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National Laboratory System (NLS)
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National Laboratory System Logo Nebraska
  • Stephen Hinrichs, M.D.
  • Tony Sambol
In Nebraska, the Laboratory Program Advisor, Tony Sambol, working with the direction of the State Public Health Laboratory Director, Dr. Stephen Hinrichs, improved - and continues to improve - communication with private clinical laboratories through site visits. The events after September 11, 2001 changed the traditional focus of the Nebraska public health laboratory from rapid testing, laboratory improvement, applied research, and support of surveillance and epidemiology investigations to an immediate need to improve awareness and testing for specimens associated with bioterrorism.
   
bullet Enlisting laboratories:
  • The State of Nebraska has 77,000 square miles, yet has only one state public health laboratory on the eastern side of the state. To make clinical laboratories aware of the Nebraska Laboratory System and to engage their participation, letters of invitation were sent to the approximately 100 private clinical microbiology laboratories in the state.

    Mr. Sambol is visiting each of these laboratories and has the majority enrolled in the system. 

bullet Improving testing for bioterrorism:
  • State-wide assessment was based on information in the CLIA database and allowed a chance to implement a state epidemiologic survey. Based upon examination of referral patterns gathered during site visits, the state was partitioned into 6 regions so that each region had a laboratory system with an anti-bioterrorism Level B laboratory to which clinical isolates suspected of bioterrorism could be referred from Level A laboratories for more thorough testing. The status of these laboratories as Level B or the newer reference laboratories has not been confirmed by HHS; nevertheless, these laboratories serve as reference centers and information sources for their constituents.
     
  • During his site visits to sentinel laboratories, Mr. Sambol assessed each laboratorys knowledge of approved testing practices for agents suspected of bioterrorism, including when and how to refer specimens to more sophisticated, reference laboratories.
     
  • Based upon his on site assessments, Mr. Sambol has created and begun to disseminate to clinical laboratories a CD ROM with CDC-approved Level-A bioterrorism training materials, including specific protocols for testing. 
bullet Finding incentives for physicians and clinical laboratory professionals:
  • Laboratories will be provided protocols for testing and referral of various public health threats, including threats to food safety such as E. coli and salmonella.
     
  • Dr. Hinrichs is investigating the possibility for a geographic information system (GIS) to provide surveillance feedback to clinical laboratories and physicians so the incidence of new cases of infectious diseases such as Influenza. Because many Level A clinical laboratories do not yet have the hardware necessary to use a GIS, this would likely be a staged process, depending upon funding, and beginning with the 6 Level B laboratories.
bullet Improving communications between the Nebraska public health laboratory and clinical settings:
  • Nebraska has been conducting an extensive survey of hospitals to determine their needs for rapid communication between the state public health laboratory and hospital laboratories, emergency rooms, and infection control committees.
     
  • In addition to existing telecommunication capacity, Nebraska is also examining possible expansions of satellite communications.
     
  • Linkages will benefit hospital communities in various ways, including distance learning, real-time consultation, electronic billing and more rapid epidemiological investigations and reporting.
bullet Interfacing with the U.S. postal system to coordinate testing of postal facilities:
  • Acting as the APHL Liaison to the U.S. Postal Service to coordinate environmental testing of postal facilities at State Public Health Laboratories, Tony Sambol, interacted with either the SPHL Director and/or the BT Laboratory Testing Coordinator for nearly every state.
     
  • Assured capacity by teaching other NLS liaisons (Snippes and Dyke) how to coordinate activities.
     
  • Accurate, timely and secure testing of postal facilities was assured.

This page last reviewed: 7/12/2004
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