5 nia manual 2004-hem&trans part 2

8/6/2019 5 Nia Manual 2004-Hem&Trans Part 2

1/38

QAP/CT-2

Laboratory NIA Indicator

State :_________________

Month :__________________ Year :______________

Indicator : C:T Ratio

Standard : 2.5:1

No Lab/HospitalC:T Ratio

Medical O&G SurgicalOrthopedi

cPaediatric AVERAGE

1

2

3

4

5

6

78

9

10

11

12

13

14

15

16

17

1819

20

21

22

23

24

25

AVERAGE

Is there a Shortfall in Quality for this Indicator? Yes ( ) No ( )

Reason forSIQ:__________________________________________________________________

_________________________________________________________________________

Any remedial action taken? _________________________

Action / :

54


2/38

____________________________________________________________________________________________________________________________________________________________________________________________________________________

Laboratory QA Programme - National Indicator Approach

PROGRAMME : Laboratory QA Programme (Transfusion)AREA OF CONCERN : Blood Inventory

INDICATOR :EXPIRY RATE OF RED CELL

Rationale : This indicator was selected to monitor the expiry rate of red cell

in blood bank inventory system so as to prevent wastage of red

cell

Definition of Terms :

Expired blood Blood collected and received by the center that has expired

Inclusion criteria : ALL RED CELL in stock (collected and received)

Exclusion criteria : Blood that is not suitable for use. (eg citrated,contaminated).

Type of Indicator : Efficiency in Stock Management

Numerator :

Denominator :

Total number of expired blood x 100%

Total number of blood in stock

Standard : Less than 5% of the blood in stock.

Note:

1. District Hospitals to send to State Pathologist biannually (by 15th July & 15th

January) using FORMAT QAP/EX-1

2. State shall compile into FORMAT QAP/EX-2 and send the report to the JKKHaematology /Transfusion by 31stJuly for 1st. cycle and 31stJanuary for the second cycle ofthe programme

Address : Dr. Yasmin AyobPengerusi, JKK Haematology /Transfusion ,Pusat Darah Negara

50400, Jalan Tun Razak, Kuala Lumpur.

QAP/EX-1

55


3/38

Indicator: Expiry Rate of Red Cells

Hospital :_____________ Year :_________________

State: ________________

Total ExpiredBlood In Stock (From Collection and received

from other hospital)Expiry Rate

Jan

Feb

Mar

Apr

May

Jun

Total (Jan June)

Jul

Aug

Sep

Oct

Nov

Dec

Total (Jul Dec)

Grand Total

Note: Exclude Unsuitable Units of Blood.

Is there a Shortfall in Quality for this Indicator? Yes ( ) No ( )

Reason forSIQ:__________________________________________________________________

_

_______________________________________________________________________Any remedial action taken? _________________________

Action / :________________________________________________________________________________________________________________________________________________________________________________________________________________________

56


4/38

QAP/EX-2

Laboratory NIA Indicator

State :_________________

Month :__________________ Year :______________

Indicator : EXPIRY RATE OF RED CELLStandard : < 5%

No Lab / Hospital Expiry Rate

1

2

3

4

5

6

7

89

10

11

12

13

14

15

16

17

18

1920

21

22

23

24

25

Is there a Shortfall in Quality (SIQ) for this Indicator? Yes ( ) No ( )

Reason for

SIQ:_____________________________________________________________________________________________________________________________________

Any remedial action taken? _________________________

Action:________________________________________________________________________________________________________________________________________________________________________________________________________________________

57


5/38

Laboratory QA Programme - National Indicator ApproachPROGRAMME : Laboratory QA Programme (Transfusion)

AREA OF CONCERN : Patient safety in Transfusion Medicine.

INDICATOR :TRANSFUSION ERROR RATE

Rationale : This indicator is selected to measure the causes of error intransfusion. Transfusion error can contribute to mortality andmorbidity to patients. Transfusion errors are preventable.

