Podcast
Questions and Answers
What is the primary goal of quality control in a clinical laboratory?
What is the primary goal of quality control in a clinical laboratory?
- Maintaining the aesthetic appeal of the laboratory setting.
- Ensuring the safety of laboratory personnel.
- Producing accurate, reliable, and timely test results. (correct)
- Minimizing the cost of laboratory testing.
According to the definition provided, what does quality control involve?
According to the definition provided, what does quality control involve?
- The elimination of all possible errors in a process.
- Only the use of statistical analysis for process monitoring.
- Solely the inspection of final products.
- An aggregate of activities like design analysis and inspection. (correct)
Which of the following best describes the scope of ISO 9000's definition of 'quality control'?
Which of the following best describes the scope of ISO 9000's definition of 'quality control'?
- The use of external audits to assess laboratory performance.
- Operational techniques and activities used to fulfill quality requirements. (correct)
- The process of identifying defective products after manufacturing.
- A set of rules dictating laboratory personnel attire and conduct.
The Levey-Jennings chart is used in quality control to monitor:
The Levey-Jennings chart is used in quality control to monitor:
What is the significance of establishing control rules (e.g., using a Westgard Multirule System) within quality control?
What is the significance of establishing control rules (e.g., using a Westgard Multirule System) within quality control?
What action should be taken when 'out of control' values are observed in a quality control process?
What action should be taken when 'out of control' values are observed in a quality control process?
Why is timely reporting of results significant in quality control?
Why is timely reporting of results significant in quality control?
Which hazard control method involves altering work habits to reduce exposure?
Which hazard control method involves altering work habits to reduce exposure?
Which of the following provides the LEAST effective method for controlling laboratory hazards?
Which of the following provides the LEAST effective method for controlling laboratory hazards?
What is the purpose of face protection like facemasks in a laboratory setting?
What is the purpose of face protection like facemasks in a laboratory setting?
What prompted the introduction of universal precautions in laboratories?
What prompted the introduction of universal precautions in laboratories?
According to the guidelines, what is the most important source of HIV and HBV in the laboratory setting?
According to the guidelines, what is the most important source of HIV and HBV in the laboratory setting?
In a Levey-Jennings chart, what does a shift indicate?
In a Levey-Jennings chart, what does a shift indicate?
What is the primary cause of a shift in a Levey-Jennings chart?
What is the primary cause of a shift in a Levey-Jennings chart?
When interpreting a Levey-Jennings chart using a single control, what action should be taken if the control value falls outside ±2 SD?
When interpreting a Levey-Jennings chart using a single control, what action should be taken if the control value falls outside ±2 SD?
When using the Westgard Multirule system, what initial action should be avoided after a rule violation?
When using the Westgard Multirule system, what initial action should be avoided after a rule violation?
What is the purpose of the lines drawn horizontally at ±1, 2, and 3 standard deviations (SDs) on a Levey-Jennings chart?
What is the purpose of the lines drawn horizontally at ±1, 2, and 3 standard deviations (SDs) on a Levey-Jennings chart?
How is the mean typically represented on a Levey-Jennings chart?
How is the mean typically represented on a Levey-Jennings chart?
What is the immediate next step if a Levey-Jennings control value falls outside of $\pm 2SD$ when using one level of control?
What is the immediate next step if a Levey-Jennings control value falls outside of $\pm 2SD$ when using one level of control?
A control value that has gone out of the $\pm 2SD$ limit indicates which of the following?
A control value that has gone out of the $\pm 2SD$ limit indicates which of the following?
How many consecutive QC results need to fall on the same side of the mean before a shift is identified?
How many consecutive QC results need to fall on the same side of the mean before a shift is identified?
Which of the following Westgard rules indicates a systematic error?
Which of the following Westgard rules indicates a systematic error?
If a laboratory run violates the R4S Westgard rule, what action should be taken?
If a laboratory run violates the R4S Westgard rule, what action should be taken?
In which phase of the laboratory testing process do most errors typically occur?
In which phase of the laboratory testing process do most errors typically occur?
What is a common cause of rejected samples in the pre-analytic phase?
What is a common cause of rejected samples in the pre-analytic phase?
Which Westgard rule is most likely to indicate the presence of random error in an analytical run?
Which Westgard rule is most likely to indicate the presence of random error in an analytical run?
According to the information, what percentage of rejected samples are due to 'Incomplete Laboratory Request Forms'?
According to the information, what percentage of rejected samples are due to 'Incomplete Laboratory Request Forms'?
What does the '10X' rule indicate?
What does the '10X' rule indicate?
Which of the following errors is most likely to occur during the pre-analytic phase of laboratory testing?
Which of the following errors is most likely to occur during the pre-analytic phase of laboratory testing?
Which action is recommended if four consecutive control results exceed either ±1SD?
Which action is recommended if four consecutive control results exceed either ±1SD?
What steps are typically included in the Pre-Analytic Phase?
What steps are typically included in the Pre-Analytic Phase?
Which action is crucial for adhering to standardized labeling protocols in a laboratory setting?
Which action is crucial for adhering to standardized labeling protocols in a laboratory setting?
What is a key element of staff education and training in maintaining laboratory standards?
What is a key element of staff education and training in maintaining laboratory standards?
Which of the following demonstrates adherence to strict laboratory protocols?
Which of the following demonstrates adherence to strict laboratory protocols?
A sample is received in the lab that is unlabeled. Following laboratory standards, what action should be taken?
A sample is received in the lab that is unlabeled. Following laboratory standards, what action should be taken?
What action should be taken if a blood sample is hemolyzed, depending on the test requested?
What action should be taken if a blood sample is hemolyzed, depending on the test requested?
