A REPORT

ON

STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES)
AT
FAITH MEDIPLEX HOSPITAL
BY
OHENHEN ADAZE EMMANUELLA
BAS/MCB/111118
300LEVEL

DEPARTMENT OF MICROBIOLOGY
FACULTY OF BASIC AND APPLIED SCIENCES

BENSON IDAHOSA UNIVERSITY,

BENIN CITY, EDO STATE.

APRIL SEPTEMBER 2014

DEDICATION

This project is dedicated to my parents, Mr. Samuel Ohenhen and Dr (Mrs.)

Esitetemhe idowu ohenhen.

CERTIFICATION
This is to certify that this report was written and compiled by OHENHEN ADAZE
EMMANUELLA with matriculation number

BAS/MCB/111118 of the Department of MICROBIOLOGY, Faculty of BASIC

AND APPLIED SCIENCES,
Benson Idahosa University, Edo State

MRS KASIA

DATE

H.OD MED LAB

MR USONOUBU USUNOMENA

DATE

INSITUTION SUPERVISOR

OHENHEN ADAZE

DATE

NAME OF STUDENT

III

ACKNOWLEDGEMENT
I wish to express my profound gratitude to God Almighty for his guidance and
protection throughout the period of my internship, my special thanks go to my
brothers for their immense support and contribution not left out the staffs of Faith

Mediplex Hospital for their individual and collective support and for the
knowledge impacted upon me and to all my lecturers at Benson Idahosa University
I say thank you all I am eternally grateful.

IV

TABLE OF CONTENT
Page
Title page

------------------

Dedication

-----------------

II

Certification

----------------

III

Acknowledgement

----------------

IV

Table of Contents

---------------

Abstract

---------------

VI

CHAPTER ONE
INTRODUCTION
1.1 General Introduction of the Laboratory

1.2

Laboratory Structure

1.3

Medical Laboratory Organogram

1.4

PPE

1.5

Registration Department

1.6

Result Dispatch Unit

1.7

Definition of Terms

CHAPTER TWO
2.1 Collection/Phlebotomy department

2.2 Apparatus Used in Collection Department

11

2.3 Definition of Terms

12

2.4 Sample Tracking

2.5 Quality control in the laboratory
2.6 Haematology Department
2.7 Packed Cell Volume (PCV)
2.8 Full Blood Count (FBC)
2.9 Malaria Parasite Test (MP)
2.10 Erythrocyte Sedimentation Rate (ESR)
2.11 Peripheral Smear
2.12 Precautions

CHAPTER THREE
3.1 Serology Department
3.2 Test Carried Out Here
3.3 How to Carry Out Some of the Test
3.4 How to Read a Test Strip
3.5 Blood Screening
3.6 Blood Group
VI
3.7 Genotype
3.8 Precautions

CHAPTER FOUR
4.1 Microbiology/Parasitology

4.2 Standard Operating Procedure for Collecting

Microbiological Samples
4.3 Some Test Carried Out in this Unit
4.4 Equipments and Materials Used in Microbiology
4.5 Urinalysis
4.6 PG
4.7 Sensitivity and Culture
4.8 Seminal Fluid Analysis (SFA)
4.9 Precautions

CHAPTER FIVE
5.1 Clinical Chemistry Department
5.2 Containers Used Here
5.3 Some of the Test Carried Out Here
5.4 Blood Sugar Test
5.5 Precautions
5.6 Perfar Department
VII
CHAPTER SIX
6.1 Problems Encountered During my Training
6.2 Profound solution to the problems
6.3 Summary
6.4 Conclusion

BIBLIOGRAPHY
Reference
Appendix

VIII
ABSTRACT
The six months industrial training placement exposes us to the basic important
of industrial training experience to undergraduates students. this enabled me to
understand the basis of laboratory practice today, the various department that make
up the laboratory which includes Registration department, Collection/Phlebotomy
department, Haematology department, Serology department, Clinical chemistry
department and Perfar department the various function each department contributes
to the functioning of the laboratory, mostly concentrating on
microbiology/parasitology because of my area of study I was vividly exposed to

the practical aspect of it and performed various laboratory work like gram staining,
urinalysis, protein and glucose test, production of agar, identification of cells and
so on. This report expatiates on the function and essence of laboratory practice and
the various test carried out here.

IX
CHAPTER ONE
1.1

GENERAL INTRODUCTION

FAITH MEDIPLEX
Faith mediplex formerly called Faith Medical Centre founded by Archbishop
Benson Idahosa (of blessed memory) in 1989, is an outreach ministry of the church
of god mission international incorporated in partnership with oral with oral Roberts
ministries,usa. It provides in maternal/child health, outpatient
/emergency,medicines.paediatrics.sugery,obstetrics/gynaecology.denistry.ophlamol
ogy,laboratory,pharmacy, and ultrasound in addition to the Benin City Centre, it

also operates branch hospitals in Abuja. Uyo, and Evbhueghare and a mobile clinic
that provides primary health care services to rural environment.in accordance with
the vision of the founder, Archbishop B.A Idahosa (of blessed memory), faith
mediplex is a medical Centre were medical excellence in patient care, research and
training is combined with evangelism ad where discounted services is provided to
patients regardless of tribe, religion or social status.

OBJECTIVE OF SIWES
The main objective of SIWES programmes are:
1 To prepare students for work situation they are likely to meet after
graduation.
2 To provide an avenue for students in Nigerian universities to acquire
industrial skills and experience in their course of study.
3 To make transition from the university into the world of work easier and thus
enhance students contacts for later job placement.
4 To provide students with an opportunity to apply their theoretical
knowledge in real work situations, thereby bridging the gap between
university work and actual practice.
5 To expose students to work methods and techniques in handling equipments
and machinery that may not be available in universities.
1
LABORATORY
is an institution equipped for scientific investigations, research or experimentation,
it is also a place where drugs, chemical are manufactured and placed for practical
observation or testing is carried out.
MEDICAL LABORATORY
is a facility where tests are carried out in order to ascertain information about the
health of a patient as pertaining to the diagnosis, treatment, and prevention of
diseases.

