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Chapter 11: Laboratory and Pharmacy Services
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Clinical Laboratory TechnologistsClinical 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
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)Clinical Laboratory Technologists (cont’d)
• Specialties
– Clinical chemistry
– Microbiology
– Blood bank
– Immunology
– Cytotechnology
– Molecular biology
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)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
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Clinical Laboratory Technologists (cont’d)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.
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Clinical Laboratory TechniciansClinical 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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Clinical Laboratory Technicians (cont’d)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
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Laboratory AssistantsLaboratory 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
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Laboratory Assistants (cont’d)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
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Laboratory Assistants (cont’d)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
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Laboratory Assistants (cont’d)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
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Laboratory Assistants (cont’d)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
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Laboratory Assistants (cont’d)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
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Laboratory Assistants (cont’d)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
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PharmacistsPharmacists
• 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
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Pharmacists (cont’d)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
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Pharmacists (cont’d)Pharmacists (cont’d)
• Course Work
– Pharmaceutical chemistry
– Pharmacology
– Business management
– Pharmacy practice
– A clinical component
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Pharmacists (cont’d)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)
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Pharmacists (cont’d)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
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Pharmacists (cont’d)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
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Pharmacists (cont’d)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
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Pharmacists (cont’d)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
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Pharmacy TechniciansPharmacy 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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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
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Pharmacy Technicians (cont’d)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