QAP/CT-2 Laboratory NIA Indicator State :_________________ Month :__________________ Indicator : C:T Ratio Standard : 2.

5:1 No Lab/Hospital Medical O&G C:T Ratio Orthopedi Surgical c Paediatric AVERAGE Year :______________

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 AVERAGE Is there a Shortfall in Quality for this Indicator? Yes ( ) No ( )

Reason for SIQ:__________________________________________________________________ __ _______________________________________________________________________ Any remedial action taken? _________________________ Action / :
54

__________________________________________________________________________ __________________________________________________________________________ ________________________________________________________________

Laboratory QA Programme - National Indicator Approach PROGRAMME AREA OF CONCERN : : Laboratory QA Programme (Transfusion) Blood Inventory

INDICATOR Rationale

: :

EXPIRY RATE OF RED CELL 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 Inclusion criteria Exclusion criteria Type of Indicator Numerator Denominator

: Blood collected and received by the center that has expired : : : : : ALL RED CELL in stock (collected and received) Blood that is not suitable for use. contaminated). Efficiency in Stock Management Total number of expired blood Total number of blood in stock (eg citrated,

x 100%

Standard Note:

Less than 5% of the blood in stock.

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 JKK Haematology /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/EX-1
55

Indicator: Expiry Rate of Red Cells

Hospital :_____________ State: ________________
Blood In Stock (From Collection and received from other hospital)

Year :_________________

Total Expired Jan Feb Mar Apr May Jun Total (Jan June) Jul Aug Sep Oct Nov Dec Total (Jul Dec) Grand Total

Expiry Rate

Note: Exclude Unsuitable Units of Blood.

Is there a Shortfall in Quality for this Indicator?

Yes (

No (

Reason for SIQ:__________________________________________________________________ _ _______________________________________________________________________ Any remedial action taken? _________________________ Action / : __________________________________________________________________________ __________________________________________________________________________ ____________________________________________________________________

56

QAP/EX-2 Laboratory NIA Indicator State :_________________ Month :__________________ Standard : < 5% No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Lab / Hospital Expiry Rate Year :______________ Indicator : EXPIRY RATE OF RED CELL

Is there a Shortfall in Quality (SIQ) for this Indicator?

Yes (

No (

Reason for SIQ:______________________________________________________________ _______________________________________________________________________ Any remedial action taken? _________________________ Action: __________________________________________________________________________ __________________________________________________________________________ ____________________________________________________________________
57

Laboratory QA Programme - National Indicator Approach PROGRAMME : Laboratory QA Programme (Transfusion) AREA OF CONCERN : Patient safety in Transfusion Medicine. INDICATOR Rationale 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 error Any error occurring from the time of collection to labeling of the patients 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 blood components are released for transfusion. 3) Error Associated With Administration of Blood Any errors which occurs after the blood released for transfusion, checking and confirmation of the blood and blood components for transfusion by the personnel responsible till the completion of transfusion. All requests for blood and blood components. 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 an emergency. 3) Group AB recipient transfused with group A or B blood in the absence Group AB Blood.

TRANSFUSION

ERROR

RATE

This indicator is selected to measure the causes of error in transfusion. Transfusion error can contribute to mortality and morbidity to patients. Transfusion errors are preventable.

Inclusion criteria Exclusion criteria

: :

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-1 2. State shall compile into FORMAT QAP/ERR-2 and send the 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 Pengerusi, JKK Haematology /Transfusion , Pusat Darah Negara 50400, Jalan Tun Razak, Kuala Lumpur. . QAP/ERR-1
58

Indicator: Transfusion Error Rate. Hospital:_____________________ State:________________________ Month January February March April May June Total (JanJune) July August September October November December Total (JulDec) Grand Total Is there a Shortfall In Quality (SIQ) for this indicator? Yes ( ) No ( ) Sampling Error Blood Bank Error Error Associated With Administration Blood

Reason for SIQ:_______________________________________________________________ ____________________________________________________________________________ Any remedial action taken? _____________________________ Action / : _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

59

QAP/ERR-2 Laboratory NIA Indicator State : ____________________ Month : ____________________ Indicator : TRANSFUSION ERROR RATE Standard : ZERO Error Associated with Administration of Blood Total number of Errors Year : _____________________

No

Lab / Hospital

Sampling Error

Blood Bank Error

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 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

_________________________________________________________________________________ _____________________________________________________________________________ Laboratory QA Programme - National Indicator Approach PROGRAMME : Laboratory QA Programme (Transfusion) AREA OF CONCERN : Precision of Laboratory Testing of Anti-HCV

INDICATOR

RATE OF LABORATORY ERROR IN ANTI-HCV SCREENING TEST

1. To monitor the reproducibility of Anti-HCV testing in the screening 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.

