Impact of introducing quality control/quality assurance (QC/QA) guidelines in respiratory specimen processing

To assess the impact of the introduction of a new quality control/quality assurance (QA/QC) protocol on the processing and reporting of respiratory specimens. After implementation of guidelines for processing respiratory specimens, an investigation was carried out over a six-month period on 200 spec...

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Bibliographic Details
Published in:Clinical microbiology and infection 2003-08, Vol.9 (8), p.810-815
Main Authors: Al Balooshi, N., Jamsheer, A., Botta, G.A.
Format: Article
Language:English
Subjects:
Bacteriological methods and techniques used in bacteriology
Bacteriology
Biological and medical sciences
deep tracheal aspirates
Fundamental and applied biological sciences. Psychology
Guidelines as Topic
Humans
Microbiology
microscopic examination
Microscopy
Quality Control
Specimen Handling - standards
sputum
Sputum - microbiology
Trachea - microbiology
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Summary:To assess the impact of the introduction of a new quality control/quality assurance (QA/QC) protocol on the processing and reporting of respiratory specimens. After implementation of guidelines for processing respiratory specimens, an investigation was carried out over a six-month period on 200 specimens, 105 sputa, and 95 deep tracheal aspirates (DTAs), assessed blindly by two independent investigators. Data regarding disagreement were arranged into two subgroups. A minor disagreement was defined as a difference in the two assessments of 25 suggestive of infection, we looked at the 107 samples rejected during the six-month period, grouped according to the suspected diagnosis. The highest number of rejected samples falls in the category of unrelated (non-respiratory) diagnosis, and clinical suspicion is not helpful in Gram stain interpretation. The annual saving (not culturing, not testing, and not treating) derived from this simple QC procedure totals about 5000 Euro. Standardization in microscopic screening of respiratory samples is difficult to achieve. Criteria for rejection must be adapted to local conditions after discussion with clinicians to increase their compliance with the newly introduced guidelines and to avoid sending unnecessary specimens. The effects on patient management and cost control are significant.
ISSN:1198-743X
1469-0691
DOI:10.1046/j.1469-0691.2003.00658.x