Medical Technology Code of Ethics PDF

LOUVELLE ANNE CHAVEZ SISON NEW ERA UNIVERSITY  Republic of the Philippines Professional Regulation Commission Manila PROFESSIONAL REGULATORY BOARD OF MEDICAL TECHNOLOGY RESOLUTION NO. 72 Series of 2022 CODE OF ETHICS O...

LOUVELLE ANNE CHAVEZ SISON NEW ERA UNIVERSITY  Republic of the Philippines Professional Regulation Commission Manila PROFESSIONAL REGULATORY BOARD OF MEDICAL TECHNOLOGY RESOLUTION NO. 72 Series of 2022 CODE OF ETHICS OF THE MEDICAL TECHNOLOGY PROFESSION WHEREAS, Section 7 of Republic Act No. 5527, also known as “Philippine Medical Technology Act of 1969”, as amended, created a Board of Examiners for Medical Technology (Board); WHEREAS, Section 11 thereof states that the Board is vested with authority to look into conditions affecting the practice of medical technology in the Philippines and whenever necessary, adopt such measures as may be deemed proper for the maintenance of good ethics and standards in the practice of medical technology and to draft such rules and regulations as may be necessary to carry out the provisions of the law; WHEREAS, the Code of Ethics was first published by the Philippine Association of Medical Technologist (PAMET) in 1968 prior to the approval of R.A. No. 5527 in 1969. It was then revised in 1997; WHEREAS, in 2012 and 2014, a review of the Code of Ethics for Medical Technology was conducted by the Board and while the contents were found to be comprehensive enough, the Board still finds the need to elaborate on some statements and to include other commitments to continuously improve the professional skills and knowledge of the medical technologists; WHEREAS, in 2018, the Board formed a Committee composed of representatives from various key sectors like the academe, industry, and laboratory practitioners to review the present Code of Ethics; WHEREAS, in 2019, the Board, together with the Committee members, organized the articles (Code) into its final draft. However, the onset of the global pandemic in 2020 resulted in the disruption and changes in priority in the work of the Board and the Committee; WHEREAS, on June 25, 2021, the Board and the Committee members resumed its work towards the finalization of the Code for the Commission’s adoption and approval; NOW, THEREFORE, the Professional Regulatory Board of Medical Technology (Board) RESOLVES to prescribe, promulgate and issue this CODE OF ETHICS OF THE MEDICAL TECHNOLOGY PROFESSION: PREAMBLE This Code of Ethics is promulgated to provide the medical technologist with proper ethical and professional standards in the practice of Medical Technology to ensure the safety and welfare of patients. This Code sets forth the fundamental ethical principles and the professional responsibilities of the medical technologist towards patients, the healthcare system, the community, his/her colleagues, self, and the profession, allied professionals and the health products industry. The medical technologist shall cherish and take pride in his/her calling and conduct himself/herself in accordance with this Code and the generally accepted principles of the International Code of Medical Technology Ethics. ARTICLE I GENERAL PRINCIPLES Section 1. The primary objective of the practice of medical technology/medical laboratory science is service to mankind, without bias to a patient’s or colleague’s race, religion, gender, political belief or medical condition. Section 2. A medical technologist shall commit to the highest degree of professionalism, excellence, competence and integrity in the practice of the profession. Section 3. A medical technologist shall adhere to principles of quality and safe practice. Section 4. A medical technologist shall put the patients’ interest above his/her own. A medical technologist shall perform his/her duties with competence and integrity and shall maintain the confidentiality of all the patients’ information in accordance with the existing legislation. Section 5. A medical technologist shall be accountable and responsible for his/her professional and personal conduct, and is expected to demonstrate good judgment and behavior to ensure excellent laboratory performance for the best possible patient care. Section 6. A medical technologist shall contribute to the profession’s development through lifelong learning such as self-development, mentorship, or collaboration with institutions and accredited local, national and international organizations in medical technology. Section 7. A medical technologist shall maintain allegiance and a deep sense of civic responsibility towards his/her community and country. Section 8. A medical technologist shall treat other professionals with respect and foster cooperation and collaboration among them. Section 9. A medical technologist shall refrain from engaging in activities which may give rise to conflict of interest. ARTICLE II RESPONSIBILITIES TO PATIENTS Section 1. A medical technologist shall attend to patients faithfully, conscientiously and timely and shall secure for them all possible benefits that may depend upon professional skill and care. A medical technologist shall be polite, courteous, attentive, reassuring and caring. Section 2. A medical technologist shall dutifully perform his/her tasks, regardless of the patient’s age, gender, creed, or nationality. Section 3. A medical technologist shall seek appropriate assistance, according to established protocols in situations beyond his/her knowledge and skills. Section 4. A medical technologist shall keep all patient’s information and results obtained with strict confidentiality, except when the disclosure is required by pertinent laws, rules and regulations. Section 5. A medical technologist shall only engage in lawful and appropriate procedures that promote the best interest and safety of the patient. ARTICLE III RESPONSIBILITIES TO SELF AND TO THE PROFESSION Section 1. A medical technologist shall personify professionalism, integrity, responsibility, accountability and competence in the conduct of his/her professional as well as personal life. Section 2. A medical technologist shall continuously update and upgrade knowledge and skills in the practice of the profession brought about by modernization as well as scientific and technical advancements in the profession. Section 3. A medical technologist shall ensure compliance with the medical technology law, other related laws and regulatory policies affecting the practice of the profession. Section 4. A medical technologist is duty-bound to report to the proper authorities illegal acts and other violations in the practice of the profession, including illegal practice, for the protection of the public. Section 5. A medical technologist shall actively support and apply principles, policies and guidelines for the protection of the environment, especially in biosafety and biosecurity practices. Section 6. A medical technologist shall ensure compliance with Quality Assurance Program following the standards of Good Laboratory Practice. Section 7. A medical technologist shall endeavor to engage in community or social work where their services are needed, such as but not limited to cases of emergency, disaster or other similar circumstances. Section 9. A medical technologist shall fulfill the duties and responsibilities as a member of the accredited professional organization through active participation in continuing professional development and other activities and to respect the constitution and by-laws of the organization. Section 10. The medical technologist shall accept reasonable professional fees on matters relative to research, consultancy, and activities that require his/ her expertise in the field of medical laboratory science and/or allied sciences. Section 11. A medical technologist shall accept, carry-out and discharge the responsibilities inherent to being a professional. He/she shall uphold the dignity of the profession by imbibing the virtues of reliability, honesty and integrity. ARTICLE IV RESPONSIBILITIES TO COLLEAGUES AND OTHER PROFESSIONALS Section 1. A medical technologist shall establish cooperative, honest and respectful working relationships with other medical technologists. Section 2. A medical technologist shall act in the spirit of fairness and maintain a culture of fellowship with the members of the medical technology and other professions. Section 3. A medical technologist shall maintain harmonious working relationships with other professionals of different interdisciplinary practice and respect the scopes and limitations of their practice vis-à-vis the other professions. ARTICLE V PROFESSIONAL RELATIONSHIP WITH THE HEALTH PRODUCT INDUSTRY (HPI) Section 1. A medical technologist shall collaborate with HPI for the advancement of medical technology and the quality of healthcare services. Section 2. A medical technologist shall foster a relationship that encourages the development of a healthcare professional practice that is committed to patients' wellbeing and is based on truthful, accurate, and updated scientific evidence. Section 3. A medical technologist shall interact with HPI to meet the highest ethical standards, preserve independent decision-making and uphold public confidence in the integrity of patient care and product and service selection. Section 4. A medical technologist shall collaborate with HPI within the bounds of applicable laws and codes of conduct for the best interest of the patients. Section 5. A medical technologist shall collaborate with HPI for professional advancement on new technologies and equipment through educational and experiential training. Article VI PENAL PROVISIONS Pursuant to the power of the Board to issue, suspend and revoke Certificates of Registration for the practice of medical technology, violation of any section of the Code of Ethics shall constitute unethical and unprofessional conduct, and shall therefore be a sufficient ground to reprimand, suspend, or revoke the Certificate of Registration of the offending medical technologist in accordance with the provisions of RA No. 5527, as amended, and Republic Act No. 8981 (PRC Modernization Act of 2000). Article VII AMENDMENTS Amendments to the Code of Ethics may be initiated by the Board, in consultation with the Accredited Professional Organization (APO) and other stakeholders. The final proposed amendments shall be submitted for approval by the Board to the Commission. Article VIII EFFECTIVITY This Code of Ethics shall take effect after fifteen (15) days following its publication in the Official Gazette or in any newspaper of general circulation. Let copies hereof be furnished the UP Law Center and the APO for the Medical Technology profession. Done in the City of Pasay, this 13th day of September, 2022. ATTESTED: APPROVED: VACANT Chairperson JOSE Y. CUETO, JR. ERWIN M. ENAD Acting Chairperson Commissioner DATE OF PUBLICATION IN THE PHILIPPINE STAR : Sept. 16, 2022 DATE OF EFFECTIVITY : Oct. 02, 2022  MEDICAL TECHNOLOGY CODE OF ETHICS By: PAMETH, PASMET (NEW- REVISED) As I enter the practice of Medical Technology, I shall: Accept the responsibilities inherent to being a professional Uphold the dignity and respect of my profession and conduct myself a reputation of reliability, honesty, and integrity Perform my task with full confidence reliability and accuracy. Treat any information I acquired about individuals in the course of my work as strictly confidential Commit myself to continuously improve my professional skills and knowledge Share my knowledge and expertise to my colleagues Contribute to the advancement of the professional organization and other allied health organizations Act in a spirit of fairness to all and a spirit of brotherhood to other members of the profession Restrict my praises, criticisms, views, opinions within constructive limits Accept employment from more than one employer only when there is no conflict of interest Be dedicated to the use of Clinical laboratory science to promote life and benefit mankind Uphold the law and shall not engage in illegal work Report any violation of the above principles of professional conduct to the authorized agency and the ethics committee of the organization. To these principles, I hereby subscribe and pledge to conduct myself at all times in a manner befitting the dignity of my profession.  