Chapter 4 Performance Improvement in Microbiology Laboratory

1
Chapter 4 Performance Improvement in
Microbiology Laboratory

• MLAB 2434 Clinical Microbiology
• Cecile Sanders Keri Brophy-Martinez

2
Terminology

• Quality Control has always been a part of the
  clinical laboratory, but had been used
  exclusively for analytical activities
• We now know that we must analyze pre-analytical,
  analytical, and postanalytical activities and the
  terminology is NOW called Performance
  Improvement (PI)

3
Terminology (contd)

• Preanalytical Stage
• Test ordering
• Order transcription
• Patient preparation
• Specimen collection
• Specimen identification
• Specimen transport

4
Terminology (contd)

• Analytical Stage
• Sample testing
• Postanalytical Stage
• Result transcription
• Result delivery
• Result review
• Action taken on basis of result

5
General Guidelines for Establishing Quality
Control

• Daily temperature checks
• Thermometer calibration (once when received from
  manufacturer)
• Equipment preventive maintenance program
  includes routine maintenance such as oiling,
  cleaning, replacing filters, etc.

6
General Guidelines for Establishing Quality
Control (contd)

• All prepared media must be quality controlled
  prior to use
• Records maintained for 2 years
• If media is purchased, can rely on manufacturers
  QC, but lab must obtain a statement of quality
  control from manufacturer
• HOWEVER, chocolate and selective agars for
  Neisseria and Campylobacter MUST be rechecked by
  lab

7
General Guidelines for Establishing Quality
Control (contd)

• Antimicrobial Susceptibility QC
• Personnel Competency proficiency testing is one
  way this can be assured (CLIA requires this)
• Continuing Education
• QC Manual must be reviewed and signed at least
  annually