In order words a medical laboratory is a place where tests are carried out to in
order to assist the doctor in the diagnosis of a patient illness and the course of
treatment

AIMS AND OBJECTIVE OF HOSPITAL LABORATORY

- To provide effective and reliable diagnosis of diseases.
- To provide medical services for patients
- To generate income for the hospital
- To provide qualitative laboratory based training for staffs and students.

DEPARTMENTS OF THE LABORATORY

-

Registration / Registration Department

Collection /Phlebotomy Department
Haematology Department
Serology Department
Microbiology/Parasitology Department
Clinical Chemistry Department
Perfar (CD4) Department
2

1.2

LABORATORY STRUCTURE

Laboratory

Registration/Reception

Collection/Phlebotomy

Department/Section

Haematology

Serology

Microbiology/
Parasitology

Clinical
Chemistry

Blood Bank
Microbiology Lab extension
(AFB UNIT)

3
1.3

MEDICAL LABORATORY ORGANOGRAM

H.O.D
MED. LAB DEPT
LAB FOCAL
PERSON

Perfar

TB FOCAL

QUALITY

SAFETY

PERSON

CONTROL

OFFICER

LAB FOCAL
PERSON

INVENTORY
MANAGER

PERSON

4
1.4

PERSONAL PROTECTITVE EQUIPMENTS (PPE)

PPE refers to protective equipments designed to protect users from hazardous
situations. It is also refers to as equipment worn to minimize exposure to serious
workplace injuries and illnesses. These injuries and illnesses may result from
chemical, physical, mechanical, or other workplace hazards.
The purpose of PPE is to reduce employee exposure to hazards when
engineering and administrative controls are not feasible or effective to reduce these
risks to acceptable levels.

PPE USED IN FAITH MEDIPLEX LABORATORY

i)
ii)
iii)

Lab coats: these are worn to protect against potential infectious fluids
Gloves : these serves as protection for the hand
Nose masks: they protect against specific dangers

iv)

Safety boot: they serve as protection for the leg.

MAINTANCE OF PPE

i)
ii)
iii)

Weekly washing of the laboratory coats

Constant changing of the laboratory
Proper storage of the safety boots and laboratory coats (a dry and clean
place that is not subjected to extreme temperatures.

5
1.5

REGISTRATION DEPARTMENT

Reception department is a unit of the laboratory where patients go first when

they arrive to get information about the service of the hospital this is also where
patients for the various test to be carried out before sending it to the cashier for
payments or to the NHIS (Nigerian Health Insurance Scheme) unit for stamping
this is only for company patients this is also where patients and wait before they
are called in for sample collection.
Registration department is a unit of the laboratory where various patients data
are received their laboratory request forms registered and taken to the
phlebotomy/collection department for sample collection, registration also entails
the registration of patients (both cash paying patients and company patients) and
registering their data in the accurate registration logbook which consists of Out
Patient Department logbook (OPD) and Companys patient logbook.
Data received from the patient and registered in the Out Patient Department
logbook;

DATE
28/6/14

LAB
NO
4509

NAME
OHENHEN
EMMANUELLA

TEST
URINALYSIS,MP

AGE

SEX

34

OPD
NO
67890

RECEIPT NO
3056788

AMOUNT
PAID
#7,000

SAMPLE
BLOOD,URINE

TIME
2:09PM

Data received from the patient and registered in the Company Patient
Department logbook;

DATE

LABNO

NAME

AGE

SEX

OPD NO

23/5/14

90778

IDEHEN
OSAS

79

2089788

COMPANYS
NAME
FAITH
MEDIPLEX
STAFF

SAMPLE
BLOOD

6
TEST
RBS, WIDAL,
1.6

TIME
3:09PM

RESULT DISPATCH UNIT

This is a unit under registration/reception department where results are given out to
the appropriate patients respectively.

1.7

DEFINITION OF TERMS

i) Pre-analytic: the movement patient data from registration to collection unit

at this point the patients data has not been analyzed.
ii) Sample: this is part of anything taken or presented for inspection example
blood, urine, sputum, stool etc.

iii) Test: these are test carried out in Faith Mediplex Hospital example full blood
count, malaria parasite test, blood group test, genotype test etc.
iv) Time: the time was registered.
v) OPDNO: this is also called out patient department no this is the number given to
every registered patient of Faith Mediplex Hospital
vi) Receipt No: this is the number on the patients receipt this is for cash paying
patients only.

7
CHAPTER TWO
2.1 COLLECTION/PHLEBOTOMY
This is a unit in the laboratory where samples are collected and then dispatched
to their various workbench for further analysis the samples can be collected
directly from the patient or brought in from the wards respectively.
Blood samples collected from the patient can either be:
-Venous blood: blood collected from the vein.
-Capillary blood: blood collected from the thumb or index finger it can also be
collected from the heel of an infant.

Technique for collecting capillary blood;

1
2
3

Cleanse the puncture area with 70% ethanol allow the area to dry.
Using a sterile pricker or lancet make a rapid puncture deep enough to
allow the free flow of blood.
Wipe away the first drop of blood with a dry piece of cotton wool and use
the next few drops for the test, do not squeeze too hard because this will
result in an unreliable result.
When sufficient blood has been collected press a piece of dry cotton wool
over the puncture area until the bleeding stops.

Technique for collecting venous blood;

1 Select a sterile dry, preferably plastic syringe of the capacity required
example 2ml, 5ml etc.
2 Apply a tourniquet to the upper arm of the patient to be able to see the vein
prominently
3 Cleanse the puncture site with 70% ethanol and allow to dry, do not retouch
the cleansed area.
8
4

6
7
8

With the thumb of the left hand holding down the skin below the puncture
site, make the venipuncture with the bevel of the needle directed upwards in
the line of the vein steadily withdraw the plunger of the syringe at the speed
it is taking the vein to fill avoid moving the needle in the vein.
When sufficient blood has been collected, release the tourniquet and
instruct to open his or her fist, remove the needle immediately press on the
puncture site with a piece of dry cotton wool
Remove the needle from the syringe and carefully fill the container(s) with
the required volume of blood.
Mix the blood in an EDTA or citrate ant coagulated container
Check the bleeding from the venipuncture site has stopped.