MEDICAL TECHNOLOGY CODE OF ETHICS By: Nardito Moraleta (OLD) Upon entering into the practice of medical technology let it be known that: I accept the responsibilities associated with my duties. I shall uphold the ideals of my profession. I am aware that since the physician relies upon my work in the diagnosis and treatment of diseases, any error may affect the health or even the life of the patient. Every procedure and observation therefore must be carried out with absolute reliability, accuracy, fairness, and honesty. I am aware of the need for mutual understanding and cooperation among my fellow workers in the medical and paramedical field in the pursuance of a worthy cause. I shall strive to preserve the integrity of myself and the professionals from whom we expect the same. I shall strive to develop necessary virtues needed in my work and shall place my service above any other considerations. I shall restrict my phrases, criticisms, values, and opinions, within constructive limits and I shall not use the knowledge I know as a tool for my selfish personal ends. I realize that the knowledge I acquired about any individual in the course of my work must be treated as confidential. And since the physician has the ultimate responsibility in the diagnosis and treatment, my result must be known only by him. I shall neither make diagnosis nor interpretations other than this in the report made by me nor shall I advice the physician or others on how to treat diseases. I shall believe in full and equal opportunities in the pursuance of our ideals within the context of the principles of human rights. To these principles, I hereby subscribe, promising to conduct myself at all times in a manner appropriate to the dignity of my profession.  MODULE 1 History of Medical Technology in the Global Context and In the Philippines STONE AGE (ANCIENT)  Diseases were treated as mystery in the early era of medical diagnosis.  Disease was believed to be caused by the negative interaction between the environment and the body. Belief of unknown – > foundation of superstition Disease – > work of evil spirits Treatment – > Prayers and rituals Febrile Condition – > purgation, sweating, blood donation and diet restriction 300 BC to 180 AD Hippocrates (IRON AGE) - Father of Medicine - Author of Hippocratic Oath - Advocated the tasting of urine, listening to the lungs, and observing outward appearances in the diagnosis of disease. NOTE: Bubbles, blood, and pus in urine indicated kidney disease and chronic illness. Galen - A Greek Physician and Philosopher Instigated a rudimentary and qualitative assessment of disorder through measurement of body fluids in relation to seasons. NOTE: Body fluids is also called that time as the 4 humors. 1. Blood 2. Phlegm 3. Black bile 4. Yellow bile - Described diabetes as “diarrhea of urine” and establish relationship between fluid intake and urine volume. Medieval Europe - Diagnosis by water casting (uroscopy) was widely practiced. - Patients submit their urine and physicians who failed to examine urine were subjected to public beatings. 900 AD - The first book detailing the characteristic of urine (color, density, quality) was written 11TH Century - Medical practitioners were not allowed to conduct physical examination of the patient’s body. - They relied on the patient’s description of the symptoms and their observations - Mechanical techniques and cadaver dissection were used 19th Century - Physicians begun using machine for diagnosis or therapeutics - Chemistry become pivotal in the diagnosis of diabetes, anemia, diphtheria, and syphilis Mid- 1800s - Chemical experts organized laboratories designed for analyzing medical specimens. Mid – 1900s -Technical laboratories regulated by the Centers for Disease Control and Prevention (CDC) began to be used for medical diagnostics in the US. Josh Hutchinson - Spirometer (for measuring the vital capacity of the lungs) Jules Herisson - Sphygmomanometer (for measuring blood pressure) As the number of patients increase and the increasing amount of medical knowledge, mechanical and chemical devices turn from general practice to specialization. Complex machineries require technical expertise, resulting in cooperative arrangement among specialist in different ields. Consequently, medical services become organized in the hospitals. With this setup, large amounts of data were required in the diagnosis and treatment of disease. Volumes of data prompted the need for information technology. The need for medical technicians and specialists also increased. In 1969, 80% of medical professionals were non-physicians. This growth drive the need for technicians to be proficient in the use of technology. Patients were likewise needed to be educated with the tests done on them. The Philippine Union College (PUC)in Baesa, Caloocan City (now Adventist University of the Philippines) absorbed MSH’s School of Medical Technology. Technology took over face to face interactions between patients and physicians since technology is use as diagnostic assessments instead of the patient’s description of symptoms. Following are some breakthrough in medical technology that allowed physicians to examine body parts. Stethoscope 1816 First diagnostic medical breakthrough invented by Rene Laennec; used to acquire information about the lungs and heartbeats Microscope 1840 Developed for medical purposes due to advances in lenses and lower costs; microscope was devised by Antonie Van Leeuwenhoek Ophthalmoscope 1850 First visual technology invented by Hermann von Helmholz Laryngoscope 1855 Devised by Manuel Garcia using two mirrors to observe the throat and larynx Heart-Lung Machine 1939 Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the patient's body. Cardiac 1941 First operated by Forsmann in 1929; develop by Moniz, Catheterization and Reboul, Rousthoi between 1930 and 1940; discovered Angiography as safe method in humans by Cournand in 1941; made seeing the heart, lung vessels, and valves possible through inserting cannula in an arm vein and into the heart with an injection of radiopaque dye for X-ray visualization X-ray 1859 Invented by Wilhelm Roentgen when he discovered by accident that radiation could penetrate solid objects of low density; allowed physicians to view the inside of the body without surgery; used to diagnose pneumonia, pleurisy, and tuberculosis since WWII Electrocardiogram 1903 Developed by William Einthoven to measure electrical changes during the beating of the heart Kenny Method 1910 Served as the pioneering work for modern physical therapy ; devised by Elizabeth Kenny in the treatment of polio (was called infantile paralysis) using hot packs and muscle manipulation; prompted the invention of a new stretcher (Sylvia stretcher in 1927) intended for transporting patients in shock. Drinker Respirator 1927 Invented by Philip Drinker to help patients with paralytic anterior poliomyelitis recover normal respirator. Electron Microscope 1931 Max Knoll and Ernst Ruska, used for visualization of small cells including tumor cells. Tomography 1972 Godfrey Houns Field developed a technique for displaying a representation of a cross section through a human body or other solid object using X rays or ultrasound. Magnetic Resonance 1970 Raymond Damadian, a medical doctor, and research Imaging (MRI) scientist discovered the basis for using magnetic resonance imaging. It is an imaging technique that uses a magnetic field and computer generated radio waves to create detailed images of the organs and tissues in your body  History of Medical Technology in the United States In the United States, the establishment of the irst clinical laboratories and the development of laboratory practice marked the growth of the medical technology ield. 1895 The University of Pennsylvania’s William Pepper Laboratory of Clinical Medicine was opened to highlight the service role of clinical laboratories. 1918 John Kolmer called for the development of a method that would certify medical technologists on a national scale. Kolmer published The Demand for and Training of Laboratory Technicians that included a description of the irst formal training course in Medical Technology. Same year when the state legislature of Pennsylvania enacted a law requiring all hospitals and institutions to have a fully equipped laboratory it for routine testing and to employ a full-time laboratory technician. 1920 Administrative units of clinical laboratories in large hospitals were directed by a chief physician. Clinical laboratories consisted of 4 to 5 divisions including clinical pathology, bacteriology, microbiology, serology, and radiology. 1922 American Society for Clinical Pathology (ASCP) was founded with the objective of encouraging the cooperation between physicians and clinical pathologist. ASCP also established the code of ethics for technicians and technologists stating that that these allied health professionals should work under the supervision of a physician and refrain from making oral or written diagnosis and advising physicians on how patients should be treated American Society for Clinical Laboratory Science (formerly the American Society for Medical Technologists), originally subgroup of ASCP, helped in the recognition of nonphysician clinical laboratory scientists as autonomous professionals. 