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Science, Technology and Medicine open access publisher.Publish, read and share novel research. Clinical EngineeringDerrico Pietro1, Ritrovato Matteo, Nocchi Federico, Faggiano Francesco, Capussotto Carlo, Franchin Tiziana and De Vivo Liliana[1] IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy1. Clinical Engineering (CE) represents the part of Biomedical Engineering focused on the applications of theories and methodologies of the broad biomedical engineering field to improve the quality of health services.
CE techniques and methodologies are mainly focused on safe, appropriate and economical management of technologies, as well as on governance and management (limited to specific responsibilities) of healthcare facility. Functional explorations and therapeutic equipment often undergo relevant innovation, such as that involving the change of the physical or biological operating principle, which is difficult to evaluate empirically (“impossibility” of randomized controlled trial (RCT), short Time To Market vs short mean life). Step 2 Identify the assessment elements The analysis of the literature should therefore lead to the definition of the assessment elements, which are the core of the assessment. Step 5 ResultsThe results obtained by aggregating the values can be represented graphically or through numerical reports. The final HTA report must provide the decision-makers with a clear, understandable summary of the information described above, in order to help them select the most appropriate technology. Case Western Reserve University earned an at-large bid in The Hartwell Foundation’s Top Ten Centers of Biomedical Research. Case Western Reserve is eligible to nominate two individuals for the Hartwell Individual Biomedical Research Awards, which provide funding to individual researchers in the U.S.
In selecting each research center of excellence, The Hartwell Foundation takes into account the shared values the institution has relating to children's health, the presence of an associated medical school and biomedical engineering program, and the quality and scope of ongoing biomedical research. Requests for proposals will soon be sought from individuals from any CWRU department, school or college.
Case Western Reserve University is committed to the free exchange of ideas, reasoned debate and intellectual dialogue.
On any given day, as one of the most recognized names in compliance and regulated services, Stericycle walks into and talks with more HIPAA covered entities than any other service provider.
Under the HIPAA Security Rule, Covered Entities and Business Associates are required to conduct an accurate and thorough analysis of the potential risks and vulnerabilities to the confidentiality, integrity and availability of electronic Protected Health Information (ePHI). FACT IS: All providers and business associates with any ePHI who are a€?covered entitiesa€? under HIPAA are REQUIRED to perform a risk analysis. In addition, all providers who want to receive electronic health record (EHR) incentive payments must conduct a risk analysis. Myth 2: Installing a certified EHR system fulfills the Security Risk Analysis Meaningful Use requirement. FACT IS: Even with a certified EHR system implemented, you must perform a full Security Risk Analysis.
Security requirements address all electronic protected health information you maintain, not just what is in your EHR.
Myth 3: My EHR vendor took care of everything I need to do about HIPAA privacy and security. Your EHR vendor can provide information, assistance and training on the privacy and security aspects of the EHR PRODUCT.
FACT IS: Checklists can be useful tools, especially when starting a risk analysis, but they fall short of performing a systematic Security Risk Analysis or documenting that one has been performed. All items for remediation noted on the checklist or in your Security Risk Analysis need to be completed to qualify for Meaningful Use. FACT IS: To comply with HIPAA, you must continue to review, correct or modify, and update security protections. There is no mandatory timeline for updates, but a best practice is to  do so at least once a year. Stericyclea€™s Steria€?SafeSM HIPAA Compliance Solution provides a high-quality solution to conduct thorough privacy and security risk assessments as a critical step in meeting your Risk Analysis Requirements under the HIPAA Security Rule. Establishment a Resource Management Program for Accreditation Process at the Medical LaboratorySedef Yenice1[1] Department of Biochemistry, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey1.
The laboratory can provide consistent test results of acceptable quality only when there is provision of appropriate facilities the laboratory environment.
