NLTC-9. Supporting Your Sentinel Laboratories
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1 NLTC-9 Supporting Your Sentinel Laboratories Rob Nickla, BT/CT LRN Coordinator, STC, RO Oregon State Public Health Laboratory
2 Outline Communication & Relationships State Specifics Sentinel Laboratory Site Specifics Trainings & Resources Helping With Identified Items ENGAGE SUPPORT MAINTAIN 2
3 Communication & Relationships Established and current database Distribution lists Routine and urgent, alerts, messages, and training announcements Consistent messaging style, and do not overburden Relationship building takes time! Professional and personal relationships Face to face introductions increase communication Provide consistent, reliable guidance, results, and products Inspection vs. consultation approach Supportive, not regulatory tone 3
4 State Specifics Geographic variability affecting site visits and scheduling Disease reporting requirements PH systems, infrastructures and partners Epidemiology Preparedness Centralized vs. decentralized local public health departments Sentinel Lab Healthcare Systems Other Partners 4
5 Sentinel Laboratory Site Specifics Variety of clinical healthcare systems Frontline clinical Core & regional microbiology laboratories Academic / Research Animal or Veterinary Select agent registered Small rural vs. large metro County or city HDs Available resources, depth of staff, turn overs, availability and scheduling Participation: Leadership and management Lead microbiologists and techs Safety Facilities Infection prevention Quality assurance Emergency preparedness Shipping/receiving 5
6 What Kind of Training? Training needs assessments, surveys, previously identified, follow up items Sentinel Lab requirements Online, e-learning, webinars and teleconferences In-person trainings At PHL At Sentinel Lab Regional host site PHL developed Partner resources ABSA, APHL, ASM, CDC, Eagleson, PHF, WHO DOT, FedEx Pack/Ship Technical Support OSHA trainings & consultations Commercial and private Competency assessments.. 6
7 Outreach & Trainings Provide resources Printed copies of guidance material, job aids, posters, handouts, updated pack/ship stickers, extra Category A box Offer and provide trainings as needed General or One Size Fits All Tailored trainings Adjustable and scalable 7
8 Site Visit Agenda Share structured and custom agenda prior to visit & seek input Review current contacts and appropriate notifications Discuss general sentinel lab requirements Discuss site specific history: LPX results, rule-outs sent in, exposures or other incidents, past questions or concerns, any follow ups, etc. Discuss biosafety & risk assessments Their process, plans, personnel Lab tour Biothreat sample walk thru Observe and discuss biosafety practices and potential hazards Gives you future frame of reference Closing discussion 8
9 APHL Training & Resources Biosafety & Biosecurity Document library Checklists Trainings SharePoint Sites Active Listserv
10 CDC TRAIN Free registration and online course 6.2 Packaging & Shipping Basic Microbiology Curriculum BT organism awareness Environmental & occupational safety 10
11 Relevant MMWRs Guidelines for Biosafety Laboratory Competency Competency Guidelines for Public Health Laboratory Professionals Guidelines for Safe Work Practices in Human and Animal Medical Diagnostic Laboratories 11
12 Clinical Laboratory Preparedness and Response Guide Updated LRN Program information Expanded all-hazard clinical lab preparedness scope Clinical laboratory regulatory references Pack/Ship, Biosafety, Biosecurity, Risk Assessments, OSHA, etc. Valuable job aids and checklists!!! Standardized guidance and reference manual for all sentinel labs 12
13 Clinical Laboratory Preparedness and Response Guide Budget allocation to print and distribute a copy to ALL state sentinel laboratories Outreach and training tool Increase awareness for biosafety, biosecurity, risk assessments, packaging & shipping, clinical laboratory preparedness Current, standard guidance Contact updates Sentinel lab resource On-site discussions 13
14 Intended Sentinel Lab Use Share the new resource internally with lab staff & with clinical partners Lab Epi Infection Control Preparedness Other Partners Increase & strengthen: Communications and networks Plans, policies and procedures Biosafety & biosecurity awareness Risk assessment processes Biothreat organism familiarization Pack/ship capabilities Regulatory awareness BSL-2 & BSL-3 laboratory inspections Generate ideas for well designed laboratory drills and exercises 14
15 Job Aids!!! Biochemical Reference Charts BSL-2 & BSL-3 Checklists Job Hazard Analysis Chart OSHA Poster Select Agent Algorithm Guide Select Agent Forms 2, 3 & 4 Select Agent Suspected ID Organism Specific Flowcharts Pack/Ship Checklists & Guidance 15
16 Packaging & Shipping Update and integrate technical resources for regulatory compliance Supply references Biothreat sample referral Job aids and checklists!!! 16
17 Packaging & Shipping Training Twice a year at PHL At sentinel laboratories Regional host sites APHL, Pat Payne Free CDC online course 17
18 Biosafety & Biosecurity Training Biosafety & biosecurity overview Risk groups and biosafety levels PPE don/doff Exposures and laboratory acquired infections (LAIs) Biological safety cabinets (BSC) Chain of custody Biohazardous waste BSL-3 practices in a BSL-2 lab Increase awareness & capacity 18
19 Biothreat Awareness Training Recognize Familiarity with biothreat organism warning signs and appropriate safety precautions Rule-Out Safe, prompt, presumptive recognition steps in accordance with ASM Sentinel Lab Guidelines Refer RECOGNIZE RULE-OUT REFER Category A shipping materials and trained staff 19
20 Biothreat Awareness Training Provide communications, guidance & resources ASM Sentinel Laboratory Protocols CDC TRAIN BT courses Biannual CAP LPX Electronic case studies Share newsworthy events Wet Lab rule-out course CDC Form 4 instruction Select Agent algorithm 20
21 Biological Risk Assessments Requires management and key laboratory personnel involvement and support Multidisciplinary team (depending on the work) Laboratorians Management/supervisors Health and safety specialists Facility and maintenance Scientists with unique expertise and experience Veterinarians (if animal work) Reach out for support OSHA, equipment manufacturers 21
22 Biological Risk Assessments Standardized approach, content and processes Conduct, evaluate and review Site specific considerations! Hazard identifications Controls and mitigations Minimize risks LAI prevention Infectious material handling PPE, waste, BSCs, equipment, disinfection and decontamination 22
23 BSL-2 & 3 Laboratory Inspections 23
24 Enlist Support From Your Partners! Offer collaboration ideas and create opportunities! Chemical, radiological, and food safety threats Exposures Risk determinations, symptom monitoring, PEP follow ups Joint trainings, drills and exercises Intelligent design and planning Epi, Preparedness, Local HDs, HAI programs, Infection Preventionists, CLIA programs, HPP, PH Liaisons, HazMat 24
25 RESOURCES! NLTC-8 25
26 Thank You 26
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