CAP “Training > Biosafety” Response Palette, 1-25-08

TRAINING IS KEY TO DIAGNOSTIC LAB BIOSAFETY. 
(ICY ROAD METAPHOR – INEXPERIENCE DRIVER MORE LIKELY TO SKID/HAVE ACCIDENT)

Improving operations at labs

  *  Risk assessment*
  *  Written protocols
  *  Ongoing training
  *  Exposure control plan
  *  Routine monitoring for staff
  *  Compliance

Biosafety ? zero risk

  *  Risk from unknown specimen greater than risk from CAP survey, e.g. 
     clinical lab first worked on Monkeypox
  *  Important not to confuse select agent status with level of risk in the lab. 
  *  Some lab associated high-risk agents are not select agents
  *  High risk organisms not seen frequently, thus need for regular training 
     and exercises
  *  Example of success: OSHA requirement for annual training in bloodborne 
     pathogens improved biosafety practices

Improving National Systems

  *  New BMBL improves/clarifies some recommendations.
  *  CLIA outlines basic safety requirements but none for biosafety cabinets.
  *  Biosafety on agenda for February CLIAC meeting.
  *  No national system for monitoring lab acquired infections, some research 
     but don’t know the full extent of the problem
  *  Regulation is not the only answer, e.g., Texas A&M lab, highly regulated, 
     still had lab acquired infections

Building Capacity for Safety

  *  Some labs do not have a biosafety cabinet or must share. Cost to
  *  purchase, maintain one.
  *  Training: must be ongoing.
  *  Inexperienced staff
  *   Workforce: staff inexperienced due to turnover or overstretched 
     staff due to workforce shortage