Quality Assessment and Safety

Quality Assessment

• program of checks and balances to ensure the quality of a laboratory services

• must involve mechanisms for error and provide opportunity to improve services

Preanalytical Components of Quality Assessment

• ensuring appropriate test ordering

• patient education, preparation, and instruction

• documentation of any problems

• accurate procedure manuals

• adequate personal training

Analytical Components of Quality Assessment

• directly involved in laboratory testing

  • equipment

  • reagents and supplies

  • procedure manuals

  • analytical methods

  • monitoring of analytical method

  • laboratory personal technical skills

Three main factors in Analytical Components

• equipments/ instrumentation

• reagents

• procedure manuals

Quality Control

• materials used to monitor analytical error

• mimic patient samples in physical and chemical characteristics

• commercially obtained or lab or prepped

Proficiency Testing

• measures to monitor and evaluate a laboratory performance compared with that of other facilities

• surveys many labs that use same QC materials

• ACCREDITED LABORATORIES MUST PARTICIPATE

Postanalytical Components

• procedures that affect results reporting interpretation

Goal of Effective Quality Assessment Program

• obtain consistently accurate and reproducible results

• test results should reflect patients condition rather than being modified due to procedural or personal variations

Procedural Factors in UA Quality Assurance

• volume of urine

• speed of centrifuge

• length of centrifuge

• concentration of sediment

• volume of sediment dispensed

Reporting Factors in UA Quality Assurance

• each lab should publish its own normal values

• all personal must use same technology

• all personnel must report standard format

• all abnormal results should be flagged for easy reference

Safety in the urinalysis laboratory

• practices to prevent spread of infection and ensure patient safety

• important because of numerous hazardous things employees are exposed to

Occupational Health and Safety Act of 1970

• established formal regulation of health and safety for all employees

• administered by occupational safety and health administration

Biological Hazards Universal Precautions

• all bodily fluids, secretions, and excretions are considered potentially infectious and capable of disease transmission

Biological Hazards Transmission-Based Precautions

• apply to specific patients with known suspected infections

Three categories of transmission based precautions

• contact precautions

• droplet precautions

• airborne precautions

Three routes of infection or disease transmission

• inhalation

• ingestion

• direct inhalation or skin contact

Regulations for Biological Hazards

• appropriate PPE is required

• all specimen must be handled/ disposed of properly

• contaminated sharps must be disposed of in puncture resistance container

• lab surfaces must be cleaned with decontaminant 10% bleach or phenolic disinfectant

Rules for Chemical Hazards

• requires each facility to have chemical hygiene plan

• requires education personnel; about chemical safety policies

Components of Chemical Hazard Regulations

• proper chemical labeling

• lab safety manual

• use of PPE

• safety equipment such as eyewash/ shower

Safety Data Sheets

• ensures all employees are aware of potential chemical hazards in the workplace

• requires chemical manufacturers to provide one for each chemical, and employers to make them available to employees

Chemical Spill Protical

• consult SDS to determine action

• make chemical spill kits accessible

• post emergency treatment procedures

• dispose of all chemicals properly