L02. Ch4 - Instrumentation Pt 2 - Lab Automation PDF

INSTRUMENTATION, LAB AUTOMATION AND INFORMATICS – PART 2 CHAPTER 4 PREAMBLE PowerPoints are a general overview and are provided to help students take notes over the video lecture ONLY. PowerPoints DO NOT cover the details needed for the Unit exam Each student is responsible for READING...

INSTRUMENTATION, LAB AUTOMATION AND INFORMATICS – PART 2 CHAPTER 4 PREAMBLE PowerPoints are a general overview and are provided to help students take notes over the video lecture ONLY. PowerPoints DO NOT cover the details needed for the Unit exam Each student is responsible for READING the TEXTBOOK for details to answer the UNIT OBJECTIVES Unit Objectives are your study guide (not this PowerPoint) Test questions cover the details of UNIT OBJECTIVES found only in your Textbook! LABORATORY AUTOMATION Main impetus behind automation has been need to create automated systems capable of reducing or eliminating the manual tasks required to perform analytical procedures. Use of LIS was a decrease in the expected 5% transcription error rate seen when laboratory results were manually transcribed. LABORATORY DEMANDS THAT DRIVE AUTOMATION (1 OF 3) Reduction in turnaround times (TAT) Increased number of different analytes Medical Laboratory staff shortages on one system Economic factors Increased number of different methods on one system Less maintenance Reduced lab errors Less down time Increased number of specimens 24/7 uptime Improved safety of C L S Increased throughput Environmental concerns such as Computer and software technology biohazard risks Primary tube sampling ADVANTAGES ASSOCIATED WITH LABORATORY TESTING BROUGHT ABOUT BY AUTOMATING CHEMICAL ANALYSIS Reduced errors Reduced cost Staff free to run additional tests Reduced imprecision Reduced TATs Reduced safety-risk factors Reduced repetitive-stress injuries Consistent sample processing AUTOMATED ANALYSIS (1 OF 2) Specimen throughput Number of tests performed per hour Discrete testing Measures only the test requested on a sample Batch analysis A group of samples is prepared for analysis. A single test is performed on each sample in the group.  AUTOMATED ANALYSIS (2 OF 2) Random-access testing Measure any specimen by a command to the processing systems. Analyze the specimen by any available process. In or out of sequence with other specimens Without regard to their initial order PREANALYTICAL STAGE (1 OF 3) Involves primarily sample or specimen processing Methods to transport specimens Human carriers or runners Pneumatic-tube delivery systems Electric-track-driven vehicles Mobile robots Conveyors or track systems EXAMPLES OF SAMPLE-PROCESSING TASKS Identify specimens Prepare sample aliquots Label specimens using bar-code Recap, store, retrieve labels Transport Sort and route Detect sample level Centrifuge sample tubes Store and retrieve Decap tubes PREANALYTICAL STAGE (2 OF 3) Automated Specimen Processing Also known as front-end sample processing. Represents the most cost-effective automation strategies for the clinical laboratory Two goals: 1. Minimize non-value-added steps in the laboratory process 2. Increase available time for value-added steps in the tasks that the CLS performs PREANALYTICAL STAGE (3 OF 3) Automated Specimen Processing Integrated specimen-processing systems allow the user to perform some or all specimen-handling tasks. Presorting Centrifugation Volume checks Clot detection Decapping Secondary tube labeling Aliquoting Destination sorting into analyzer racks ANALYTICAL STAGE (1) Sample Introduction Automatic sampling may be accomplished using several different physical mechanisms. In most analyzers, samples are transferred using a thin, stainless steel probe. Another feature associated with sampling is the ability of the sampler to detect the presence of a liquid. Liquid-level sensor Designed to detect the presence of a sample by measuring the electrical capacitance of the surrounding area. TASKS INCLUDED IN THE ANALYTICAL STAGE OF LABORATORY TESTING Sample introduction and transport to cuvette or dilution cup Reagent measurements, transport, and introduction to cuvette Mixing of sample and reagent Incubation Detection Calculations Readout and result reporting ANALYTICAL STAGE (2) Reagents Most laboratories use bulk reagents, Chemistry analyzers that use unit test reagents may require some preparation. Complete inventory is established on a real-time basis within the computer. On-board reagent storage compartments are refrigerated to maintain reagent stability. Automated analyzers are categorized as either open or closed. Open-reagent analyzer Reagents other than the manufacturer’s reagents can be used. Closed-reagent analyzer Operator can only use the instrument manufacturer’s reagents. ANALYTICAL STAGE (3) Reagents Correct proportion of reagents and samples must be constant to achieve precise and accurate results. Liquid reagents are aspirated, delivered, and dispensed by pumps or positive- displacement syringes. Syringe devices are widely used in automated systems for both reagent and sample