Definition of Terms :Transfusion error : Transfusion error is defined as deviation from standard set of

protocol.These errors are classified as follows:1) Sampling and labeling errorAny error occurring from the time of collection to labeling of thepatients sample.2) Blood Bank Error (Transcription & Techinal)Any errors occurring in the laboratory, form the time of the sample

received, appropriate test performed till the blood and bloodcomponents are released for transfusion.3) Error Associated With Administration of BloodAny errors which occurs after the blood released for transfusion,checking and confirmation of the blood and blood components fortransfusion by the personnel responsible till the completion oftransfusion.

Inclusion criteria : All requests for blood and blood components.Exclusion criteria : If blood was given with advice by blood bank, in the following

situations:1) Rhesus negative patient was given Rhesus positive blood in an

emergency situation.

2) Group O was transfused to a non-group O recipient in anemergency.

3) Group AB recipient transfused with group A or B blood in theabsence Group AB Blood.

Type of Indicator : Safety

Standard : 0 (Zero)

Note:1. Distrcict Hospitals to send to State Pathologist biannually (by 15th July & 15th January)using FORMAT QAP/ERR-12. State shall compile into FORMAT QAP/ERR-2 and send the report to the JKKHaematology /Transfusion by 31st July for 1st. cycle and 31st January for the second cycle of

the programme.Address : Dr. Yasmin Ayob

Pengerusi, JKK Haematology /Transfusion ,Pusat Darah Negara

50400, Jalan Tun Razak, Kuala Lumpur. .

QAP/ERR-1

58


6/38

Indicator: Transfusion Error Rate.

Hospital:_____________________

State:________________________

Month Sampling Error Blood Bank Error Error Associated WithAdministration Blood

January

February

March

April

May

June

Total (Jan-June)July

August

September

October

November

December

Total (Jul-Dec)

GrandTotal

Is there a Shortfall In Quality (SIQ) for this indicator? Yes ( ) No ( )

Reason for SIQ:_______________________________________________________________

____________________________________________________________________________

Any remedial action taken? _____________________________

Action / :_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

59


7/38

QAP/ERR-2Laboratory NIA Indicator

State : ____________________

Month : ____________________ Year : _____________________

Indicator : TRANSFUSION ERROR RATE

Standard : ZERO

No Lab / Hospital Sampling Error Blood BankError

ErrorAssociated

withAdministration

of Blood

Totalnumber of

Errors

1

2

3

4

5

6

7

8

9

10

11

12

13

14

1516

17

18

19

20

21

22

23

24

25

Is there a Shortfall In Quality (SIQ) for this indicator? Yes ( ) No ( )

Reason for SIQ:_______________________________________________________________________________________________________________________________________________

Any remedial action taken? _____________________________

Action / :______________________________________________________________________________

60


8/38

______________________________________________________________________________________________________________________________________________________________


AREA OF CONCERN : Precision of Laboratory Testing of Anti-HCV

INDICATOR :RATE OF LABORATORY ERROR IN ANTI-HCVSCREENING TEST

Rationale : 1. To monitor the reproducibility of Anti-HCV testing in thescreening center.

2. To assess overall performance in Anti-HCV testing.3. To identify problems and to take remedial action.4. To improve quality service and cost-effectiveness.


AntiHCV

EIA

Initially Reactive (IR)

Repeatedly Reactive (RR)

Total Sample (T)

Precision

Antibody to Hepatitis C virus.

Enzyme Immuno Assay.

The first reactive result from the pilot tube

The reactive result from the repeat testing of the initially reactivesample

Total sample of the month

Reproducibility of the result

Inclusion criteria : All Anti HCV EIA test perform for blood donor screening.

Exclusion criteria : All Anti HCV tests performed by methods other than EIA.

Type of Indicator : Proficiency

Numerator :

Denominator :

Initial Reactive Repeat Reactive x 100%.

Total number of Sample Repeat Reactive

Standard : Less than 0.5 % (Semi-automation)Less than 0.25% (Fully automation)

Note:Please send your report to the JKK Haematology /Transfusion by 31st July for 1st. cycle and31stJanuary for the second cycle of the programme.

Address : Dr. Yasmin AyobPengerusi, JKK Haematology /Transfusion ,Pusat Darah Negara

50400, Jalan Tun Razak,Kuala Lumpur.