Table 2 and 3 summarize the requirements for laboratory director and technical supervisor, respectively. Ensure that policies and procedures are established for monitoring individuals who conduct pre-analytical, analytical, and post-analytical phases of testing to assure that they are competent and maintain their competency to process specimens, perform test procedures and report test results promptly and proficiently, and whenever necessary, identify needs for remedial training or continuing education to improve skills.
Specify, in writing, the responsibilities and duties of each consultant and each supervisor, as well as each person engaged in the performance of the pre-analytical, analytical, and post-analytical phases of testing. Figure 1 shows a checklist developed in our laboratory to assess the competency of a medical laboratory technician who performs point of care (POC) urinanalysis.
Face Velocities should be between 80 and 120 FPM at the working sash height with an optimum level of 100 FPM. Certification is required annually or any time the hood is moved or has had maintenance performed. All chemicals must be appropriately labeled and shall not be placed near or over floor drains. Smoking is prohibited throughout all facilities at the organisation (with the exception specially designed "designated smoking areas"),Lab Personnel shall not wear loose (e.g. All unnecessary material, boxes, and containers must be disposed of in the appropriate manner.
All emergency and contingencies plans and evacuation routes shall be clearly posted in conspicuous places. Implementing a resource management program for accreditation process at the medical laboratory. Employee competence and performance-based assessment: a College of American Pathologists Q-Probes study of laboratory personnel 522 institutions. Personnel standards and quality assurance practices of biochemical genetic testing laboratories in the United States.
Curriculum content and evaluation of resident competency in clinical pathology (laboratory medicine): a proposal. 1990A Guide for evaluating the performance of chemical protective clothing (CPC) Cincinnati, OH, US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention. Primary containment for biohazards: selection, installation and use of biological safety cabinets. 2005 Protection of laboratory workers from occupationally acquired infections; approved guideline, 3 ed.
1995The association of state and territorial public health laboratory directors and US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention. Hepatitis B is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. The risk for Hepatitis B virus infection in international travelers is generally low, although people traveling to certain countries are at risk. The Hepatitis B vaccine is usually given as a series of 3 or 4 shots over a 6-month period.
Is it harmful to have an extra dose of Hepatitis B vaccine or to repeat the entire Hepatitis B vaccine series?
The Hepatitis B vaccine is not recommended for people who have had serious allergic reactions to a prior dose of Hepatitis B vaccine or to any part of the vaccine. Yes, there is a combination vaccine that protects people from both Hepatitis A and Hepatitis B. Hepatitis B immune globulin is a substance made from human blood samples that contains antibodies against the Hepatitis B virus. About MedasendIn business since 1999, Medasend was founded as a full service waste management company for the healthcare industry.
Nanosized particles (≤100nm in size) of gold are materials of great value with huge potential in biomedical, industrial and environmental applications.
The technology holds great promise because of their small size which gives them new diverse properties that are different from the bulk gold.
As growth of the technology continues there is need for tighter toxicological regulations arising from it anthropogenic sources especially to human health and safety risks associated.
The likely exposures to AuNPs and its nanomaterials can occur during development, production or synthesis, use, waste disposal, and as AuNP-composite bound consumer products in markets, homes, and outdoor activities. Despite the impact made by the nanoparticles, a total review of their toxicity may be of fundamental important to human and the environment. Its activities especially concern the appropriate management of biomedical technologies (from purchasing to risk controlling) and the development and the adjustment of hospital informative systems and telemedicine networks.
Thus, CE covers all those knowledge and methods applied to the management of biomedical technologies, ranging from their early evaluation and assessment, to their technical conduct, to their dismissing.
The technical evaluationAs discussed in the previous paragraph, HTA now represents a multidimensional field of inquiry that increasingly responds to broad social forces such as citizen participation, accelerated technological innovation, and the allocation of scarce resources among competing priorities (Battista, 2006). As regards safety, electromedical equipment are regulated by directives and technical norms that constitute not only a fair guarantee of their safety but also a valid guide to evaluate it for the specific context of its intended utilization.