1950 Medical technologists in the United States sought professional recognition from the government of their educational quali ications through licensure laws.  History of Medical Technology in the Philippines 1565 The first hospital the Spaniards established; Hospital Real in Cebu was moved to Manila to cater to military patients. 1578 Franciscans built the San Lazaro Hospital 1596 Hospital de San Juan de Dios was founded 1641 The Hospital de San Jose was founded in Cavite 1611 Dominicans founded the University of Santo Tomas (UST) 1871 UST established the irst faculties of pharmacy and medicine. With the establishment of both health and educational institutions, journals of science and medicine were also published including the Boletin de Medicina de Manila (1886), the Revista Farmaceutica de Filipinas (1893), and Cronicas de Ciencias Medicas (1895) (Anderson, 2006) 1806 The central board of vaccination which started producing and distributing vaccine lymph had 122 regular vaccinators (vacunadores) in Manila and other major towns by 1898 1876 Provincial medical of icers were appointed to provide health care services throughout the country. 1883 Board of Health and Charity was established and expanded in 1886 1887 The Laboratorio Municipal de Manila was established by the Spanish authorities for laboratory examinations of food, water, and clinical samples. General Antonio Luna was employed as a chemical expert in this laboratory and pioneered water testing, forensics, and environmental studies. 19th century Spaniards were authorities in medicine, started exploring the microbial causes of diseases. 1898 Spanish Military hospital was converted into the First Reserve Hospital Lt. Col. Henry Lipincott who was a chief surgeon of the Division of the Paci ic and Eight Army Corps. The hospital has a diagnostic laboratory but was not fully maximized when it irst became operational due to its director contracting typhoid fever. Richard P. Strong, successor, utilized the laboratory to perform autopsies and to examine blood, feces, and urine along with other laboratory services 1901 The US government, through the Philippine Commission, established a Bureau of Government Laboratories under the Philippine Commission Act NO. 156 The Bureau which was in Calle Herran (Pedro Gil), Ermita, Manila had a science library, chemical section, and serum laboratory to produce vaccines. The biology laboratory was designed to address and develop methods in the diagnosis, treatment, and prevention of human and animal diseases. In the Chemical laboratory- food, plant composition, and minerals were investigated. 1899 to 1902 The Spanish colonial rule breakdown because of Philippine- American war. In replacement of the Spanish Health System, the Americans established public health institutions modeled after military health care systems. 1905 The Bureau of Government Laboratories was reorganized, and the Bureau of Science was established for medical of icers who sought a career in laboratory research. The Bureau worked with the Army Board for the Study of the Tropical Diseases until the latter was disbanded in 1914. The bureau also focused on pathology. The Bureau of Science worked closely with the Philippine General Hospital (PGH) and the University of the Philippines. It then became an active center for scienti ic research and instruction in the country. The biological laboratory of the Bureau diligently studied samples of body luids to identify the racial bases of diseases. Paul Freer, the bureau’s irst director, ensured that the biological laboratory would be equipped with adequate supplies and equipment such as incubators, sterilizers, microscopes, microtomes, stains, glassware, and chemicals. The main laboratory was composed of two stories and divided into two wings with rooms in the biological wing having microscope tables by the windows. The rooms had enough space for general laboratory work and processes such as iltering, distilling, and heating. Each biological room has a chemical worktable with gas, water, and vacuums. The opposite wall had a hood with a lue extended to the attic. The biological wing’s loors all had incubators heated by Bunsen burners and refrigerating boxes. Unfortunately, the building was destroyed during World War II. Presently the National Institutes of Health of University of the Philippines- Manila occupies the area. 1944 US forces landed in Leyte, the laboratories including the 3rd, 5th, and 8th, Medical Laboratories and the 19th Medical General Laboratory were relocated to the West Paci ic Area. Added to the list were the 26th and 27th Medical Laboratories and the 363rd Medical Composite Detachment. Medical units were not merged but deployed separately as small detachments or mobile laboratories in different islands. 19th, 3rd, and 363rd operated in Leyte, 27th in Tacloban, 26th in Lingayen Gulf (only laboratory in Luzon following US invasion on January 9, 1945) 1909 Laboratory received over 7000 fecal specimens, 900 urine specimens, and 700 blood specimens. The Bureau’s medical research and laboratory investigations were mainly focused on microbiology in connection with the different diseases, like malaria, leprosy, tuberculosis, and dysentery At the end of war, the civilian board of Health established by the Americans was changed into the Bureau of Health. 1915 Bureau was reorganized into the Philippines Health Service but reverted to the Bureau of Health by 1933. June 1927 The University of the Philippines’ College of Public Health opened its Certi icate in Public Health Program which aim to provide proper training to the Philippine Health Service’s medical of icers December 8, Japan attacked the whole manila. Amid this turmoil, the Medical Laboratory 1941 unit of the US Army provided medical services. It was also tasked to perform routine water analyses, examination of food supplies, distribution of special reagents, solutions, culture media and investigation of epidemics and epizootics. The unit also performed special serological, bacteriological, pathological, and chemical examinations, port-mortem examinations, and preservation of pathological specimens of value to the US Army Medical Department. June 18, 1942 The 3rd Medical laboratory was the irst laboratory unit to be assigned in the South West Paci ic Area (SWPA)  The irst clinical laboratory in the Philippines was established during World War II by the 6th Infantry Division of the US Army at Quiricada St. Sta. Cruz, Manila. It is known as the Manila Public Health Laboratory. June 1945 When the US Army left, the laboratory was endorsed to the National Department of Health and was non-operational until it was reopened in October of the same year by Dr. Pio de Roda with the help of then Manila City Health Of icer Dr. Mariano Icasiano. After instituting the public health laboratory in Manila, Dr. Pio de Roda along with Dr. Prudencia Sta. Ana, conducted a training program for aspiring laboratory workers. Later, Dr. Sta Ana was asked to prepare a six month formal syllabus for the training program with certi icate for the trainees. Dr. Tirso Briones joined the two later. 1954 The training program ended in 1954 when the Bureau of Private Education approved a four-year course in Bachelor of Science in Medical Technology. In the same year, the Manila Sanitarium and Hospital (MSH) opened the irst School of Medical Technology in the Philippines under the leadership of Mrs. Willa Hedrick, wife of Dr. Elvin Hedrick. Soon after, MSH started its medical internship and residency training program which was af iliated with Loma Linda University in California. The Philippine Union College (PUC)in Baesa, Caloocan City (now Adventist University of the Philippines) absorbed MSH’s School of Medical Technology. What was left with MSH was the facility for its clinical division. Dr. Jesse Umali, irst graduate of the Medical Technology Program. He later graduated as a Doctor of Medicine at Far Eastern University (FEU) and became a successful OB-gynecologist in the US. 1957 UST initially offered the Medical Technology course as an elective for pharmacy students. 1961 Medical Technology was recognized as an of icial program in UST.  MODULE 2 Medical Terminologies and Abbreviations and Ethics in the Profession I. FACTS  Why is Medical terminologies and acronyms important? - due to laboratory personnels are in constant communication with other health workers and patients.  Most MEDICAL TERMS are DERIVED from GREEK.  MEDICAL TERM 3 BASIC PARTS: 1. Root word E.g : Colon- Colon Phlebo- Vein Hemat- blood Aero- air 2. Prefix E.g : A/an --- absence, without Hyper--- increase/ above/ high Poly--- many Pre--- before 3. Suffix E.g : -megaly---enlargement - uria--- urine -emia--- blood - ostomy--- to make an opening/ mouth II. RULES IN COMBINING MEDICAL TERMS:  If suffix starts with a consonant, a combining vowel needs to be used (usually the letter O). Combining vowel does not change the meaning of the root word and is added in order to make the pronunciation of the word easier. The combining vowel is added between the root word and the suffix. EXAMPLES hemat + logy = hematology – study of blood phlebo + tomy = phlebotomy – the process of cutting into the vein using a needle PLURAL AND SINGULARS  SINGULAR PLURAL bacterium bacteria SINGULAR PLURAL nucleus nuclei bacillus bacilli thrombus thrombi ovum ova spermatozoon spermatozoa III. ACRONYMS/ ABBREVIATIONS  Commonly encountered in health care practice that medical technology students should know. DOH – Department of Health 2PPBS – 2 hours Postprandial blood Sugar CHED – Commission on Higher Education AFS – Acid Fast Stain VDRL – Venereal Disease Research Laboratories PCQACL – Philippine Council for Quality Assurance in the Clinical Laboratories AIDS- Acquired Immune Deficiency Syndrome FBS – Fasting Blood Sugar AIDs – Autoimmune disorders/diseases IN – Intravenous AMI – Acute Myocardial Infarction HIV – Human Immunodeficiency Virus BUN – Blood Urea Nitrogen IU – international Unit NPO – Nothing Per Orem ICU – Intensive Care Unit BAP – Blood Agar Plate K – Potassium General Medical Abbreviations Source:  ADM - Admission, Admitted  AOB - Alcohol on Breath  ALS - Advanced Life Support  AMA - Against Medical Advice, American Medical Association  ASAP - As Soon As Possible  A&W - Alive and Well  BM - Bowel Movement  BMD - Bone Mass Density  BMI - Body Mass Index  BMR - Basal Metabolic Rate  BP - Blood Pressure  C - Centigrade, Celsius  CBF - Cerebral Blood Flow  CC - Cubic Centimeter, Chief Complaint, Critical Care  C/O - Complains Of, Care Of  CV - Cardiovascular  D/C - Discontinue or Discharge  DNR - Do Not Resuscitate  DO - Disorder  DOB - Date of Birth  DOT - Directly Observed Therapy  DSM - Diagnostic and Statistical Manual of Mental Disorders  Dx - Diagnosis  EDC - Estimated Date of Confinement  EDD - Estimated Delivery Date  EGA - Estimated Gestational Age  FB - Foreign Body  FHR - Fetal Heart