Rationale

Definition of Terms AntiHCV EIA Initially Reactive (IR)

: 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 reactive sample Total sample of the month Reproducibility of the result : : : : : : All Anti HCV EIA test perform for blood donor screening. All Anti HCV tests performed by methods other than EIA. Proficiency Initial Reactive Repeat Reactive x 100%. Total number of Sample Repeat Reactive

Repeatedly Reactive (RR) Total Sample (T) Precision Inclusion criteria Exclusion criteria Type of Indicator Numerator Denominator 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 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.
61

Laboratory QA Programme - National Indicator Approach PROGRAMME : Laboratory QA Programme (Transfusion) AREA OF CONCERN : Precision of Laboratory Testing of HbsAG Testing INDICATOR :

RATE OF LABORATORY ERROR IN HBSAg SCREENING TEST

1. To monitor the reproducibility of HbsAg testing in the screening 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.

Rationale

Definition of Terms HBsAg : EIA Initially Reactive (IR)

: 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 reactive sample Total sample of the month Reproducibility of the result : : : : : : All HBsAg EIA test perform for blood donor screening. All HBsAg tests performed by methods other than EIA. Performance Initial Reactive Repeat Reactive x 100%. Total number of Sample Repeat Reactive

Repeatedly Reactive (RR) Total Sample (T) Reproducibility Inclusion criteria Exclusion criteria Type of Indicator Numerator Denominator 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 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/HBSAG-01 Laboratory NIA Indicator

62

YEAR: LABORATORY/ID : HOSPITAL:.. INDICATOR: Laboratory Error in HbsAg Screening Test Standard: Numerator: Denominator:
**Note: Numerator values must be less than denominator values. MONTH January February March April May June SUB-TOTAL July August September October November December SUB-TOTAL TOTAL Numerator Denominator Performance achieved

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-02 Laboratory NIA Indicator
63

YEAR: LABORATORY/ID : HOSPITAL:.. INDICATOR: Laboratory Error in Anti-HVC Screening Test Standard: Numerator: Denominator:
**Note: Numerator values must be less than denominator values. MONTH Numerator Denominator January February March April May June SUB-TOTAL July August September October November December SUB-TOTAL TOTAL Performance achieved

Is there a shortfall in Quality for this indicator?

Yes

No

If yes please fill the SIQ Report. Comments: __________________________________________________________________________ __________________________________________________________________________ ____________________________________________________________________ QAP/TR-SIQ
64

SHORTFALL IN QUALITY REPORTING FORMAT LABORATORY / ID: .. HOSPITAL: .. INDICATOR: Standard: Actual performance achieved: Reason for Shortfall in Quality: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ ________________________________________________________________ Remedial Action: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ ________________________________________________________________ Month/Year:

Performance after implementation of remedial action: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ ________________________________________________________________

Laboratory NIA Indicator

65

(FORMAT FOR JKK REPORT TO INDIVIDUAL LABORATORY 1) YEAR: LABORATORY/ID : HOSPITAL:.. INDICATOR: . Standard: .. Your Performance: . Overall Performance:
MONTH January February March April May June SUB-TOTAL / AVERAGE July August September October November December SUB-TOTAL / AVERAGE TOTAL / AVERAGE Average Overall Performance Achieved

Suggestion for Remedial Action / Comments: __________________________________________________________________________ ______________________________________________________________________ ________________________________________________________________________

66

Laboratory NIA Indicator FORMAT FOR JKK REPORT TO INDIVIDUAL LABORATORY 2 MONTH / YEAR: . LABORATORY / ID: HOSPITAL: .. INDICATOR: .. Standard: . No. Laboratory ID Numerator Denominator Performance achieved

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

HBV RESULT FORM (NEQAP)

Date of panel Receipt: Lab ID No.: REAGENT LOR NO. EXPIRY DATE POSITIVE CONTROL LOT NO. NEGATIVE CONTROL LOT NO.