Finally, after the comparison of all pairs, the weight of each indicator will be calculated.Step 4 Value of the indicators The next step is to assess each technological alternative (the subject of the assessment) on the basis of the mathematical framework so far implemented. Moreover, it is essential to follow a standardized scheme, preferably one from a HTA agency or scientific community.
Ten institutions, including Cornell University and The Johns Hopkins University, earned spots on the list, while Case Western Reserve and Yale University are the only two at-large participants. The foundation also considers the institutional commitment to support collaboration, provide encouragement and extend technical support to the investigator, especially as related to translational approaches and technology transfer that could promote rapid clinical application of research results.
The university shares our values, and together, we will seek to inspire innovation and achievement,” Dombrose said.
Candidates should hold a full-time appointment, and be eligible to serve as a principal investigator in early-stage, innovative, strategic or translational biomedical research with the potential to benefit children of the United States.
Speakers and scholars with a diversity of opinions and perspectives are invited to the campus to provide the community with important points of view, some of which may be deemed controversial. Know the facts and consider if your organization is adequately identifying and addressing HIPAA threats and vulnerabilities.

Ita€™s our mission to listena€”and to see whata€™s missing or where therea€™s potential exposure.
While that sounds simple enough, audit findings from the Department of Health and Human Services Office for Civil Rights (OCR) reveal widespread noncompliance with this requirement. However, EHR vendors are not responsible for making their products compliant with HIPAA Privacy and Security Rules. Your annual Risk Assessment is valuable protection for patient informationa€”and your business.
Our all-in-one HIPAA package also meets your needs for HIPAA training and policy documentation. An employee competency and assessment checklist to assess the competency of a medical laboratory technician who performs point of care (POC) urinanalysis. IntroductionThe Laboratory Accreditation Program from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is one of the most widely used CMS-approved accreditation program.
These include adequate buildings, space within the laboratory, appropriate utilities, and supplies and equipment for performance of laboratory tests. Any area which deals with corrosive, flammable or otherwise hazardous material is required to have immediate access to eyewash and drench shower facilities. All drains, including floor drains and cup sinks should be flushed with water on a weekly basis to eliminate sewer odors. Glass containers and other potentially sharp objects shall not be disposed of in common office refuse. Washington: US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention. Recommendations of CDC and the healthcare infection control practices advisory committee (HICPAC).
Travelers to regions with moderate or high rates of Hepatitis B should get the Hepatitis B vaccine. After receiving all three doses, Hepatitis B vaccine provides greater than 90% protection to infants, children, and adults immunized before being exposed to the virus. Also, it not recommended for anyone who is allergic to yeast because yeast is used when making the vaccine.
A “booster” dose of Hepatitis B vaccine is a dose that increases or extends the effectiveness of the vaccine. The combined Hepatitis A and B vaccine is usually given as three separate doses over a 6-month period.
It is given as a shot and can provide short-term protection (approximately 3 months) against Hepatitis B. Our mission: to provide a reliable and affordable alternative for medical waste management services and compliance training. The diverse properties include size and size distribution, surface chemistry, agglomeration and aggregation, shapes, solubility and dispersibility, surface charge and surface area.
These potential adverse effects ought to be examined for biocompatibility and environmental impact before they can be manufactured on large scale for in-vivo usage.
These exposures may account for their accumulation in the soil, water bodies, animals and plants which may lead to environmental hazards of unknown degree. In view of the above, NIOH has initiated major research project to investigate the toxicity of gold nanoparticles and generate data needed for the risk assessment of these nanoparticles. The number of in-house repairs reached 90% and more after one year and continue to grow as in-house personnel sharpen their required basic skills. CE combines with the medicine knowledge for conducing of healthcare activities by providing expertise in a wide spectrum of topics, from human physiology and biomechanics to electronics and computer science.As biomedical technology developed towards ever more complex systems and spread in every clinical practice, so the field of CE grew. Also, in this case the complexity of the method may vary from a very simple linear sum up to more complex fuzzy or neural network systems.3.