delivery. Direct tube sampling is offered on many of the new model lines. ANALYTICAL STAGE (4) Mixing Magnetic stirring Rotating paddles Forceful dispensing Use of ultrasonic energy Vigorous lateral displacement Incubation Warming of instrument components or solutions in automated analyzers Must be constant and accurate Timing is monitored by the instrument’s computer system. Represents an extremely complex process given the throughput for these systems Detection In automated analyzers, absorption spectroscopy remains the principal means of measuring a wide variety of compounds. Electrochemiluminescent methods have also been incorporated. SUMMARY OF MAJOR FUNCTION AND OPTIONS AVAILABLE TO FACILITATE THEM THAT IS COMMON TO AUTOMATED CHEMISTRY ANALYZERS (1 OF 4) Sample Introduction Reagents Use Robot-like arm with aspiration probe Bulk Worm gear device that pulls the Reagent identification aspiration probe from one point to Inventory another Open-reagent system Thin stainless steel probe Closed-reagent system Clot detector Liquid-level sensor Disposable plastic pipette tips SUMMARY OF MAJOR FUNCTION AND OPTIONS AVAILABLE TO FACILITATE THEM THAT IS COMMON TO AUTOMATED CHEMISTRY ANALYZERS (3 OF 4) Mixing Detection Magnetic stirrers Photometer/spectrophotometer Rotating paddles Fluorimeters Forceful dispensing Electrochemical Incubation Luminometer Circulating water baths Infrared detectors Peltier-thermoelectric module POSTANALYTICAL STAGE (1 OF 2) Signal processing Involves conversion of an analog signal derived from the detector to a digital signal usable by all communication devices Data processing by computers includes: Data acquisition Calculations Monitoring and displaying data POSTANALYTICAL STAGE (2 OF 2) Computers Have profoundly affected the entire process of automated laboratory instruments Provide a means of communication between the analyzer and operator Have the ability to be linked to other computers Has drastically improved automation efforts Many have on-board troubleshooting capabilities. AUTOMATED SYSTEM DESIGNS (1) Total laboratory automation (TLA) Refers to combination of pre-analytical components, intra-analytical components, and post-analytical components interconnected together Advantages Decrease in labeling errors Reduced turnaround times Potential reduction in full-time equivalents (FTEs) Drawbacks Needs for substantial financial investment Increased floor space AUTOMATED SYSTEM DESIGNS (2) Integrated modular systems Provide a more attractive approach for hospital laboratories and physician group laboratories because the systems are smaller, require less initial capital investment, and require less planning Workstations Represent a unique environment within a laboratory facility dedicated to one type of testing AUTOMATED SYSTEM DESIGNS (3) Work cells Combination of a specimen manager with instruments or consolidated instruments of chemistry and immunoassay reagents Provide a broad spectrum of analytical tests Specimen manager Modular work cells Fully integrated systems Trend to integrate several modules into one continuous system that will allow the user to assay photometric, immunoassay, and electrochemical assays Use random-access technology to allow the analysis of several different types of chemistry assays AUTOMATED SYSTEM DESIGNS (4) Options for Integrated Automated Systems Instrument Connectors AU-Connector uses intelligent sample management and tube-presorting capabilities. Keeps all the analyzers working at full potential Middleware Software that allows a laboratory to: Connect its existing LIS and instrumentation to facilitate automating information Perform tasks not currently done with the laboratory’s existing hardware and software EXAMPLES OF AUTOMATED ANALYZERS aADVIA Centaur XPT, Connected to Atellica™ COAG 360 System, a Fully Automated High Volume Coagulation Aptio Automation System Analyzer FUTURE TRENDS Test menus will continue to increase Multiple detectors and platforms will be incorporated into a single automated system. Provide users with more flexibility Increased interest in proteomics will eventually bring this discipline into the clinical laboratory. INFORMATICS (1 OF 3) Laboratory information systems (LIS) Described as a group of microprocessors and computers connected together to provide management and processing of information Span all three phases of testing: Preanalytical Analytical Postanalytical LIS and point-of-care testing INFORMATICS (2 OF 3) Patient Demographics Patient’s name Sex Age/birth date of birth (DOB) Patient number (assigned by health-care facility) Referring physician Admitting diagnosis INFORMATICS (3 OF 3) Order Entry Patient identifiers Ordering physician Test-request time and date Test name Test priority (e.g., stat, routine) Special instructions pertaining to the request Specimen draw time POSTAMBLE READ the TEXTBOOK for the details to answer the UNIT OBJECTIVES. USE THE UNIT OBJECTIVES AS A STUDY GUIDE All test questions come from detailed material found in the TEXTBOOK (Not this PowerPoint) and relate back to the Unit Objectives