Applied Practice Experience (APE) – Reflection PapER
APE Project Background:
As a medical technologist by profession, one of my favorite tasks is to develop and
validate new methods in the microbiology laboratory and introduce new innovations that will
provide better and faster results to our patients while making life easier for the technologists
working on the bench. As a laboratory leader, my duty evolved to guide my staff in performing
new validation and in ensuring that we validate the most valuable tests that will benefit our
patients and organization. Working on my APE project allowed me to work on this new
validation using two perspectives as a lab technologist and as a lab leader. Furthermore, the APE
project also allowed me to apply some of the new skills that I have already acquired during my
DrPH program to my existing laboratory knowledge and experience that I have gained through
my career.
The focus of my APE project was to develop a new workflow combining MALDI-TOF
technology with a simple latex test (Immulex) to correctly identify S. pneumoniae from positive
blood cultures. The idea was developed to resolve a limitation in our direct MALDI-TOF
identification from positive blood culture when we cannot distinguish S. pneumoniae from other
closely related species. Evidence-Informed Public Health I and Introduction to Doctoral Training
classes introduced me to many new research and writing tools that were very helpful and
improved my research and writing skills significantly. I used these tools in writing the
manuscript that will be one of my main deliverables for this APE project. For example, I learned
so many different ways in performing a literature search in different databases which was very
helpful as I was collecting information for my manuscript. The Public Health Microbiology and
Public Health Biosafety courses provided me with the appropriate knowledge, background, and
skills that I needed to perform the technical tasks during my validation safely and accurately. The
APE has been a very rewarding and interesting experience where I combined my existing work
experience with the knowledge that I gained from my DrPH program to work and complete my
APE project/deliverables. Below is the list of competencies that I chose to work on and enhance
during my APE experience.
APE Competencies:
Competency 1: Cultivate new resources and revenue streams to achieve a strategic goal.
Healthcare organizations worldwide are always looking for ways to save money and
secure new revenue sources. Our organization is no different as we are always trying to find
efficiencies in our laboratory to improve turnaround time (TAT) and reduce costs. By developing
and validating this new workflow during my APE project, our laboratory will be able to save
money by using this new workflow instead of using expensive multiplex PCR tests without
compromising the TAT or the quality of the results. This cost-saving is estimated to be around
100$ per patient.
Competency 2: Communicate public health science to diverse stakeholders, including
individuals at all levels of health literacy, for purposes of influencing behavior and policies.
The results of this validation performed during my APE project will be communicated to
the scientific community through a submitted manuscript to a respected microbiology journal.
The developed workflow is simple and can be easily implemented with minimal cost across
microbiology laboratories worldwide. Most importantly, it will resolve a common problem for
the technologists on the bench and will provide definitive identification of S. pneumoniae rapidly
from positive blood cultures. The results were also shared with the lab clinical team and the lab
management.
Competency 3: Demonstrate the laboratory’s culture of quality by integrating
operations, services, and infrastructure into a system that meets applicable regulatory
standards, professional guidelines, and customer requirements for ensuring and
maintaining quality and continually improved laboratory services.
The new workflow integrated the new MALDI TOF technology that is already available
and validated in our laboratory with a new latex test (Immulex) that is highly sensitive and
specific for the detection of S. pneumoniae. This new workflow was developed in compliance
with all professional and regulatory standards (CAP, CLSI). It meets the needs of our patients by
providing quality results in a timely manner.
Competency 4: Promote general laboratory practice related to scientific and technical
components of laboratory testing including appropriate use and storage of laboratory
reagents and supplies, use, maintenance, and calibration of laboratory equipment,
performing pre- post- and examination phase steps of testing, and compliance with
regulations and guidelines governing laboratory testing.
Laboratory procedures were available, reviewed, and followed in compliance with all
regulatory standards during the APE project. All positive blood cultures were subbed to the
appropriate media. All reagents for subculture, biochemicals, and gram stain were stored
correctly according to manufacturer instructions. The MALDI TOF instrument was calibrated
and maintained according to manufacturer instructions.
Competency 5: Adhere to policies and principles governing actions and behaviors that are
essential when working in a microbiology laboratory including working safely with
microbiological agents, assessing microbiological samples during the pre-, post-, and
examination phases, and ensuring regulatory compliance.
Laboratory procedures were available, reviewed, and followed in compliance with all
regulatory standards during the APE project. All positive blood cultures were subbed to the
appropriate media. Blood cultures were handled safely while wearing PPE under the biosafety
cabinets. All biohazard waste was disposed of in the appropriate designated containers.