We all have moments when we lose self control, usually under stress of some kind: frustrated by highway traffic, pressed for time, shopping in a crowded store, irritated by arguing. In a similar way, stress in the laboratory can cause us to lose self control of a different kind: our own personal checks and balances in performing manual testing.
Engineers rely on different kinds of feedback loops to ensure a system is properly maintained. In a feedback loop, actual output is compared to desired output and the system self-corrected. Examples include your household thermostat or water heater. Laboratory instruments are designed to self-correct, but many verification processes accomplish the same thing. When we review a laboratory result, we decide if it’s reliable based on a number of factors: age, gender, delta checking, instrument errors, etc. If it isn’t, we may repeat the test (self-correct).
But not all laboratory tasks produce data. Manually reading blood bank test tube reactions, for example, requires concentration and attention, but it doesn’t produce data that can be checked unless another tech verifies the reaction. It is self controlled in the sense that it relies on religious habits that a tech doesn’t have to think about to be able to reliably remember with confidence the actual reaction. Developing these kinds of good work habits is a hallmark of an experienced bench technologist.
Nursing and other professions may have a perception that we are all button pushers and the instruments do all the work, but there are a remarkable number of processes that still rely on self control alone.
- Patient identification - asking the patient, reading a requisition, and “time outs” rely on manual verification.
- Specimen labeling - immediately labeling a specimen after collection is often a recreated event e.g. “I always do it this way” to verify performance.
- Specimen aliquoting - pouring off tubes and labeling the secondary tube are highly subject to self control.
- Reading reactions - any kind of manual interpretation of a reaction is variable to degrees and subject to interference from distractions, mood, environment, etc.
This isn’t to say that these tasks are performed better or worse than instruments, but there is certainly a potential for greater variation and error. Next, I’ll consider a practical example with a possible solution.
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