However,, this methodology was initially focused and applied on a small scale, concerning (clinical) engineering questions pertaining to a technology’s safety and technical performances, and involving the investigation of one or more properties, impacts, or other features of health technologies or applications.The technical evaluation represents, in fact, the core object of Clinical Engineering (CE) activity in HTA and is often conducted at a meso level.
The most interesting results of these searches are selected and details investigated in order to intensify and develop the assessment. In order to make the assessment as objective as possible, the specific characteristics that support the assessment of a single area (and, subsequently, of the whole health technology) must be fully and measurably detailed, therefore objective and “instrumentally” measurable indicators are preferred. For this purpose, we assign values (quantitative or qualitative) to each lowest level KPI (usually a micro KPI, but also macro KPI and, rarely, even an evaluation area), on the basis of available literature data, and technical specifications or expert judgment. Chair at Case Western Reserve University School of Medicine, professor of physiology and biophysics, and Department of Medicine chair at MetroHealth. The internal competition to select two Case Western Reserve nominees will be complete by October, and nominations are due to The Hartwell Foundation by Nov.
The views and opinions of those invited to speak on the campus do not necessarily reflect the views of the university administration or any other segment of the university community.
As with any medicine, there are very small risks that a serious problem could occur after getting the vaccine. Booster doses are recommended only for hemodialysis patients and can be considered for other people with a weakened immune system. For instance biological molecules can be adsorbed on the gold nanoparticle surfaces for release inside the cells. The shapes may vary from star, rod, sphere, triangular, wires, bipyramids, branched nanocrystals, to nail like etc. The possible routes of exposures to human are by inhalation, absorption through the skin contact, ingestion, injection (medical procedures) and release from implants. Healthcare risk managementBecause of the strong pressure on the health structures to optimize the services provided while lowering the associated costs and reducing the likelihood of adverse events, an organizational approach, in which a Healthcare Risk Management program plays a central role, becomes important.
Health Technology AssessmentNowadays many factors, ranging from the aging of population to the continuous fast-paced technology innovation, as well as the even more critical scarcity of economic resources, emphasize the importance of correct resource allocation at every level of a national health care system. Equipment’s efficacy is often evaluated only by design data or in vitro or animal model tests.
Technology managementHundreds to many thousands of medical devices may need to be managed in a healthcare facility, with several million Euros being invested each year for the acquisition of new health technologies and for planned technology replacement, while thousands of maintenance processes per year are required in order to maintain the efficiency of these devices. Testing requirements of each organization are at least equivalent to those of CLIA '88, they execute to some extent different testing standards and rationales in reaching the goal of quality laboratory testing. Specimen collection facilities are designated to respect patient's privacy, security, comfort, and disabilities. Eye wash bottles are not adequate equipment.Personal Protective Equipment Personal Protective Equipment such as goggles, masks, gloves and cover gowns must be readily available and not worn outside the immediate work areas. 40-75 liter must be stored in specific safety containers, 75 and over must be stored in a safety cabinet.Hazardous Waste Disposal Hazardous waste training is required for all employees who handle hazardous material.
ConclusionResource management for accreditation process at the medical laboratories applies to many aspects of quality management including personnel, basic facilities, equipment, security and safety.
However, the potential risks associated with Hepatitis B are much greater than the risks the vaccine poses.
Booster doses are not recommended for persons with normal immune status who have been fully vaccinated.
They are currently in use as sensitive detection x-ray contrast agent due to their radioactive-labelling by neutron activation. They can also be found in the environment as airborne thereby adhering to surfaces making it difficult to detect. The decrease in OEM corrective maintenance was soon significant: as a consequence, OEMs were able to focus their attention on accurate preventive maintenance in order to prevent certain predictable failures. Mistakes can be minimized, in fact, by creating organizational systems and using technologies to make it easier to do the right thing.
