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Science, Technology and Medicine open access publisher.Publish, read and share novel research. Establishment a Resource Management Program for Accreditation Process at the Medical LaboratorySedef Yenice1[1] Department of Biochemistry, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey1. The laboratory can provide consistent test results of acceptable quality only when there is provision of appropriate facilities the laboratory environment. Table 2 and 3 summarize the requirements for laboratory director and technical supervisor, respectively. Ensure that policies and procedures are established for monitoring individuals who conduct pre-analytical, analytical, and post-analytical phases of testing to assure that they are competent and maintain their competency to process specimens, perform test procedures and report test results promptly and proficiently, and whenever necessary, identify needs for remedial training or continuing education to improve skills.
Specify, in writing, the responsibilities and duties of each consultant and each supervisor, as well as each person engaged in the performance of the pre-analytical, analytical, and post-analytical phases of testing. Figure 1 shows a checklist developed in our laboratory to assess the competency of a medical laboratory technician who performs point of care (POC) urinanalysis. Face Velocities should be between 80 and 120 FPM at the working sash height with an optimum level of 100 FPM. Certification is required annually or any time the hood is moved or has had maintenance performed. All chemicals must be appropriately labeled and shall not be placed near or over floor drains.
Smoking is prohibited throughout all facilities at the organisation (with the exception specially designed "designated smoking areas"),Lab Personnel shall not wear loose (e.g.
All unnecessary material, boxes, and containers must be disposed of in the appropriate manner. All emergency and contingencies plans and evacuation routes shall be clearly posted in conspicuous places. Implementing a resource management program for accreditation process at the medical laboratory.
Employee competence and performance-based assessment: a College of American Pathologists Q-Probes study of laboratory personnel 522 institutions. Personnel standards and quality assurance practices of biochemical genetic testing laboratories in the United States. Curriculum content and evaluation of resident competency in clinical pathology (laboratory medicine): a proposal.
1990A Guide for evaluating the performance of chemical protective clothing (CPC) Cincinnati, OH, US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention.
Primary containment for biohazards: selection, installation and use of biological safety cabinets. 2005 Protection of laboratory workers from occupationally acquired infections; approved guideline, 3 ed. 1995The association of state and territorial public health laboratory directors and US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention. Field ServicesKiser Hydro is able to dispatch dedicated field service teams, each equipped with necessary standard tools for hydroelectric work as quickly as needed.
Kiser Hydro has been servingthe hydropower industry in theUnited States and Canadafor over 40 years. Generator InstallsWe offer full installation of generators, and will co-ordinate everything for you, from digging a trench to contacting your propane supplier. We offer generator installs in Smiths Falls, Perth, Almonte, Ottawa, Kingston and surrounding areas. Generator ServicingFull 20 point inspection twice a year on your equipment, and optional 24hr support so you are never left in the dark, and swimming in a flooded basement. We offer generator servicing in Smiths Falls, Perth, Almonte, Ottawa, Kingston and surrounding areas. An employee competency and assessment checklist to assess the competency of a medical laboratory technician who performs point of care (POC) urinanalysis. IntroductionThe Laboratory Accreditation Program from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is one of the most widely used CMS-approved accreditation program. These include adequate buildings, space within the laboratory, appropriate utilities, and supplies and equipment for performance of laboratory tests. Any area which deals with corrosive, flammable or otherwise hazardous material is required to have immediate access to eyewash and drench shower facilities. All drains, including floor drains and cup sinks should be flushed with water on a weekly basis to eliminate sewer odors. Glass containers and other potentially sharp objects shall not be disposed of in common office refuse. Washington: US Department and Health and Human Services Public Health Service Centers for Disease Control and Prevention. Recommendations of CDC and the healthcare infection control practices advisory committee (HICPAC). This gives Kiser Hydro's team the ability to consider the entire picture, and get the job done right. That's why Kiser Hydro offers complete and extensive inspection and maintenance services, and can tailor these to your plant.


Testing requirements of each organization are at least equivalent to those of CLIA '88, they execute to some extent different testing standards and rationales in reaching the goal of quality laboratory testing.
Specimen collection facilities are designated to respect patient's privacy, security, comfort, and disabilities. Eye wash bottles are not adequate equipment.Personal Protective Equipment Personal Protective Equipment such as goggles, masks, gloves and cover gowns must be readily available and not worn outside the immediate work areas. 40-75 liter must be stored in specific safety containers, 75 and over must be stored in a safety cabinet.Hazardous Waste Disposal Hazardous waste training is required for all employees who handle hazardous material.
