RE: Automation of Special Stains - QC

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From:"Johnson, Mickey" <JohnsoM@shmc.org>
To:"'Tapper, Sheila'" <STapper@smdc.org>, "'HistoNet Server' (E-mail)" <HistoNet@Pathology.swmed.edu>
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Sheila,

This is an interesting question. RE:Tom McNemar's idea, which parallels
mine. This has been an ongoing discussion with our microbiology department
who do all the AFB stains, including the ones on tissue sections.  The
insist that the control be on a separate slide, for fear of an organism
migrating from the control to patient slide.  I would also be very
interested in a consensus on this.

On another note, I would like to thank everyone who responded to my question
about doing frozen sections on CJD cases.  Many valid points were brought up
regarding Body Substance Isolation, etc.  The problem with this disease is
that even with recommended decontamination and/or cleaniong of the cryostat,
there is still the possibility of infection long after the fact. Our
epidemiologist and I will be evaluating all the responses and forming a
hospital policy to include frozen sections. When we have completed this, I
will post on the histonet. I hope to hear from more of you about your
policies.  Thanks again

Mickie

Michael L Johnson, BS, HTL(ASCP)
Histology Supervisor
Department of Pathology
Sacred Heart Medical Center
W. 101 8th Avenue
Spokane, WA 99220

johnsom@shmc.org
 

-----Original Message-----
From: Tapper, Sheila [mailto:STapper@smdc.org]
Sent: Monday, March 20, 2000 1:05 PM
To: 'Tom T. McNemar'; Colbert, Laurie; 'histonet@pathology.swmed.edu'
Subject: RE: Automation of Special Stains - QC


Have you ever had trouble with microorganisms traveling from your positive
control to the patient tissue?  My pathologist refuses to allow
microorganism controls to be placed on the same slide, for fear that
something may contaminate the patient tissue.  

Sheila

	-----Original Message-----
	From:	Tom T. McNemar [SMTP:TMcNemar@lmhealth.org]
	Sent:	Monday, March 20, 2000 10:26 AM
	To:	Colbert, Laurie; 'histonet@pathology.swmed.edu'
	Subject:	RE: Automation of Special Stains - QC

	With regard to the question of positive/negative controls.....  In
our lab
	we mount the positive control on the same slide as the patient.
This way
	you always know that the control and patient were stained exactly
the same.
	Granted, we go through a huge number of control blocks but so far
they have
	been pretty easy to come by.  We buy special slides that have a red
box for
	the control tissue.  It has worked well for us.
	Tom Mc Nemar
	Pathology Supervisor
	Licking Memorial Hospital
	Newark, Ohio


	> -----Original Message-----
	> From:	Colbert, Laurie [SMTP:LColbert@phsca.org]
	> Sent:	Sunday, March 19, 2000 2:37 PM
	> To:	'histonet@pathology.swmed.edu'
	> Subject:	RE: Automation of Special Stains
	> 
	> In the past we used the Leica Autostainer to do some special
stains.  This
	> worked well, but large amounts of reagent were needed to fill the
slide
	> buckets on the stainer and the number of stains that could be
performed at
	> one time was limited.
	> 
	> We now have two Cytologix stainers in our lab.  One was purchased
and one
	> is
	> on loan until Cytologix can improve on the turn-around time.  The
stains
	> are
	> really nice on this stainer, but there are a  few problems with
	> consistency.
	> The stainer can accommodate 48 slides at one time, but, as I
mentioned
	> earlier, the turn-around time is not good when you have multiple
stains or
	> multiple slides (more that 3 or 4) slides of one stain.  What is
really
	> nice
	> is that we can run stains overnight and they are ready to hand out
first
	> thing in the morning.  So this aspect has improved our turn-around
time.
	> 
	> Cytologix is aware of the problems with their stainer, and they
are very
	> receptive to any issue or problem we have had.  I think this is
going to
	> be
	> a really great stainer down the line when some of the bugs have
been
	> worked
	> out.  For now, we will continue work around the problems, and the
stainer
	> really has saved us several times when we were short on people.
And I
	> have
	> to emphasize that their customer service has been good.
	> 
	> I may be opening a can of worms here, but I have a question in
regards to
	> automation of stains.  I feel there is no real quality control on
the
	> stainers that stain one slide at a time (vs. batch staining as on
the
	> Leica
	> Autostainer).  Sure, your control may be positive, but how do you
know the
	> patient slide was stained properly when it is stained independent
of the
	> control slide?  We have had our control slide come out negative,
but our
	> patient was positive, so who's to say that this couldn't  happen
the other
	> way around???
	> 
	> Laurie Colbert
	> Saint Joseph Medical Center
	> Burbank, CA



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