61


9/38


AREA OF CONCERN : Precision of Laboratory Testing of HbsAG Testing

INDICATOR : RATE OF LABORATORY ERROR IN HBSAg SCREENINGTEST

Rationale : 1. To monitor the reproducibility of HbsAg testing in thescreening center.

2. To assess overall performance in HbsAg testing.3. To identify problems and to take remedial action.4. To improve quality service and cost-effectiveness.


HBsAg:

EIA

Initially Reactive (IR)

Repeatedly Reactive (RR)

Total Sample (T)

Reproducibility

Hepatitis B surface Antigen.

Enzyme Immuno Assay.

The first reactive result from the pilot tube

The reactive result from the repeat testing of the initially reactivesample

Total sample of the month

Reproducibility of the result

Inclusion criteria : All HBsAg EIA test perform for blood donor screening.

Exclusion criteria : All HBsAg tests performed by methods other than EIA.

Type of Indicator : Performance

Numerator :

Denominator :

Initial Reactive Repeat Reactive x 100%.

Total number of Sample Repeat Reactive

Standard : Less than 0.8% (semi-automation)Less than 0.5% (fully automation)

Note:Please send your report to the JKK Haematology /Transfusion by 31st July for 1st. cycle and

31stJanuary for the second cycle of the programme.Address : Dr. Yasmin Ayob


50400, Jalan Tun Razak, Kuala Lumpur.

QAP/HBSAG-01Laboratory NIA Indicator

62


10/38

YEAR: LABORATORY/ID :HOSPITAL:..

INDICATOR: Laboratory Error in HbsAg Screening Test

Standard:

Numerator:Denominator:**Note: Numerator values must be less than denominator values.

MONTH Numerator Denominator Performance

achieved

January

February

March

April

May

June

SUB-TOTAL

July

August

September

October

November

December

SUB-TOTAL

TOTAL

Is there a shortfall in Quality for this indicator? Yes No

If yes please fill the SIQ Report using Format QAP/TR-SIQ.Comments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

QAP/HCV-02Laboratory NIA Indicator

63


11/38


INDICATOR: Laboratory Error in Anti-HVC Screening Test

Standard:Numerator:Denominator:**Note: Numerator values must be less than denominator values.MONTH Numerator Denominator Performance

achieved

January

February

March

April

May

June

SUB-TOTAL

July

August

September

October

November

December

SUB-TOTAL

TOTAL

Is there a shortfall in Quality for this indicator? Yes No

If yes please fill the SIQ Report.Comments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

QAP/TR-SIQ

64


12/38

SHORTFALL IN QUALITY REPORTING FORMAT

LABORATORY / ID: ..HOSPITAL: ..

INDICATOR:

Standard:

Actual performance achieved: Month/Year:

Reason for Shortfall in Quality:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Remedial Action:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Performance after implementation of remedial action:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Laboratory NIA Indicator65


13/38

(FORMAT FOR JKK REPORT TO INDIVIDUAL LABORATORY 1)


INDICATOR: .

Standard: ..

Your Performance: .

Overall Performance:

MONTHAverage OverallPerformance Achieved

January

February

March

April

May

June

SUB-TOTAL / AVERAGE

July

August

September

October

November

December

SUB-TOTAL / AVERAGE

TOTAL / AVERAGE

Suggestion for Remedial Action / Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

66


14/38

Laboratory NIA IndicatorFORMAT FOR JKK REPORT TO INDIVIDUAL LABORATORY 2

MONTH / YEAR: .LABORATORY / ID: HOSPITAL: ..

INDICATOR: ..

Standard: .

No. Laboratory ID Numerator Denominator Performanceachieved

Suggestion for Remedial Action / Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

SUGGESTION

1. TO PROPOSE THE REMEDIAL ACTION.2. NEED REPORT / REPLY FROM JKK WITHIN 3 MONTHS FROM THE DATE LINE /

CLOSING DATE.

3. STANDARDIZE THE FORMAT OF REPORTING.

67


15/38

HBV RESULT FORM(NEQAP)

Date of panel Receipt:Lab ID No.:

REAGENT LOR NO.

EXPIRY DATE

POSITIVE CONTROL LOT NO.

NEGATIVE CONTROL LOTNO.

