New blood bank technology prepares students for modern laboratory work

ECU’s clinical laboratory science students — who after graduation run the nation’s medical labs in hospitals, for public health offices and in the pharmaceutical and biotech industry — got a huge boost recently with the acquisition of a new device that automates the process for identifying blood types.

ECU clinical laboratory science senior Bryce Glover loads samples into a gel assay testing console. (Photo by Steven Mantilla)

Funding for the new system, some $6,600, came in part from the American Society for Clinical Pathology and the Department of Clinical Laboratory Science priority fund.

The instrument, known as the Ortho Clinical Diagnostics workstation, replaces a laborious process of mixing blood samples with reagents by hand to allow laboratory professionals to quickly and accurately establish blood types and identify donated blood that can be safely transfused to a recipient.

Traditional blood analysis methods, which ECU’s Department of Clinical Laboratory Science chair Dr. Guyla Evans and her faculty peers still teach their students, involves mixing drops of blood with antibodies that register specific blood types. The process also registers Rh factor, proteins on the surface of some people’s blood cells that affect who can receive blood donations from whom.

Using the established test tube method is a time and attention intensive process.

“It can be kind of hard to teach students how to read the tubes because it’s subjective. You have to read the tubes right away, and there are a lot of steps,” said Michael Foster, a senior from Roanoke Rapids, who already works in the blood bank at ECU Health Medical Center in Greenville.

Using test tubes to identify blood samples is a tricky business: laboratory personnel must identify cell reactions by eye and they have a limited time to observe and interpret the results.

“The name of the game in blood banking is accuracy, but it’s also speed. You want to get it in the centrifuge and as soon as it’s ready to come out of the incubator and get it going,” Evans said.

The new system uses a cartridge, which requires less blood in the sampling process and has the advantage of leaving the sample readable by technicians for up to 24 hours. This allows laboratorians to double check their work or have a peer review their results.

ECU clinical laboratory science senior Bryce Glover adds reagents to a test tube during a blood testing exercise. (Photo by Steven Mantilla)

An added benefit for the cartridge system is baked-in surety of the testing chemicals.

“You don’t have to worry about adding the wrong reagents because the cards are color-coded and the reagents are already added in,” Foster said.

Each cartridge may cost up to $25, which isn’t cheap, but Evans and Lorie Schwartz, a research technician and CLS instructor, both agree that the new system is at least as cost effective as traditional testing methods due to labor costs and the intangible benefit of assurance that the results are valid.

The new system is less mentally taxing for the medical laboratory scientist, Evans explained.

“In the blood bank, everything has to be carefully documented. Nothing is ever assumed or taken for granted—blood bankers trust no one, they believe no one,” Evans said. “If I’m going to do a cross match for two units, and the antibody screen and the blood typing, that’s 12 to 15 tubes that I have to label every time. It’s a lot faster to label one card or a couple of cards, depending on what testing you’re doing.”

The CLS department received the equipment in December, just a bit too late for the current class of students, including Foster, who will graduate in May. The seven graduating students were able to train on the gel microcolumn system during clinical rotations with ECU Health and Nash UNC Health, where they got hands-on experience.

Evans said the COVID-19 pandemic made teaching blood banking techniques very difficult because, while theory is crucial to understanding lab work, getting hands-on training is critical for learning.

Students who learned during the pandemic were dropped into the deep end during clinical rotations in working labs and had to put theory into practice, both with traditional test tube methods and the gel cartridge system.

“During clinicals, we went through quite a number of cards trying to figure out what antibodies were present in the blood because they would give us unknown samples and we would spend the entire eight hours trying to figure out what the sample was,” said Bryce Glover, a senior from Fayetteville. “If we went down the wrong path, that was one card wasted.”

Because they are eligible to work in clinical labs once their clinical rotations were completed, Foster, Glover and the other members of their cohort already have jobs in area labs.

“ECU Health and ECU’s commitment to incorporating the latest technologies into both health care delivery and hands-on training for our future workforce not only benefits students during their academic journey but also equips them with valuable skills that are highly sought after in the health care industry,” said Carolyn Merritt, ECU Health lab scientist.

ECU clinical laboratory science students Michael Foster, right, and Bryce Glover examine a gel assay testing cartridge at the College of Allied Health Sciences. (Photo by Steven Mantilla)

“Keeping students up to date on the latest technologies, such as gel testing, is crucial for optimizing their limited time during clinical rotations. Our goal is to help prepare the next generation of high-quality health care professionals, and hands-on experience with innovative technology ensures our students are well equipped to provide important services once they enter the workforce,” Merritt said.

The advances in high tech equipment, combined with severe staffing shortages, have exacerbated what Evans sees a worrying trend — laboratory professionals aren’t seen on the hospital floors or interacting with nursing staff.

Being squirreled away in a windowless lab the majority of the workday means that medical laboratory scientists and technicians are often disconnected from their peers. Evans counsels her students to be part of the hospital and medical communities they will eventually be part of.

“They must make an effort to be seen as part of the hospital team because they usually aren’t seen,” Evans said.

While medical laboratory scientists might not be as visible as other members of the health care continuum, their role in diagnosing and treating patients can’t be overstated. With an expected need of nearly 17,000 more medical lab scientists nationwide by 2032, the critical skill set that Pirate graduates bring to hospitals and clinics is invaluable.

“When our students get into the clinical system, that’s when they really see the workflow and that last piece of their education comes together,” Evans said. “We’ve been really fortunate that our clinical sites, even though they know they’re dealing with personnel shortages, are taking students on which is extra work they don’t get compensated for. They’re doing it because they know it’s important and that is invaluable.”

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