Exam 2

Question 1

What is a combing form?

Answer 1

Word root and combing vowel

Question 2

What is CLIA ‘88?

Answer 2

Clinical Laboratory Improvement Amendments of 1988 in response to concerns about laboratory testing errors.

Question 3

Name a major advance in the accuracy and reliability of laboratory testing.

Answer 3

Quality control

Question 4

The Joint Commissions(TJC) was formerly known as what?

Answer 4

Joint Commission on Accreditation of Healthcare Organization(JCAHO).

Question 5

Lean focuses on doing what for business to include laboratories?

Answer 5

Lean focuses on reducing waste.

Question 6

Six sigma focuses on doing what for business to include laboratories?

Answer 6

Six Sigma focuses on reducing variability.

Question 7

What are some Key Lean lessons?

Answer 7

• It is not possible to over communicate
• Continuously focus on improvement.
• Engage all facets of and organization, not just a core team.
• Actions speak louder than words.
• Ideas flow from the bottom up.
• Be respectful to every individual.
• A feedback loop is critical to overcome challenges.
• Staff must be accountable to achieve success.

Question 8

Laboratories must have what types of manuals available to employees in their labs?

Answer 8

Procedure and policy manuals

Question 9

Quality assessment procedures monitor what processes?

Answer 9

• Test request procedures
• Patient identification
• Specimen procurement and labeling
• Specimen transportation and processing
• Lab personnel performance
• Lab instrumentation, reagents and test procedures
• Turn around times
• Accuracy of the final result

Question 10

Accuracy

Answer 10

closeness of the result to the true or actual value(bullseye)

Question 11

Precision

Answer 11

(repeat ability or reproducibility) of obtaining the same value in subsequent tests on the same sample(around the bulls eye)

Question 12

What is a delta check failure?

Answer 12

the difference between a patients present lab result and consecutive previous results which exceed a predefined limit.

Question 13

Define Sensitivity

Answer 13

the proportion of cases with a specific disease or condition that give a positive result

Question 14

Define specificity

Answer 14

the proportion of cases with absence of the specific disease or condition that gives a negative result

Question 15

what are active errors? give examples

Answer 15

Active error is obvious-occurs at the interface between health care worker and the patient.
Ex. *Failing to identify a patient before phlebotomy.
* Missing a blood vessel during phlebotomy
*error with collection tubes
*errors with collection transport
*errors with data entry
*errors with an instrument or computer

Question 16

What are latent errors? Give examples

Answer 16

Latent are related to the organization or design of the laboratory

ex. *Staffing problems
* information technology
* equipment malfunctions
* policy and procedures
* teamwork factors
* management and organization
* work environment(disconnect between lab and patients)

Question 17

What are some common avoidable causes of false positive and false negative test results?

Answer 17

• use of a test at an inappropriate time
• use of obsolete test
• use of a test with poor sensitivity or specificity
• use of a test that lacks validation
• use of a test on patient population with high or low prevalence of disease under consideration
• use of a test on a patient population that differs from the intended or studied population

Question 18

What are some consequences of false positive and false negative test results?

Answer 18

• no impact in some cases
• cascade of increasingly expensive or invasive follow-up testing
• lengthened hospital stay
• additional office visits
• inappropriate therapy
• psychological trauma caused by false belief of having a disease.