Early evaluation not possibleFigure 2.Representation of Health Technology, Medical Device and Medical Electrical Equipment setsA further classification of medical electrical equipment can be made according to their main characteristics or function.
As evident from the analysis of adverse events occurring during the last few years, serious incidents can often be related to the malfunctioning of medical devices. Since 1995, clinical laboratories surveyed using JCAHO standards have been deemed to be certifiable under CLIA '88 requirements. The laboratory director is responsible for defining the process of selecting and using equipment, reagents, and other supplies that affect the quality of services.
Since the vaccine became available in 1982, more than 100 million people have received Hepatitis B vaccine in the United States and no serious side effects have been reported. Their persistent and bioaccumulation in these environments can elevate health risk to organisms and the environment.
It is clear that patient safety can be increased by means of appropriate procedures aimed at avoiding possible mistakes or correcting those that do happen. HTA may address the direct, intended consequences of technologies as well as their indirect, unintended consequences; its main purpose is to inform technology-related policy-making in health care. As concerns the management of these technologies, uniformity of equipment is also important for better and easier use by the operators, and ensures the availability of backup equipment.
In particular, a high degree of obsolescence of the technologies, as well as missed, inadequate or improper maintenance, are among the possible causes of failure not attributable to the manufacturer.
The purpose of CLIA '88 is to ensure that all laboratory testing, wherever performed, is done accurately and according to good scientific practices and to provide assurance to the public that access to safe, accurate laboratory testing is available [1]. As part of this process, the director defines performance criteria for test methodologies, equipment, and quality control. Manufacturer or other authoritative storage requirements are met, such as for temperature, ventilation and humidity.
A comprehensive program that includes management commitment, effective training, regular audits of critical functions to identify potential problems, implementation of corrective action and establishment of priorities for improvement benefits the laboratory in many ways. This may give them the possibilities of entering the food chain thereby influencing the biotic and abiotic processes. Significant discounts were obtained based on the percentage of in-house corrective maintenance, justifying the cost related to internal technicians and the energies needed to set up the whole system.Table 5. In particular, the potential for biomedical equipment related adverse events needs to be analyzed in order to prevent their occurrence: healthcare structures have to use systematic analytical methods and instruments to manage technological risks to both patients and operators. The most common mode of acquisition is by rental or service, where the cost of the equipment is included in the cost of the reagents.

Therefore, in every healthcare facility, responsibility for the safe management of medical devices should be identified.
Joint Commission inspect their members using performance standards that meet or exceed those of CLIA. Employee orientation and competency assessment activities are accomplished through a number of training and measurement of performance once a year [7]. The aim of the health organizations is to take care of patients, by providing effective, appropriate and, in particular, safe treatments. Conducting an HTA processAn HTA process is conducted by interdisciplinary groups using explicit analytical frameworks drawing from a variety of methods: given the variety of impacts addressed and the range of methods that may be used in an assessment, several types of experts are needed in HTA.
The CED can provide a relevant contribution to the prevention of adverse events resulting from medical device failures by the technical and clinical assessment of the technologies to be acquired and proper management of maintenance. Another reason for performing competency assessment with laboratory personnel is that it is also a requirement of the College of American Pathologist (CAP) for accreditation.
A policy covering security issues concerning patients, visitors, other customers, personnel, and property is established. Extinguishers must be properly mounted, unobstructed and be properly labeled for the intended use. The healthcare institutions (such as the clinicians themselves) have to ensure the care, as adequate as possible, of patients, avoiding or at least containing damage caused by human and system errors. CAP General Inspection Checklist indicate that the manual that describes training activities and evaluations must be specific for each job description. Equipment (software and hardware), reference materials, consumables, reagents, and analytical systems are safeguarded from adjustments or tampering which would invalidate test results.Laboratory areas for which space and design should be addressed include areas where clerical functions are performed.