CONTROL TESTS RESULTS OD OD MEANS OD MEANS/COC

NEGATIVE CONTROL, OD

NEGATIVE CONTROL, OD

POSITIVE CONTROL, OD

CUT-OFF OD (COC)

METHOD: .

SAMPLE RESULT

Sample CodeEIA Test Sample

InterpretationSample OD Cut-Off OD Sample ODCut-Off OD

HBV1

HBV2

HBV3

HBV4

HBV5

HBV6

Note: *sample OD divided by Cut-Off OD

Comment:

Reporting Officer:

68


16/38

Laboratory QA Programme - National Indicator Approach

PROGRAMME : Laboratory QA Programme (Haematology)AREA OF CONCERN : Efficiency of work process for optimum patient management

INDICATOR :TOTAL TURNAROUND TIME FOR URGENT FULL BLOOD

COUNT (FBC)

Rationale : FBC is a basic and commonly requested Haematology test tocheck for blood cell parameters for the investigation of primaryand secondary haemotological disorders.

Definition of Terms :Urgent FBC : Urgent FBC is defined as all FBC that are indicated as urgent by

the requesting doctor for immediate management of patient.

Inclusion criteria : All requests sent for full blood count that are labeled as urgent.

Study design : 1. 2 surveys are conducted yearly (January June and July December). Period of data collection is 2 weeks (per survey)or minimum of 30 requests whichever is higher.

2. Half yearly report should be submitted to JKKHaemotology/Transfusion.

3. Participating laboratory may use the enclosed FormQAP/FBC-1 for data collection.

4. Please complete form A and summary of report in Form Band send them to Pusat Darah Negara by the end of thesurvey month.

Type of Indicator : Timeliness

Numerator : Total no. of urgent FBC request that comply to the standard

Denominator : Total no. of urgent FBC request

Standard : Total TAT for urgent FBC request less than 60 minutes.

Percentage of : Numerator X 100%achievement Denominator

Target achievement : > 90%

Note:Please send your report to the JKK Haematology /Transfusion by 31st July for 1st. cycle and

31st

January for the second cycle of the programme.Address : Dr. Yasmin Ayob


50400, Jalan Tun Razak,Kuala Lumpur.

FORM QAP/FBC-1

69SURVEY OF TOTAL TURNAROUND TIME OF URGENT FBC


17/38

(To be filled by MLT-in-charge)

For data collection only. Do not send to QAP Hematology in Pusat Darah Negara

Patient ID No.: ____________________ Ward: ________

Steps Time *Please comment if there is delay betweeneach step

1 Venepuncture

2 Collection for dispatch

3 Arrival at the lab

4 Completion of sampleanalysis

5 Result informed /dispatched to ward

6 Time result reviewed bytreating doctor

7 Total TAT (to be filledby officer in-charge)

*Note: Time taken from venepuncture to sample arrived at the lab should not exceed 30minutes.

70


18/38

National Indicator Approach in Coagulation

PROGRAMME : QA Programme in CoagulationAREA OF CONCERN : Efficiency of Work Process for Assessment of Hemostasis status.

INDICATOR : Total TURN AROUND TIME (TTAT) for PT and APTT

Rationale : PT and APTT are coagulation screening tests used:i. To determine the hemostasis status of patients with bleeding or

risk of bleeding.As the clotting factors are labile, specimen for PT and APTT needto be processed immediately.

Inclusion criteria : All appropriate requests as in i.Exclusion criteria : i. Coagulation profile

ii. Patients on anticoagulant therapyiii. All requests without proper clinical summary

Type of Indicator : Timeliness

Numerator :

Denominator :

Total number of PT/APTT results made available within 60 minutes

Total number of requests for PT/APTT within the inclusion criteria

Standard : Total Turn Around Time of Less than 90 minutes

Reporting : Expected performance is 100%, however it may vary from laboratoryto laboratory depending on a number of factors:

Customers especially Clinicians

Staffing Automation/Manual techniques

ReagentsPeriod of Data :Collection

Two surveys of 2 weeks each need to be performed for the year. The1st survey during the first half of the year followed by the 2nd surveyduring the 2nd half.

