Impact of COVID-19 pandemic on accredited programs and graduates who sat for the American Society for Clinical Pathology Board of Certification examination: graduates' perspective.

OBJECTIVE: Students in health profession education programs were severely affected by the COVID-19 pandemic at both didactic and clinical training levels. The purpose for this American Society for Clinical Pathology Board of Certification (ASCP BOC) study was to determine the impact of the COVID-19 pandemic on graduates. This study represents the perspectives of laboratory professional graduates who sat for the BOC certification in their respective professional disciplines. METHODS: A survey was sent to all graduates from the National Accrediting Agency for Clinical Laboratory Science (NAACLS), Accrediting Bureau of Health Education Schools (ABHES), and Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited programs who sat for the ASCP BOC examination in 2020 and 2021 to determine the impact of COVID-19 on laboratory professional graduates during the pandemic. RESULTS: A total of 180 graduates responded to the survey. The majority of graduates indicated that at least 1 didactic program component was shifted to an online system during the pandemic and that both clinical and nonclinical student laboratories were affected. Although program completion for most graduates was not delayed, one-third of graduates delayed taking their respective BOC exam. Due to the lack of knowledge application through practical hands-on laboratory experience in their educational programs, graduates reported feeling a lack of readiness with regards to preparing for the national certification examination as well as for employment. CONCLUSION: The study results showed the pandemic greatly impacted the education experience and readiness for the ASCP BOC examinations for graduates. Factors such as the absence of in-person learning and hands-on experience-both crucial aspects in laboratory training-and the ripple effects as a result of the pandemic, such as job loss, financial constraints, and health concerns, contributed to the decreased quality of education for graduates.

Impact of COVID-19 pandemic on accredited programs and graduates who sat for the American Society for Clinical Pathology-Board of Certification Examination: program directors' perspective.

OBJECTIVE: Health professions education programs were severely affected by the COVID-19 pandemic at clinical and didactic training levels. The purpose for this American Society for Clinical Pathology-Board of Certification (BOC) study was to determine the impact of the COVID-19 pandemic on the graduates who sat for BOC certification in their respective professional disciplines from the perspective of program directors (PDs). A separate article will be published on the graduates' perspective. METHODS: A survey was sent to all PDs from the National Accrediting Agency for Clinical Laboratory Science, Accrediting Bureau of Health Education Schools, and Commission on Accreditation of Allied Health Education Programs, accredited programs whose graduates are certified by the BOC, to determine the impact of COVID-19 on healthcare graduates and education programs during the pandemic. RESULTS: A total of 201 PDs responded. All programs consistently reported that the pandemic had a negative impact on their students' BOC pass rate and scores. When asked what educational formats were used, all groups used virtual live lectures and recorded lectures. University programs were found to use more online student laboratories and simulation laboratory sessions than the hospital programs, affecting the psychomotor skills of their students. CONCLUSION: The results indicated that the effects from the COVID-19 pandemic were related to the inherent differences between hospital and university programs. This study revealed that the pandemic affected university programs more than hospital programs.

A novel comprehensive efficacy test for textiles intended for use in the healthcare setting.

Soft surfaces, including textiles are found throughout healthcare settings. Pathogens can survive for long periods of time on textiles, and can be transferred to and from the skin. Antimicrobial fabrics are used as an engineering control to prevent infection. Efficacy testing standards have limitations, including single microorganism challenges, multiple fabric plies tested, and lengthy contact times. We developed a novel method that better models in-use conditions through testing standardized mixtures of pathogens and normal skin microorganisms, artificial soils, and a 15-min contact time. Reproducible growth of all microorganisms from frozen stocks was achieved using this method. A novel rechargeable, monitorable N-halamine cotton cellulose fabric, containing 5885 ± 98 ppm of active chlorine, was evaluated with the new method using PBS, artificial sweat, and artificial sweat plus 5% serum as soil. Pathogens tested included Acinetobacter baumannii, Candida albicans, Escherichia coli, vancomycin-resistant Enterococcus faecalis, methicillin-resistant Staphylococcus aureus, methicillin-susceptible Staphylococcus aureus, and Pseudomonas aeruginosa. Each was tested singly and in the presence of a representative normal skin flora mixture, including: Acinetobacter lwoffii, Corynebacterium striatum, Micrococcus luteus, and Staphylococcus epidermidis. When tested singly, all microorganisms were reduced by 3.00 log10 or greater, regardless of artificial soil. In mixture, 4.00 log10 or greater reductions were achieved for all microorganisms. These results suggest that the novel testing method can be used to provide more comprehensive and realistic efficacy information for antimicrobial textiles intended for use in healthcare. Furthermore, the N-halamine fabric demonstrated efficacy against multiple pathogens, singly and in mixtures, regardless of the presence of artificial soils.

