QUALITY CONTROL
Refers to the quantitative methods used to monitor the quality of procedures such as inspection and calibration of equipment
QUALITY ASSURANCE
The program through which the laboratory guarantees quality patient care by providing accurate and reliable test results in an appropriate and timely manner.
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Both QC and QA are included in total quality management (TQM) which is the entire set of approaches used by the institution top provide patient satisfaction. Continuous quality improvement is the goal of TQM programs.
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A complete phlebotomy procedure manual must be available to phlebotomist. A directory of services and/or floor book should be available with information about tests and requirements and collection times, patient prep, etc.
CAP and JCAOH require that QA addresses pre-analytical (before), analytical (during), and post analytical (after) quality.
The phlebotomist is most responsible for controlling pre-analytical variables which are those that occur before analytical of the specimen.
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Venous blood specimen collection accounts for more than half of the errors in pre-analytical variable
ANALYTIC VARIABLE
Those that occur during testing, can be affected by pre-analytic variables such as collection time or transport condition
POST ANALYTIC VARIABLE
Such as delays in reporting results or improper entry of results be part of the phlebotomists responsibilities
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Failure to properly identify a patient is the most serious error in phlebotomy and can result in injury or death to the patient.
DELTA CHECK IN LAB
(compares previous result with current) may prevent an error in patient identification, but proper identification of the patient is essential to all phlebotomy function.
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Assuring all equipment is not damaged, expired, or compromised is essential.
PROPER PATIENT PREPARATION
Is essential such as fasting, diurnal variation, medications, age, sex, altitude, etc.
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Selection of appropriate site and proper tourniquet application and removal are critical to sample integrity.
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Improper cleansing of site for blood cultures is a current QA project in our laboratory.
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Proper transport of sample is also essential to a quality specimen.