Samples collected in phlebotomy department

- Blood
- Semen

Urine
Stool
Swab this include ear swab, eye swab, wound swab etc.
Sputum etc.

2.2

Apparatus Used in Collection Department

1 Containers: this is used to collect samples example fluoride oxide

container which has a yellow lid. Plain container which has a yellow lid,
EDTA container which has a green lid, sterile container, reclaimed
container etc.

9
Fig 1.

Containers for blood collection

2 Syringes: this ranges from 2ml, 5ml, 10ml, 20ml etc. This is used to
collect blood sample from the vein.
3 Ethanol: this is for sterilizing the surface of the point of collection.
4 Lancet: this is used to prick the thumb for collection of blood when small
amount of blood is required for the test.
5 Cotton wool: cotton wool is use for cleaning the laboratory cotton wool
is made into wet and dry balls called swab, this is also used for
disinfecting before collection.
6 Tourniquet: this is used to tighten the upper arm of the patient so the vein
can be visible
10
2.3

Definition of terms

1 AFB(Acid fast bacilli) used to detect tuberculosis

2 M/C/S :Microscopy culture and sensitivity
3 SPUTUM: Matter coughed up and expectorated from the mouth composed
of saliva and discharges from the respiratory passages
4 SWAB STICK:A small piece of soft absorbent material attached to a stick to
aid access
5 ANALYTIC: From collection to the various work bench.
6 WARDS: These include private wards, emergency room, specialist clinic,
labour ward etc.

2.4

Sample tracking

This is a unit in the laboratory under collection/phlebotomy this is where all

the samples collected (directly from patients and samples brought in from
the wards) are brought here to ensure the samples are properly labeled and
tally with the patients information on the requisition form and the samples
are taken to their appropriate benches for quick analysis. Results are entered
in the laboratory record log book and sent to the result dispatch unit

11
2.5

QUALITY CONTROL IN THE LABORATORY

Quality control refers to the maintaining high laboratory standards to
insure that results are correct
Quality control system is used to detect, reduce, and correct deficiencies
in laboratorys internal analytical process prior to release of patient result, in
order to improve the quality of the result reported by the laboratory.

1MPORTANCE OF QUALITY CONTROL IN THE LABORATORY

1 Quality control helps to evaluate most steps of laboratory
System, including sample handling, reagent suitability and machine
performance.
2 Quality control is used to check the competency of the personnel
performing the test.
3 Quality control is a mechanism used top regulates quality service in
the laboratory.
4 It enhances accurate and precise results(reliability)
5 It helps to check laboratory errors
6 Quality control provides standard operating procedures for each and
every test to be carried out by a laboratory workers

2.6

HAEMATOLOGY DEPARTMENT
Haematological department are mainly used:

-To investigate anemia,

-To investigate infections and pyrexia (fever) of unknown origin (PUO),
-To investigate clinically important haemoglobinopathies,
-To monitor patients receiving antiretroviral therapy (ART
12
2.7

PACKED CELL VOLUME (PCV)

This test shows the volume of blood in the body that is to say this test show if the
body is deficient of blood or if the blood has excess blood.
The packed cell volume is that proportion of whole blood occupied by red
cells
PCV can be tested in two ways:
i)
ii)

With the use of a haematocrit centrifuge

With the use of a QBC centrifuge

WITH THE USE OF A HAEMATOCRIT CENTRIFUGE

APPARATUS
-Blood sample
-Micro haematocrit centrifuge

- Haematocrit reader
-Plastocil
Fig 1.1

Haematocrit centrifuge

PROCEDURES
-The blood sample is collected directly from a patient in a
heparinizing capillary or the sample is collected from the
EDTA container in a plain capillary tube
-Seal the capillary tube with plastocil or fire

-Spin the sample in the micro haematocrit centrifuge for

5minutes
-Read the result with an haematocrit reader
- The result is then recorded in the patient form and also on the haematology log
register
-The result is then taken to the result dispatch unit

2.8

Full Blood Count (FBC)

This test is carried out to check a person general health as well as screening for
specific conditions such as anaemia
-White Blood Cell (WBC) this test is done to investigate HIV AIDS, infections,
and unexplained fever
-Differential white blood cell (Diff) this test is done to provide information on
different white cells present in the circulating blood.
- Platelet count (PLT) this test indicates the number of platelets in a specified blood
volume.
-Haemoglobin (HB) this test indicates the amount of oxygen carrying protein
within red blood cells.
-Granulocytes (GRAMS) this are types of white blood cells that is made up of
small granules, which contains protein.
14
-PCV (Packed cell volume) this measures the proportion of the red blood cells to
the total blood volume and it is reported as percentage

APPARATUS FOR FULL BLOOD COUNT

- Blood sample
- QBC centrifuge
- QBC machine
Fig 1.2

QBC Centrifuge
PROCEDURES FOR FBC
- The blood sample is collected directly from a patient or from an EDTA
container into a QBC tube.
- The QBC tube is placed in the QBC centrifuge with the use of a balance, the
QBC centrifuge is used to separate the whole blood from the serum
15
- The QBC tube is then placed on the QBC machine, the result is then
displayed on the screen of the QBC machine
- The result is then recorded in the patient form and also on the haematology
log book register
- The result is then taken to the result dispatch unit

Fig 1.3

QBC Machine

2.9

MALARIA PARASITE TEST

This test is done to ascertain if a person has malaria.

APPARATUS FOR MALARIA PARASITE TEST

-Blood sample
-QBC tube
16
-QBC centrifuge
-Microscope
-Immersion oil
PROCEDURE FOR MALARIA PARASITE TEST
- The blood sample is collected directly from a patient or from an EDTA
container into a QBC tube.

