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Online compliance and continuing education courses for clinical laboratories

Supervisor Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Supervisor and links to relevant pages within the course.

Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.

Laboratories Individuals

CLIA General Laboratory Review
What is the first thing you do before you handle or open a chemical:View Page
What is the first thing you would do before you handle or open a chemical:View Page

Descriptive Statistics
Your supervisor asks you to give the 95% range of normal Serum BUN levels, the range within which 95% of healthy people will fall. What is this range? ( = 19.6 mg/dL, s = 6.1 mg/dL)View Page

HIPAA Privacy and Security Regulations
Case Study: Physical SafeguardsYou are a supervisor of a health clinic. During orientation of a new employee, you instruct him to keep the door leading from a patient area to a computer work area locked at all times. On several occasions, he forgets to make sure the door is locked as he leaves. Which of the following are true regarding this situation?View Page
Case Study: Limiting Use & Disclosure of PHI A nurse from the Winterhaven Outpatient Facility calls requesting an HIV test result on a patient, concealing the fact that she had received a needle stick injury from that same patient. You provide the nurse with the HIV test result. The nurse's request was appropriate.View Page
Fax Machines

Fax Machines may be used to transmit PHI, provided that you also in compliance with your own institution's policies and procedures. To minimize the risk of misdirected faxes: Preprogram fax machines with frequently used destination numbers.Double check accuracy when faxing to numbers which are not preprogrammed.Always include a Confidentiality Statement on the cover page.Check transmittal confirmation after each fax, to ensure that the information was sent to the correct number.Do not leave the original report on the fax machine.Report fax errors to your supervisor or other designated person.

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HIV Safety for Florida
Evaluation and Treatment

Your supervisor will refer you for an immediate evaluation and any necessary treatment. Confidentiality will be maintained.Your blood will be tested only with your consent.

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If an Exposure Occurs

Give first aid. Wash needlesticks and cuts with soap and water. Flush splashes to the nose, mouth, or skin with water. Irrigate eyes with clean water, saline, or sterile irrigants. Report exposure to supervisor.

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Introduction to Bioterrorism
If a package or envelope appears suspicious, the most important thing you should do is:View Page
What do I do if I find a suspicious package?

If a package or envelope appears suspicious: DO NOT OPEN IT and if at all possible, DO NOT TOUCH IT any more than necessary! If powder has spilled, do not clean it up. Leave the area and close any doors, but stay near the area. The reason for this is to lessen the chance of contaminating others and to warn others not to enter the room. Make sure you supervisor and emergency personnel have been notified immediately. As soon as security is in place, wash your hands with soap and water. After evaluation and if so deemed, pre-designated personnel should shut down the air handling system in the building. Make a list of names, addresses, and telephone numbers of all persons who were in the area to share with law enforcement and emergency officials if requested. Follow decontamination procedures as instructed by emergency authorities.  

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Responding to an Alarm

If you receive an alert that an aerosol device was triggered or that a biological agent was released in the area: Make sure any fans are turned off. Leave the area immediately. Close the door to the area to keep others out. Notify your supervisor or emergency personnel immediately. Shut down the air handling system in the building. Make a list of all persons that were in the area to give to authorities if requested.

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Introduction to Quality Control
Instrument Maintenance

Instruments require regular maintenance by laboratory personnel, and sometimes by qualified repair technicians. The instrument manufacturer will provide recommendations for how often to perform maintenance; those recommendations should be followed. Generally, a log book will document the details of the maintenance: date time name of employee or service engineer description of maintenance done, including listing any parts replaced description of problems encountered description of steps taken to resolve the problem and verify the instrument is functioning, after the changes were madeInstrument logs should be regularly reviewed by supervisors to monitor instrument performance. By reviewing the logs, the supervisor can make changes to the maintenance schedule, based on the frequency of breakdowns.