Definition of Terms : PT Prothrombin TimeAPTTActivated Partial Thromboplastin TimeTTAT Time taken from sample collection till the results areinformed or dispatched to the wards.Appropriate All requests as in i and ii.

Coagulation profile A set of tests used to diagnose bleedingdisorders.

71


19/38

Note : i. All PT and APTT tests should be performed within 2 hours Standard requirement as in QAP for Hemostasis RoyalCollege of Pathologists Australia and WHO External QualityAssurance Scheme in Blood Coagulation UK.

ii. DIC profile includes PT/APTT, D-Dimer, FibrinogenConcentration and Platelet Count.

iii. To help laboratories to Time-monitor the movement of thespecimens, please refer to the format as shown in Form C. Itcould be implemented in the form of a Special Request Form orin a simple Stamp (chop) format.

Participants could use Form A or B to submit their reports

Please forward your Performance Reports to the JKK Haematology /Transfusion by 31 st July for1st. cycle and 31stJanuary for the 2ndcycle of the programme.

Address : Dr. Yasmin AyobPengerusi, JKK Haematology /Transfusion ,

Pusat Darah Negara50400, Jalan Tun Razak, Kuala Lumpur. .

72


20/38

FORM A

Participating Laboratory : __________________.

Contact Person : __________________.

Designation : __________________.

Tel No. : __________________.

Reporting Form Performance of Test During Office Hours

Day/Date Total numberof PT/APTT

requests

Number ofresults < 90

minutes

Number ofresults >90

minutes

Performance (%)

1

23

4

5

6

7

8

9

10

11

12

1314

Total

*Note: Individual laboratories can prepare their own format of reporting

Mean total number of PT/APTT requests :________________________

Mean total number of results 90 minutes : ________________________

Mean performance (%) : ________________________

Overall Performance : Good/Satisfactory/Poor

Comment:

73

NIA TOTAL TURN AROUND TIME FOR PT AND APTT


21/38

FORM B

Participating Laboratory : __________________.

Contact Person : __________________.

Designation : __________________.

Tel No. : __________________.

Reporting Form Performance of Test After Office Hours

Day/Date Total numberof PT/APTT

requests

Number ofresults < 90

minutes

Number ofresults >90

minutes

Performance (%)

1

2

34

5

6

7

8

9

10

11

12

13

14Total

*Note: Individual laboratories can prepare their own format of reporting

Mean total number of PT/APTT requests :________________________

Mean total number of results 90 minutes : ________________________

Mean performance (%) : ________________________

Overall Performance : Good/Satisfactory/Poor

Comment:

74

NIA TOTAL TURN AROUND TIME FOR PT AND APTT


22/38

FORM C

Format for Time-monitoring of Specimen for PT/APTT

Activities: Time: Name of Staff:

Time of Venesection ____________ am / pm.

Time Specimen dispatched to Lab: ____________ am / pm.Time Specimen Received at the Lab: ____________ am / pm.

Time Results made available: ____________ am / pm.

75


23/38

PUSAT DARAH NEGARA KUALA LUMPURJalan Tun Razak, 50400 Kuala Lumpur

NATIONAL EXTERNAL QUALITY ASSESSMENT BLOOD BANKING 03/2004

7 OKT. 2004Kepada semua peserta, Lab Code: 001

Re : NEQABB 03/2004

1. Contoh - contoh yang dibekalkan :a) Serum dan sel dari pesakit bertanda :

1. Cell 3 Lot:21050.40.2 & Serum 1 Lot:16680.40.2 dan2. Cell 4 Lot:21060.40.2 & Serum 2 Lot:16690.40.23.

b) Sel daripada penderma :1. Cell 1 Lot:21020.40.2 dan2. Cell 2 Lot:21040.40.2

3.

2. Jalankan ujian-ujian berikut untuk pesakit-pesakit di atas :

a) Kumpulan darah ABO dan Rhesus untuk pesakit sahajab) Antibody Screening dengan menggunakan sel screening I/II atau I/II/IIIc) Ujian antibody idenfikasi jika perlud) Ujian crossmatching setiap pesakit dengan setiap penderma.

