Evidence-Based Practice in Laboratory Medicine: Analysis and Examples

This assignment delves into the application of evidence-based practice within laboratory medicine, emphasizing its importance in improving patient outcomes. It begins by defining evidence-based practice as a decision-making process supported by scientific evidence and highlights its reliance on expert opinion, scientific evidence, and patient perspectives. The assignment then outlines the essential steps involved, from framing clinical questions to making informed decisions, and discourages the use of intuition. The core of the assignment provides two detailed examples from a placement laboratory: the Collagen Mason’s Trichrome Stain and the Haematoxylin and Eosin stain, illustrating how evidence-based practice is applied to optimize staining procedures based on reagent age and desired results. It also addresses the challenges in implementing evidence-based practices, emphasizing the need for laboratories and clinicians to overcome traditional behaviors and embrace evidence-based information. The assignment concludes by referencing relevant sources to support the discussed concepts.

Evidence Based Practice in Laboratory Medicine
Name of the Student
Name of the University
Author’s Note

Evidence based practice is an extensively used decision making process applied in
various service provision fields and is supported by strong scientific evidence to improve
client outcome very efficiently. In this regard, medical science is a domain where the
evidence based practice have been utilised in the field of nursing and medicine to improve
health outcomes of patients (1). Evidence based practice primarily relies on coordinated
contribution of several aspects that includes expert opinion, scientific evidence and client,
patient or caregiver perspectives and priorities. It is person centred practice that takes into
consideration the needs, values, interests and choices of individuals receiving care. The
essential steps followed are framing the clinical question relevant to the patient, finding
relevant scientific evidence, assessing the evidence, making comparison with the real life
scenario and finally making the clinical decision. It strongly discourages use of single
observations and intuition to make clinical decisions. Incorporation the principles of evidence
based practices in the field of laboratory medicine various issues like sufficiency of testing,
profit of the laboratory and eventual clinical outcomes of the tests (2). The fitness of
laboratory medicine in the care pathway, nature and quality of testing, appropriate testing,
utility of testing and the method in which the tests can impact clinical actions, all of these
factors can be evaluated by applying evidence based practice in laboratory medicine.
Two detailed examples of evidence based practice in our placement laboratory have
been provided herein. Collagen Mason’s Trichrome Stain is a differential staining procedure
used to differentiate between collagen and smooth muscle tissues in tumours. Moreover, it is
used to detect the increase in collagen fibres in case of diseases like cirrhosis. It is one of the
most routine staining tests for liver and kidney tissues. As suggested by the name three
different stains viz. hematoxylin (purple nuclear stain), mix of xylidin and acid fuscin (red
cytoplasmic stain) and aniline blue (light green collagen fibre stain) constitute Mason's
trichrome stain (3). The staining principle depends on the permeability of the tissues to the

different stains. The Aniline blue in our laboratory was prepared 9 months ago; hence it is
preferable to apply the stain for 10minutes instead of 5minutes. The following pictures show
Aniline blue staining for 5 minutes and 10 minutes respectively.
Fig: Aniline blue stained for 5 minutes and 10 minutes respectively.
The second example cited here is Haematoxylin and Eosin stain, which is used extensively in
RMIT pathology lab. Haematoxylin eosin staining is often considered as gold standard as
cancer suspected biopsies are often stained with haematoxylin and eosin stains (4). In RMIT
pathology lab used reagents are used at times which is why staining the nucleus for 4 minutes
instead of 1.5-3 minutes often show better results. When old reagents are being used, the
reagents lose some of their intensity and so applying them for longer duration is required.

Evidence based practice has been adopted by many fields to improve the quality of
the concerned practice. In laboratory medicines evidence based approaches provide logic and
well defined processes. However, there are still challenges regarding the application of the
principles as traditional behaviours still prevail to this date. It is the responsibility of the
laboratories and the clinicians to curb such hurdles and help apply evidence based
information in the field of laboratory medicine.

References
1) Rousseau DM, Gunia BC. Evidence-based practice: the psychology of EBP
implementation. Annual review of psychology. 2016 Jan 4;67:667-92.
2) DiCenso A, Guyatt G, Ciliska D. Evidence-Based Nursing-E-Book: A Guide to Clinical
Practice. Elsevier Health Sciences; 2014 Mar 18.
3) Rahunen K, Rieppo L, Lehenkari P, Finnilä M, Saarakkala S. Evaluation of quantitativity
of histological collagen stains in articular cartilage. Osteoarthritis and cartilage. 2016 Apr
1;24:S307-8.
4) Chan JK. The Wonderful Colors of the Hematoxylin–Eosin Stain in Diagnostic Surgical
Pathology. International journal of surgical pathology. 2014 Feb;22(1):12-32.