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Laws and Rules of the Florida Board of Clinical Laboratory Personnel
Public health laboratory scientists

Public health laboratory scientists are also regulated by the Board. The table below outlines the various requirements for applicants to receive licensure for a public health laboratory. Public Health Laboratory RequirementsDirectorFulfill the same requirements as a clinical laboratory directorSupervisorBe certified by National Registry in Clinical Chemistry or American Society for MicrobiologyBe licensed as a technologistHave five year's relevant experiencePass the state examTechnician (microbiology)Have a Bachelor's degree in one of the biological sciencesObtain American Society for Microbiology or the National Registry in Microbiology Certification in Public Health Microbiology Technician (chemistry)Have a Bachelor's degree in one of the chemical, biological, or physical sciencesObtain National Registry of Clinical Chemistry Certification in Public Health ChemistryTechnician (conditional)Have a Bachelor's degree in one of the chemical or biological sciencesPerform tests only under the direct supervision of a licensed pathologist, director, supervisor, or technologist.Receives a conditional two-year license, which may be renewed only once A license from the Board of Clinical Laboratory Personnel allows you to work in a public health laboratory at the same level and specialty.

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Supervisor Qualifications

Meets one of the following:Doctoral degree in chemical science, biological science, clinical laboratory science, or medical technology + one year of lab experienceMaster's degree in chemical science, biological science, clinical laboratory science, or medical technology + three years of lab experienceBachelor's degree + five years of lab experience, of which two must have been as a technologistLicensed as a technologist or meets the requirementsMeets one of the following:Passes a Board-certified examCompletes 25 hours of continuing education in administration and supervisionCompletes one hour of HIV / AIDS continuing educationCompletes two hours of medical errors continuing education

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Types of licenses

Clinical laboratory personnel licenses are divided into four types: director, supervisor, technologist, and technician. Each type has different roles, responsibilities, qualifications, and continuing education requirements. When you apply for a license, you must apply for one of these four types. All licensed clinical laboratory personnel are permitted to collect, process, store, and ship specimens and perform manual testing procedures. Directors, supervisors, and technologists are permitted to interpret and report test results. In addition, each license is valid for one or more specialties. Clinical laboratory personnel are only permitted to conduct testing that falls under their specialty. Specialties include microbiology, chemistry, blood banking, immunology / serology, and more. A full list will be presented later in this program.

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Description of Specialties (3)

Specialists in radioassay use radionuclides to determine the chemical makeup of body fluids such as blood and urine. Specialists in blood gas analysis evaluate lung and breathing function by levels of oxygen, carbon dioxide, pH, and hemoglobin with automated tests. Specialists in histology examine cellular and tissue samples using fixation, dehydration, embedding, microtomy, frozen sectioning, staining, and other similar techniques. Histology specialists licensed as technicians can perform specimen processing, embedding, cutting, staining, and frozen sectioning only under the general supervision of a director, supervisor, or technologist. Specialists in cytology process and interpret samples relating cytopathological disease. Non-gynecological cytology preparations can be screen by a specialist in cytology but final review and interpretation must be done by a physician.

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Continuing Education Requirements for Renewal

All licensed clinical laboratory personnel must earn at least 24 hours of continuing education credits every two years. These continuing education hours must be completed by time your license. Continuing education requirements include:At least one hour for each specialty for which you are licensedA two-hour course on medical errorsA one-hour course on laws and rules of the Florida Board (this course)A one-hour course in administration and supervision (directors and supervisors only)If you have just received your license, you do not need to complete this continuing education requirement during the first two-year period of your license, except for courses that may be required by your specialty.

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License on probation

An individual whose license that has been put on probation for violating the laws of the Board may be subject to any or all of the following requirements, as assigned by the Board: Practice only under direct supervision of a licensed clinical laboratory personBe reviewed on a quarterly basis by his / her supervisor, with reports submitted to the BoardSubmit a personal quarterly report to the Board describing the individual's progressComplete additional continuing education requirementsConsult a psychiatristNot consume alcohol or use any controlled or illegal substancesAttend AA or NA meetings weeklyUndergo and pay for random drug testingPay an administrative fineFailure to comply with all conditions of the probation will mean that the individual's license will be suspended or revoked.