- The QBC tube is placed in the QBC centrifuge with the use of a balance, the
QBC centrifuge is used to separate the whole blood from the serum
- Place the QBC tube on a microscope
- Add few drops of immersion oil
- Read the result by counting the malaria parasite and estimating the value
- The result is then recorded in the patient form and also the haematology log
book register
- The result is then taken to the result dispatch unit

2.10 ERYTHROCYTE SEDIMENTATION RATE (ESR)

This is a nonspecific test it is raised in a wide range of infectious, inflammatory,
degenerative, and malignant conditions associated with changes in plasma protein,
particularly increases in fibrinogen, immunoglobulins, and C-reactive protein.

APPARATUS FOR ESR

-Blood sample
-Western ESR pipette
-Western ESR stand with levelling device
-Timer
17
PROCEDURE FOR ESR
-The sam0ple is collected directly from a patient in an EDTA container or is
brought in from the ward
-Mix the blood well
-Remove the cap of the container and the blood in the ESR stand
-Insert a western green pipette and ensure its positioned vertically

-Draw the blood to the 0 mark of the western green pipette avoiding air bubble 9
-Set the time for 1hour ensure the ESR stand and pipette will not be exposed to
direct sunlight
-After exactly 1hour read the level at which the plasma meets the red cells in Mm
-The result is then recorded in the patient form and also the haematology log book
register
-The result is then taken to the result dispatch unit

2.11

PERIPHERAL SMEAR

This test is done to see the picture of the red blood cell

APPARATUS FOR PERIPHERAL SMEAR

-Blood sample
-Glass slide
-Cover slip
-Capillary tube

18
PROCEDURES FOR PERPHERAL SMEAR
-Place a drop of blood using a capillary tube on the end of a clean dry slide
-using a clean smooth edged spreader draw spreader back to touch the drop of
blood and allow the blood to extend along the edge of a spreader
-wipe clean the end of the of the spreader
-immediately airs dry the film by waving the slide back and forth

-when completely dry and within a few minutes of making the blood film, fix it in
absolute film methanol
-stain using leishman staining technique
- The result is then recorded in the patient form and also the haematology log book
register
-The result is then taken to the result dispatch unit.

2.12

PRECAUTIONS

1) Ensure that personal protective equipments (PPE) example laboratory coat

covered shoes hand gloves etc. during working hours
2) All working surface should be disinfected before and after use
3) Ensure that appropriate specimen containers are used and properly
Labeled to avoid mix up
4) Always wash your hands after working
5) Always consider every sample as a possible infectious sample

19
CHAPTER THREE
SEROLOGY DEPARTMENT
4.2

Test carried out here;

- HIV (Human Immunodeficiency Virus); this test is done to ascertain if a

patient has the HIV virus.
- H.PYLORI (Helicobacter Pylori); this test is done to ascertain if a patient
has ulcer.

- RPR (Rapid Plasma Regain); this test is done to ascertain if a patient has
syphilis.

- SERUM BHCG (Beta-Human chorionic Gonadotropin Quantitative); this

test is done to ascertain if a patient is Pregnant.

- HBSAG(Hepatitis B Surface Antigen)- This test is done to ascertain if a

patient has Hepatitis B
That
- HCV(Hepatitis B virus)-This test is done to ascertain if a patient has
Hepatitis c
-

WIDAL TEST This test is done to ascertain if a patient has typhoid fever
or not

20
3.3

HOW TO CARRY SOME TEST

i) HIV is a lenti virus that causes acquired immune deficiency a condition in

humans in which progressive failure of the immune system allows life threatening
opportunistic infections and cancer to thrive without treatment average survival
time after infection is estimated to be 9-11 years hiv occurs by transfer of blood,
semen, vaginal fluids, pre ejaculation, or breastmilk.
There is currently no cure for hiv but with proper management there is is a high
survival rate.
Apparatus for HIV

1)
2)
3)
4)

Micro pipette
HIV REAGENT STRIP
Bucket centrifuge
Uni Gold
Fig 1.4

Bucket Centrifuge
21
Fig 1.5

Hiv test strip

PRODECURE

1)
2)
3)
4)
5)
6)
7)

The blood sample is collected either directly from the patient or is

brought in from the ward in an EDTA container.
Spin the blood sample using the bucket centrifuge this is to separate the
whole blood from the serum
Use the micro pipette to collect the serum part of the blood
Put few drops of the serum on the strip
If positive the use of another HIV test strip HIV combs 11 to confirm the
result is used
Record the result in the patient form and also on the serology logbook
register.
The patient result is then taken to the dispatch unit.
22

ii) Serum BHCG is produced during pregnancy levels can first be detected by a
blood test about 11days after conception and 12-14 days after conception by a
urine test.

APPARATUS FOR SERUM BHCG TEST

-pipette
-SERUM BHCG test strip
-bucket centrifuge

PROCEDURE
1)
2)
3)
4)
5)
6)
7)

The blood sample is collected either directly from the patient or is

brought in from the ward in an EDTA container.
Spin the blood sample using the bucket centrifuge this is to separate the
whole blood from the serum
Open a SERUM BHCG reagent strip
Use the pipette to collect the serum part of the blood
Put few drops of the serum on the strip
Record the result in the patient form and also on the serology log book
register
The patient result is then taken to the dispatch unit
iii) H.pylori called Helicobacter pylori previously called Campylobacter
pylori this infects the stomach it happens during child hood a common cause
of peptic ulcer it can be treated with the use of antibotics.

23
APPARATUS FOR H.PYLORI
- Micro pipette

- H.PYLORI reagent strip

- Bucket centrifuge

PRODECURE
1)
2)
3)
4)
5)
6)
7)

The blood sample is collected either directly from the patient or is

brought in from the ward in an EDTA container.
Spin the blood sample using the bucket centrifuge this is to separate the
whole blood from the serum
Open a H.PYLORI reagent strip
Use the micro pipette to collect the serum part of the blood
Put few drops of the serum on the strip
The result is recorded in the patient form and also on the serology log
book register
The patient result is then taken to the dispatch

iv) HBSAG is the surface antigen of hepatitis B virus it indicates the infection of
the liver. It can be cured with proper management
HCV is the lead reason for liver transplant though the virus usually reoccurs
after transplantation No vaccine against hepatitis c virus.