CONTROL TESTS RESULTS NEGATIVE CONTROL, OD NEGATIVE CONTROL, OD POSITIVE CONTROL, OD CUT-OFF OD (COC)

OD

OD MEANS

OD MEANS/COC

METHOD: . SAMPLE RESULT Sample Code Sample OD EIA Test Cut-Off OD Sample OD Cut-Off OD Sample Interpretation

HBV1 HBV2 HBV3 HBV4 HBV5 HBV6 Note: *sample OD divided by Cut-Off OD Comment: Reporting Officer:

68

Laboratory QA Programme - National Indicator Approach PROGRAMME AREA OF CONCERN INDICATOR : : : Laboratory QA Programme (Haematology) Efficiency of work process for optimum patient management TOTAL TURNAROUND TIME FOR URGENT FULL BLOOD COUNT (FBC)

Rationale

FBC is a basic and commonly requested Haematology test to check for blood cell parameters for the investigation of primary and secondary haemotological disorders. Urgent FBC is defined as all FBC that are indicated as urgent by the requesting doctor for immediate management of patient. All requests sent for full blood count that are labeled as urgent. : 1. 2. 3. 4. 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. Half yearly report should be submitted to JKK Haemotology/Transfusion. Participating laboratory may use the enclosed Form QAP/FBC-1 for data collection. Please complete form A and summary of report in Form B and send them to Pusat Darah Negara by the end of the survey month.

Definition of Terms Urgent FBC Inclusion criteria Study design

: : :

Type of Indicator Numerator Denominator Standard Percentage of achievement

: : : : :

Timeliness Total no. of urgent FBC request that comply to the standard Total no. of urgent FBC request Total TAT for urgent FBC request less than 60 minutes. Numerator X 100% 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 Pengerusi, JKK Haematology /Transfusion , Pusat Darah Negara 50400, Jalan Tun Razak, Kuala Lumpur.

FORM QAP/FBC-1 SURVEY OF TOTAL TURNAROUND TIME OF URGENT FBC

69

(To be filled by MLT-in-charge)

For data collection only. Do not send to QAP Hematology in Pusat Darah Negara
Patient ID No.: ____________________ Steps 1 2 3 4 5 6 7 Venepuncture Collection for dispatch Arrival at the lab Completion of sample analysis Result informed / dispatched to ward Time result reviewed by treating doctor Total TAT (to be filled by officer in-charge) Time Ward: ________ *Please comment if there is delay between each step

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

70

National Indicator Approach in Coagulation

PROGRAMME AREA OF CONCERN INDICATOR Rationale : QA Programme in Coagulation : Efficiency of Work Process for Assessment of Hemostasis status. : : Total TURN AROUND TIME (TTAT) for PT and APTT 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 need to be processed immediately. All appropriate requests as in i. i. Coagulation profile ii. Patients on anticoagulant therapy iii. All requests without proper clinical summary Timeliness Total number of PT/APTT results made available within 60 minutes Total number of requests for PT/APTT within the inclusion criteria Total Turn Around Time of Less than 90 minutes Expected performance is 100%, however it may vary from laboratory to laboratory depending on a number of factors: Customers especially Clinicians Staffing Automation/Manual techniques Reagents Two surveys of 2 weeks each need to be performed for the year. The 1st survey during the first half of the year followed by the 2nd survey during the 2nd half. PT Prothrombin Time APTT Activated Partial Thromboplastin Time TTAT Time taken from sample collection till the results are informed or dispatched to the wards. Appropriate All requests as in i and ii. Coagulation profile A set of tests used to diagnose bleeding disorders.

Inclusion criteria Exclusion criteria

: :

Type of Indicator Numerator Denominator Standard Reporting

: : : : :

Period of Data Collection Definition of Terms :

71

Note

i.