Training classes should be offered through the Fire Marshal.Pressurized Cylinders All cylinders must be stored in proper locations.
The planning process by lab leaders needs to address the ability to provide these and other resources, as required.
Because this function is often critical to reporting the correct result on a patient or maintaining specimen identity, consideration should be given to providing areas where interruptions are uncommon and individuals can give full concentration to the transcriptions or data entry being completed.One of the fundamental processes is to develop an Employees Occupational Safety and Health Program (EOSHP) to address all types of hazardous materials and wastes in the laboratory [17].
All cylinders must be secured in an upright position and properly restrained to prevent falling.
There should also be adequate education to appropriate staff about the quality management system plan and implementation.
The records must make it possible for the inspector to be able to determine what skills were assessed and how those skills were measured. Our EOSHP project was introduced as a reference case and published in the source book entitled “Understanding Health Care Facility Safety” by Joint Commission [18]. This communication delineates an execution of resource management (RSM) program and some quality assurance tools that have been developed and tailored in our laboratory to comply with the requirements for laboratory accreditation by Joint Commission International (JCI) [2].2. Retraining and reassessment of employee competency must occur when problems are identified with employee performance. Cylinders of all gases having a Health Hazard Rating of 3 or 4 shall be kept in a continuously mechanical ventilated hood or other ventilated enclosure. Technological risk managementDealing with clinical risk and patient safety means also dealing with biomedical technologies.
Methods The objectives of this work were achieved in accordance with the mission of the hospital, the objectives of our laboratory, any applicable laws or regulations and all relevant accreditation standards. The training and assessment program must be documented and specific for each job description [8]. It is essential to communicate the hazard information and protective measures required to use these chemicals safely to exposed or potentially exposed employees who may use the chemicals. Maximum number of cylinders of a flammable gas shall be not more than 3 (25 x 127cm) 45 square meter in an unsprinkled space or not more than 6 (25 x 127cm) in a sprinkled space of 45 square meter. In fact, as medical treatments have greatly progressed along with the analogous technological advances in medical equipment (ME), all medical procedures depend, to some extent, on technology to achieve their goals.
The related policies and procedures were developed to provide guidance for workers when implementing the process.
The implementation of EOSHP incorporates the establishment of a Chemical Hygiene Plan, description of a Hazard Communication Quality Standard (HCQS), development an Employee’s Guide to Handle the Hazardous Chemicals to assist the laboratory staff in complying with the EOSHP HCQS, identification of the staff who will be responsible for the initial set up of the EOSHP and the day-to-day activities necessary to comply with each aspect of the HCQS, construction an inventory of all hazardous chemicals used in the laboratory and a written list comprising the hazard descriptions of chemicals. Liquefied Gas Cylinders in laboratory work areas shall not exceed 3 cylinders (23 x 76cm) in a sprinkled space or exceed 2 cylinders (23 x 76cm) in an unsprinkled space.Room Use Identification All access doors must be marked when rooms or areas are being used for chemical, biological or radioactive purposes as outlined in the Chemical Hygiene Plan.
Despite the (presupposed) inherent safety of MEs (also guaranteed by a plethora of laws and technical standards), device-related adverse events occur every day in hospitals around the world. The policies were generated based on standard requirements for resource provision and management by JCI [3]. Trainings include department policies, job-related tasks, patient safety and Employees Occupational Safety and Health Program (EOSHP). In this respect, guidelines of NFPA (National Fire Protection Association, USA) provide comprehensive source to delineate hazard symbols and classifications [19]. The implementation of this resource management (RSM) program is undertaken in five major sub-fields. During the first year that an individual is performing such patient testing, competency must be assessed every six months [9-16]. In accordance with the EOSHP HCQS, the Material Safety Data Sheets (MSDS) for the specific hazardous products or chemicals should be supplied.