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Supervisor Responsibilities

A supervisor is responsible for the day-to-day performance of laboratory testing and adherence to laboratory procedure. Other duties include:Performing technologist or technician duties as needed, if properly licensedConducting direct supervision of technologists and technicians if required by the test or the technologist's or technician's licenseEvaluating technologists' and technicians' competency in running tests and reports resultsBeing available to all personnel to answer questions and resolve problemsEnsuring that quality control is performed and corrective action taken if necessaryScheduling tests and personnelUpdating policy manualsProviding methods to identify, access, store, transport, and dispose of specimensFollowing company policy

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Technician Responsibilities

Technicians perform laboratory testing under direct and general supervision, as required by the test and the conditions of the technician's license. Other duties include:Performing tests only as authorized by the director and the technician's licensed specialty.Following the laboratory's procedure for specimen handling and running testsParticipating in proficiency testing and demonstrating that proficiency samples are tested in the same manner as patient samplesFollowing quality control and instrument calibration policiesDocumenting corrective action taken when results exceed the laboratory's acceptable performance valuesIdentifying potential problems with tests or report resultsNotifying a technologist or supervisor if results are outside the laboratory's acceptable performance levels

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Competency and Licensing Violations

Clinical laboratory personnel must be licensed and competent to perform their duties. This means holding the appropriate type of license for the task being performed (director, supervisor, technologist, or technician) and being certified in the appropriate specialty for any testing being performed. For example, an individual licensed as a technician in hematology may not perform the duties of a technologist in hematology, nor may that individual perform testing in the microbiology specialty. Showing a lack of competence to perform even licensed duties is a violation of Board rules. Consistent errors can tarnish a laboratory's reputation, and even a single error can harm patient care. Licensed personnel must be certain that they can perform their duties accurately and competently. All of the following are violations of Board rules:Performing clinical duties for which one does not hold a license.Performing services one knows one is not competent to perform.Showing lack of competence or making consistent errors in testing or reporting.Having a license revoked or suspended in another state.

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Failing to Report a Violation

Helping another person commit any of these violations of Board rules is also a violation, with substantial penalties. If you know about a violation, you must report it to the appropriate authorities, perhaps your supervisor or lab director, or the Board itself. If you know about a violation and don't report it, you may have your license suspended or have to pay a fine.

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Which of the following is NOT a responsibility of a clinical laboratory supervisor?View Page
Which is not a type of Florida clinical laboratory license?View Page
You cannot work in a clinical laboratory unless you have a four-year college degree.View Page
If you know that a colleague has a drug problem that affects his / her work, you must report the colleague to the Board, your supervisor or director, or to another authority.View Page
You notice that a co-worker seems to be making a lot of mistakes and has to ask you for help in performing routine tests. The co-worker has the right license and specialty, though. What should you do?View Page
Which of the following continuing education courses are required for ALL new clinical laboratory supervisors, technologists, and technicians?View Page

Medical Error Prevention
Factors that Contribute to Medical ErrorsView Page

Medicare Compliance for Clinical Laboratories
Element 6

Element 6: The laboratory monitors and regularly audits compliance activities, policies and procedures to ensure they are being followed.If a problem is detected through the audit or monitoring process, it should be reported to the appropriate supervisor, manager or the CO.

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Confidentiality

All employees have a responsibility to maintain the confidentiality of medical information. Medical information should never be discussed outside of the laboratory. It should only be discussed with the ordering doctor or an authorized representative of the doctor. Employees should verify the identity of the individual requesting such information Employees who communicate with patients, physicians or their office staff, insurance company representatives or government employees about any laboratory activity should only give information they know to be true and accurate. Employees should never give false information and should never guess the answer to any question. In case of doubt, refer the person to a supervisor.

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Tests performed and ordered correctly

The laboratory has a system in place to detect tests that are not performed due to a laboratory error and stop or credit the billing for these tests. The laboratory cannot bill for tests that are not performed. Employee aware of a test being canceled or not being performed for some reason must follow the policies and procedures associated with correcting the billing. The laboratory only performs tests that are ordered by individuals authorized to order tests. If an employee knows that a test has been ordered by someone other then an authorized individual, the employee should report it to their supervisor or the CO.

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Communication with physicians and patients

It is important that billing department employees are clear and accurate when communicating with physician office personnel and patients. Never guess at the answer to a question; ask if you are unsure. Do not speculate or express personal opinions. When requesting diagnosis information from the physician office staff be careful to not lead them to give a billable code: The code must come from the patient's medical record. There is an incentive program for patients to find and report fraud and abuse by health care providers, including laboratories, so: Billing department employees must accurately state laboratory policies and procedures, or forward the call to a supervisor to avoid misstatements and misunderstandings.

