usually last 4 years • “0-6” programs, for high school student applicants • Residency programs following graduation increasingly required • MS & PhD degrees available

28. Pharmacists (cont’d) • Course Work • Pharmaceutical chemistry • Pharmacology • Business management • Pharmacy practice • A clinical component

29. Pharmacists (cont’d) • Licensure • Required in all states • Requires PharmD & passing several exams: • All states: North American Pharmacists Licensure Exam (NAPLEX) • Most states: Multistate Pharmacy Jurisprudence Exam (MPJE)

30. Pharmacists (cont’d) • Work Responsibilities • Receive prescriptions & fill them • Monitor work of technicians • Counsel patients • Confer with physicians & other health care professionals • Maintain confidential medication records • Plan, monitor, & evaluate drug treatment plans • Complete third-party insurance forms • Run a business

31. Pharmacists (cont’d) • Personal Characteristics • Organizational skills • Eye for detail • Conscientiousness • Reliability • Strong analytical & problem-solving skills • Good judgment & common sense • Good communication & interpersonal skills • Good teamwork skills

32. Pharmacists (cont’d) • Employment Opportunities and Trends • Rapid growth: 17% between 2008 & 2018 • Factors prompting growth: • Increased demand for prescription drugs due to population growth • New drugs becoming available • Setting distribution: • 65% in community pharmacies • 22% in hospitals

33. Pharmacists (cont’d) • Professional Organization: NPhA • One of several professional associations for pharmacists • Represents interests of minority pharmacists • Works to advance standards of pharmaceutical care • Works to stimulate interest in pharmacy as a career • Benefits: • Annual convention • Regional meetings • Continuing education • Networking

34. Pharmacy Technicians • History of the Profession • Began with training program by U.S. Army in mid-1940s • 1940s to 1960s: establishment of a formal system of training • 1975: American Society of Health-System Pharmacists (ASHP) established • 1982: accreditation standards established • 1983: ASHP began accrediting programs • 1990s: national certification program & model curriculum developed

35. Pharmacy Technicians (cont’d) • Education • Some trained on the job • Most complete formal training • Accredited programs must: • Provide at least 600 hours of training over 15 or more weeks • Cover topics stipulated in model curriculum • Develop individualized training plan for each student • Require extensive lab experience • Offer an internship or externship in at least two settings • HS diploma or equivalent required by some states

36. Pharmacy Technicians (cont’d) • Course Work • Introduction to pharmacy • Medical terminology • Pharmacology • Pharmacy math • Commercial pharmacy practice • Hospital pharmacy practice • Pharmacy law & ethics • Computer applications • Psychology • Speech or interpersonal communications

37. Pharmacy Technicians (cont’d) • Certification • Required in some states, optional in most • Offered by several organizations • Requires passing a national exam • Recertification required every 2 years via continuing education

38. Pharmacy Technicians (cont’d) • Work Responsibilities • Accept a written prescription • Review info on prescriptions for accuracy • Prepare prescriptions • Prepare prescription labels • Choose proper containers & label them • Price & file prescriptions • Perform administrative tasks

39. Pharmacy Technicians (cont’d) • Personal Characteristics • Responsibility • Eye for detail • Organizational skills • Customer service skills • Friendly, professional attitude • Good teamwork skills • Ability to work independently

40. Pharmacy Technicians (cont’d) • Employment Opportunities and Trends • Rapid growth: 31% between 2008 & 2018 • Factors prompting growth: • Increased demand for prescription drugs due to population growth • Pharmacy technicians taking on new roles • Setting distribution: • 73% in retail pharmacies • 18% in hospitals

41. Pharmacy Technicians (cont’d) • Professional Organizations • American Association of Pharmacy Technicians (AAPT) • Represents interests of members to public & health care organizations • Helps technicians update their skills • Provides continuing education programs, a national convention, & a career center • National Pharmacy Technician Association (NPTA) • Promotes professional development • Advocates for the profession • Conducts industry-related research