Quality Assessment and Safety

What is a quality assessment?

A program of checks and balances to ensure the quality of a laboratory’s services

What is required in a quality assessment?

Must involve a mechanism for error detection and provide an opportunity to improve services.

What are the three aspects of urinalysis?

• Pre-analytical

• Analytical

• Post analytical

What are pre-analytical procedures?

All the steps that happen before a specimen is tested.

What should happen before a test is ordered?

The correct test-ordering process should be followed.

What are the important steps for handling a specimen?

Collection, transportation, storage, and handling.

What are the main things that happen before testing?

1. Ordering the test

2. Preparing the patient

3. Collecting the specimen

4. Transporting/storing it

5. Handling any problems

What are the components directly involved in laboratory testing?

• Equipment

• Reagents and supplies

• Procedures

• Analytical methods

• Quality control

• Laboratory personnel

What are analytical methods?

The specific methods used to perform and analyze a laboratory test.

What are three examples of analytical components?

• Equipment/instrumentation

• Reagents

• Procedure manuals

What type of reagents should laboratories use?

Reagent-grade or analytical-grade reagents.

What standards should procedure manuals follow?

Clinical and Laboratory Standards Institute (CLSI) standards.

What is the purpose of quality control (QC)?

To assess and monitor errors in laboratory testing.

What are internal QC materials?

Materials that mimic patient samples in their physical and chemical characteristics.

Why do internal QC materials mimic patient samples?

To make sure the test works correctly on samples similar to real patient samples.

What are tolerance limits?

The acceptable range for QC results.

What is proficiency testing?

A way to compare a laboratory’s performance with other laboratories.

How does proficiency testing work?

Many laboratories test the same QC materials and compare their results.

What is a systematic error?

An error that causes test results to be consistently too high or too low.

What should a standardized laboratory report include?

• Test results

• Reference ranges

• Helpful comments

What does reproducible mean?

Getting similar results when the same test is repeated correctly.

Why is documentation important in quality assurance (QA)?

It provides evidence that procedures and actions were completed correctly.

What is the main goal of laboratory safety?

To prevent infections and keep patients and employees safe.

What law established formal health and safety regulations for employees?

The Occupational Health and Safety Act of 1970.

What organization administers workplace health and safety regulations?

OSHA (Occupational Safety and Health Administration).

What are universal precautions?

Treating all body fluids, secretions, and excretions (except sweat) as potentially infectious.

What are transmission-based precautions?

Precautions used for patients with known or suspected infections.

What are the three types of transmission-based precautions?

• Contact

• Droplet

• Airborne precautions

What are the three routes of infection transmission?

• Inhalation

• Ingestion

• Direct inoculation or skin contact.

What PPE is required when handling body fluids?

Appropriate personal protective equipment (PPE).

How should contaminated sharps be disposed of?

In puncture-resistant containers and then incinerated or autoclaved.

What can be used to decontaminate laboratory surfaces and equipment?

10% bleach or a phenolic disinfectant.

What does OSHA require regarding hazardous chemicals?

Each facility must have a Chemical Hygiene Plan.

What is a Chemical Hygiene Plan?

A plan that explains safety policies and procedures for hazardous chemicals.

What are some parts of a Chemical Hygiene Plan?

• Proper chemical labeling

• A laboratory safety manual

• PPE

• Safety equipment

What safety equipment should be available for chemical hazards?

An eyewash station and emergency shower.

What is an SDS?

A Safety Data Sheet that provides hazard and safety information about a specific chemical.

What is OSHA's Hazard Communication Rule?

A rule that ensures employees know about potential chemical hazards at work.

What does "Employee Right to Know" mean?

Employees have the right to know about the chemical hazards they may be exposed to.

Who must provide SDSs for chemicals?

• Chemical manufacturers and suppliers must provide them

• Employers must make them available to employees.

How should compressed gas tanks be stored?

They must be secured at all times, both when being used and transported.

When should valve caps be on compressed gas tanks?

At all times except when the tank is being used.

What safety equipment should all laboratory personnel know how to use?

• Fire extinguishers

• Alarm stations

• Emergency showers

• Eyewash stations.

What is the easiest way to remember the main laboratory safety hazards?

• Biological = infection

• Chemical = chemicals

• Electrical = equipment

• Fire = flammable materials.