All PT and APTT tests should be performed within 2 hours Standard requirement as in QAP for Hemostasis Royal College of Pathologists Australia and WHO External Quality Assurance Scheme in Blood Coagulation UK. DIC profile includes PT/APTT, D-Dimer, Fibrinogen Concentration and Platelet Count. To help laboratories to Time-monitor the movement of the specimens, please refer to the format as shown in Form C. It could be implemented in the form of a Special Request Form or in a simple Stamp (chop) format.

ii.

iii.

Participants could use Form A or B to submit their reports Please forward your Performance Reports to the JKK Haematology /Transfusion by 31st July for 1st. cycle and 31st January for the 2nd cycle of the programme. Address : Dr. Yasmin Ayob Pengerusi, JKK Haematology /Transfusion , Pusat Darah Negara 50400, Jalan Tun Razak, Kuala Lumpur. .

72

FORM A Participating Laboratory : __________________. Contact Person : __________________. Designation : __________________. Tel No. : __________________. NIA TOTAL TURN AROUND TIME FOR PT AND APTT Reporting Form Performance of Test During Office Hours Day/Date Total number of PT/APTT requests Number of results < 90 minutes Number of results >90 minutes Performance (%)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 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 total number of results > 90 minutes Mean performance (%) Overall Performance Comment: :________________________ : ________________________ : ________________________ : ________________________ : Good/Satisfactory/Poor

73

FORM B Participating Laboratory : __________________. Contact Person : __________________. Designation : __________________. Tel No. : __________________. NIA TOTAL TURN AROUND TIME FOR PT AND APTT Reporting Form Performance of Test After Office Hours Day/Date Total number of PT/APTT requests Number of results < 90 minutes Number of results >90 minutes Performance (%)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 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 total number of results > 90 minutes Mean performance (%) Overall Performance Comment: :________________________ : ________________________ : ________________________ : ________________________ : Good/Satisfactory/Poor

74

FORM C Format for Time-monitoring of Specimen for PT/APTT Activities: Time of Venesection Time Specimen dispatched to Lab: Time Specimen Received at the Lab: Time Results made available: Time: ____________ am / pm. ____________ am / pm. ____________ am / pm. ____________ am / pm. Name of Staff:

75

PUSAT DARAH NEGARA KUALA LUMPUR

Jalan Tun Razak, 50400 Kuala Lumpur

NATIONAL EXTERNAL QUALITY ASSESSMENT BLOOD BANKING 03/2004 7 OKT. 2004 Kepada 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 2. Cell 4 Lot:21060.40.2 & Serum 2 Lot:16690.40.2 3. b) Sel daripada penderma : 1. Cell 1 Lot:21020.40.2 2. Cell 2 Lot:21040.40.2 3.

dan

dan

2. Jalankan ujian-ujian berikut untuk pesakit-pesakit di atas : a) Kumpulan darah ABO dan Rhesus untuk pesakit sahaja b) Antibody Screening dengan menggunakan sel screening I/II atau I/II/III c) Ujian antibody idenfikasi jika perlu d) Ujian crossmatching setiap pesakit dengan setiap penderma. Semua keputusan ujian yang lengkap hendaklah dihantarkan ke alamat di bawah :

DR. YASMIN AYOB PENGARAH PUSAT DARAH NEGARA JALAN TUN RAZAK
50400 KUALA LUMPUR

FAX : 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 Hanisa Musa (Tel: 03-2693 3888 / 2695 5565 / 2695 5566 / 2695 5572)
76

 KUALITI BERMULA DARI ANDA

NATIONAL EXTERNAL QUALITY ASSESSMENT BLOOD BANKING 03/2004 Specimens received ( Date ) : ____/ ____/___ Specimens tested ( Date ) Specimens tested by Sample Quality : ___/____/___ : ___________ Lab code : 001

Satisfactory Unsatisfactory

Serum P1 P2

P3

Patient Cells P1 P2 P3

Donor Cells 1 2 3

Unsatisfactory, state reason

Initial of Tester

ABO and Rh(D) Grouping Specimen Patient 1: Patient 2: Patient 3: ANTSERA Anti Anti Anti A B AB LECTIN Anti Anti A1 H A CELLS B O Rh TYPING Anti Rh D Cont. ABO & RhD GROUPING

