Saeeda.

Chandio Senior technologist II Microbiology

Process or system for monitoring quality of laboratory testing, and accuracy and precision of results

the the

Routinely collect and analyze data from every test run or procedure Allows for immediate corrective action

IQC refers to the set of procedures undertaken by the laboratory staff for the

continuous and immediate

monitoring of laboratory work in order to decide whether the results are reliable enough to be released.

Quality of specimen Validity of test method Performance of test procedure, reagents and media Reports and interpretation Staff Equipment

Lab Tech-The person who performs testing Supervisor-The person who is responsible for day-to-day activities, training, delegation of work

Director-The person who is responsible for entire seamless operation, planning, and control of all activities Ministry of Health-Place responsible for infrastructure, man power, and resources.

Must be trained to perform the tests Follow SOPs Must run QC samples Maintain all the record up to date Inform the Supervisor of any problems--immediately Corrective actions taken by them must be noted down and any implications on other samples

Train the Lab tech for the assigned job Provide periodic training to the lab techs Prepare the controls and check the values Prepare and update the SOPs -easy to understand Keep record of Equipment Maintenance, problems, and repairs Keep records of training, SOPs, equipment, etc. Ensure all Lab tasks on time

The Quality of the specimen The Performance of test procedures, reagents and media

Appropriate specimen Collection method

Delivery system

Record amount prepared Source Lot number Sterilization method Preparation date and Expiration date Prepared by

Check: Sterility Ability to support growth

Indicative, selective, or inhibitory

Characteristics of the medium

Biochemical response

Test QC organisms with each new batch or lot number

Check for growth of fastidious organisms on media of choice incubate at time and temp recommended RECORD Results on Media QC form

Biological indicators (BIs) Chemical indicators (CIs)

Mechanical monitoring

If you have not documented it,

you have NOT done it

If you have not documented, it is a RUMOUR !!!

Staining and Microscopy Culture Media Incubation Organism Identification Antimicrobial Susceptibility Testing

Dating when received and when opened Weighing Dissolving Sterilizing Storage of prepared media Addition of enrichments [e.g. Blood] Sterility Testing Incubation of inoculated media

Agar Plates Haemolysis controls Selective media controls

Liquid broths Positive and negative reactions

Therefore Stock Cultures

Organisms to be maintained must be adequate to check all media and test systems.

E. coli MacConkey, XLD, susceptibility tests Staphylococcus aureus Blood agar, Mannitol Salt, susceptibility tests Neisseria gonorrhoeae chocolate, Thayer-Martin

Gram stain QC Use gram positive and gram negative organisms to check daily
ZN QC

Other Stains Reagents

Use positive and negative AFB slide with every batch stained. Check as used positive and negative reactions Check as used with known positives and negatives.

Storage of antibiotic disks CLSI Method Detailed QC Procedures to ensure reproducibility of results 0.5 Mcfarlands standard Depth of agar!!

Many organisms have predictable antimicrobial test results Staphylococcus spp. are usually susceptible to vancomycin Streptococcus pyogenes are always susceptible to penicillin Klebsiella pneumoniae are resistant to ampicillin

If you encounter an unusual pattern rule out error by checking identification of organisms repeat antimicrobial susceptibility test Report if repeat testing yields same result, or refer the isolate to a reference laboratory for confirmation

Clinician should be notified about panic values immediately. Panic values are life potential-threatening results, Positive LPA Positive gram stain for CSF Positive KLB Positive blood culture.

 thanks