Rate  FM - Fetal Movement  FROM - Free Range of Motion  FT - Full Term  FX - Fracture  GA - Gestational Age  GH - Growth Hormone  GHRH - Growth Hormone Releasing Hormone  GI - Gastrointestinal  GU - Genitourinary  H&P - History and Physical Examination  HB - Hemoglobin  HDL - High Density Lipoprotein  HPI - History of Present Illness  H/O - History Of  HR - Heart Rate (or Hour)  HS - Hour of Sleep (Bedtime)  I&O - Intake and Output  ICU - Intensive Care Unit  ID - Infectious Diseases  IM - Intramuscular  IP - Inpatient  IQ - Intelligence Quotient  IU - International Units  IV - Intravenous  IVP - Intravenous Push  MCO - Managed Care Organization  N/V - Nausea/Vomiting  NKDA - No Known Drug Allergies  NM - Neuromuscular  NTG - Nitroglycerin  NVD - Normal Vaginal Delivery  O2 - Oxygen  OPD - Outpatient Department  P - Pulse  Post-op - Postoperative (after surgery)  Pre-op - Preoperative (before surgery)  PA or PT - Patient   PT - Physical Therapy  PCP - Primary Care Physician  PPE - Personal Protection Equipment  RBC - Red Blood Cell  RF - Risk Factor  RXN - Reaction  S - Sans (without)  SC or SQ - Subcutaneous  S/S - Signs and Symptoms  STAT - Statim (immediately)  SX - Symptoms  T - Temperature  TLC - Total Lung Capacity  TPR - Temperature, Pulse, Respiration  UO - Urine Output  USOH - Usual State of Health  WT - Weight Emergency Medical Abbreviations In an emergency situation, rapid communication can be the difference between life and death. Common abbreviations found in an ER include:  A&O - Alert and Oriented  ABC - Airway-Circulation-Breathing  A-Fib - Atrial Fibrillation (irregular heartbeat)  CAB - Circulation-Airway-Breathing  CPR - Cardiopulmonary Resuscitation  CVA - Cerebral Vascular Accident (stroke)  DOA - Dead on Arrival or Date of Admission  EBL - Estimated Blood Loss  EC - Eye Contact  ER - Emergency Room   FEF - Forced Expiratory Flow  FRC - Functional Residual Capacity  GSW - Gunshot Wound  LOF - Loss of Fluid  MVA - Motor Vehicle Accident  NAD - No Acute Distress  REM - Rapid Eye Movements  SOB - Shortness of Breath  VF - Ventricular Fibrillation  VS - Vital Signs  VSS - Vital Signs Stable Common Prescription Abbreviations  ABX - Antibiotics  AC - Ante Cibum (before meals)  Ad lib - Ad Libitum (at will, as desired)  BC - Birth Control  BID - Bis In Dies (twice a day)  CAP - Capsule  GTT - Guttae (drops)  MDD - Maximum Daily Dose  NPO - Nil Per Os (nothing by mouth)  OCP - Oral Contraceptive Pill  OPV - Oral Polio Vaccine  OTC - Over The Counter  PC - Post Cibum (after meals)  PCN - Penicillin  PNV - Prenatal Vitamins  PO - Per Os (by mouth)  PRN - Pro Re Nata (as needed)  q2h - Quaque Segunda Hora (every 2 hours)  q4h - Quaque Quarta Hora (every 3 hours)  qam - Quaque Ante Meridiem (every morning)  qd - Quaque Die (once a day)  qh - Quaque Hora (once every hour)  qhs - Quaque Hora Somni (every night at bedtime)  qid - Quater In Die (four times a day)   qod - Quaque Altera Die (every other day)  qpm - Quaque Post Meridiem (every evening)  RDI - Recommended Daily Intake  Rx - Recipe (prescription)  TAB - Tablet  TIW - Three Times a Week Medical Orders and Procedure Abbreviations  AA - Amino Acid  ABG - Arterial Blood Gas  AXR - Abdominal X-Ray  BAC - Blood Alcohol Content  BE - Barium Enema  BMT - Bone Marrow Transplant  Bx - Biopsy  CABG - Coronary Artery Bypass Graft  CBC - Complete Blood Count  CFT - Complement Fixation Testing  C/S - Cesarean Section  CXR - Chest X-Ray  ECC - Emergency Cardiac Care  ECG or EKG - Electrocardiogram  ECMO - Extracorporeal Membrane Oxygenation  ECT - Electroconvulsive Therapy  ECV - External Cephalic Version  FNA - Fine Needle Aspiration  FOBT - Fecal Occult Blood Testing  FSH - Follicle Stimulating Hormone  GLT - Glucose Loading Test  GTT - Glucose Tolerance Test  H20 - Water  HPA - Hypothalamic Suppression Test  I&D - Incision and Drainage  IUI - Intrauterine Insemination  IVF - In Vitro Fertilization   KUB - Kidney, Ureter, Bladder (x-ray)  OGTT - Oral Glucose Tolerance Test  PAP - Pulmonary Artery Pressure, Papanicolaou Test  PEEP - Positive end Expiratory Pressure  T&C - Type and Cross (blood)  TPA - Tissue Plasminogen Activator (dissolve clots), Total Parenteral Alimentation (intravenous nutritional needs)  UA - Urinalysis  US - Ultrasound  WB - Whole Blood  WBC - White Blood Cell  WNL - Within Normal Limits  XRT - External Radiation Therapy Abbreviations for Medical Diagnoses or Symptoms  ADHD - Attention Deficit Hyperactivity Disorder  AIDS - Acquired Immune Deficiency Syndrome  ALS - Amyotrophic Lateral Sclerosis (Lou Gehrig's disease)  ARDS - Adult Respiratory Distress Syndrome  ARF - Acute Renal Failure, Acute Rheumatic Fever  BAD - Bipolar Affective Disorder  CA - Cancer  CAD - Coronary Artery Disease  CF - Cystic Fibrosis  C/F - Chills, Fever  CHD - Congenital Heart Disease  CHF - Congestive Heart Failure  COLD - Chronic Obstructive Lung Disease  COPD - Chronic Obstructive Pulmonary Disease  CP - Chest Pain  CP - Cerebral Palsy  DTR - Deep Tendon Reflex  DVT - Deep Venous Thrombosis  EBV - Epstein-Barr Virus  ECASA - Enteric Coated Acetylsalicylic Acid  EGC - Early Gastric Cancer  FAS - Fetal Alcohol Syndrome  F/C - Fever, Chills  HA - Headache, Hemolytic Anemia  HAV - Hepatitis A Virus  HBV - Hepatitis B Virus  HCV - Hepatitis C Virus  HDV - Hepatitis D Virus  HIV - Human Immunodeficiency Virus  HTN - Hypertension  IBD - Inflammatory Bowel Disease  IBS - Inflammatory Bowel Syndrome  ICP - Intracranial Pressure  IDDM - Insulin-Dependent Diabetes Mellitus  IPF - Idiopathic Pulmonary Fibrosis  JRA - Juvenile Rheumatoid Arthritis  JVD - Jugular Venous Distension  KS - Kaposi Sarcoma  LAD - Leukocyte Adhesion Deficiency  LBP - Lower Back Pain  LBW - Low Birth Weight  LIH - Left Inguinal Hernia  MD - Muscular Dystrophy  MS - Multiple Sclerosis  NIDDM - Non-Insulin Dependent Diabetes Mellitus  OCD - Obsessive Compulsive Disorder  ON - Optic Neuritis  OSA - Obstructive Sleep Apnea  PCOS - Polycystic Ovarian Syndrome  PD - Parkinson's Disease  PE - Pulmonary Embolism  PKD - Polycystic Kidney Disease  PID - Pelvic Inflammatory Disease   PIH - Pregnancy-Induced Hypertension  PMS - Premenstrual Syndrome  PTSD - Post-Traumatic Stress Disorder  RA - Rheumatoid Arthritis  RAD - Reactive Airway Disease  RDS - Respiratory Distress Syndrome  RHD - Rheumatic Heart Disease  SAB - Spontaneous Abortion  SBO - Small Bowel Obstruction  SBS - Shaken Baby Syndrome  STD - Sexually Transmitted Disease  TAH - Total Abdominal Hysterectomy  TB - Tuberculosis  TBI - Traumatic Brain Injury  TGA - Transient Global Amnesia  UC - Ulcerative Colitis  URI - Upper Respiratory Infection  UTI - Urinary Tract Infection  VB - Vaginal Bleeding  VBAC - Vaginal Birth After Cesarean Section Medical Abbreviations for Body Parts  ABD - Abdomen  AD - Auris Dextra (right ear)  AS - Auris Sinistra (left ear)  AU - Aures Unitas (both ears)  CBD - Common Bile Duct  LLL - Left Lower Lobe  LLQ - Left Lower Quadrant  LUL - Left Upper Lobe  LUQ - Left Upper Quadrant  LV - Left Ventricle  OD - Oculus Dexter (right eye)  OS - Oculus Sinister (left eye)  OU - Oculus Uterque (both eyes)  PNS - Peripheral Nervous System  RA - Right Atrium  RUL - Right Upper Lobe  RUQ - Right Upper Quadrant  RV - Right Ventricle, Residual Volume  UE - Upper Extremity (NOTE: Assignment first sem) 1. TIBC – Total Iron-Binding Capacity 2. HDL – High-Density Lipoprotein 3. LDL – Low-Density Lipoprotein 4. ALT – Alanine Transaminase 5. ABG – Arterial Blood Gas 6. NPN – Non-protein Nitrogen 7. BUA – Blood Uric Acid 8. GTT – Glucose Tolerance Test 9. PCR – Polymerase Chain Reaction 10. CBC – Complete Blood Count 11. MCV – Mean Corpuscular Volume 12. MCH – Mean Corpuscular Volume 13. EEG – Electroencephalogram 14. CNS – Central Nervous System 15. QNS – Quantity Not Sufficient 16. CSF – Cerebrospinal Fluid 17. EDTA – Ethylenediaminetetraacetic Acid 18. WBC – White Blood Cells 19. RBC – Red Blood Cells 20. UTI – Urinary Tract Infection 21. STD – Sexually Transmitted Disease/s 22. IV – Intravenous 23. CDC – Center for Disease 24. WHO – World Health Organization 25. FBS – Fasting Blood Sugar 26. SGOT – Serum Glutamic-Oxaloacetic 27. SGPT – Serum Glutamic Pyruvic Transaminase 28. NPO – Nothing by Mouth 29. DOH – Department of Health 30. STAT – medical abbreviation for rush or urgent. (Derived from a Latin word, Statim, which means immediately)  2.1 ETHICS IN THE MEDICAL TECHNOLOGY PROFESSION  ETHICS- moral code that guides how an individual should behave.  SCHOOL OF ETHICS - deals with a diverse prescription of universal concepts and principal morality types that serve as foundation of moral beliefs. - E.g Some may say that the standards of right or wrong are always relative depending on cultural and social factors. In many cases ethics can be connected to morality.  DONALD HARRINGTON “morality can be viewed in different perspectives – as law, inner conviction, love, personal growth, social transformation.”  ETHICAL RELATIVISM (moral relativism) - a school of ethics anchored on the principle: that morality is relative to the norms of a particular culture or society. - acknowledges societal diversity, that every society has a unique moral design and culture; people’s beliefs are greatly influenced by culture. For Eg. Some cultures may accept certain acts and behaviors that are unacceptable to other cultures.  ETHICAL PRAGMATISM - Pragmatism is a philosophical approach or movement that began in the 1870s. - It is more of a theory on knowledge, truth, and meaning rather than morality.  ETHICAL UTILITARIANISM - states that the rightness or wrongness of actions is determined by their consequences. - The principle: utility states that “actions are good if they tend to promote happiness, bad as they tend to produce unhappiness. The utility or usefulness of an action is determined by the extent to which it promotes happiness rather than its reverse.”  MORAL ISSUES - There are numerous ethical issues in the field of medicine that are perceived to be controversial. - CONCERNS/ PROBLEMS that need to be considered when doing an ethical review in the context of the health care profession;  Diversity  decision making  Compliance  governance CONTROVERSIAL ISSUES:  ABORTION - Can be direct, induced, or even caused by natural cases or accidents. -Abortion becomes necessary when the life of the mother is at stake. -illegal in the Philippines. -Article II, Section 12 of the 1987 Philippine Constitution states that: The state recognizes the sanctity of life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception (Article II, Section 12).  