APPARATUS FOR HBSAG AND HCV

-Pipette
-Reagent test strips (HBSAG and HCV)
-Bucket centrifuge
24
PRODECURE
1)

The blood sample is collected either directly from the patient or is

brought in from the ward in an EDTA container.

2)
3)
4)
5)
6)
7)

Spin the blood sample using the bucket centrifuge this is to separate the
whole blood from the serum
Open the reagent strip
Use the pipette to collect the serum part of the blood.
Put few drops of the serum on the strip
Record the result in the patient form and also on the serology log book
register
The patient result is then taken to the dispatch unit.
Fig 1.5

Hepatitis B Virus

25
v) Syphilis is a sexually transmitted infection caused by spirochete bacterium
Treponema palidum subspecies palidum the primary route of transmission is
through sexual contact

APPARATUS FOR RPR

-pipette
-RPR reagent test strip
-bucket centrifuge

PRODECURE
1)
2)
3)
4)
5)
6)
7)

The blood sample is collected either directly from the patient or is

brought in from the ward in an EDTA container.
Spin the blood sample using the bucket centrifuge this is to separate the
whole blood from the serum
Open a RPR test strip
Use the pipette to collect the serum part of the blood
Put few drops of the serum on the test strip
Record the result in the patient form and also on the serology log book
register
The patient result is then taken to the dispatch unit

APPARARUS FOR WIDAL TEST

-widal reagent
-Mixer

26
-Pipette
-Grouping tile

PROCEDURE

1) The blood sample is collected either directly from the patient or is brought in
from the ward in an EDTA container.
2) The pipette is used to collect blood and a drop of blood is placed on eight
spaces of the grouping tile.
3) S.paratyphi H is added on space 1, S.paratyphi A-H is added on space 2,
S.paratyphi B-H is added on space 3, S.paratyphi C-H is added on space 4
4) S.paratyphi A-O is added on space 1, S.paratyphi B-O is added on space 2,
S.paratyphiC-O is added on space 3, S.paratyphi D-O is added on space 4
5) The mixer is used to mix the blood and the widal reagent used
6) The grouping tile is then rocked.
7) The result is recorded in the patient form and also on the serology log book
register
8) The patient result is then taken to the dispatch unit.

27

3.4

HOW TO READ A TEST STRIP

THE REPRESENTATION BELOW SHOWS HOW TO READ A TEST STRIP;

H
S
R

The presence
One line shows the
Test is negative

The presence of
two lines shows the
Test is positive

The presence of
no line shows the test
is invalid which
means it needs
to be repeated.

28

Fig 1.6

BLOOD BANK/SEROLOGY DEPARTEMENT

3.5

BLOOD SCREENING

This test is performed prior to blood transfusion in order to determine if the

donors blood is compatible with the blood of an intended recipient
This test consists of requirement for screening blood and what to screen for.

What to screen for:

-SYPHILIS
-RETROVIRAL
-HEPATISIS B SURFACE ANTIGEN
-HEPATISIS C VIRUS
29
REQUIREMENT FOR SCREENING BLOOD

Check the blood for:

a) Date the blood was bled
b) Date the blood will expire
c) Blood bag no
d) The blood group must be written clearly

3.6

BLOOD GROUP

This test is carried out to ascertain a patients blood group which can either be
used
-For personal knowledge
-As a requirement for blood transfusion
-To identify matches for organ transplant
-As a requirement for pre-marital screening etc.

APPARATUS FOR BLOOD GROUP TEST

-Grouping tile
-Antiserum (Anti A, Anti B, Anti D)
-pipette
-mixer

30
Fig 1.7

An example of the reaction that takes place

Fig 1.8

ANTISERUM

31
PROCEDURE

1) The blood sample is collected either directly from the patient or is brought in
from the ward in an EDTA container.
2) The pipette is used to collect blood and a drop of blood is placed on three
spaces of the grouping tile.
3) Anti A monoclonal is added on space 1
4) Anti B monoclonal is added on space 2
5) Anti D Duoclone monoclonal is added on space 3
6) The mixer is then used to mix the blood and Antiserum used.
7) The grouping tile is then rocked
8) The result is Recorded in the patient form and also on the serology log book
register
9) The patient result is then taken to the dispatch unit
HOW TO READ THE REACTIONS OF BLOOD GROUP
ANTI A

ANTI B

ANTI D

RESULT

REACTION

REACTION

REACTION

O POSITIVE

REACTION

NO REACTION

REACTION

A POSITIVE

NO REACTION

NO REACTION

NO REACTION

O NEGATIVE

NO REACTION

REACTION

REACTION

B POSITIVE

REACTION

NO REACTION

NO REACTION

A NEGATIVE

NO REACTION

REACTION

NO REACTION

B NEGATIVE

REACTION

REACTION

REACTION

AB POSITIVE

REACTION

REACTION

NO REACTION

AB NEGATIVE

ANTI A shows-A Rhesus

AN TI B shows B Rhesus
ANTI D shows the positivity and negativity of the blood sample.

3.7

GENOTYPE

Genotype is the genetic constitution of an organism; the genotype determines the

hereditary potentials and limitations of an individual from embryonic formation
through adulthood.
There are three main types of genotype
- AA
-AS
-SS
Others include AC

PROCEDURE FOR CARRYING OUT GENOTYPE TEST

1 Pour the buffer into a chamber, soak wicks and position
2 Soak cellulose acetate paper in buffer for at least 20minutes
3 Bloat acetate paper between two pieces of absorbent paper and quickly
remove excess moisture
4 Lyse control sample with distilled water.
33
5 Apply control sample to cellulose side of the paper at a point approximately
3cm from the cathode
6 Place the spotted cellulose acetate paper into chamber and cover the tank
7 Apply 450v for 5-15minutes at room temperature

Read results

3.8 PRECAUTIONS
1 Wear appropriate protective clothing when working
2 Do not allow unauthorized personnel to enter the working area of
the laboratory
3 Know how to decontaminate specimens and other infectious materials
4 Report immediately to the laboratory officer in charge, any spillage or other
accident involving exposure to infectious materials
5 Do not overfill discard containers
6 Dispose of laboratory waste safely

