CSMLS MLA Exam key terms

The stage of the testing process that occurs before the sample is analyzed, covering patient identification, collection, labelling, transport, and storage. Most laboratory errors originate here, so MLA vigilance has the greatest impact on result quality.

Confirming that the person being collected from or tested matches the request using at least two unique identifiers, such as full name and date of birth, plus a unique hospital or health number where available. Never use room or bed number alone.

Applying patient identifiers and collection details to the container at the bedside immediately after collection, with the collector signing or initialling. Labelling away from the patient or after leaving the room is a leading cause of misidentified specimens.

A miscollected or mislabelled blood specimen in which the blood in the tube does not belong to the patient named on the label. It is a serious patient safety event requiring incident reporting and recollection.

Puncture of a vein, usually in the antecubital fossa, to obtain blood. Correct site selection, tourniquet timing under one minute, and appropriate needle gauge reduce haemolysis and pre-analytical error.

The standardized sequence for filling blood tubes to prevent additive carryover between containers, generally blood culture, coagulation, serum, heparin, EDTA, then fluoride-oxalate tubes. Follow the tube manufacturer's and your facility's validated sequence.

Transfer of an additive from one tube, or from a needle, into the next specimen, which can distort results. It is minimized by correct order of draw and by using discard or coagulation tubes as appropriate.

Presence of ethylenediaminetetraacetic acid from a purple-top tube in a specimen intended for another test. It can falsely lower calcium and magnesium and invalidate coagulation and some chemistry results.

Rupture of red blood cells releasing haemoglobin and intracellular contents into plasma or serum. It falsely raises potassium, LDH, and AST and interferes with many assays, so the specimen may need recollection.

The interval a constricting band is left in place during venipuncture. Prolonged application causes haemoconcentration and falsely elevated potassium, protein, and enzyme values; keep it under one minute.

Obtaining blood from a skin puncture, typically the lateral aspect of a fingertip or the heel of an infant. Warming the site, avoiding squeezing, and wiping away the first drop reduce haemolysis and tissue fluid contamination.

Skin puncture of the heel in infants, limited to the medial or lateral plantar surface to avoid the calcaneus and posterior tibial artery. Depth must be controlled, and the procedure is used for newborn screening and small-volume tests.

Conditions that make a sample unacceptable for testing, such as missing or mismatched identifiers, wrong container, insufficient volume, gross haemolysis, or delayed transport. Rejections are documented and communicated to the ordering site.

The period during which a specimen retains acceptable analytical properties under specified storage conditions. Exceeding it can cause analyte loss or gain, so transport times and temperatures must follow the test's requirements.

A continuous temperature-controlled system for transporting and storing temperature-sensitive specimens, reagents, and blood products. Breaks in the chain can invalidate results or damage products and must be documented.

Documented, unbroken record of who collected, handled, and stored a specimen from collection to reporting. It is essential for forensic, workplace, and legal testing where specimen identity may be challenged.

Obtaining blood for microbial culture, ideally before antibiotics, using aseptic technique and skin antisepsis. Adequate volume and the correct number of sets increase sensitivity and reduce contamination.

Practices that prevent introduction of microorganisms into a specimen, patient, or sterile field, including hand hygiene, sterile equipment, and not touching key parts. It is required for blood cultures, urine cultures, and invasive procedures.

Introduction of an unwanted substance or microorganism into a specimen or environment. In microbiology it can produce false-positive cultures; in chemistry it can alter analyte concentrations.

Infection control measures applied to all patients regardless of diagnosis, including hand hygiene, gloves, gowns, masks, eye protection, and safe sharps handling. They are the foundation of routine laboratory safety.

Cleaning hands with soap and water or alcohol-based rub at defined moments, including before and after patient contact and after glove removal. It is the single most effective measure for preventing healthcare-associated infection.

Barriers such as gloves, gowns, masks, respirators, and eye protection worn to protect the worker from exposure to blood, body fluids, chemicals, and aerosols. Selection follows a hazard assessment and facility policy.

Additional precautions beyond standard precautions used for patients with known or suspected infectious agents, categorized as contact, droplet, and airborne. Signage and appropriate barrier equipment are required at the point of care.

A percutaneous injury from a needle, lancet, or other sharp object, carrying risk of bloodborne pathogen transmission. It requires immediate first aid, reporting, source assessment, and post-exposure follow-up.

A puncture-resistant, leakproof, labelled receptacle for used needles, lancets, and blades. It must not be overfilled, and sharps must never be recapped by hand or discarded in regular waste.

Preventive treatment, such as antivirals or antibiotics, started after a significant occupational exposure to reduce the chance of infection. It is guided by the source's status and local occupational health protocols.

Waste generated during healthcare that may be infectious or otherwise hazardous, separated at the point of generation into designated streams. Correct segregation protects workers and the environment and is legally regulated.

A standardized document describing a hazardous chemical's properties, hazards, handling, first aid, and spill response. It must be accessible to workers who use or may be exposed to the substance.

The planned procedure for containing, absorbing, disinfecting, and disposing of a chemical or biological spill. It includes evacuation, personal protective equipment, spill kit use, and incident reporting.

Testing known control materials alongside patient samples to verify that a method performs within defined limits. Out-of-range results trigger investigation before patient results are released.

The broader system of policies and activities designed to ensure reliable laboratory results, including quality control, proficiency testing, audits, and corrective action. It addresses the whole testing pathway, not only the analyzer.

External program that sends unknown samples to a laboratory and compares its results with peer laboratories. Acceptable performance is a requirement for accreditation and reveals systematic bias.

Comparison of a patient's current result with a previous result to flag unexpectedly large changes that may indicate a specimen or analytical error. It is an automated safety net in the laboratory information system.

Software that manages orders, specimen tracking, results, and reporting in the laboratory. Accurate entry and verification within it are central to the MLA's role in result integrity.

A result so far outside normal limits that it may be life-threatening and requires immediate notification of the responsible clinician. The read-back of the value is documented with time and recipient.

Repeating a verbally communicated result or order back to the sender to confirm accuracy. It is required for critical values, verbal orders, and any high-risk communication.

Purposeful, respectful interaction that builds trust and addresses a patient's concerns, using plain language, active listening, and confirmation of understanding. It supports informed consent and reduces anxiety during collection.

A patient's voluntary agreement to a procedure after receiving an explanation of its purpose, risks, benefits, and alternatives. The MLA confirms consent according to policy and respects the right to refuse.

The duty to protect personal health information from unauthorized access or disclosure, sharing it only with those who need it for care or as permitted by law. Breaches are reportable and may carry professional consequences.

The limits that keep the working relationship focused on the patient's needs rather than the worker's, avoiding dual relationships, favouritism, and personal involvement. Boundary crossings are disclosed and managed.

The tasks and responsibilities a health worker is educated, authorized, and competent to perform. An MLA must recognize when a request exceeds that scope and escalate to a regulated professional.

Taking responsibility for one's own actions, decisions, and errors, including reporting them promptly and participating in corrective action. It is a core professional and ethical obligation.

A factual record of an unplanned event, near miss, or error that affected or could have affected safety. It supports learning and system improvement and is not a substitute for clinical documentation.

An adverse response to blood component administration, ranging from mild fever to haemolysis or anaphylaxis. Suspected reactions require stopping the transfusion, maintaining access, and notifying the transfusion service immediately.

Population-based testing of infants for treatable congenital conditions using dried blood spots collected by heel puncture. Timing, adequate saturation of the card, and rapid transport are critical to valid results.