EUTHANASIA(mercy killing) - practice of ending a life intentionally, usually in situations when the individual is terminally ill, to relieve him or her of pain and suffering. - regarded as a merciful release of an individual from an incurable sickness. HERBERT HENDIN (2004) - describes euthanasia as “the process of inducing the painless death of a person who is severely debilitated for reasons assumed to be merciful, either through voluntary, non- voluntary, or involuntary means.” TYPES OF EUTHANASIA  Voluntary euthanasia - when an individual gives consent to subject himself or herself to a painless death  Non-voluntary euthanasia - conducted when the permission of the patient to perform the process is unavailable, like in the case of patient in a deep comatose, or neonates born with significant and major birth defects.  Involuntary euthanasia - when the individual does not give his or her consent. NOTE: To this date, euthanasia remains to be controversial because it is the act of taking away a life in a way that is perceived to be against the society’s accepted moral standards.  Genetic Engineering - a controversial ethical issue because it involves genetic manipulations that perceived to be against moral standards set by the society. - Through genetic engineering, humans are seen to acting as their own gods because of procedures that enable them to manipulate the genetic make-up of organisms. The following are some procedures involved in genetic engineering:  Genetic Screening - is a procedure whose main purpose is to screen, choose, and select the genes for proper detection of any genetic disease and other chromosomal malformations (Ciabal, 2003). - usually done for the early diagnosis of diseases.  Genetic Interventions - are techniques such as genetic control, therapy, and surgery.  Stem-cell Therapy - is a form of genetic engineering that makes use of stem cells to treat or prevent diseases. - It has been the subject of controversy because of how stem cells are sourced.  In vitro fertilization (IVF) - popularly known as laboratory fertilization. - In the past, this technology became the subject of controversies because of many religious groups opposing the procedure as they perceive it to be a deviation from natural process of fertilization.  Professional Ethics Professional ethics covers the morally accepted behavior of individuals in the workplace. It guide individuals in dealing with issues and conflicts in the workplace in order for them to remain functional. >The of a particular profession serves as the.  MODULE 3 DEFINING THE PRACTICE OF MEDICAL TECHNOLOGY NATURE OF MEDICAL TECHNOLOGY Science - primarily concerned with the study of the natural world and the interrelationship among the biological, psychological, and even the social world. - Many principles of medical technology are highly dependent on developments in the scientific disciplines and areas such as chemistry, electronics, optics and mechanics, among others, in order to develop a utilizable biotechnology that will aid in the diagnosis of diseases. Technology- the application of science in ways that are considered beneficial to society. Technology can be defined in three ways: 1.) As a physical artefact, machine, or instrument; 2.) As an activity or a means to accomplish a goal; and 3. ) As knowledge (Howell, 1996). Rogers (1983) asserts that “technology is a design for instrumental action that reduces the uncertainty in the cause-effect relationships involved in achieving a desired outcome.” Technology also consists of..  Physical elements such as equipment, materials, or products  Intangible elements, such as knowledge, skills, procedures, principles, or information base required to successfully implement the technology. MEDICAL TECHNOLOGY is designed to improve the detection, diagnosis, treatment, and monitoring of diseases.  CLINICAL LABORATORY TESTING plays a crucial role in the detection, diagnosis, and treatment of diseases.  CLINICAL LABORATORY SCIENTISTS - perform most of these laboratory tests, are involved in the examination and analysis of body fluids, tissues, and cells.  LABORATORY SCIENTISTS - look for the presence of bacteria, parasites, and other microorganisms in the body. - They analyze the chemical contents of fluids, match blood for transfusions, and test for drug levels in the blood to show a patient’s response to a specific treatment. -They also prepare specimens for examination, to count cells, and look for abnormal cells in the blood and other body fluids with the use of microscopes, cell counters, and other sophisticated laboratory equipment. - After testing and examining a specimen, they analyze the results and relay them to physicians.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS  Philippines, Medical Technology Act of 1969 (R.A 5527) - defines the scope of work of the different medical technology professionals.  Clinical Laboratory Act of 1966 (R.A. 4688)  Blood Banking Acts of 1956 (R.A. 1517)  Blood Banking Acts of 1995 (R.A. 7719). TASKS OF MEDICAL TECHNOLOGY PROFESSIONAL IN THE PRACTICE OF LABORATORY SCIENCE. 1.) Perform Clinical Laboratory Testing - must be capable of performing the most basic to the most advanced laboratory tests. - A graduate of B.S. Medical Technology/Medical Laboratory Science is expected to show competency in performing routine laboratory tests: urinalysis and fecalysis (stool examination). - He or she should be capable of performing hematologic, microbiologic, serologic, chemical, and other procedures in the different areas of laboratory science. 2. ) Perform Special Procedures - are also expected to perform special procedures: MOLECULAR AND NUCLEAR DIAGNOSTICS, in diagnosing diseases. 3.) Ensure Accuracy and Precision of Results In performing different procedures to diagnose diseases, a medical technologist should always be conscious of the accuracy and precision of both the testing process and its results. Accuracy and precision impacts the interpretation of results by the physician to provide proper medication in the treatment of diseases. 4.) Be Honest in Practice A practicing medical technologist, like any other professional, is expected to be honest in the practice of his or her work. It is important that a medical technologist values honesty esp. conveying or reporting the results of any laboratory procedure. He or she should act according to the Medical Technology profession’s Code of Ethics and his or her pledged oath of practice. Therefore he or she must be honest at all times in the conduct of teat procedures to come up with accurate and precise results. 5.) Ensure Timely Delivery of Results In collaborating with other health care practitioners, a medical technologist must be aware of the urgency of delivering results on time esp. in cases that require urgent treatment. There are times when physicians will request laboratory tests which require immediate action. TAKE NOTE ON; - “STAT” - source of the requests (e.g., from the emergency room, (ER) or operating room (OR). It is important for the medical technologist to be alert to fully address the needs of the patient. Since some of the laboratory procedures are time bound, it is important that the MEDTECH is able to perform the duties required of him or her as soon as possible. 6.) Demonstrate Professionalism - must be able to perform his or her functions according to the professional Code of Ethics for medical technology professionals. - should be aware of the laws and regulations governing the practice of medical technology and should not exploit the function beyond its boundaries. 7.) Uphold Confidentiality - Ensuring confidentiality of patient’s information is one of the core duties within the medical practice (De Bord et al.). CONFIDENTIALITY requires health care providers to keep a patient’s personal health information private, unless the patient consents to release the information. Patient records are expected to be kept in confidence by the medical technologist. It should be kept and made available only when necessary. 8.) Collaborate with Other Health Care Professionals - A medical technology professional is required to collaborate with other health care practitioners in order to build a well-functioning team. COLLABORATION - act of working together in order to achieve a desired outcome. - A highly-trained physician will only be able to efficiently treat his or her patient if laboratory testing, monitoring, drug prescription and dosage, and more are properly rendered and administered by other health care professionals. These protocols cannot be done by the physician alone. 8. ) Conduct Research - Practicing medical technologists must also be engaged in research activities to update their skills. RESEARCH WORK whether experimental or descriptive can contribute significantly to the discovery of new knowledge in the field of medical technology and in assessing and revisiting already known ones. It can greatly help in the further development of the field and may be used as future reference for patient care. 9. ) Involvement in Health Promotion Programs Medical technologists should not be confined only to the four corners of their clinical laboratories. Medical technology is a multi-disciplinary field which consistently ventures into other areas of health care including health promotion. A medical technology professional must be actively involved in reaching out to the community. The following are some ways that medical technology professionals can help the community: 1. Cooperate with other health care professionals in health promotion campaigns such as promoting the ideal attitudes on hygiene, community sanitation, waste segregation, and disease prevention. 2. Implement pre-planned programs of health promotion campaigns. 3. Offer free laboratory testing such as blood typing, urinalysis, fecalysis, blood sugar testing, cholesterol testing, and other tests beneficial to the entire community. 4. Collaborate with other health care professionals once diagnosis are done.   DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL It is important to note that medical technologists work closely with other laboratory personnel in order to provide accurate and precise laboratory results. The different roles of different laboratory personnel are interconnected and that they should work in harmony in order to provide the best patient care. The other laboratory personnel include:  PATHOLOGIST - a duly registered physician - specially trained in methods of laboratory medicine, or the gross and microscopic study and interpretation of tissues, secretions and excretions of the human body and its function in order to diagnose disease, follow its course, determine the effectivity of treatment, ascertain cause of death, and advance medicine by means of research.  MEDICAL LABORATORY TECHNICIANS - a person certified by and registered with the Board of Medical Technology and qualified to assist a medical technologist and/or qualified pathologist in the practice of medical technology as defined in R.A. 5527. QUALIFICATIONS to become a Medical Laboratory Technician: 1. ) Failed to pass the medical technology licensure examination given by the Board of Medical Technology but obtained a general rating of at least 70%. 