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Int J Lab Hematol. 2015 Dec;37(6):729-38. doi: 10.1111/ijlh.12397. Epub 2015 Jun 24.

Internal Quality Control Practices in Coagulation Laboratories: recommendations based on a patterns-of-practice survey.

Author information

1
Institute for Quality Management in Healthcare (IQMH), Toronto, ON, Canada.
2
Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada.
3
Sunnybrook Health Sciences Centre and University Health Network, Toronto, ON, Canada.
4
Ottawa Hospital-General Campus, Ottawa, ON, Canada.

Abstract

INTRODUCTION:

Internal quality control (IQC) procedures are crucial for ensuring accurate patient test results. The IQMH Centre for Proficiency Testing conducted a web-based survey to gather information on the current IQC practices in coagulation testing.

METHODS:

A questionnaire was distributed to 174 Ontario laboratories licensed to perform prothrombin time (PT) and activated partial thromboplastin time (APTT).

RESULTS:

All laboratories reported using two levels of commercial QC (CQC); 12% incorporate pooled patient plasma into their IQC program; >68% run CQC at the beginning of each shift; 56% following maintenance, with reagent changes, during a shift, or with every repeat sample; 6% only run CQC at the beginning of the day and 25% when the instruments have been idle for a defined period of time. IQC run frequency was determined by manufacturer recommendations (71%) but also influenced by the stability of test (27%), clinical impact of an incorrect test result (25%), and sample's batch number (10%). IQC was monitored using preset limits based on standard deviation (66%), precision goals (46%), or allowable performance limits (36%). 95% use multirules. Failure actions include repeating the IQC (90%) and reporting patient results; if repeat passes, 42% perform repeat analysis of all patient samples from last acceptable IQC.

CONCLUSION:

Variability exists in coagulation IQC practices among Ontario clinical laboratories. The recommendations presented here would be useful in encouraging standardized IQC practices.

KEYWORDS:

Coagulation; hemostasis; laboratory practice; quality control

PMID:
26108698
DOI:
10.1111/ijlh.12397
[Indexed for MEDLINE]

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