34

CHAPTER FOUR

4.1

MICROBIOLOGY/PARASITOLOGY

Microbiological investigations are important in the diagnosis, treatment, and

surveillance of infections diseases and policies regarding the selection and use of
antimicrobial drugs it is therefore essential that test reports:
-

4.2

Are reliable
Standardized
Provide the information that is required at the time it is needed
In a form that can be understood

SOP (Standard operating procedure for collecting microbiological samples)

1)
2)
3)
4)
5)
6)

The amount and type of specimen required container to use, and need for
any preservative or transport medium
Best time to collect a specimen
Aseptic and safe methods of collection to avoid contamination and
accidental infection
Labeling of specimen container
Conditions in which specimens needs to be kept prior to and during their
transport to the
Arrangements for processing specimens that are urgent and those
collected outside of normal working hours eg blood cultures collected by
a medical staff

35
4.3
SOME OF THE TESTS CARRIED OUT IN THIS UNIT
- urinalysis
- Urine microscopy, culture, and sensitivity(m/c/s)
- Stool microscopy, culture and sensitivity (m/c/s)
- High vaginal swab(HVS)
- Semen fluid analysis (SFA)
- Tuberculosis (AFB); this is a potentially serious infectious diseases that
mainly affect your lungs.

- Preparation of agar plates

- Protein and glucose
- Blood culture; is a laboratory test to check for bacteria or other
microorganisms in a blood samples.
And so on
4.4

EQUIPMENTS AND MATERIALS USED IN MICROBIOLOGY

-incubator: this is used to grow microorganisms at different temperatures suitable

for their growth and also for drying plates

Fig 1.9
36
-inoculation loop: this is used for inoculation of samples, microbial growth etc.
and also for streaking
-petri dish: this is usually filled with growth medium made from agar and is used to
culture samples for the isolation of microorganism

-microscope: this is used to view microorganisms and cells which cannot be seen
with the naked eyes.

Fig 2.0

37
- Bunsen burner: this is used to flame or sterilize the inoculating wire loop to
reduce contamination
-weighing balance: this is used to take accurate weight of substances to be used
-autoclave: this is used for sterilization of liquids, culture media and apparatus such
as glass wares
-sensitivity: this is used to check the effectiveness of different antibiotics on
microbial growth of culture samples

-grease pencil: this is used for labeling to avoid mix-up

-forceps: these are also called test tube holders
-glass slides and cover slips: this is a thin flat rectangular piece of glass that is used
as platform for microscopic specimen observation
-centrifuge tubes: this is used for measuring the urine before spinning

4.5

URINALYSIS

Urinalysis is used to detect and assess a wide range of disorders such as urinary
tract infection, kidney diseases and diabetes

APPARATUS
-urine sample
-centrifuge tubes
-microscope

38
-coverslips, glass slides
-reclaimed containers
- combs 11 test strip

Fig 2.1
Combs 11 test strip

PROCEDURE
1) The urine is collected in a reclaimed container from the patient
2) The urine is taken to the microbiology/parasitology department of the lab for
examination
3) The reagent strip is dipped into the urine for 5seconds and the result is shown on
the strip
4) The urine is put in the centrifuge tube measuring up to 6cm
39
5) The urine is then put in the bucket centrifuge with a balance measuring the same
for spinning, the centrifuge sediments the urine.
6) The urine is then removed from the centrifuge and then poured away and the
urine remains is then placed on a glass slide and covered with a coverslip and then
observed under the microscope
7) The result is then recorded on the patient form and the microbiology logbook

Fig 2.2

Comparison between two reactive strips, one pathological (to the left, from a
patient with diabetes mellitus), and an unreacted strip to the right, from top to
bottom the pathological strip shows: leukocytes (-), nitrites (-), urobillinogen (-),
proteins (+), pH (5), hemoglobin (+), specific gravity (1.025), ketone(+++),
bilirubin (+), glucose(+++).

40
4.6

PROTEIN AND GLUCOSE

This test is usually done by pregnant women coming for their weekly antenatal
routine checkup

APPARATUS

-urine sample
-reclaimed container
-medi test comb 2 reagent strip

PROCEDURE
1) The urine is collected in a reclaimed container
2) The test strip is dipped in the urine for about 5seconds
3) The result is shown on the reagent strip medi comb 11

4.7 CULTURE
This is indicated when its not possible to diagnose a serious fungal infection
microscopically or a specirs identification needs to be established or confirmed.

APPARATUS
-Wire loop
-Agar plate
41
-Bunsen burner
PROCEDURE
-Sterilize the working environment
-mix the urine sample well
-use the flame from the Bunsen burner to sterilize the wire loop
-dip the wire loop into the urine and make a streak on the agar plate

-put the agar in the incubator and leave for 24hours

Media used for culture

Urine-blood agar, chocolate agar, and cled agar
Sputum -blood agar, chocolate agar, macconkey agar and cled agar
Blood culture -blood agar, chocolate agar, and cled agar
Swab-blood agar, chocolate agar, and cled agar

4.8

HOW TO MAKE A SMEAR

Smears should be spread evenly covering an area of about 15-20 mm diameter

on a slide.
- Purulent specimen: using a sterile wire loop make a thin preparation do not
centrifuge a purulent fluid eg c.s.f containing pus cells.
- Non purulent fluid specimen: centrifuge the fluid and make a smear from a
drop of well mixed sediment.

42
- Culture: emulsify a colony in sterile distilled water and and make a thin
preparation on a slide. When a broth culture, transfer a loopful to a slide and make
a thin preparation
- Sputum: use a piece of clean stick ymto transfer and spread purulent snd
caseous material on a slide soak the stick in phenol or hypochlorite disinfect before
discarding

- Swabs: roll the swabs on a slide this is particularly important when looking for
intracellular bacteria such as N. gonorrhoeae (urethal , cervical, or eye swab ).
Rolling tbe swabs qvoids danaging the pus cells.
- Faeces: use a piece of clean stick to transfer pus and mucus to a
slide.decontaminate the stick before discarding it. Spread to make a thin
preparation.