2. )When employed in the government institution shall have the equivalent civil service eligibility not lower than the second grade. 3. ) Passed the civil service examination for medical laboratory technicians given on March 21, 1969. 4. ) Finished a two-year college course 5. And has at least one (1) year experience of working as a medical laboratory technician.  PHLEBOTOMIST - an individual trained to draw blood either for laboratory tests or for blood donations. - In the Philippines, a medical technologist is required to be skilled in phlebotomy. - But in other countries, phlebotomists need not get a degree (Cardona et al., 2015). REQUIREMENTS: Training and going through phlebotomy programs sponsored by the community. After completing the program, they may take the examination to be recognized as certified phlebotomist by the American Society of Clinical Pathology (ASCP)  CYTOTECHNOLOGIST A cytotechnologist is a laboratory personnel who works with the pathologist to detect changes in body cells which may be important in the early diagnosis of disease. This is primarily done by examining. MODULE 4 BASIC CONCEPTS OF LABORATORY BIOSAFETY AND BIOSECURITY WHY is observing and implementing laboratory safety precautions are of utmost importance in the medical technology practice? --> Individuals who handle and process microbiological specimen are vulnerable to pathogenic microorganisms which are possible sources of laboratory acquired infections. BIOSAFETY -containment principles, technologies, and practices that are implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release. - focuses on laboratory procedures and practices necessary to prevent exposure to and acquisition of infections BIOSECURITY - refers to the protection, control, and accountability for valuable biological materials within laboratories, in order to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release (WHO, 2006). - maintenance of secure procedures and practices in handling biological materials and sensitive information “BIOSAFETY protects people from germs” while “BIOSECURITY protects germs from people.” BRIEF HISTORY OF LABORATORY BIOSAFETY - Traces its history in North America and Western Europe. (1943)  US BIOLOGICAL WEAPONS PROGRAM (1943) - beginning; commencement - origin of biosafety is rooted. - ordered by then US President Franklin Roosevelt - was active during the Cold War. -->Ira L. Baldwin - became the first scientific director of Camp Detrick (now Fort Detrick) -was tasked with establishing the biological weapons program for defensive purposes to enable the United States to respond if attacked by such weapons. (1969) - US BIOLOGICAL WEAPONS PROGRAM was eventually terminated by US President Richard Nixon. (After the second World War) - Camp Detrick was designated a permanent installation for biological research and development.  Therefore, BIOSAFETY WAS AN INHERENT COMPONENT OF BIOLOGICAL WEAPONS DEVELOPMENT. --> Newell A. Johnson - Designed modifications for biosafety at Camp Derrick. - He engaged some of Camp Detrick’s leading scientists about the nature of their work. - Developed specific technical solutions such as Class III safety cabinets and laminar flow hoods to address specific risks. (1984) Consequent meetings eventually led to the formation of the American Biological Safety Association (ABSA). OTHER CONTRIBUTORS OUTSIDE THE UNITED STATES: --> Arnold Wedum (1907 & 1908) - described the use of mechanical pipettors to prevent laboratory-acquired infections (Kruse, 1991), cited by Salerno, 2015). -->Pharmaceutical company in Pennsylvania (1909) - developed a ventilated cabinet to prevent infection from mycobacterium tuberculosis. (1967) - height of increasing mortality and morbidity due to smallpox - WHO aggressively pursued the eradication of the virus. - Serious concerns about the biosafety practices worldwide were raised, contributing directly to the decision of the World Health Assembly to consolidate the remaining virus stock into two locations: 1.) Center for Disease Control and Prevention (CDC) in the United States 2.) State Research Center of Virology and Biotechnology VECTOR in Russia. (1983) - WHO published the Laboratory Biosafety manual. (1984) - the CDC and NIH jointly published the Biosafety in Microbiological and Biomedical laboratories. These documents marked the development of the practice of laboratory biosafety. --> ARNOLD WEDUM - director of Industrial Health and Safety at the US Army Biological Research Laboratories in 1944 - recognized as one of the pioneers of biosafety that provided the foundation for evaluating the risks of handling infectious microorganisms and for recognizing biological hazards and developing practices, equipment, and facility safeguards for their control.  BRIEF HISTORY OF LABORATORY BIOSECURITY (1996) - the US government enacted the Select Agent Regulations to monitor the transfer of a select list of biological agents from one facility to another. (AMERITHRAX 2001) slightly after the terrorist attacks and the anthrax attacks - the US government changed its perspective. - The revised Select Agent Regulations then required specific security measures for any facility in the United States that used or stored one or more agents on the new, longer lists of agents. (2012) - Revision of the Select Agent Regulations that sought to address the creation of two tiers of select agents. Tier 1 agents - are materials that pose the greatest risk of deliberate misuse, and the remaining select agents. This change was intended to make regulations more risk-based, mandating additional security measures for Tier 1 agents. Other countries also relatively implemented and prescribed biosecurity regulations for bioscience facilities. Singapore’s Biological Agents and Toxins Act is similar in scope with the US regulations but with more severe penalties for noncompliance. South Korea’s Act on Prevention of Infectious Diseases in 2005 was amended to require institutions that work with listed ‘highly dangerous pathogens” to implement laboratory biosafety and biosecurity requirements to prevent the loss, theft, diversion, release, or misuse of these agents. Around the world, biosecurity implementation has become a purely administrative activity based on a government developed checklist.  LOCAL AND INTERNATIONAL GUIDELINES ON LABORATORY BIOSAFETY AND BIOSECURITY (1983) - WHO published its 3rd edition of the Laboratory Biosafety Manual to address concerns on biosafety guidance for research and health laboratories, issues on risk assessment and guidance to commission and certify laboratories. 3rd edition LAB BIOSAFETY MANUAL - includes information on the different levels of containment laboratories (Biosafety levels 104), different types of biological safety cabinets, good microbiological techniques, and how to disinfect and sterilize equipment. - In terms of biosecurity, it covers the packaging required by international transport regulations and other types of safety procedures for chemical, electrical, ionizing radiation, and fire hazards. - The manual puts emphasis on the continuous monitoring and improvement directed by a biosafety officer and the biosafety committee. (2003) - The Cartagena Protocol on Biosafety (CPB) was made effective. CARTAGENA PROTOCOL ON BIOSAFETY (CPB) -applies to the 168 member-countries - provides an international regulatory framework to ensure “an adequate level of protection in the field of safe transfer, handling, and use of Living Modified Organisms (LMOs) resulting from modern biotechnology.” - The regulations primarily tackle the safe transfer, handling, and use of LMOs that may have adverse effects on the conservation of biological diversity except those that are used for pharmaceutical purposes. THE NEW NATIONAL COMMITTEE ON BIOSAFETY OF THE PHILIPPINES (NCBP) - established under E.O. 430 series of 1990 - was formed on the advocacy efforts of scientists. - The mandate of NCBP focuses on the organizational structure for biosafety: procedures for evaluation of proposals with biosafety concerns; procedures and guidelines on the introduction, movement, and field release of regulated materials; and procedures on physio- chemical and biological containment. (March 17, 2006) - the Office of the President promulgated E.O. 514 establishing the National Biosafety Framework (NBF) National Biosafety Framework (NBF) - prescribes the guidelines for its implementation, strengthening the National Committee on Biosafety of the Philippines. - a combination of policy, legal, administrative, and technical instruments developed to attain the objective of the Cartagena Protocol on Biosafety which the Philippines signed on May 24, 2000. Administrative Order No. 8 - issued by The Department of Agriculture (DA) - to set in place policies on the importation and release of plants and plant products derived from modern biotechnology. (DOH Administrative Order No. 2007-0027). - The DOH together with NCBP, formulated guidelines in the assessment of the impacts on health posed by modern biotechnology and its implications. - The guidelines aid in evaluating and monitoring processed food derived from or containing GMO. - The DOH requires clinical laboratories to ensure policy guidelines on laboratory biosafety and biosecurity. DIFFERENT ORGANIZATIONS IN THE FIELD OF BIOSAFETY The following are some prominent organizations inside and outside the Philippines that have undertaken initiatives in advocating for laboratory biosafety and biosecurity: American Biological Safety Association (ABSA) – FOUNDED: 1984 - a regional professional society for biosafety and biosecurity. - It promotes biosafety as a scientific discipline and provides guidance to its members on the regulatory regime present in North America. Asia-Pacific Biosafety Association (A-PBA) - FOUNDED: 2005 - a group that acts as a professional society for biosafety professionals in the Asia-Pacific region. European Biological Safety Association (EBSA) -FOUNDED: JUNE 1996 - a non profit organization that aims to provide a forum for discussion and debates on issues of concern and to represent those working in the field of biosafety. - focuses on encouraging and communicating among its members information and issues on biosafety and biosecurity as well as emerging legislation and standards. Philippine Biosafety and Biosecurity Association (PhBBA) - created by a multidisciplinary team with members coming from the health and education sectors as well as individuals from the executive, legislative, and judicial branches of the government. - The long term goal of the association is to assist the DA and DOH in their efforts to create a national policy and implement plan for laboratory biosafety and biosecurity. Biological Risk Association Philippines (BRAP) - tagline “assess, mitigate, monitor.” - a non-government and non-profit association that works to serve the emergent concerns of biological risk management in various professional fields such as in the health, agriculture, and technology sectors throughout the country. CLASSIFICATIONS OF MICROORGANISMS ACCORDING TO RISK GROUPS Risk group 1 – includes microorganisms that are unlikely to cause human or animal disease. These microorganisms bring about low individual and community risk. Risk group 2 – includes microorganisms that are unlikely to be a significant risk to laboratory workers and the community, livestock, or the environment. This risk group bring about moderate individual risk and limited community risk. Risk group 3 – includes microorganisms that are known to cause serious diseases to humans or animals and may present a significant risk to laboratory workers. They bring about high individual risk, and limited to moderate community risk. Risk group 4 – includes microorganisms that are known to produce life-threatening diseases to humans or animals. They bring about high individual and community risk. CATEGORIES OF LABORATORY BIOSAFETY ACCORDING TO LEVELS In order to facilitate precautionary measures, CDC categorized laboratories into four biosafety levels: Biosafety Level 1 (BSL-1) – is suitable for work involving viable microorganisms that are defined and with well-characterized strains known not to cause disease in humans. This level is the most appropriate among undergraduate and secondary educational training and teaching laboratories that require basic laboratory safety practices, safety equipment, and facility design that requires basic level of containment.  Biosafety Level 2 (BSL-2) – is basically designed for laboratories that deal with indigenous moderate-risk agents present in the community. It observes practices, equipment, and facility design that are applicable to clinical, diagnostic, and teaching laboratories consequently observing good microbiological techniques. BSL-2 is appropriate when work is done with human blood, body fluids, tissues, or primary human cell lines where there is uncertain presence of infectious agents. Hand washing sinks and waste decontamination facilities must be available and access to the laboratory must be restricted when work is being conducted. Agents associated with human disease include measles, virus, Salmonella species, pathogenic Toxoplasma, Clostridium botulinum, hepatitis B virus Biosafety Level 3 (BSL-3) – puts emphasis on primary and secondary barriers in the protection of the personnel, the community, and the environment from infectious aerosol exposure. Work with indigenous or exotic agents with a potential for respiratory transmission, and that may cause serious and potential lethal infection are being conducted here. Secondary barriers for this level are highly required including controlled access to the laboratory and ventilation requirements to minimize the release of infectious aerosols from the laboratory while special engineering and design features are being considered. Biosafety Level 3 (BSL3) - microorganisms that cause serious disease, transmitted by inhalation like M. tuberculosis, yellow fever virus, Hantavirus. Biosafety Level 4 (BSL-4) – is required for work with dangerous and exotic agents that pose high individual risks of life-threatening disease that may be transmitted via the aerosol route, for which there are no available vaccines or treatment. The laboratory worker’s complete isolation from aerosolized infectious materials is accomplished primarily by working in a Class III biosafety cabinet or in a full-body, air-supplied positive-pressure personnel suit. A BSL-4 laboratory is generally a separate building or completely isolated zone with specialized ventilation requirements and waste management systems Biological safety cabinet or microbiological safety cabinet It is an enclosed, ventilated laboratory workspace for safely working with materials contaminated with (or potentially contaminated with) pathogens requiring a defined biosafety level BSCs first became commercially available in 1950.  MODULE 5 BIORISK MANAGEMENT In working with infectious agents and toxins in laboratories, one must consider the practices and procedures on biocontainment to ensure biosafety and biosecurity. Proper management is necessary to carry out total safety of laboratory workers and patients.. HAZARD refers to anything in the environment that has the potential to cause harm RISK is generally defined as the possibility that something bad or unpleasant (such as an injury or loss) will happen. BIORISK – is the risk associated to biological toxins or infectious agents. Sources of RISK: -Unintentional exposure to unauthorized access -accidental release or loss, - theft, - misuse, - diversion, - intentional unauthorized release of biohazards. BIORISK MANAGEMENT – integration of biosafety and biosecurity to manage risks when working with biological toxins and infectious agents. - also a “system or process to control safety and security risks associated with the handling or storage and disposal of biological agents and toxins in laboratories and facilities.” - It is divided into three primary components or the AMP Model assessment (A), mitigation (M), performance (P). AMP model - requires that control measures be based on a robust risk assessment, and a continuous evaluation of effectiveness and suitability of the control measures. Identified risks can be either mitigated, avoided, limited, transferred to an outside entity, or accepted. HOW CAN BIO RISK MANAGEMENT SYSTEM FAIL? Like a three legged stool, a bio risk management system fails if one of the components, or legs, is overlooked or is not addressed. KEY COMPONENTS OF BIORISK MANAGEMENT a. RISK ASSESSMENT -the initial step in implementing biorisk management process. - Includes the identification of hazards and characterization of risks that are possibly present in the laboratory.  In performing risk assessment, a structured and repeatable process is followed. It consists of the following steps in performing risk assessment: 1. Define the situation – the risk assessment team must identify the hazards and risks of the biological agents to be handled. Next, at-risk hosts, who could be humans or animals inside and outside the laboratory, must be identified. 2. Define the risks - defining the risks must include a review of how individuals inside and outside the laboratory may be exposed to the hazards. It could either be through droplets, inhalation, ingestion, or inoculation in case a biological agent has been identified as the hazard. 3. Characterize the risks – to characterize the overall biosafety risks, the risk assessment team needs to compare the likelihood and the consequences of infection-either qualitatively or quantitatively. 4. Determine if risks are acceptable or not – this process of evaluating the biorisk arising from a biohazard takes into account the adequacy of any existing controls, and deciding whether or not the biorisk is acceptable. b. MITIGATION PROCEDURES  Biorisk mitigation measures are actions and control measures that are put into place to reduce or eliminate the risks associated with biological agents and toxins. There are five major areas of control or measures that can be employed in mitigating the risks. 1. Elimination – the most difficult and most effective control measure, involves the total decision not to work with a specific biological agent or even not doing the intended work. 2. Substitution – the second control measure, is the replacement of procedures or biological agent with a similar entity in order to reduce the risks. (for ex. Instead of using B. anthracis, use B. thuringiensis. 3. Engineering controls – setting an engineering controls include physical changes in work environment that can reduce or prevent exposure to hazards. (ex. Installation of biosafety cabinets, safety equipments like centrifuge with cover, autoclave, and machines with indicators), facility design, enabling proper airflow, ventillation system to ensure directional airflow, and air treatment systems to decontaminate or remove agents from exhaust air, controlled access zones, airlocks or laboratory entrances, or separate buildings or modules to isolate the laboratory. 4. Administrative control – refers to the policies, standards, and guidelines used to control risks. This also include proficiency and competency training for laboratory staff, displaying of biohazrd or warning signages, markings, and labels, controlling visitor and worker access, and documenting written standard operating procedures. 5. Personal Protective Equipment (PPE) – these are devices worn by workers to protect them against chemicals, toxins, and pathogenic hazards in the laboratory. - considered the least effective measures because it only protects the person who is wearing it, and only when it is used correctly. E. g Gloves, gowns, respirators As emphasized by Salerno ( 2015), not one of the mitigation controls or measures is completely effective at controlling or reducing all risks. The effectivity of mitigating risks relies on the combination of all the different measures and proper utilization of each. c. PERFORMANCE EVALUATION This is the last pillar of biorisk management model that involves a systemic process intended to achieve organizational objectives and goals. The model ensures that the implemented mitigation measures are indeed reducing or eliminating risks. It also helps to highlight biorisk strategies that are not working effectively and measures that are ineffective or unnecessary. Performance Management is simply a reevaluation of the overall mitigation strategy.  