Module - Clinical Biochemistry Investigation of Major Organ Function (SLS100)

STP

Aim of this module

This module will provide the trainee with the knowledge and understanding of the normal physiology of the major organs and the biochemical parameters in common use for the investigation and management of major organ dysfunction. In the work-based module they will be expected to apply this knowledge as they learn to perform common methods used in the investigation of major organ function and gain experience of the interpretation of patient results in a variety of clinical settings.

Work-based learning outcomes


  1. Interpret routine requests for clinical biochemistry investigations of major organ function in the correct clinical context and process the specimens that accompany those requests.
  2. Perform a range of laboratory and point-of-care techniques (POCTs) used in the workplace to investigate major organ function.
  3. Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance.
  4. Report the results of commonly performed clinical biochemistry investigations of major organ function.
  5. Use laboratory IT systems for handling, processing and storage of patient data.

Work-based Competencies


Learning outcome Title Knowledge
1 1

Identify the most appropriate test for at least two example clinical presentations, e.g. diabetes, acute coronary syndrome, acute kidney injury etc.

  • The application of common biochemical markers of major organ function to a range of frequently encountered clinical disorders.
  • The repertoire, specimen requirements, storage, ordering, reference ranges and turnaround times of the methods used to investigate major organ function.
2 1,5

Use computer software associated with the LIMS and laboratory equipment.

  • Request entry, result enquiry, result validation, rules base and reporting procedures.
3 1,5

Receive, label and store routine clinical biochemistry samples.

  • Minimum data set required for identification of samples and the importance of ensuring that this is complete and correct.
  • Factors affecting sample integrity and appropriate corrective action.
  • Types and implications of hazards and risks associated with handling specimens and relevant control measures.
  • Procedures for handling samples which may contain category 2,3 and 4 pathogens.
  • Safe laboratory practices, including principles of decontamination of equipment and work areas.
  • Local and national health and safety policies and procedures and their application.
  • Legal and ethical considerations and requirements in respect of examination, selection of control material and disposal of specimens.
  • Relevant records, their importance and how to complete these correctly.
4 2,3

Use automated instrumentation (modular systems, elementary robotics and automated immunoassay analysers) in your training laboratory, which incorporates the following techniques:

  • ion selective electrodes
  • spectrophotometry
  • immunoassay
  • enzymology
  • plus one other from:
    • fluorimetry
    • nephelometry/turbidimetry.
  • Scientific basis of the following techniques: spectrophotometry, osmometry, ion selective electrodes, enzymology, immunochemical techniques, electrophoresis, chromatography and solid phase chemistry.
  • The biological and statistical basis of biological variation, reference values and action limits.
  • Use of calibration and control materials.
  • The quality management process that ensures the correct location and storage of documentation and specimens at each stage of the process.
  • The design, operation and performance of automated analytical platforms, including random access, modular, robotics, etc.
  • Principles and practice of internal quality control and external quality assessment.
  • Common analytical interferences caused by contamination, interferences, age of sample, etc.
  • Performance of analyses in accordance with appropriate standard operating procedure.
5 2,3

Use manual and semi-automated techniques to specified standard operating procedures, to include:

  • spectrophotometry
  • osmometers
  • urine analysis (e.g. dipsticks or pregnancy tests)
  • HbA1c analysis.
  • Scientific basis of the following techniques: spectrophotometry, osmometry, ion selective electrodes, enzymology, immunochemical techniques, electrophoresis, chromatography and solid phase chemistry.
  • The biological and statistical basis of biological variation, reference values and action limits.
  • Use of calibration and control materials.
  • The quality management process that ensures the correct location and storage of documentation and specimens at each stage of the process.
  • The design, operation and performance of automated analytical platforms, including random access, modular, robotics, etc.
  • Principles and practice of internal quality control and external quality assessment.
  • Common analytical interferences caused by contamination, interferences, age of sample, etc.
  • Performance of analyses in accordance with appropriate standard operating procedure.
6 2,3

Use one of the following POCT methods/devices to specified quality standards:

  • blood gas analysers
  • co-oximetry
  • blood glucose meters.
  • Scientific basis of the following techniques: spectrophotometry, osmometry, ion selective electrodes, enzymology, immunochemical techniques, electrophoresis, chromatography and solid phase chemistry.
  • The biological and statistical basis of biological variation, reference values and action limits.
  • Use of calibration and control materials.
  • The quality management process that ensures the correct location and storage of documentation and specimens at each stage of the process.
  • The design, operation and performance of automated analytical platforms, including random access, modular, robotics, etc.
  • Principles and practice of internal quality control and external quality assessment.
  • Common analytical interferences caused by contamination, interferences, age of sample, etc.
  • Performance of analyses in accordance with appropriate standard operating procedure.
7 2,3

Perform analysis of the following analytes:

  • albumin
  • creatinine
  • calcium
  • bilirubin
  • transaminases
  • troponin
  • glucose
  • sodium and potassium
  • Scientific basis of the following techniques: spectrophotometry, osmometry, ion selective electrodes, enzymology, immunochemical techniques, electrophoresis, chromatography and solid phase chemistry.
  • The biological and statistical basis of biological variation, reference values and action limits.
  • Use of calibration and control materials.
  • The quality management process that ensures the correct location and storage of documentation and specimens at each stage of the process.
  • The design, operation and performance of automated analytical platforms, including random access, modular, robotics, etc.
  • Principles and practice of internal quality control and external quality assessment.
  • Common analytical interferences caused by contamination, interferences, age of sample, etc.
  • Performance of analyses in accordance with appropriate standard operating procedure.
8 4,5

Produce reports using validated results on common clinical biochemistry investigations.

  • The preparation of reports and the reporting process for patients being investigated for major organ function.
  • Essential information to be included in a report (CPA report, standard).
  • The appropriate use of interpretive comments and limits of responsibility in the authorisation and issue of reports.
  • Critical action limits that may require urgent action and how to instigate such action.
  • Limits of responsibility in the authorisation and issue of interpretative reports.
  • Clinical conditions that may require urgent action and how to instigate such action.
  • Normal and abnormal results and their significance to clinical question or condition.
9 2,3

Control infection risks in accordance with departmental protocols.

  • Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation.
  • Protocol for hand washing and how effective hand washing contributes to control of infection.
10 2,3

Minimise risks and hazards in compliance with health and safety policies.

  • The relevant health and safety regulations for laboratory and clinical investigations.
  • The specific health and safety regulations for the specialism, type of specimen/sample and investigation.
  • The potential hazards and risks and the actions to be taken to minimise these.
  • Responsibilities and scope of practice of laboratory personnel involved in performing investigations and reporting those investigations to users.

Work-based assessment


Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Receive book process and store common clinical biochemistry specimens
DOPS Perform Serum Osmolality
DOPS Undertake IQC procedure acceptance criteria
DOPS Set up a daily analyser and undertake reagent top up
DOPS Perform daily maintenance procedures
OCE An appropriate activity agreed with your Training Officer