HEMA QUALITY ASSURANCE/CONTROL Flashcards
Specimen Quality Assurance
__________ are not recommended as RBCs contain activating factors for the intrinsic portion of the coagulation cascade…
These may shorten the _____
Hemolyzed specimens ; APTT
Specimen Quality Assurance
Specimen should be centrifuged to get ________ (RCF of ____ for ___ minutes)
platelet - poor plasma ; 1000x g for 10 minutes
Specimen Quality Assurance
_______ are recommended as contact with glass may result in initiation of _________ and the shortening of ____
Plastic tubes ; coagulation cascade ; APTT
Specimen Quality Assurance
The plasma should be processed within ______ or stored at _____ in a tightly stoppered tube
30 min ; 4°C
_____________ is set up within a laboratory to monitor and ensure the reliability of test results from that laboratory
Internal Quality Control
The primary tool for internal quality control is called a ________.
control
A control is a specimen with a predetermined range of result values, called ________, that is processed in the same manner as a patient sample.
control values
In Internal Quality Control, ________ are processed with each series or run of patient samples.
control samples
In Internal Quality Control, If the result of a test on a control sample is different from its known value, this indicates a problem in the _________ being used.
equipment/methods
Internal Quality Control in Hematology Lab
The purpose of running IQA is to:
- Check the accuracy of tests system by comparing the daily run to the assigned Mean Value.
- Assess the precision of test system through cumulative run comparison CV%
- Predict and or to detect the potential errors and fluctuations in test system before it could affect the Patients Results.
- Assure the stability of analytical runs by running control every 8 hours.
Is an important component of the total quality assurance program of a clinical hemostasis lab such as PT, APTT, coagulation factor activity assays (e.g., fibrinogen, factor [F] VIII, FIX, FXI), vWf assays, unfractionated heparin monitoring, lupus anticoagulant testing, and plt function.
EXTERNAL QUALITY ASSURANCE (EQA)
MAJOR BENEFITS OF EQA
1) Enhance patient care and safety through improved laboratory testing;
2) characterize test accuracy and precision across multiple methods;
3) correlate specific method variables with accuracy and precision;
4) identify interfering substances and quantify their effects across multiple methods;
5) identify clinical laboratories that are at risk for poor performance so that their performance can improve; 6) satisfy accreditation and regulatory requirements.
These are variables that can occur from the time
when the test is ordered by the physician until
the sample is ready for analysis.
pre-analytical variables
Effects of Pre-analytical Variables on the Quality
of Laboratory Testing
The ________ is the most important.
pre-analytical stage
Pre-analytical variables account for up to _____ of
laboratory errors.
75%
The _________ & __________ depend primarily on the integrity of the specimen submitted to the laboratory.
analytical stage / post analytical stages
_______ involved in specimen collection have a direct impact on the outcome of patients lab results.
Laboratory staff
PRE-ANALYTICAL VARIABLES
Patient Identification
Turnaround Time
The highest frequency of errors occurs with
the use of handwritten labels and request
forms.
Patient Identification
In patient identification, the use of _________ has significantly reduced ID problems.
bar code technology
Delayed and lost test requisitions, specimens and reports can be major problems for labs.
Turnaround time
Recording of the actual times of specimen collection, receipt in the lab and reporting of results with use of computers will solve these problems.
Turnaround time
factors influencing quality in pre-analytical
Right Specimen
Right Collection
Right Labeling
Right Quantity
Right Transport
Right Storage
factors influencing quality in analytical
Laboratory Professionals
Reagents
Equipment
Selection of Test - SOP
Records
Biosafety
factors influencing quality in post-analytical
Recording
Interpretation
Turnaround Time
Report to Right User
stages of quality control
pre-analytic - analytic - post analytic
doctor and patient satisfaction
quality assurance system
pre-analytic stages of quality control includes:
Preparation of Patient
Specimen Collection
Transportation of Sample
Sample Accession
analytic stages of quality control includes:
Sample Preparation
Test in Run
Final Testing
post-analytic stages of quality control includes:
Report Generation
Report Dispatch
Report Interpretation