4.9

SENSITIVITY

Sensitivity test is done to check for drugs that can be effective or completely
inhibit the growth of microorganisms discovered from culturing. Sensitivity
indicates the gram positive disc and gram negative disc the media grows on and the
ones resistant to growth.

Gram positive disc

AUG
APX
E
S
L
GN
CPX
GAX

Augmentin
Ampiclox
Erythromycin
Streptomycin
Linomycin
Gentamycin
Ciprofloxacin
Gaxin
43
Gram negative disc

T
AM
LVX
AUG
AMX
N

Tertracyclin
Ampicillin
Levofloxacin
Augmentin
Amoxicillin
Nitrofurantion

SXT
CEP

4.10

Septrin
Ceporex

SEMEN FLUID ANALYSIS

This test helps to analyze the health of a mans sperm.

Information required for this test

i) Method of production
ii) Time examined
iii) Time received
iv) Time produced

PROCEDURE
- The semen is collected in a sterile container from the patient
- The semen is taken to the microbiology/parasitology bench for further analysis
-The semen is then analyzed time is of the essence with this test

44
Types of examination
Macroscopic observation this includes what we can see
-Appearance
-PH: acidic or alkaline to check the PH of a semen sample a strip is placed in it to
check

-volume: the amount collected

-Viscosity: to check if its thick its supposed to be moderate in nature

Microscopic observation this include what we cannot see except with the use
of a microscope this includes the motility of the sample, the pus cells

CULTURE
This depends on the pus cells(pus cells also known as white blood cells are
produced when there are microorganisms in the semen sample when its more than
5 then it is deterministic that something is wrong) and then culture is needed when
its 1-2 nothing is wrong and culture is not needed.
Pus cells can be identified by viewing it under the microscope.

4.11

SKIN SMEAR

With the interesting simplification of diagnostic and treatment techniques, this test
is done for tge diagnosis of leprosy, currently the diagnosis of leprosy is based on
clinical signs and symptoms skin smears were originally used for distinguishing
between paucibacillary and multibacillary leprosy.however, it is possible to classify
leprosy without skin smear results and the existence of laboratory facilities
45
should not be pre-requisite for the implantation of MDT(multi drug therapy)
Examination of a skin smear for the presence of M.leprae may occasionally be
needed to confirm a clinical diagnosis of multibacillary leprosy such a smear is
simply reported as 'positive' or 'negative' for M. leprae.
Classification of leprosy for treatment purposes
For treatment purposes, leprosy is classified as either paucibacillary (PB) or
multibacillary (MB) with different MDT regimens being used to treat PB and MB
leprosy.

Paucibacillary leprosy in this form of leprosy, few or very few M. leprae bacilli
are present in skin lesions.
Multibacillary leprosy in this form of leprosy many (multiple) bacilli are present
in lesions

4.12

PRECAUTION

i) Always ensure the use of the appropriate protective clothing when working in the
lab
ii) Always wash hands after handling infectious sample
iii) Do not eat, drink store food or apply cosmetics in the working area of the lab
iv) Never mouth pipette
v) Avoid spillages by using racks to hold containers
vi) Dispose laboratory waste safely.

46
CHAPTER FIVE

5.1

CLINICAL CHEMISTRY

This is a unit of the laboratory that deals with analysis of bodily fluids.

5.2

THE CONTAINERS USED IN CHEMISTRY

-Flouride oxalate container: this is used for blood sugar tests it contains anticoagulant, the blood sample collected in this container is first spinned in the
centrifuge
-Plain containers: this is used to collect samples for analyzing other chemistry test
such as liver function test, lipid profile test etc. the blood collected in the plain
container is first allowed to clot then dislodged(separation of blood)before
spinning.

5.3

STANDARD OPERATING PROCEDURE OF CHEMISTRY

-the volume required for sample collection and the appropriate container
-best time for sample collection
-labeling of sample containers
-conditions in which sample needs to be kept
-arrangements for processing sample

47
5.4

SOME OF THE TEST CARRIED OUT HERE

-blood sugar test: this includes fasting blood sugar (FBS), random blood sugar
(RBS) and 2HRS PP.
-liver function test: this test gives information about the state of a patients liver.
-E/U/CR (electrolyte urea and creatinine): this test is used to detect the
abnormalities of blood chemistry including kidney failure
-thyroid function test: this test is used to check the levels of the hormones made by
the thyroid gland.

-lipid profile test: this test is used to measure how well your thyroid gland is
working.
-prostrate specific test (PSA)
-hormonal profile and so on

5.5

BLOOD SUGAR TEST

Fasting blood sugar; this is done to measure the amount in the blood it is also a
glucose test
This is done before eating (between 8am to 12pm)
Random blood sugar; this is also a glucose test it is done after the patient has taken
food or fluids
This is done by after 12pm
Both tests can be done with use of a reflotron machine or with the use of a
glucometer
With the use of a reflotron machine;

48
APPARATUS
i)

Blood sample

ii)

Glucose test strip

iii)
Fig 2.3

Reflotron plus machine

iv)

Calibrated pipette

PROCEDURE
- The blood sample is collected in a fluoride oxalate container and then taken
to the clinical chemistry bench to be worked on
- The blood sample is spun in the bucket centrifuge for 3minutes thereby
separating the whole blood from the serum
- The calibrated pipette is used to take the serum part of the blood and it is
pipetted to 32micromililitre and spotted on the glucose test strip and placed
inside the reflotron machine
50
- A click is heard to know if the strip is placed accurately
- The result is displayed on the screen
With the use of a Glucometer:
APPARATUS
- Blood sample
- Glucometer

PROCEDURE
- The blood sample is collected directly from the patient by pricking the
patients thumb with a lancet.
- A drop of blood is then placed on the glucose test strip
- The result is then displayed on the screen and recorded.

5.6

PRECAUTIONS

-always ensure the use of laboratory coats and hand gloves during working hours
-always discard test strip after use
-always disinfect the working bench before and after working
-always apply extreme when working with HIV patients (CD4) samples
-always wash and dry your hands after use

51
5.7

PERFAR DEPARTMENT

This is a unit in the laboratory that deals with the provision of high throughput
herogram, clinical chemistry and CD4 assessment for HIV AIDS patient in order
words this is to say this department deals with the regular routine checkup for HIV
AIDS patient
PERFAR Means the U.S Presidents Emergency Plan Aids Relief.