Cleaning and disinfection in home care: A comparison of 2 commercial products with potentially different consequences for respiratory health.

BACKGROUND: Home care aides perform personal care and homemaking services in client homes, including cleaning and disinfection (C&D). Although C&D are performed to remove soil and dust, they are increasingly performed for infection prevention. Many C&D products contain respiratory irritants. The objective of this study was to evaluate 2 commercial products for C&D effectiveness on common household surfaces in seniors' homes. METHODS: Two C&D visits were conducted in 46 seniors' homes. One visit applied a bleach-containing cleaning product and the other applied an environmentally preferable product. Before and after C&D, the study team performed organic soil bioluminometer measurements on surfaces and collected cotton swab and wipe samples for total bacteria count, Staphylococcus aureus, and Clostridium difficile identification. RESULTS: Both products removed microorganisms from tested surfaces. S aureus was found in 7 households, 1 strain of which was methicillin-resistant. Both products removed S aureus from all surfaces. Bleach-containing products removed somewhat more soil than environmentally preferable products, although results were statistically significant for only 1 surface. CONCLUSIONS: The study showed similar, not identical, C&D performance for 2 cleaning products with potentially different consequences for respiratory health. Additional research is needed to develop robust recommendations for safe, effective C&D in home care.

Impact of Time Lapse on ASCP Board of Certification Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) Examination Scores.

BACKGROUND: Research in several professional fields has demonstrated that delays (time lapse) in taking certification examinations may result in poorer performance by examinees. Thirteen states and/or territories require licensure for laboratory personnel. A core component of licensure is passing a certification exam. Also, many facilities in states that do not require licensure require certification for employment or preferentially hire certified individuals. OBJECTIVE: To analyze examinee performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) certification examinations to determine whether delays in taking the examination from the time of program completion are associated with poorer performance. METHODS: We obtained examination data from April 2013 through December 2014 to look for changes in mean (SD) exam scaled scores and overall pass/fail rates. First-time examinees (MLS: n = 6037; MLT, n = 3920) were divided into 3-month categories based on the interval of time between date of program completion and taking the certification exam. RESULTS: We observed significant decreases in mean (SD) scaled scores and pass rates after the first quarter in MLS and MLT examinations for applicants who delayed taking their examination until the second, third, and fourth quarter after completing their training programs. CONCLUSIONS: Those who take the ASCP BOC MLS and MLT examinations are encouraged to do so shortly after completion of their educational training programs. Delays in taking an exam are generally not beneficial to the examinee and result in poorer performance on the exam.

Laundering habits of student nurses and correlation with the presence of Staphylococcus aureus on nursing scrub tops pre- and postlaundering.

Little is known about student nurse laundering practices. Student nurses swabbed their scrub tops after clinical and after laundering, and they completed a laundry survey; 13.5% of students wore the same scrub more than once, and few followed recommended guidelines by using hot water (20%) or bleach (5.6%) when laundering scrubs. After clinical shifts, 17% of swabs tested positive for Staphylococcus aureus; however, laundering eradicated it from 64.3% of positive samples. This was not statistically significant.

Effectiveness of five-day-old 10% bleach in a student microbiology laboratory setting.

In the student laboratory, 10% bleach (sodium hypochlorite) is used to disinfect benches before and after work, and when a spill occurs. Centers for Disease Control and Prevention (CDC) Guidelines recommend diluting bleach daily. In a student laboratory setting, the organisms in use are known and may include only selected standard bacteria. Diluting bleach daily is time consuming and wastes bleach. We hypothesized that 10% bleach stored in low density polyethylene (LDPE) wash bottles would maintain sufficient chlorine concentration to be effective against the organisms used in the student laboratory for five days, so that bleach could be diluted weekly instead of daily. Approximately 3 x 10(6) CFU of each bacterium were spotted to a laboratory bench surface in duplicate and allowed to air dry. One spot was individually cleaned with five-day old 10% bleach following the same protocol as student laboratories. The second spot was uncleaned and sampled as a control. Contact plates containing D/E Neutralizing agar were touched to the spots, incubated overnight at 35 degrees C and examined for growth. An uninoculated spot was also sampled as a background control. A total of 22 different organisms were tested, representing the major groups of organisms used in the student laboratories. All organisms tested were eliminated by the five-day old bleach. All uncleaned spots showed dense growth. The background control had no growth. Reducing the dilution of bleach to once a week rather than daily will save time and money, which can then be devoted to more teaching and curriculum responsibilities, while still maintaining laboratory safety.

