Infection Prevention and Medical Laboratory Science: A Partnership in Patient Safety

Benjamin D. Galvan, MLS(ASCP), CIC, CPH, ASCLS Patient Safety Committee Member

As a recent graduate of the Louisiana State University (LSU) Health Sciences Center clinical laboratory science program in 2015, I was rapidly immersed into my first healthcare-related role in the microbiology department. Working in a large, academic medical center, I quickly learned both the impact and importance that the medical laboratory professional plays across the continuum of care. Working in the clinical microbiology department, I also began to comprehend my impact on health outcomes and patient safety. From early detection of positive blood cultures and multi-drug resistant organisms (MDROs), to rapid notification of epidemiologic-important organisms to the local health department, I felt I played an important role in promoting patient safety and public health.

As a medical laboratory scientist (MLS) specially working in clinical bacteriology, I was interested in understanding multi-drug resistance and began asking questions like, “What happens after sending out the final report?” and, “What are we doing to prevent this?” This curiosity would lead me to my current career in, and passion for, infection prevention.

“Interdisciplinary collaboration is crucial for promoting patient safety initiatives, and the bridge between IP and the lab is one that must be cultivated and supported.”

For those who may not know, infection preventionists (IPs) are specially trained professionals who are adept at identifying and preventing actual and potential pathways for the transmission of communicable diseases. IPs are also experienced data analysts, educators, epidemiologists, consultants, and strategic partners in improving patient safety and health outcomes. IPs traditionally come from professional backgrounds in nursing, public health, and clinical laboratory science/microbiology. IP can be boardcertified in both infection control (CIC^®) and long-term care infection prevention (LTC-CIP) through the Certification Board of Infection Control and Epidemiology (CBIC). The CBIC also offers an associate in infection prevention certification (a-IPC©), which is available to those not yet in the profession and who may be interested in pursuing it.

But infection preventionists cannot do this alone! Infection preventionists and medical laboratory scientists both play a pivotal and collaborative role in promoting patient safety. IPs rely heavily on the clinical laboratory to provide meaningful, accurate, and evidence-based results that aid in the identification of MDROs, that support the surveillance of healthcare associated infections (HAI), and that promote antimicrobial and diagnostic stewardship initiatives. The clinical laboratory also plays a crucial role in providing testing modalities that can assist in the rapid identification of microorganisms in blood cultures and strain typing to identify potential healthcare-associated transmission of MDROs. By providing this, IPs can then use the data and information to more accurately identify gaps and opportunities to drive performance improvement in hospital practices that ultimately lead to improved patient safety.

Additionally, the clinical laboratory plays an imperative role in education, not only for IPs but also for students, nurses, and physicians alike. This education is vital to ensure best practices in test ordering, specimen collection, and result interpretation ultimately leading to timely and appropriate treatment of infections. The clinical laboratory can also provide important quality data for IPs including, but not limited to, trends in blood and urine culture contamination rates that may be leading to overuse of antibiotics, and antibiogram data that supports appropriate prescribing of antimicrobials thereby promoting the reduction of MDRO incidence and post-operative wound infections.

In addition to the microbiology lab, other departments play a vital role in patient safety as well:

• Molecular diagnostics departments provide rapid results of HIV testing following needlestick injuries to identify the need for prophylaxis.
• Immunology departments provide antibody titers to understand a patient’s immunity to certain vaccinepreventable diseases.
• Hematology departments provide results that help identify neutropenic patients that may be at risk of infections.
• Blood banks provide a quality-controlled environment that prevents the transmission of blood-borne pathogens.

And this only scratches the surface!

Ultimately, the understanding of these important concepts not only highlights the critical role that the lab plays in patient safety across the continuum of care, but also demonstrates that MLS professionals bring a unique and indispensable lens on healthcare to the infection prevention profession. Interdisciplinary collaboration is crucial for promoting patient safety initiatives, and the bridge between IP and the lab is one that must be cultivated and supported.

Benjamin D. Galvan is the Director of Infection Prevention for HCA Florida South Tampa and West Tampa Hospitals.