52
CHAPTER SIX
6.1

PROBLEMS ENCOUNTERED DURING MY TRAINING

During my industrial training I encountered numerous problems the major ones

are listed below:
i)

Restriction to performing some tests

ii)

Frequent exposure to different airborne dangers and hazardous

substances

iii)

Restriction to working in some unit of the laboratory example the

PERFAR department.

iv)

Constant exposure to various patients illness especially the Tuberculosis

patients.

v)

Refusal of some patients to allow you collect their blood sample on the
basis that you an IT Student

vi)

Constant exposure to HIV patient sample when working in some

departments.

6.2 PROFOUND SOLUTIONS TO THE PROBLEMS ENCOUNTERED

i)

Always be on your personal protective equipments

ii)

Be extremely cautious and careful when dealing with highly infectious

sample like HIV samples and Sputum samples.
53
Always consider every sample brought in to be a highly infectious
sample.

iii)

iv)

6.3

Always treat patient with care and love and try to be understanding even
when proven difficult.

SUMMARY

The impact of the student industrial work experience scheme (S.I.W.E.S) is a basic
foundation in learning and it exposes the student to a working environment and
adaptation to the working environment.
Chapter one of this report comprises of the General Introduction of the
Laboratory, Laboratory Structure Medical Laboratory Organogram, PPE,
Registration department, Result dispatch unit, Definition of terms. While chapter
two focuses Collection/Phlebotomy department , Apparatus Used in Collection

Department , Definition of Terms, Sample Tracking Quality control in the

laboratory.
Haematology Department, Packed Cell Volume (PCV) , Full Blood Count (FBC)
Malaria Parasite Test (MP) , Erythrocyte Sedimentation Rate (ESR),Peripheral
smear, Precautions, chapter three of this report is concerned with the Serology
Department, Test Carried Out Here, How to Carry Out Some of the Test, How to
read a test strip ,Cross Matching, Blood Group, Genotype, Precautions. Chapter
four is based on Microbiology/Parasitology, Standard Operating Procedure for
Collecting Microbiological Samples, Some Test Carried Out in this Unit
Equipments and Materials Used in Microbiology, Urinalysis, PG Sensitivity and
Culture, Seminal Fluid Analysis (SFA), Precautions, chapter five is based on
Clinical Chemistry Department, Containers Used Here Some of the Test Carried
Out Here, Blood Sugar Test Precautions, Perfar Department while chapter six
Summary and Conclusion are the major discussion.

54
CONCULSION

Having successfully completed my industrial training program I have acquired a

solid understanding of the theoretical and practical aspect of the laboratory in
general I have also understood the various laboratory processes importance of test
carried out in the laboratory more importantly the reason and relevance of the test
been carried out.
Therefore laboratory practice is the most important factor influencing diagnostic
medicine.

55

BIBILIOGRAPHY

Cheesbrough, M. (2006). Collection of Blood: Distinct Laboratory Practice in

Tropical Countries. Part 2, 2nd edition, Cambridge University Press, pp.295-298.
Vadiya, K.A. (2012). Quantitative Buffy Coat (QBC) Test and Other Diagnostic
Techniques for Diagnosing Malaria. National Journal of Medical Research, 3(2):
386-387.
Bains, B.J. (1996). The Haematological Features of HIV Infections. 99, pp.1-8
Cheesbrough, M. (2006). How to Make a Smear: Distinct Laboratory Practice in
Tropical Countries. Part 2, 2nd edition, Cambridge University Press, pp.36.
www.wikipedia.org/wiki/clinical chemistry. (2013)
www.wikipedia.org/wiki/urinalysis. (2012)

56
APPENDIX

GUILDLINE TO THE PREPARATION OF BLOOD AGAR

BLOOD AGAR
To make about 35 blood agar plates
Nutritious agar

.500ml

Sterile defibrinated blood ..25ml

For most pathogens, haemolysis-free defibrinated horse sheep,goat,or rabbit

blood can be used .sheep blood however may contain inhibitor to
H.influenzae.human blood particularly expired citrated donor blood , should not be
used because this may contain substances inhibitory to the growth of some
pathogens, citrate inhibits the growth of beta haemolytic streptococci. Human
blood may also contain infectious agents and antibiotics.

Note: before preparing a batch of blood agar plates, a few plates should be prepare
first to make sure the blood is sterile.

1 Prepare the agar medium as instructed by manufacturer. Sterilize by

autoclaving at 121C for 15minutes transfer to a 50C water bath.
2 When the agar has cooled to 50C, add aseptically the sterile blood and mix
gently but well. Avoid forming air bubbles.
Important: the blood must be allowed to warm to room temperature before being
added to the molten agar.

57
3 Dispense aseptically in 15ml amount in sterile petri dish as described in
subunit 7.4.

4 Date the medium and give it a batch number.

5 Store the plates at 2-8C, preferably in sealed plastic bags to prevent loss of
moisture.
Shelf life: up to 4 weeks or longer providing there is no change in the appearance
of the medium to suggest contamination, haemolysis, or deterioration.

Use of layered blood agar plates

This reduces the amount of blood needed and is also preferred by some workers
because the thinner layer of blood enables haemolytic reactions to be seen more
clearly.
Layered blood agar plates are prepared by pouring about 8 ml of the agar into each
plate and when this has gelled, adding 8 ml of blood agar.

pH of medium: Depending on the agar base used, the pH should be within the
range pH 7.2-7.6 at room temperature.
Performance: inoculate plates with 5 hour broth cultures of S. pyogenes and S.
pneumonia. Inoculate also a plate with H. influenza and streak with S. aureus.
Incubate the plates in a carbon dioxide enriched atmosphere at 35-37oC overnight
check for the growth characteristics of each species, e.g. haemolytic reactions of S.
pyrogenes and pneumonia and the satellitism of H. influenza.
Note also the size of the colonies and degree of growth. Compare with the results
of previous performance tests.
58