ConclusionResource management for accreditation process at the medical laboratories applies to many aspects of quality management including personnel, basic facilities, equipment, security and safety. Since 1995, clinical laboratories surveyed using JCAHO standards have been deemed to be certifiable under CLIA '88 requirements.
The laboratory director is responsible for defining the process of selecting and using equipment, reagents, and other supplies that affect the quality of services. The purpose of CLIA '88 is to ensure that all laboratory testing, wherever performed, is done accurately and according to good scientific practices and to provide assurance to the public that access to safe, accurate laboratory testing is available [1]. As part of this process, the director defines performance criteria for test methodologies, equipment, and quality control. Manufacturer or other authoritative storage requirements are met, such as for temperature, ventilation and humidity. A comprehensive program that includes management commitment, effective training, regular audits of critical functions to identify potential problems, implementation of corrective action and establishment of priorities for improvement benefits the laboratory in many ways. Joint Commission inspect their members using performance standards that meet or exceed those of CLIA. Employee orientation and competency assessment activities are accomplished through a number of training and measurement of performance once a year [7]. Another reason for performing competency assessment with laboratory personnel is that it is also a requirement of the College of American Pathologist (CAP) for accreditation.
A policy covering security issues concerning patients, visitors, other customers, personnel, and property is established.
Extinguishers must be properly mounted, unobstructed and be properly labeled for the intended use.
CAP General Inspection Checklist indicate that the manual that describes training activities and evaluations must be specific for each job description. Equipment (software and hardware), reference materials, consumables, reagents, and analytical systems are safeguarded from adjustments or tampering which would invalidate test results.Laboratory areas for which space and design should be addressed include areas where clerical functions are performed. Training classes should be offered through the Fire Marshal.Pressurized Cylinders All cylinders must be stored in proper locations. The planning process by lab leaders needs to address the ability to provide these and other resources, as required. Because this function is often critical to reporting the correct result on a patient or maintaining specimen identity, consideration should be given to providing areas where interruptions are uncommon and individuals can give full concentration to the transcriptions or data entry being completed.One of the fundamental processes is to develop an Employees Occupational Safety and Health Program (EOSHP) to address all types of hazardous materials and wastes in the laboratory [17]. All cylinders must be secured in an upright position and properly restrained to prevent falling.
There should also be adequate education to appropriate staff about the quality management system plan and implementation. The records must make it possible for the inspector to be able to determine what skills were assessed and how those skills were measured. Our EOSHP project was introduced as a reference case and published in the source book entitled “Understanding Health Care Facility Safety” by Joint Commission [18]. This communication delineates an execution of resource management (RSM) program and some quality assurance tools that have been developed and tailored in our laboratory to comply with the requirements for laboratory accreditation by Joint Commission International (JCI) [2].2. Retraining and reassessment of employee competency must occur when problems are identified with employee performance. Cylinders of all gases having a Health Hazard Rating of 3 or 4 shall be kept in a continuously mechanical ventilated hood or other ventilated enclosure.
Methods The objectives of this work were achieved in accordance with the mission of the hospital, the objectives of our laboratory, any applicable laws or regulations and all relevant accreditation standards. The training and assessment program must be documented and specific for each job description [8]. It is essential to communicate the hazard information and protective measures required to use these chemicals safely to exposed or potentially exposed employees who may use the chemicals. Maximum number of cylinders of a flammable gas shall be not more than 3 (25 x 127cm) 45 square meter in an unsprinkled space or not more than 6 (25 x 127cm) in a sprinkled space of 45 square meter. The related policies and procedures were developed to provide guidance for workers when implementing the process. The implementation of EOSHP incorporates the establishment of a Chemical Hygiene Plan, description of a Hazard Communication Quality Standard (HCQS), development an Employee’s Guide to Handle the Hazardous Chemicals to assist the laboratory staff in complying with the EOSHP HCQS, identification of the staff who will be responsible for the initial set up of the EOSHP and the day-to-day activities necessary to comply with each aspect of the HCQS, construction an inventory of all hazardous chemicals used in the laboratory and a written list comprising the hazard descriptions of chemicals.