MODULE 6 Medical Technology / Clinical Laboratory Science Education  CURRICULUM ->comes from the Latin Word ”Currere” : means to run. DEFINITION OF CURRICULUM a. According to the Glossary of Educational Reforms - refers to the knowledge and skills students are expected to meet; the units and lessons that teachers teach; the assignments and projects given to students; the books, materials, videos, presentations, and readings used in a course; and the tests, assessments, and other methods used to evaluate student learning. b. - the means and materials with which students interact for the purpose of achieving identified educational outcomes. c. According to John Dewey - “continuous reconstruction, moving from the child’s present experience out into that represented by the organized bodies of truth that we call studies…the various studies…are themselves experience – they are that of the race.” d. According to the Indiana Department of Education - Refers to the planned interaction of students with instructional content, materials, resources, and processes for evaluating the attainment of educational objectives. CURRICULUM is: - systematic and organized; - explicitly states outcomes (knowledge, skills) the learners/students have to achieve and learn through the use of planned instructional processes and other learning implements in a specific period; - consists of a planned process of measurement, assessment, and evaluation to gauge student learning; and - is designed for students. (Medical Technology Curriculum) CHED (The Commission on Higher Education) - established on May 18, 1994; - through the passage of Republic Act No. 7722, the Higher Education Act of 1992. - it is a government agency under the Office of the President of the Philippines - Covers institutions of higher education both public and private. - It is tasked to organize and appoint members of the technical panel for each discipline/program area. TCMTE (Technical Committee for Medical Technology Education) - under CHED -composed of leading academicians and practitioners responsible for assisting the Commission in setting standards among institutions offering Bachelor of Science in Medical Technology/Medical Laboratory Science program and in monitoring and evaluating such institutions. BACHELOR OF SCIENCE IN MEDICAL TECHNOLOGY/ BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE WHAT? - a four year program. - consist of general education (g.e) and professional courses (p.c). FIRST YEAR: SECOND YEAR: Completion of G.E and P.C THIRD YEAR: FOURTH YEAR BSMT/BSMLS: Students' internship training in CHED-accredited training laboratories affiliated with their college/department. HOW ? - there is the policy of taking prerequisites for some courses For example, before taking the course Immunology and Serology, one should have already completed the course Clinical Bacteriology. - A student taking the BSMT/BSMLS program must be aware of the courses he or she needs to take in order to move on to more advanced courses in the curriculum. WHAT is the guide for institutions offering BSMT/BSMLS program? --------> CHED Memorandum Order (CMO) No. 13, series of 2017 (PSG for BSMT/BSMLS program) WHAT are indicated in the CMO No. 13, series of 2017? - the prescribed minimum number of units per course - whether each course has laboratory or lecture component. General Education Courses ---> it aims to develop humane individuals that have a deeper sense of self and acceptance of others. --->The general courses included in the new CMO are: a. Understanding the Self Nature of identity; factors and forces that affect the development and maintenance of personal identity. b. Readings in Philippine History Philippine History viewed from the lens of selected primary sources in different periods, analysis and interpretation. c. The Contemporary World Globalization and its impact on individuals, communities and nations, challenges and responses. d. Mathematics in the Modern World Nature of mathematics, appreciation of its practical, intellectual, and aesthetic dimensions, and application of mathematical tools in daily life. e. Purposive Communication Writing, speaking and presenting to different audiences and for various purposes f. The Life and Works of Rizal A study of the life, works and writings of Dr. Jose P. Rizal, the national hero and martyr, as they relate to the socio-political situation of the Philippines during his time and its implication to our present time. It traces the hero’s life, ideals, concept of education, good government, and nationalism as embodied in his writings, particularly the Noli Me Tangere and El Filibusterismo. g. Science, Technology, and Society Interactions between science and technology and social, cultural, political and economic contexts which shape and are shaped by them: specific examples throughout human history of scientific and technological developments. h. Art Appreciation Nature, function and appreciation of the arts in contemporary society. i. Ethics Principles of ethical behavior in modern society at the level of the person, society, and interaction with the environment and other shaped resources. Core courses ---> These are inter-disciplinary and are stated broadly enough to accommodate a range of perspectives and approaches. ---> The courses expand starting from the self to cover the nation and the world and various ways of comprehending social and natural realities (artistic, scientific, mathematical). --->2 other important dimensions are given attention: 1.) communicating in different modalities and for varied purposes, 2.) basic ethical considerations that enable communities and societies to live peaceably in the face of competing claims, opposing viewpoints, and diverse faiths and cultures.  Course/ Year Definition Subject 1. (PMLS 1) - deals with the basic concepts and principles related to the Principles of (BSMT) Medical Technology/Medical Laboratory Science Medical profession. Laboratory - Its emphasis is on the education, biosafety practices, and Science1: 1rst year waste management. Introduction to Medical Laboratory Science, Laboratory Safety, and Waste Management 2. (PMLS 2) Clinical Laboratory Assistance Principles of -->encompasses the concepts and principles of the different Medical assays performed in the clinical laboratory. Laboratory 1rst Year Science 2: Clinical Phlebotomy Laboratory Assistance ---> deals with the basic concepts, principles, and application and of the standard procedures in blood collection, post-analytic Phlebotomy variables that affect reliability of test results. 3. Community >> involves the study of the foundation of community health and Public ND that include human ecology, demography, and epidemiology. 2 Health for YEAR >> It emphasizes the promotion of community, public, and MT/MLS environmental health and the immersion and interaction of students with people in the community. 4. Cytogenetics 2nd >> the study of the concepts and principles of heredity and YEAR inheritance which >>include genetic phenomena, sex determination, and genetic defects rooted in inheritance, among others. It also discusses the abnormalities and genetic disorders involving the chromosomes and nucleic acids (DNA and RNA).  >>Emphasis is given to the analysis of nucleic acids and their application to medical science. 5. Human 2nd >> the study of the fundamentals of cells, tissues, and Histology YEAR organs. >> emphasis on microscopic structures, characteristics, differences, and functions. >>The laboratory component of this course primarily deals with the microscopic identification and differentiation of cells that make up the systems of the body. 6. Histopatholog 3rd >> Covers the basic concepts and principles of disease ic techniques YEAR processes, etiology and the development of anatomic, with Cytology microscopic changes brought about by the disease process. >> deals with the histopathologic techniques necessary for the preparation of tissue samples collected via surgery, biopsy, and/or autopsy for macroscopic and microscopic examinations for diagnostic purposes. >> Some of the tests that students perform for the laboratory component of the course in a school-based laboratory are: 1.Tissue processing 2.Cutting of processed tissue 3.Staining 4.Mounting of stained tissue for microscopic examination 5.Performing biosafety and waste management 7. Clinical 3rd >> deals with the study of the physiology and morphology of Bacteriology YEAR bacteria and their role in infection and immunity. >> emphasis is on the collection of specimen and the  isolation and identification of bacteria. >> also covers antimicrobial susceptibility testing and development of resistance to antimicrobial substances. >> Some of the procedures and tests that students perform for the laboratory component of the course in a school-based laboratory are: 1. Preparation of culture media 2. Collection of specimen 3. Preparation of bacterial smear 4. Staining of smear 5. Inoculation of specimen on culture media 6. Characterization of colonies of bacteria growing in culture media 7. Performing different biochemical tests for identification of bacteria 8. Biosafety and waste management 9. Quality assurance and quality control 10.Antimicrobial susceptibility testing 8. Clinical 2ND >> concerned with the study of animal parasites in humans Parasitology YEAR and their medical significance in the country. >> Its emphasis is on the pathophysiology, epidemiology life cycle, prevention and control, and the identification of ova and/or adult worms and other forms seen in specimens submitted for diagnostic purposes. >> Some of the procedures and tests that students perform for the laboratory component of the course in a school-based laboratory are:  1. Microscopic identification of diagnostic features of different groups of parasites pathogenic to man (e.g., nematodes, trematodes, cestodes, protozoa, plasmodium, among others) 2. Different methods of preparing smear for microscopic examination (e.g., direct fecal smear, Kato-Katz, among others) 9. Immunohema 3rd >> tackles the concepts of inheritance, characterization, and tology and YEAR laboratory identification of red cells antigens and their Blood Bank corresponding antibodies. >> It also covers the application of these antigens and/or antibodies in transfusion medicine and transfusion reactions work-up. >> Some of the procedures and tests that students perform for the laboratory component of the course in a school-based laboratory are: 1.ABO and Rh typing 2.Coombs test (direct and indirect Coombs) 3.Blood donation process 4.Compatibility testing 5.Transfusion reaction work-up 6.Preparation of RBC suspension 10. Mycology 3rd >> Deals with the study of fungi and viruses as agents of and Virology YEAR diseases with emphasis on epidemiology, laboratory identification and characterization, and prevention and control. 11. Laboratory 2nd >> This course looks into the concepts of laboratory Management YEAR management which are planning, organizing, staffing, directing, and controlling as applied in clinical laboratory setting.  >> It also tackles the process of solving problems, quality assurance and quality control, preparation of policy and procedure manuals, and other activities necessary to maintain a well-functioning laboratory. 12. Medical 2nd >> Medical Technology course encompasses various laws, Technology YEAR administrative orders, and other approved legal documents Laws and Bio related to the practice of Medical Technology/ Medical Ethics Laboratory Science in the Philippines. >> Bioethics looks into the study of ethics as applied to health, and health care delivery and to human life in general. 13. Hematology 1 3rd >> deals with the study of the concepts of blood as a tissue. YEAR >> Emphasis: Formation, metabolism of cells, laboratory assays, correlation with pathologic conditions, special hematology evaluation >> Some of the procedures and tests that students perform for the laboratory component of the course in a school-based