MED LAB 454

CLINICAL IMMUNOHEMATOLOGY ROTATION

Spring - 2003

3 Credit Hours

University of New Mexico
Medical Laboratory Sciences

Instructor:  Sally Steen

In this document...

Course Description
Course Presentation
Evaluation Criteria
Evaluation
Theory Requirements
Performance Requirements
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Course Description:
Supervised instruction in the performance of blood banking procedures in an affiliated laboratory. Taught 36-40 hours per week for a minimum of 3 weeks.

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Course Presentation:
Each student is scheduled individually in the Immunohematology laboratory to receive instruction and perform all tests as specified in the performance objectives for the course. Students will be under the direct supervision of the clinical Immunohematology instructing technologists. A suggested weekly schedule is:

  • Week 1: ABO, Rh (including weak D/Du) and antibody screening, as with prenatal samples; basic crossmatching; antibody identification; antigen typing, ABO subgrouping and Rh phenotyping; DAT and newborn workups; RhIg workups.
  • Week 2: Donor phlebotomy and component preparation; issue and release blood components; blood inventory; HDN and exchange transfusion workups; antibody titer; absorption and elution; AIHA testing. Continue to perform routine testing introduced in first week.
  • Week 3: Quality assurance for components, reagents and equipment; transfusion reaction workups; special studies such as HLA typing or pheresis and special components as appropriate. Continue to perform routine testing already introduced.

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Evaluation Criteria:
By the end of this course, students should be able to:

  1. Demonstrate successful knowledge of clinical Immunohematology theory by performance on written tests and passing ratings on theory application as specified in the attached theory requirements. (All theory objectives for MLS 340L and 440L, as printed in the Immunohematology Lab Manual, are also applicable to MLS 454.)
  2. Perform the rotation requirements as specified on the attached Practicum Performance Objectives meeting acceptable levels of performance.
  3. Demonstrate a professional approach to the clinical practicum as specified in the MLS program's affective objectives for clinical rotations.

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Evaluation:
Grades for the Clinical Immunohematology Practicum, MLS 454, will be based on the following three areas. Grades for each area must be 72% or better, in order for the final grade to be calculated. If one area is <72% then the grade for that area becomes the final course grade.

Theory (written tests)                                     33% of final grade
Performance Evaluation
- Practicals
- Performance Checklist (P/F)
                                     33% of final grade
Professionalism
- Professional Development Form
                                      34% of final grade

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Theory Requirements:
On completion of this course, the student will be able to:

  1. Discuss the theory, use, performance, and interpretation of results of the following procedures, including proper controls:
    • ABO grouping
    • A subgrouping
    • Rh typing (including weak D/Du)
    • other antigen typings
    • antibody screening test
    • antibody identification
    • compatibility testing
    • direct antiglobulin test
    • elution
    • auto-absorption
  2. Correlate clinical and laboratory data.
  3. Discuss and compare all blood groups studied with regard to inheritance, biochemistry, nomenclature, characteristics and identification of antigens and antibodies, and clinical significance.
  4. Describe and compare the various techniques used in the blood bank (saline, LISS, enzyme, albumin, antiglobulin, gel) with regard to how they are performed and the reasons for their use.
  5. Briefly describe preparation of all blood bank reagents.
  6. List AABB criteria for donor selection and donor unit processing.
  7. Describe proper preparation, storage, dating period, and use of each blood component: prbcs, FFP, platelets, cryoprecipitate.
  8. Discuss and contrast the etiology, laboratory findings, treatment, and prevention of hemolytic disease of the newborn.
  9. Identify potential candidates for Rh immune globulin and determine their eligibility.
  10. Describe and analyze auto-immune hemolytic anemia in terms of:
    • causes
    • lab findings
    • acquiring compatible blood
  11. Discuss causes, symptoms, treatment, and choose appropriate laboratory work-up methods for transfusion reactions.
  12. Select appropriate blood for transfusion to each patient, including neonates.
  13. Discuss quality assurance measures currently used for blood components, reagents and equipment.
  14. State, compare and contrast appropriate AABB Standards regarding laboratory testing, quality control, and component processing, storage, and use.

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Performance Requirements:

I. Clerical and Sample Preparation

The student should perform the following:

  1. Identify patient name, medical record number, and date of sample and correlate these with information on request form.
  2. Determine suitability of sample in terms of identification, freshness or physical condition.
  3. Process samples in appropriate manner (centrifuge, refrigerate, etc.).
  4. Use appropriate safety precautions in handling specimens.
  5. Complete work sheets, log books, and other paperwork, as well as all computer entries, correctly for each procedure performed.

II. Testing

The student should perform the following procedures. ABO and Rh testing should be 100% accurate, and antibody detection/identification should be 80% accurate.

  1. ABO grouping 
  2. Rh typing (including weak D)
  3. Other antigen typings
  4. Antibody screening test
  5. Antibody identification
  6. Antibody titration
  7. Absorption
  8. Elution
  9. Direct antiglobulin test
  10. Compatibility test
  11. Cord blood work-up
  12. Exchange transfusion work-up
  13. Rh immune globulin work-up
  14. Transfusion reaction work-up

In addition, the student should:

  1. Demonstrate an organized performance of the daily workload.
  2. Correctly prepare and issue blood and components for transfusion.

III. Quality Control

The student should perform the following:

  1. Perform and document appropriate daily quality control procedures on reagents.
  2. Perform and document appropriate daily quality control checks on temperature regulated equipment.
  3. Explain and demonstrate proper operation of available equipment.

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