Liquefied Gas Cylinders in laboratory work areas shall not exceed 3 cylinders (23 x 76cm) in a sprinkled space or exceed 2 cylinders (23 x 76cm) in an unsprinkled space.Room Use Identification All access doors must be marked when rooms or areas are being used for chemical, biological or radioactive purposes as outlined in the Chemical Hygiene Plan. The policies were generated based on standard requirements for resource provision and management by JCI [3]. Trainings include department policies, job-related tasks, patient safety and Employees Occupational Safety and Health Program (EOSHP).


In this respect, guidelines of NFPA (National Fire Protection Association, USA) provide comprehensive source to delineate hazard symbols and classifications [19]. The implementation of this resource management (RSM) program is undertaken in five major sub-fields. During the first year that an individual is performing such patient testing, competency must be assessed every six months [9-16]. In accordance with the EOSHP HCQS, the Material Safety Data Sheets (MSDS) for the specific hazardous products or chemicals should be supplied.
In addition, appropriate resources are provided for the maintenance and improvement of the quality management system.
Appropriate signs and labels are prepared as hazard warnings to convey the hazardous effects of the materials. Required job qualifications are defined for all laboratory staff positions, as well as job expectations.
Guidelines are determined in the event of a chemical spill, incident, or leak from a sealed container.
A copy of the Employee’s Guide to Handle the Hazardous Chemicals is handed out as training source document. The primary policies for managing biological hazards should define the mechanisms for oversight for controlling exposures to biological materials in the workplace and include the bloodborne pathogens and exposure plan [21-25].
The related policies and procedures for handling biohazardous materials need to be developed to provide guidance for worker safety when handling or exposure to biological agents and included in the new employee orientation and annual update training programs (Fig. The administration and supervision of patient exposures to and infection with biological agents is the primary responsibility of organization’s Infection Control Unit.
Assessments of risk for the biological safety management activities are accomplished through a number of audits and data collections on a semi-annual basis. All occupational exposures to or injuries from biological materials are to be reported by employees to the EOSHP coordinator. Biological safety posters including the information, reporting and reduction of exposures to bloodborne pathogens and tuberculosis [28] are posted in all major areas of the laboratory facilities. A Laboratory Waste Management program should be established to safely control hazardous chemical and biological waste from receipt or generation through use or final disposal in the laboratory. Chemical waste is characterized as non-hazardous or hazardous in accordance with the rules and regulations specified by OSHA (The federal Occupational Safety and Health Administration, USA) [29,30]. With this regard, a substance, which exhibits one of the four hazardous characteristics (corrosivity, ignitability, reactivity, toxicity), is delineated as Hazardous Chemical Waste. Chemical waste that does not exhibit any of the hazardous characteristics as defined above is considered non-hazardous chemical waste. Any waste that is potentially biohazardous, infectious, or pathological is described as Biological Waste. A Waste Characterization Checklist needs to be developed to determine whether the waste is hazardous or non-hazardous (Fig. The ALARA program [31] and associated work practices are put in practice to reduce risks to workers by keeping doses well below the limits. Laboratory instruments and analytical systems are tested upon installation, and prior to use to assure their capability of meeting performance expectations.
For new analytical methods, the laboratory verifies, at a minimum, accuracy, precision and the reportable range, as well as confirming that the reference range applies to its patient population. If the laboratory has modified the test or if the method is very complex with many steps, the laboratory also verifies analytical sensitivity and analytical specificity. The laboratory leaders provide for a program to regularly monitor and demonstrate proper calibration and function of instruments, reagents, and analytical systems.
Calibration, calibration verification, function checks, and preventive maintenance are performed on instruments and analytical systems, as needed, and at least according to manufacturers' recommendations. All required verification checks are documented, along with remedial action when instruments or test methods did not meet performance expectations. Records of major repairs, parts replacement, and semiannual or annual calibration checks and preventive maintenance must be retained for the life of the instrument. Procedures should be determined to check periodically the validity and quality of reagents and water quality used in laboratory testing. The details of environmental conditions and supporting safety utilities are represented in Table 4.
The laboratory's safety processes should include adequate fire detection and prevention policies.
Adequate safety devices such as emergency eyewash, safety cans, puncture-resistant containers for discarding all waste sharps [37], fire extinguishers and blankets are made available and training should be provided to all laboratory staff.



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