71 B.1: On-Site Evaluation Short Checklist On-Site Evaluation Short ...

B.1: On-Site Evaluation Short Checklist
Laboratory:
District/Administrative Unit:
Number of Microscopists/Technicians:
Qualifications of current staff:
Supervisor/Head of Laboratory:
Date of Visit:
Visiting Supervisor:
APPENDIX
B
Item Adequate/ Problems Identified
Acceptable *
SOP Y N
Separate area for TB work Y N
Separate tables for specimen
Receipt/smear preparation/ Y N
Microscopy
Power supply Y N
Running water supply Y N
Waste containers with lid Y N
Waste disposal by
Autoclave/burning/buried Y N
Balance
Adequate Stock & Supply of:
Specimen cups Y N
Slides Y N
Stains Y N
* NTP will need to establish standards for acceptance using IUATLD/WHO recommendations for
equipment, reagents, and safety as well as national recommendations based on resources. All supervisors
should be trained prior to conducting on-site evaluation.
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EXTERNAL QUALITY ASSESSMENT
Item Adequate/ Problems Identified
Acceptable *
Smearing/Staining Y N
Equipment
Slide boxes Y N
Microscopes
Laboratory Register
Y
N
Laboratory Forms Y N
Personnel Y N
Training status Y N
Safety Practices
General order/Cleanliness
Y
N
Timely reporting of results Y N
to clinicians
Is QC using positive and negative control slides performed
as required by the NTP
Are all slides kept as required by the NTP EQA Program
Are slides properly stored in slide boxes
Yes No
Yes No
Yes No
Workload
Number of smears last Number of suspect last Number of follow up
quarter
quarter
smears last quarter
Total:
Total:
Total:
# Pos # Neg # Pos # Neg
Overall remarks:
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APPENDIX
B
Action Required:
Rechecking and/or Panel Testing Results (refer to feedback form)
Have any performance problems (based on criteria set by NTP) been identified
through rechecking or panel testing Yes No
If yes, explain any need for corrective action:
Has corrective action been adequately implemented Yes No
If no, explain:
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