Semua keputusan ujian yang lengkap hendaklah dihantarkan ke alamat di bawah :

DR. YASMIN AYOBPENGARAH

PUSAT DARAH NEGARA

JALAN TUN RAZAK50400 KUALA LUMPURFAX : 03 2698 0362 / 2695 5597

Sila hantarkan keputusan ujian anda sebelum atau pada 22-Oct-04

Terima kasih di atas kerjasama anda . Segala pertanyaan, sila hubungi Puan Rozi HanisaMusa (Tel: 03-2693 3888 / 2695 5565 / 2695 5566 / 2695 5572)

76


24/38

KUALITI BERMULA DARI ANDA


Specimens received ( Date ) : ____/ ____/___ Lab code : 001

Specimens tested ( Date ) : ___/____/___

Specimens tested by : ___________

Sample Quality

Unsatisfactory, state reason Initial of Tester

ABO and Rh(D) Grouping

ANTSERA LECTIN CELLS Rh TYPING ABO &

Specimen AntiA

AntiB

AntiAB

AntiA1

AntiH

A B O AntiD

RhCont.

RhDGROUPING

Patient 1:

Patient 2:

Patient 3:

Serum Patient Cells Donor Cells

P1 P2 P3

P1 P2 P3 1 2 3

77

Satisfactory

Unsatisfactory


25/38


Crossmatching Result

PATIENT 1 DONOR 1 DONOR 2 DONOR 3

Negative

Weak Positive

Strong Positive

RT IAT Other RT IAT Other RT IAT Other

Compatible

Incompatible


Negative

Weak Positive

Strong Positive


Compatible

Incompatible


Negative

Weak Positive

Strong Positive


Compatible

Incompatible

78


26/38

*RT Room Temperature, IAT AHG Phase, Other other method eg gel card (Please thick whichmethod that your lab use)


Antibody Screening (Indirect Coombs Test)

Specimen

SALINERT

SALINE 370C IAHG /DIAMED

DCT COOMBSCONTROLCELLS

INTER-PRETATION

S I SII SIII S I S II SIII S I SII SIII S I S II

NO :

NO :

NO :

Antibody Identification

Ab SPECIFICITY TECHNIQUE FORAb ID

SCREENING CELL PANEL USED

MANUFACTURER : BATCH :



PLEASE INDICATE WHICH IAHG METHOD WAS USED FOR THE ANTIBODY SCREENS

ALBUMINAHG

LISSAHG

GELCARD(DIAMED)

COMMENTS AND ADDITIONAL INFORMATION : ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

79


27/38

* PLEASE RECORD ALL RESULTS ON WORKSHEETS INCLUDING THEAGGLUTINATION GRADES *

H A E M A T O L O G Y

National External Quality Assurance Programme

Survey 06/01

Return to: Dr. Yasmin AyobPengarah

Pusat Darah NegaraJalan Tun Razak

50400 Kuala Lumpur

Phone: 03-26933888Facsimile: 03-26980362

Dispatch date: 2/16/2006Closing date: 3/1/2006

80


28/38

HAEMATOLOGY NEQAPSURVEY 06/01

81


29/38

WORKSHEET Posting date: 2/16/2006 Closing date:3/1/2006

This worksheet provides your instructions for SURVEY 06/01. Please read through thesenotes carefully before reporting your responses on the RESULT SHEET provided.

Please return the RESULT SHEET only, to the Haematology NEQAP, before the closing date

stated on the worksheet.

Listed below are the specimens provided with this survey, as well as the test requirements.

Component Specimen Requirement

Full Blood Count 06/01.1C06/01.2C

WBC, RBC, Hb, HCT, MCV, PLTWBC, RBC, Hb, HCT, MCV, PLT

Differential 06/01.1M Differential Count

Morphology 06/01.1M Description & Diagnosis

Full Blood Count: Specimens, 06/01.1C and 06/01.2C

The samples provided contain 2.5 mL of stabilized whole blood. Please process as patient

whole blood samples by your usual method.

Differential: Specimen, 06/01.1M

Please perform a differential on the stained blood film provided. For the sake uniformity,please do not report bands but include them as their metamyelocytes or neutrophilsaccording to the stage of maturation.

Please report your differential in whole numbers only.