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Special role for managers/supervisors

All compliance guidance documents point to leadership support as critical to an effective compliance program.Ethics and compliance go hand in hand.Managers have a responsibility to protect the company from illegal and unethical actions by employees.Managers can be sanctioned for the actions of employees who report to them.Managers can be sanctioned for failure to detect violations.Managers and supervisors are responsible for employee actions and must: Talk to employees about compliance issues. Ensure employees understand violations are serious. Ensure employees understand that disciplinary action will be taken.

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Preventing whistleblowers

Managers and supervisors are the company's first line of defense.Ensure that lines of communication remain open.Ensure that employees understand their responsibility to report problems.Respond with appropriate seriousness when a problem is reported.Always follow-up on employees questions and reports. Ensure proper documentation is kept concerning reported problems and report them to the next level of authority when appropriate.

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Case Study 9

The setting is automated chemistry department, night shift, busy core laboratory for a hospital based outreach laboratory. A medical technologist who operates the automated chemistry analyzer on third shift encounters short samples a couple of times a night. When this happens, he runs as many of the ordered tests as he can and fills in the blank results with a comment indicating that a short sample occurred. As far as he knows there isn't a policy that addresses this problem directly.The test reports out with the results and the comments. The technologist does not have to change the physician order in any way and is providing the maximum results that can be reported for the specimen in a timely fashion. This is done as a matter of patient care and quality service. There has not ever been a complaint about this practice as far as he knows. Are there any additional steps this technologist should be taking?Correct Answer: The technologist should follow the procedures that the laboratory has in place for testing and billing samples for which there is no order or for ambiguous orders. If the policies do not seem to address his particular situation, he thinks there should be a separate policy to cover this situation or has a question about it, he should talk to his supervisor or to the laboratory compliance officerDiscussion: This choice addresses the problem in the most complete manner, in that the employee fulfills his responsibility to take action when he thinks there is a problem.

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Case Study 10

The setting is nursing home where a phlebotomist from the laboratory goes to draw blood samples each day. The phlebotomist picks up the requisitions for blood test orders at the nursing station and then goes to the various rooms to draw blood from the patients. She notices that every requisition has an Advanced Beneficiary Notice (ABN) attached to it that is signed by the patient, even when the tests that were ordered don't need them. She asks the nurse at the station but she informs the phlebotomist that she doesn't know anything about it because it is done on the night shift.She lets the phlebotomist know that she will inform the nursing supervisor about it when she arrives at 9:00 AM. The phlebotomist completes her blood draws and returns to the laboratory. What should the phlebotomist do, if anything, in addition to her letting the nurse know about the problem?Correct Answer: The phlebotomist should report the incident to her supervisor upon returning to the laboratory.Discussion: Since the laboratory is submitting the claims for any Medicare patients that the phlebotomist might draw, the problem is the labs problem. However, it is not going to change the fact that the ABNs were already signed by the patients if the phlebotomist refuses to draw them or if the nursing personnel are required to remove them. By contacting the supervisor, an appropriate representative from the laboratory can follow up with the nursing supervisor to ensure they understand the laws and regulations that govern ABNs.

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Case Study 8

The setting is a billing office in a laboratory where two or more clerks work together in very close proximity with each other, so that each can easily see what the other is doing. A billing clerk notices that one of his fellow employees is changing or adding codes to requisitions he is processing. This employee is a friend of his and he knows that he really needs the job at the laboratory because he is a single parent raising two kids. He also knows that what the employee is doing is against the company's compliance policies.He asks the employee about it and is given the explanation that because the computer requires something to be entered in the ICD-9 code field and he only does this with non-Medicare patients, it doesn't matter. The employee explains that it saves him a lot of time he uses to call to get codes for the Medicare patients. What should this clerk do about this?Correct Answer: She should talk to the supervisor about the problem even if she talks to the employee about it and the employee says she will talk to the supervisor and stop doing it.Discussion: Every employee who becomes aware of a violation of the law or a compliance policy has a responsibility to take action, which includes reporting the problem to a supervisor or the compliance officer. It doesn't matter that these patients are not Medicare patients, the important thing is that the employee is violating a compliance policy. If this employee does not report the problem he is himself violating a compliance policy. If it is subsequently discovered that he knew and didn't report it, he could be terminated. If there is a need for refunds to be done or other action, it will not occur and could create a big problem for the lab in a subsequent audit or other action.