Systematic assessment of culture review as a tool to assess errors in the clinical microbiology laboratory.

CONTEXT: Daily supervisory review is a common practice in microbiology laboratories; however, there are no publications describing errors corrected by this practice. OBJECTIVE: To determine (1) the correction rates for routinely reviewed positive cultures, (2) the correction rates for negative cultures, and (3) the types of corrections that are found, including the number with potential clinical significance. DESIGN: We prospectively assessed errors identified during culture report review for all positive (10-month period) and negative (1-month period) cultures at a single, university-based clinical microbiology laboratory in the United States. Errors were classified using predefined categories, and total and per category error rates were determined. A chi(2) test was used to assess significant differences between error rates. RESULTS: A total of 112,108 culture reports were examined; 914 reports required a total of 1043 corrections. Of 101,703 positive culture reports, 786 (0.8%) required 900 corrections, 302 (0.3%) of which were potentially clinically significant. Of 10,405 negative culture reports, 128 (1.2%) required 143 corrections, 5 (0.05%) of which were potentially clinically significant. The rate of potentially clinically significant errors was significantly higher among positive versus negative culture reports (P < .001). Errors from positive culture reports most commonly involved susceptibility (374 [42%]), reporting (275 [31%]), and identification workup (217 [24%]). Most potentially significant errors from positive culture reports involved susceptibility testing (n = 253) and specimens from wound or lower respiratory tract (P < .001). CONCLUSIONS: Review of culture reports from positive cultures from nonsterile sites with special attention to antimicrobial susceptibility testing and reporting would be most likely to detect potentially significant errors within the clinical microbiology laboratory.

A 2-year study of Gram stain competency assessment in 40 clinical laboratories.

We used a computer-based competency assessment tool for Gram stain interpretation to assess the performance of 278 laboratory staff from 40 laboratories on 40 multiple-choice questions. We report test reliability, mean scores, median, item difficulty, discrimination, and analysis of the highest- and lowest-scoring questions. The questions were reliable (KR-20 coefficient, 0.80). Overall mean score was 88% (range, 63%-98%). When categorized by cell type, the means were host cells, 93%; other cells (eg, yeast), 92%; gram-positive, 90%; and gram-negative, 88%. When categorized by type of interpretation, the means were other (eg, underdecolorization), 92%; identify by structure (eg, bacterial morphologic features), 91%; and identify by name (eg, genus and species), 87%. Of the 6 highest-scoring questions (mean scores, > or = 99%) 5 were identify by structure and 1 was identify by name. Of the 6 lowest-scoring questions (mean scores, < 75%) 5 were gram-negative and 1 was host cells. By type of interpretation, 2 were identify by structure and 4 were identify by name. Computer-based Gram stain competency assessment examinations are reliable. Our analysis helps laboratories identify areas for continuing education in Gram stain interpretation and will direct future revisions of the tests.

Standardized test scores as an admission requirement.

OBJECTIVE: The usefulness of standardized test scores as an admission requirement for the University of Washington Medical Technology Program (UWMTP) was evaluated. Scores from the Allied Health Professions Admissions Test (AHPAT) were used. DESIGN: Student data (n = 183) were analyzed and evaluated statistically using Pearson correlation and Cox proportional hazards regression analyses. Sensitivity and specificity for several admissions criteria were calculated. SETTING: The UWMTP is a 2 + 2 medical technology program (MTP) located in a large public university. PARTICIPANTS: Student records for classes of 1993 through 2000 were reviewed. Eligibility for inclusion was based on completeness of student record. MAIN OUTCOME MEASURES: Several admission criteria were analyzed for their ability to predict success in the UWMTP and on the ASCP Board of Registry (BOR) certification examination, and for their sensitivity and specificity. RESULTS: Pearson correlations for the AHPAT total score were r = 0.402 with the MTP GPA and r = 0.414 with the BOR exam. Cox proportional hazards regression analysis defined the decreased likelihood of failure for each unit increase in the test score. For the MTP GPA, the risk decrease was 0.8% for the AHPAT total and 2.8% for the Biology subtest. For the BOR exam, the risk decrease was 0.8% for the AHPAT total and 2.8% for the Verbal subtest. The admissions criteria selected based on specificity (26.7%) and maximum sensitivity (100%) was one in which the student must achieve at least two of the following three scores: AHPAT total > or = 150, Biology subtest score > or = 10, Verbal subtest score > or = 5. CONCLUSIONS: Scores on a standardized test can be used to predict success in a MTP and on the ASCP BOR exam.