Morphology Film: Specimen, 06/01.1M

Blood films are stained with Leishmans. Brief patient history is provided. Please make a

haematology diagnosis, or most likely diagnosis. FAB classification is to be attempted ifrelevant. Any prominent artifact should also be noted .

Haemotology National External Quality Assurance Programme page 1

Fax: 03-26980362

Tel: 03-26933888

82


30/38

HAEMATOLOGY NATIONAL EXTERNAL QUALITY ASSURANCE PROGRAMME

FULL BLOOD COUNT

Specimen Method/Instrument Test Units Results

06/01.1C WBC 10 ^ 9/L _ _.

_

RBC 10 ^ 12/L _ . _

Hb g/L _ _ _

HCT % _ . _ _

MCV fL _ _ _

Plt 10 ^ 9/L _ _ _

06/01.2C WBC 10 ^ 9/L _ _ ._

RBC 10 ^ 12/L _ . _

Hb g/L _ _ _

HCT % _ . _ _

MCV fL _ _ _

Plt 10 ^ 9/L _ _ _

DIFFERENTIAL

Specimen Method Test Units Results

06/01.1M Neut % _ _

Lymph % _ _

Mono % _ _

Eosin % _ _

Baso % _ _

Blast % _ _

Promyelo % _ _

Myelo % _ _

Metam % _ _

Atyp % _ _

Others % _ _

NRBC / 100WC _ _

RETURN TO:Dr. Yasmin Ayob

Pengarah

Pusat Darah Negara

Jalan Tun Razak

50400 Kuala Lumpur

MAILING ADDRESS - PART NO 001Dr.Yasmin Ayob

Pusat Darah Negara

Jalan Tun Razak

Kuala Lumpur.

83


31/38

HAEMATOLOGY NATIONAL EXTERNAL QUALITY ASSURANCE PROGRAMME

MORPHOLOGY

CASE STUDY 06/01.1M

A 6 months years old malay boy was admitted due to febrile fit with acute pharyngitis

WBC: 15.2 x 10e9/L Hb: 10.5 g/dL PLT: 598 x 10e9/LRetic: 2.33% MCV :52.8 fL MCH: 16.1pg

Most prominent feature:

Final Diagnosis:

Reported by: ______________________________________________(Specialist Haematologist / Pathologist / Scientist / Other )

Signature ....................................

Date Received ............................

Date Returned ............................

84


32/38

National External Quality Assurance Program in Basic Coagulation

Makmal Hematologi ________________ Participating Lab Code: ________________

QAP Coordinator :________________________________________________Tel: ____________Fax: ____________

1st Survey March 2005

ObjectiveThe sole purpose of this survey is to assist all participating laboratories improve theirperformance in coagulation tests. The final outcome of any survey should be treated as aguideline only and not as an absolute performance status. The choice of different reagentsand Coagulation Analyzers contribute to different normal ranges and these make it difficult tohave one standard normal range value for all. Even a compromise for this value can onlyplease a few and thus no QAP is an absolute indication of ones performance. Alternatively, toovercome this problem all participating laboratories could use one common reagent andanalyzer. What matters most is the correlation of the laboratory results with the clinicalfindings of the patients.

InstructionYou are provided with one vials of the patients freeze-dried plasma. Reconstitute each vial with1.0ml distilled water, gently mix and leave standing at room temperature for at least 10 min beforetesting. Test all samples within 60mins.

All QA samples have been screened and found negative for HBV, HCV and anti-HIV. Nevertheless,normal precautions have to be taken in its handling and disposal.

Please carry out all or any of the following tests and comment on the results. Please send in all yourreplies by 14th March 2005 so as to be included in the statistical analysis of the results.

1. Prothrombin Time = ________ sec.Your Normal Control = ________ sec.Name of your PT reagent= __________________

The Normal Range = __________________

2. A.P.T.T = ________ sec.Your Normal Control = ________ sec.Name of APTT reagent = __________________The Normal Range = __________________

85


33/38

3. Methodology = Manual / Automation (Name of Analyzer:_________________)

4. Comment on the results:

Please provide the following information:

1. Date survey was received by your lab: _____________________

2. Date results were dispatched by fax : _____________________

3. Designation of staff who providedanswers for Questions 1-2 : Medical Officer / Scientific Officer / MLT

4. The NAME of the person directly involvedwith this QA program and the correctaddress for all future correspondence : ..