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Case Study 1

A billing clerk is entering billing demographics on requisitions as a part of the normal days work. The department is under pressure to reduce accounts receivable, which means that the more clean claims that are filed, the better. This particular requisition is for a Medicare patient and has an LMRP test but does not have a diagnosis on it. She remembers that just a few requisitions before this one she had a requisition from the same doctor that had this same test on it that did have a diagnosis that allowed the test to be billed. She thumbs back in the pile and finds the previous requisition, notes the code that was used and adds it to the current requisition. This will help her meet the department goal of getting claims paid and reducing accounts receivable. It is all right for her to do this because:Correct Answer: She should not do this because it is against the law to change diagnosis information on a requisition.Discussion: A laboratory employee should never change, add or use previously received diagnosis information for the purpose of making a test billable for the Medicare program or for any other insurance or payer. This is a form of fraud and for each claim submitted as a result of this activity the laboratory is liable for a false claim and would have to pay the government back three up to times the reimbursement for the test and up to $10,000 for each claim submitted. Further, if the employee is caught doing this, even if the employee is ignorant of the law and any laboratory policy prohibiting it, she must be disciplined and so should the supervisor. Any employee who notices another employee doing this should correct the employee and report the incident to the department supervisor immediately.

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OSHA Bloodborne Pathogens
If an Exposure Occurs

If an exposure occurs, wash the affected area immediately with soap and water and notify your supervisor at once.

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Evaluation and Treatment

Your supervisor will refer you for an immediate evaluation and any necessary treatment. Confidentiality will be maintained.Your blood will be tested only with your consent.

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OSHA Chemical Hygiene (updated 2007)
Goals of this Program

Locate potentially hazardous chemicals in your workplace. Describe the procedure for obtaining a copy of an MSDS. Recognize chemical labeling and its meaning. Discuss exposure control measures with your supervisor. Locate the MSDS book in your workplace.

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Your Responsibility

Read the manufacturers' labels and MSDS sheets and follow the instructions and warnings. Access pertinent safety information through your supervisor. If you detect any potential hazards either in the facility or in your work procedures, contact your supervisor as soon as possible.

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Read the Label!

Before you move, handle or open a chemical container, READ THE LABEL and follow the instructions. If you are not sure about something, ask your supervisor before you act.

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Right to Know

As an employee, you have the right to know the types of hazardous substances that are used in your workplace. Material Safety Data Sheets, or MSDS, are available in paper or electronic versions in each laboratory section and are there to inform you of these hazards. Ask your supervisor for the exact location.

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To Request a MSDS

To request an MSDS from your supervisor, do so in writing and it will be made available to you within 15 working days.

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Common Sense Rules

Make these common sense rules a part of your job: Identify hazards before you start a job. Don't take chances. Ask your supervisor when in doubt. Be prepared! Know how and where to get help.

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OSHA Electrical Safety (updated 2007)
Checks and Inspections

All laboratory instruments and appliances should be checked for ground integrity and current leakage before initial use, after repair or modification, and any time a problem is suspected.Periodic checks should be made on all electrical wires. If frayed wires are found, the equipment should be immediately removed from use and repaired.Report to your supervisor any shocks or tingling received from electrical equipment.

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OSHA Fire Safety (updated 2007)
Be Alert

Be on the alert for any maintenance problems that may cause a fire such as loose electrical switches or frayed equipment cords. Notify your supervisor immediately.

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OSHA Formaldehyde
Monitoring Results

Employee monitoring results are reviewed by your supervisor and must be provided to you within 15 days of receipt.

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In case of a spill...

In case of a spill first, dike up the formaldehyde with absorbent pillows.Then dispose of these pillows in a sealed, formaldehyde-labeled container.Your supervisor will show you the location of these emergency spill clean-up materials or discuss alternative procedures.

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If you become contaminated...

Should you become contaminated with formaldehyde, a quick drench shower and an eye wash station are available in your area.Ask your supervisor for their exact location and how they work.

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The Urine Microscopic: Microscopic Analysis of Urine Sediment
Abnormal Crystals

There are a number of crystals which are seen less frequently but are of considerable significance when they appear. Their presence should be verified by further testing and confirmed by a supervisor or pathologist before reporting the results. Polarized light can aid in crystal identification.

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