77

NATIONAL EXTERNAL QUALITY ASSESSMENT BLOOD BANKING 03/2004 Crossmatching Result PATIENT 1
RT

DONOR 1
IAT Other RT

DONOR 2
IAT Other RT

DONOR 3
IAT Other

Negative Weak Positive Strong Positive Compatible Incompatible

PATIENT 2
RT

DONOR 1
IAT Other RT

DONOR 2
IAT Other RT

DONOR 3
IAT Other

Negative Weak Positive Strong Positive Compatible Incompatible PATIENT 3

RT

DONOR 1
IAT Other RT

DONOR 2
IAT Other RT

DONOR 3
IAT Other

Negative Weak Positive Strong Positive Compatible Incompatible

78

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

NATIONAL EXTERNAL QUALITY ASSESSMENT BLOOD BANKING 03/2004 Antibody Screening (Indirect Coombs Test)
SALINE RT SALINE 370C SIII SI S II SIII SI IAHG / DIAMED SII SIII DCT COOMBS CONTROL CELLS SI S II INTERPRETATION

Specimen NO : NO : NO :

SI

SII

Antibody Identification Ab SPECIFICITY TECHNIQUE FOR SCREENING CELL PANEL USED Ab ID MANUFACTURER : BATCH : MANUFACTURER : MANUFACTURER : BATCH : BATCH :

PLEASE INDICATE WHICH IAHG METHOD WAS USED FOR THE ANTIBODY SCREENS ALBUMIN AHG LISS AHG GEL CARD (DIAMED)

COMMENTS AND ADDITIONAL INFORMATION : ______________________________ _______________________________________________________________ _______________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________

79

* PLEASE RECORD ALL AGGLUTINATION GRADES *

RESULTS

ON

WORKSHEETS

INCLUDING

THE

HAEMATOLOGY National External Quality Assurance Programme

Survey 06/01

Return to:

Dr. Yasmin Ayob Pengarah Pusat Darah Negara Jalan Tun Razak 50400 Kuala Lumpur

Phone: 03-26933888 Facsimile: 03-26980362 Dispatch date: 2/16/2006 Closing date: 3/1/2006

80

HAEMATOLOGY NEQAP SURVEY 06/01

81

WORKSHEET 3/1/2006

Posting date: 2/16/2006

Closing date:

This worksheet provides your instructions for SURVEY 06/01. Please read through these notes 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 Full Blood Count Differential Morphology

Specimen 06/01.1C 06/01.2C 06/01.1M 06/01.1M

Requirement WBC, RBC, Hb, HCT, MCV, PLT WBC, RBC, Hb, HCT, MCV, PLT Differential Count 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 neutrophils according 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 i s to be attempted if relevant. Any prominent artifact should also be noted .

Haemotology National External Quality Assurance Programme Fax: 03-26980362 Tel: 03-26933888

page 1

82

Posting date : 20/09/2001 Closing date : 06/10/2001 HAEMATOLOGY NATIONAL EXTERNAL QUALITY ASSURANCE PROGRAMME FULL BLOOD COUNT
Specimen 06/01.1C Method/Instrument Test WBC RBC Hb HCT MCV Plt 06/01.2C WBC RBC Hb HCT MCV Plt Units 10 ^ 9/L 10 ^ 12/L g/L % fL 10 ^ 9/L 10 ^ 9/L 10 ^ 12/L g/L % fL 10 ^ 9/L Results _ _ . _ _ . _ _ _ _._ _ _ _ _ _ _ _ _

_ _ . _ _ . _ _ _ _ _ _ ._ _ _ _ _ _ _

DIFFERENTIAL
Specimen 06/01.1M Method Test Neut Lymph Mono Eosin Baso Blast Promyelo Myelo Metam Atyp Others NRBC Units % % % % % % % % % % % / 100WC Results _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

RETURN TO: Dr. Yasmin Ayob Pengarah Pusat Darah Negara Jalan Tun Razak 50400 Kuala Lumpur

MAILING ADDRESS - PART NO 001 Dr.Yasmin Ayob Pusat Darah Negara Jalan Tun Razak Kuala Lumpur.