Why is it important to collect fasting samples for tests that require them?
Why is it important to collect fasting samples for tests that require them?
A phlebotomist collects a blood sample for a test that requires a specific anticoagulant, but mistakenly uses a different tube. What is the correct course of action?
A phlebotomist collects a blood sample for a test that requires a specific anticoagulant, but mistakenly uses a different tube. What is the correct course of action?
Why is it important to ensure adequate sample volume when collecting blood in tubes containing preservatives?
Why is it important to ensure adequate sample volume when collecting blood in tubes containing preservatives?
How can ergonomic hazards in the laboratory be minimized?
How can ergonomic hazards in the laboratory be minimized?
What is the best way to prevent "repetitive motion injuries" in the laboratory?
What is the best way to prevent "repetitive motion injuries" in the laboratory?
Flashcards
Trend
Trend
A trend occurs with six or more consecutive QC results on one side of the mean.
Shift
Shift
A shift is indicated by a change followed by six QC results on one side of the XÌ„.
Mean (XÌ„)
Mean (XÌ„)
The mean is the average value in a set of data, here XÌ„ = 190.5.
Standard Deviation (SD)
Standard Deviation (SD)
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+/- 2 SD
+/- 2 SD
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Out of Control
Out of Control
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Westgard Multirule System
Westgard Multirule System
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Control Value
Control Value
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Corrective Action
Corrective Action
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Signages
Signages
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Administrative Controls
Administrative Controls
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Personal Protective Equipment (PPE)
Personal Protective Equipment (PPE)
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Eye Protection
Eye Protection
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Universal Precautions
Universal Precautions
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R4S Rule Violation
R4S Rule Violation
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Random Error
Random Error
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41S Rule Violation
41S Rule Violation
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Systematic Error
Systematic Error
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10X Rule Violation
10X Rule Violation
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Pre-Analytic Phase
Pre-Analytic Phase
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Highest Error Rate
Highest Error Rate
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Incomplete Laboratory Request Forms
Incomplete Laboratory Request Forms
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Wrong Patient Identification
Wrong Patient Identification
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Rejecting Results
Rejecting Results
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Standardized Labelling
Standardized Labelling
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Criteria for Rejecting Samples
Criteria for Rejecting Samples
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Unlabeled Sample
Unlabeled Sample
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Hemolyzed Sample
Hemolyzed Sample
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Ergonomic Hazard
Ergonomic Hazard
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Repetitive Motion Injuries
Repetitive Motion Injuries
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Poor Illumination
Poor Illumination
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Insufficient Patient Information
Insufficient Patient Information
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Transporting Specimen Standards
Transporting Specimen Standards
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Non-fasting Samples
Non-fasting Samples
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Quality Control
Quality Control
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Definition of Quality Control
Definition of Quality Control
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Types of Quality Control
Types of Quality Control
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Quality Control in the Laboratory
Quality Control in the Laboratory
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Levey-Jennings Chart
Levey-Jennings Chart
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ISO 9000
ISO 9000
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Study Notes
Quality Management and Laboratory Safety
- Quality control is a critical aspect of laboratory practices
- Ensures accurate, reliable, and timely results
- Essential for accurate diagnosis and effective treatment
Quality Control Definition
- Quality control is the set of procedures and techniques used to maintain a desired level of quality.
- Aims at quantifying the unavoidable errors to decide if they are acceptable.
Internal and External QC
- Internal Quality Control (INTRALAB): In-house procedures, continuous monitoring of operations, and daily checks to ensure reliable data.
- External Quality Control (INTERLAB): Collaborates with other labs, proficiency testing, and national and international programs.
Quality Control in the Laboratory
- A system ensures accuracy and precision
- Testing known samples to identify issues
- Monitoring analytical processes to detect errors
Quality Control Charts (Levey-Jennings)
- Common quality control tool
- Graphically represent control data
- Plots control values over time for analysis
- Used for identifying trends and shifts in data
- Calculate mean and standard deviation
- Mark +1, +2, +3 standard deviation intervals
- Identify whether a run is "in control" or "out of control"
- Use Westgard Multirule to determine if results are acceptable
- Identifying trends and shifts in data
Laboratory Workflow Phases
- Pre-Analytic Phase: Patient preparation, sample collection, sample receipt, and sample transport, high error frequency.
- Analytic Phase: Actual testing of samples, QC checks and analysis.
- Post-Analytic Phase: Reporting and record keeping, reliability and proper data entry are crucial.
Laboratory Hazards
- Chemical Hazards: Ingestion, needle-sticks, exposure, adverse health effects
- Biological Hazards: Biohazards, exposure routes, health risks
- Physical Hazards: Elements causing harm (e.g., temperature, radiation, slips).
- Ergonomic Hazards: Work conditions stressing the body, repetitive motion.
Hierarchy of Controls
- Elimination: Removing the hazard (e.g. physically removing the hazard).
- Substitution: Replacing the hazard with something safer
- Engineering Controls: Isolating the person from the hazard (e.g. fume hoods).
- Administrative Controls: Changing work practices (e.g., SOPs, changing work schedule).
- Personal Protective Equipment (PPE): Worker protection (e.g., lab coats, gloves).
Errors in Laboratory Work
- Pre-Analytic Errors: Usually occur from human handling (i.e. wrong patient information, insufficient samples).
- Analytical Errors: Equipment malfunction, incorrect procedures, QC failure.
- Post-Analytic Errors: Reporting errors, improper data entry, or delays in reporting.
Key Performance Metrics
- Turnaround time (TAT): The time taken to complete test/ order.
- Accuracy: Closeness of a measurement to its true value.
- Precision: Closeness of agreement among a set of test results.
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