CAP Inspection Week --

 


Did you date your reagents?!

Do you know where the (M)SDS is?!

Do you know where our spill kit is?!

Make sure you readback the blood type before issuing that!

Label your tubes properly!!

"This is how we're supposed to do it, but usually we just do this" You can't say that!!

Make sure the QC logs are initialed!

Are you doing everything right?! 

AACC.org put together a chart of the most common deficiencies found in the clinical laboratory during inspection days. It encompasses the major bodies such as CMS labs, CMS Physicians Office Lab, CAP, COLA, and Joint Commission.

Most Common Laboratory Inspection Deficiencies
Competency assessments, accurate procedure manuals, correlations of instruments, reagent labeling/expiration, and method validation approval are some I think are the most drilled into people's heads. 

Activity Menu by CAP is defined as the type and complexity of testing per department.

A survey put out by CMS highlights some of the most common deficiencies with a detailed explanation of each. 

At almost 5% of all labs surveyed, CMS spotted a deficiency regarding 

"The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented."

The least common deficiency, yet still 59 labs surveyed, failed to have a technical supervisor who met the required qualification requirements. HMM. VERY INTERESTING. 

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