....

Please FAX your results to : ____________________ (by 14hb March 2005) _____________________

Fax No. ______________

If you encounter any problems with thissurvey, kindly contact : ____________________

____________________Tel: ________________

86


34/38

H AEMATOLOGYNational External Quality Assurance Programme

JABATAN PATOLOGIHOSPITAL KUALA LUMPUR

Survey 01/02

Return to:

Phone: 03-26155281Facsimile: 03-26970417

Dispatch date:Closing date:

87

Dr. Roshida HassanUnit HematologiJabatan PatologiHospital Kuala LumpurJalan Pahan50586 Kuala Lumpur


35/38

HAEMATOLOGY NEQAP

IMMUNOPHENOTYPING PROGRAM

Objective

This program provides a platform for inter-laboratory assessment among providers of automatedlymphocyte subset enumeration service particularly those providingCD4 /CD8 enumeration formanagement of patients with HIV infection. The specimens provided can be tested for CD3, CD4,CD8, CD19, and NK cells.

Instructions

Please check all specimens on arrival and report any omissions or leakages on receipt. Analysisshould be carried out immediately. The specimens are to be processed as for any other routinespecimens intended for flowcytometric analysis.

Please submit the results obtained according to the tests performed by your instrument in the relevantboxes in the result sheet attached.

a) Automated CD4 / CD8 analyser : CD3 , CD4 and CD8.b) Flowcytometer : CD3 , CD4 ,CD8, CD19 and NK cells.

Testing schedule :

The tentative schedule is as follows :

SURVEY DATE

01/02 End Jan 2002

02/02 March 2002

03/02 July 2002

04/02 September 2002

Closing date is 2 weeks from the date of dispatch of the specimens.

88


36/38

HAEMATOLOGY NEQAP

IMMUNOPHENOTYPING PROGRAM

Participant's Information Program IPT 2002

PARTICULARS

Institution

Department

Contact

Telephone

Facsimile

Email

Please where applies to your routine laboratory, sample handling and processing proceduresFLOW CYTOMETRY PLATFORM ANTIBODY PANEL

FACSCalibur CD45/CD14

FACScan CD3/CD4

FACSCount CD3/CD8

Othersplease specifiy CD3/CD19

CD3/CD16+56

CD3/CD4/CD45

ANTIBODY SOURCE CD3/CD8/CD45

CD3/CD19/CD45BD CD3/CD16+56/CD45

DAKO CD3/CD4/CD45/CD8

Othersplease specifiy CD3/CD16+56/CD45/CD19

Othersplease specifiy

SAMPLE PREPARATION

RESULT REPORTING

Assay

Whole blood PBMC Absolute CD4 Count

Single platform/direct countIntegrity Check Differential WBC count

Yes No Othersplease specifiy

Red Cell Lysis

FACSLysing Solution Gating Strategies

NH4Cl Lysis CD45/CD14

Othersplease specifiy CD45/SSC

FSC/SSC

89


37/38

Othersplease specifiy

Sample Fixation(paraformaldehyde)

Yes No

IPT PROGRAM 2002

RESULT SHEET SURVEY _____/02

Please process these samples as you would for the routine cases and record the results in spacesallocated below.

Lymphocyte subset

Tube IPT 1 Tube IPT 2

% Absolute Count

Cells / l % Absolute CountCells / lCD 3

+

__ __ . __ __ __ . __

CD 3+CD 4+ __ __ . __ __ __ . __

CD 3+CD 8+ __ __ . __ __ __ . __

CD 19+ __ __ . __ __ __ . __

CD 3- CD 16+ __ __ . __

__ __ . __

CD 3- CD56+ __ __ . __ __ __ . __

CD 3 -( CD 16+CD56+ ) __ __ . __ __ __ . __

90


38/38

Important

Date of receipt: ..

Were the specimens in a satisfactory condition? If not give reason/s

..

..

5 nia manual 2004-hem&trans part 2

Documents