83

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 Retic: 2.33% Most prominent feature: Hb: 10.5 g/dL MCV :52.8 fL PLT: 598 x 10e9/L MCH: 16.1pg

Final Diagnosis:

Reported by: ______________________________________________ (Specialist Haematologist / Pathologist / Scientist / Other ) Signature .................................... Date Received ............................ Date Returned ............................
84

National External Quality Assurance Program in Basic Coagulation

Makmal Hematologi ________________ ________________ QAP Coordinator : ________________ ________________ ________________ Tel: ____________ Fax: ____________ Participating Lab Code:

1st Survey March 2005 Objective

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

Instruction
You are provided with one vials of the patients freeze-dried plasma. Reconstitute each vial with 1.0ml distilled water, gently mix and leave standing at room temperature for at least 10 min before testing. Test all samples within 60 mins. 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 your replies 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 Your Normal Control Name of APTT reagent The Normal Range = ________ sec. = ________ sec. = __________________ = __________________

85

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 provided answers for Questions 1-2 : Medical Officer / Scientific Officer / MLT

4. The NAME of the person directly involved with this QA program and the correct address for all future correspondence : .. .. .. Please FAX your results to (by 14hb March 2005)
If you encounter any problems with this survey, kindly contact

: ____________________ _____________________ Fax No. ______________

: ____________________ ____________________ Tel: ________________

86

H AEMATOLOGY National External Quality Assurance Programme

JABATAN PATOLOGI HOSPITAL KUALA LUMPUR Survey 01/02

Return to: Dr. Roshida Hassan Unit Hematologi Jabatan Patologi Hospital Kuala Lumpur Jalan Pahan 50586 Kuala Lumpur

Phone: 03-26155281 Facsimile: 03-26970417 Dispatch date: Closing date:

87

HAEMATOLOGY NEQAP IMMUNOPHENOTYPING PROGRAM Objective

This program provides a platform for inter-laboratory assessment among providers of automated lymphocyte subset enumeration service particularly those providingCD4 /CD8 enumeration for management 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. Analysis should be carried out immediately. The specimens are to be processed as for any other routine specimens intended for flowcytometric analysis. Please submit the results obtained according to the tests performed by your instrument in the relevant boxes 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 01/02 02/02 03/02 04/02 DATE End Jan 2002 March 2002 July 2002 September 2002

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

88

HAEMATOLOGY NEQAP IMMUNOPHENOTYPING PROGRAM Participant's Information

PARTICULARS
Institution Department Contact Telephone Facsimile Email
Please where applies to your routine laboratory, sample handling and processing procedures

Program IPT 2002

FLOW CYTOMETRY PLATFORM FACSCalibur FACScan FACSCount Others please specifiy

ANTIBODY PANEL CD45/CD14 CD3/CD4 CD3/CD8 CD3/CD19 CD3/CD16+56 CD3/CD4/CD45 CD3/CD8/CD45 CD3/CD19/CD45 CD3/CD16+56/CD45 CD3/CD4/CD45/CD8 CD3/CD16+56/CD45/CD19 Others please specifiy

ANTIBODY SOURCE BD DAKO Others please specifiy

SAMPLE PREPARATION RESULT REPORTING

Assay
Whole blood PBMC

Absolute CD4 Count

Single platform/direct count Differential WBC count Others please specifiy

Integrity Check
Yes No

Red Cell Lysis

FACSLysing Solution NH4Cl Lysis Others please specifiy

Gating Strategies
CD45/CD14 CD45/SSC FSC/SSC 89

Others please 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 spaces allocated below.

Lymphocy te subset %
CD 3+ CD 3+CD 4+ CD 3+CD 8+ CD 19+ __ __ . __ __ __ . __ __ __ . __ __ __ . __

Tube IPT 1 Absolute Count Cells / l %

Tube IPT 2 Absolute Count Cells / l

__ __ . __ __ __ . __ __ __ . __ __ __ . __ __ __ . __

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

__ __ . __ __ __ . __ __ __ . __ __ __ . __ __ __ . __

90

Important
Date of receipt: .. Were the specimens in a satisfactory condition? If not give reason/s

.. ..

91