An adverse event is (as defined by Medicines and Healthcare Products Regulatory Agency, MHRA) “an event that causes, or has the potential to cause, unexpected or unwanted effects involving the safety of device users (including patients) or other persons”.
ME related adverse events can occur for several reasons, ranging from incorrect choice and acquisition of the device, wrong installation, and poor maintenance, to use error and device obsolescence.As stated before, a systemic approach is needed.
In addition, appropriate resources are provided for the maintenance and improvement of the quality management system. Appropriate signs and labels are prepared as hazard warnings to convey the hazardous effects of the materials. Such an approach, identified as Medical Equipments Risk Management (MERM), is part of the global Technology Management (Wilkins & Holley, 1998) as practised by the Clinical Engineering Department (CED) within the hospital.
Required job qualifications are defined for all laboratory staff positions, as well as job expectations. Guidelines are determined in the event of a chemical spill, incident, or leak from a sealed container.
A copy of the Employee’s Guide to Handle the Hazardous Chemicals is handed out as training source document. The primary policies for managing biological hazards should define the mechanisms for oversight for controlling exposures to biological materials in the workplace and include the bloodborne pathogens and exposure plan [21-25].
The related policies and procedures for handling biohazardous materials need to be developed to provide guidance for worker safety when handling or exposure to biological agents and included in the new employee orientation and annual update training programs (Fig. The administration and supervision of patient exposures to and infection with biological agents is the primary responsibility of organization’s Infection Control Unit. Assessments of risk for the biological safety management activities are accomplished through a number of audits and data collections on a semi-annual basis.
All occupational exposures to or injuries from biological materials are to be reported by employees to the EOSHP coordinator. Biological safety posters including the information, reporting and reduction of exposures to bloodborne pathogens and tuberculosis [28] are posted in all major areas of the laboratory facilities. A Laboratory Waste Management program should be established to safely control hazardous chemical and biological waste from receipt or generation through use or final disposal in the laboratory.
Chemical waste is characterized as non-hazardous or hazardous in accordance with the rules and regulations specified by OSHA (The federal Occupational Safety and Health Administration, USA) [29,30]. With this regard, a substance, which exhibits one of the four hazardous characteristics (corrosivity, ignitability, reactivity, toxicity), is delineated as Hazardous Chemical Waste. Chemical waste that does not exhibit any of the hazardous characteristics as defined above is considered non-hazardous chemical waste. Any waste that is potentially biohazardous, infectious, or pathological is described as Biological Waste. A Waste Characterization Checklist needs to be developed to determine whether the waste is hazardous or non-hazardous (Fig. The ALARA program [31] and associated work practices are put in practice to reduce risks to workers by keeping doses well below the limits.
Laboratory instruments and analytical systems are tested upon installation, and prior to use to assure their capability of meeting performance expectations. For new analytical methods, the laboratory verifies, at a minimum, accuracy, precision and the reportable range, as well as confirming that the reference range applies to its patient population. If the laboratory has modified the test or if the method is very complex with many steps, the laboratory also verifies analytical sensitivity and analytical specificity.
The laboratory leaders provide for a program to regularly monitor and demonstrate proper calibration and function of instruments, reagents, and analytical systems. Calibration, calibration verification, function checks, and preventive maintenance are performed on instruments and analytical systems, as needed, and at least according to manufacturers' recommendations. All required verification checks are documented, along with remedial action when instruments or test methods did not meet performance expectations.
Records of major repairs, parts replacement, and semiannual or annual calibration checks and preventive maintenance must be retained for the life of the instrument.
Procedures should be determined to check periodically the validity and quality of reagents and water quality used in laboratory testing.
The details of environmental conditions and supporting safety utilities are represented in Table 4. The laboratory's safety processes should include adequate fire detection and prevention policies. Adequate safety devices such as emergency eyewash, safety cans, puncture-resistant containers for discarding all waste sharps [37], fire extinguishers and blankets are made available and training should be provided to all laboratory staff.

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