Se ha denunciado esta presentación.
Utilizamos tu perfil de LinkedIn y tus datos de actividad para personalizar los anuncios y mostrarte publicidad más relevante. Puedes cambiar tus preferencias de publicidad en cualquier momento.

Quality control ppt BIOCHEMISTRY

19.172 visualizaciones

Publicado el

Quality control ppt BIOCHEMISTRY

  1. 1. Three principles of clinical lab
  2. 2. What is Quality? Quality defined as conformance to the requirements of users or customers
  3. 3. Total quality management of the clinical lab
  4. 4. Quality Control Emphasizes statistical and nonstatistical check procedures Able to detect the problems early enough to prevent their consequences Techniques and procedures that monitor performance parameters
  5. 5. Prerequisite for an effective lab service Promotion of quality control and continuous improvement of the total testing process, including preanalytical and postanalytical phases
  6. 6. Steps in obtaining a laboratory test
  7. 7. Lab testing processes and their potential errors Test ordering Specimen acquisition Analytical measurement Test reporting Test interpretation
  8. 8. Test ordering Inappropriate test Handwriting not legible Wrong patient identification Specimen acquisition Analytical measurement Test reporting Test interpretation Lab testing processes and their potential errors
  9. 9. Test ordering Specimen acquisition Incorrect tube Incorrect patient identification Inadequate volume Collected at wrong time Improper transport conditions Analytical measurement Test reporting Test interpretation Lab testing processes and their potential errors
  10. 10. Test ordering Specimen acquisition Analytical measurement Instrument not calibrated correctly Specimen mix-up Incorrect volume of specimen Interfering substance present Instrument precision problem Test reporting Test interpretation Lab testing processes and their potential errors
  11. 11. Test ordering Specimen acquisition Analytical measurement Test reporting Wrong patient identification Report not legible Report delayed Transcription error Test interpretation Lab testing processes and their potential errors
  12. 12. Test ordering Specimen acquisition Analytical measurement Test reporting Test interpretation Interfering substance not recognized Specificity of the test not understood Precision limitations not recognized Analytical sensitivity not appropriate Previous values not available for comparison Lab testing processes and their potential errors
  13. 13. Elements of a QA/QC Program Commitment Facilities and resources Technical competence Technical procedures Problem solving mechanisms
  14. 14. Quality Control: Technical Procedures Control of preanalytical variables Control of analytical variables Control of analytical quality using statistical methods and control charts
  15. 15. Test requests Patient preparation Patient identification Specimen acquisition Specimen transport Specimen processing Specimen distribution Preparation of work lists Control of preanalytical variables
  16. 16. Patient Identification The highest frequency of errors occurs with the use of handwritten labels and request forms. The use of bar code technology has significantly reduced ID problems. Turnaround time Delayed and lost test requisitions, specimens and reports can be major problems for labs. Recording of the actual times of specimen collection, receipt in the lab and reporting of results with use of computers will solve these problems.
  17. 17. Manual entry of data even with the double checking of results Computerization will reduce this type of transcription error. Lab tests are affected by many factors, such as, recent intake of food, alcohol, or drugs; smoking, exercise, stress, sleep, posture during specimen collection The lab must define the instructions and procedures compliance with these instructions can be monitored directly efforts should be made to correct non compliance
  18. 18. • Prolonged tourniquet application. • Blood collection from an arm into which an intravenous infusion is running. Specimen Collection • To monitor and control these problems, specially trained lab team assigned to specimen collection • The identification of the person collecting a specimen should be maintained • Clinicians should be encouraged to report clinically inconsistent results. Hemolysis during blood collection
  19. 19. Analytical methodology Standardization Calibration procedures Documentation of analytical protocols Monitoring of critical equipment and materials Control of analytical variables
  20. 20. • Water quality • Calibration of volumetric glassware and pipets • Stability of electrical power • Stability of temperature of heating baths, refrigerators, freezers and centrifuges Many analytical variables
  21. 21. • Procedure name • Clinical significance • Principle of method • Specimen of choice • Reagents and equipments • Procedure • Reference values • Comments • References The procedure Manual should contain the following
  22. 22. • Values cover medical decision points • Similar to the test specimen (matrix) • Available in large quantity • Stored in small aliquots • Ideally, should last for at least 1 year Using stable ‘controls’
  23. 23. • Reconstitute lyophilized material carefully & strictly as per label direction • Frozen sample to be thawed properly. After attaining room temp., mix slowly by inversion and then use. • Storage temperature to be strictly followed Precautions to be followed
  24. 24. Assayed Unassayed Level 1 , 2 and 3
  25. 25. • Have a known concentration of the substance (analyte) being measured • Used to adjust instrument, kit, test system in order to standardize the assay • Sometimes called a standard, although usually not a true standard • This is not a control Using ‘Calibrators’
  26. 26. Day to day internal QC programme Is a most useful tool For maintenance of long term Consistency ( Accuracy ) control Long term Precision control of analytical method Internal Q C monitors a single lab
  27. 27. Provides independent validation of internal QC program Gives valid estimation of long term accuracy of analytical system Compares performance of different labs
  28. 28. Control of analytical quality using statistical methods and control charts Statistical methods Mean, SD, CV Accuracy Precision Control charts Levey-Jennings Control Chart Westgard multirule chart Shewhart SD control chart
  29. 29. l Levey-Jennings Control Chart
  30. 30. Trends & Shifts
  31. 31. CUSUM Control Chart
  32. 32. Control of analytical quality using patient data Clinical correlation of test results Correlation with other lab tests
  33. 33. •Tietz test book of clinical Biochemistry •Varley •Kaplan •Internet References

×