SAFETY AND QUALITY MANAGEMENT Flashcards
(125 cards)
1
Q
most significant hazard in the immunology lab
A
obtaining and testing specimen
2
Q
the manner of how organisms are transmitted is called
A
chain of infection
3
Q
6 elements in chain of infection
A
infectious agent reservoir portal of exit means of transmission portal of entry susceptible source
4
Q
infectious agents examples
A
bacteria
fungi
virus
parasite
5
Q
a place where the infectious agent can live and multiply
A
reservoir
6
Q
means of transmission
A
direct contact droplets airborne vehicle vector
7
Q
MOT:
host touches contaminated medium
A
direct contact
8
Q
MOT:
host inhales infected aerosol droplets from px or specimen
A
droplets
9
Q
MOT:
host inhales dried aerosol particulates circulating on the air current or dust particles
A
airborne
10
Q
MOT:
host ingests contaminated food or water
A
vehicle
11
Q
MOT:
animal or mosquito bite
A
vector
12
Q
In the chain of infection, a contaminated specimen or an infected patient is considered a/an:
A
reservoir
13
Q
T/F:
Portal of exit and entry can be the same
A
TRUE
mucous membranes of the eyes, nose, mouth,
PEx: + other body fluids
PEn: + breaks in the skin, open wounds
14
Q
Most susceptible hosts include:
A
Patients with severe diseases, receiving chemotherapy, newborns and infants, elderly, immunocompromised
15
Q
T/F:
Once the chain of infection is complete, the infected host becomes another source able to transmit the microorganisms to others
A
TRUE
16
Q
most likely source of infection in serological testing
A
CONTACT with patient specimens
17
Q
best way to prevent completion of chain of infection
A
prevent transmission
18
Q
2 main organizations who formulated guidelines to which laboratories must strictly adhere to.
A
Centers for Disease Control and Prevention (CDC)
Occupational Safety and Health Administration (OSHA)
19
Q
1 prevention of infection
A
handwashing
20
Q
methods of hand hygiene
A
handwashing
use of alcohol-based antiseptic cleansers
21
Q
T/F:
use of alcohol-based antiseptic cleansers may be done after contact with spore-forming bacteria
A
FALSE:
alcohol-based cleansers are not recommended for sanitation upon contact with spore-forming bacteria.
Handwashing is necessary.
22
Q
T/F:
Wearing gloves is a substitute for hand sanitizing
A
FALSE
23
Q
T/F:
A true latex allergy from gloves can be life threatening
A
TRUE
24
Q
CDC developed standard precautions by combining recommendations of what procedures?
A
universal precautions (UP) body substance isolation (BSI)
25
All patients were assumed to be potential carriers of bloodborne pathogens.
Universal precaution
26
OSHA stands for:
Occupational Safety and Health Administration
27
T/F:
| Each health-care institution is responsible for designing and implementing its own exposure control plan
TRUE
28
Which regulation by OSHA requires all employers to have a written BloodBorne Pathogen Exposure Control Plan?
Occupational Exposure to BloodBorne Pathogen Standard
29
Components of the OSHA Bloodborne Pathogen Exposure Control Plan
* engineering controls
* work practice controls
* personal protective equipment
* medical
* documentation
30
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Providing sharps disposal containers and needles with safety devices
Engineering Controls
31
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Requiring discarding of needles with the safety device activated and the holder attached
Engineering controls
32
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Labeling all biohazardous materials and containers
Engineering controls
33
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Requiring all employees to practice standard precautions
Work Practice Controls
34
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Prohibiting eating, drinking, smoking, and applying cosmetics in the work area
Work Practice Controls
35
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Establishing a daily work surface disinfection protocol
Work Practice Controls
36
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Providing laboratory coats, gowns, face shields, and gloves to employees and laundry facilities for non-disposable protective clothing
Personal Protective Equipment
37
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Providing immunization for the hepatitis B virus free of
charge
Medical
38
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Providing medical follow-up to employees who have been accidentally exposed to bloodborne pathogens
Medical
39
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Documenting annual training of employees in safety standards
Documentation
40
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Documenting evaluations and implementation of safer
needle devices
Documentation
41
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Involving employees in the selection and evaluation of new devices and maintaining a list of those employees and the
evaluations
Documentation
42
Which component of the OSHA Bloodborne Pathogen Exposure Control Plan?
Maintaining a sharps injury log including the type and brand of safety device, location and description of the incident, and confidential employee follow-up
Documentation
43
How long before postexposure prophylaxis is initiated upon confirmation of infection in evaluation of a laboratory accident?
within 24 hours
44
most frequent encountered exposure in the laboratory that places laboratorians in danger of contracting viruses
needlesticks
45
In administering postexposure prophylaxis, what tests are conducted in the sample of the patient?
HBV, HCV, HIV
46
For instances of significant exposure, what could replace patient consent to proceed with testing?
physician order/court order
47
In laboratory accidents, when the patient tests positive for HIV, what medications and PEP are given?
PEP using zidovudine (ZDV)
| one or two additional anti-HIV medications
48
In laboratory accidents, when the patient tests positive for HIV, when is the employee retested after administration of medication?
at intervals of 6 weeks, 12 weeks and 6 months
49
In laboratory accidents, when the patient tests positive for HBV, what medication or treatment is given for unvaccinated employees?
Hepatitis B immune globulin (HBIG)
| HBV vaccine
50
In laboratory accidents, when the patient tests positive for HBV, what medication or treatment is given for vaccinated employees?
tested for immunity
| PEP
51
In laboratory accidents, when the patient tests positive for HCV, what PEP is given?
No PEP is available
52
In case of needlestick injuries, any exposed employee should be counseled to report any
symptoms related to viral infection that occur within _______ of the exposure.
12 weeks
53
T/F:
All biological waste must be placed in appropriate containers labeled with the biohazard symbol
FALSE
except urine
54
most commonly used disinfectant for contaminated nondisposable equipment
1:10 dilution of sodium hypochlorite
55
what material should bleach be stored in
plastic
56
DOT stands for:
Department of Transportation
57
IATA stands for:
International Air Transport Association
58
Under DOT and IATA regulations, all diagnostic specimens require _________.
triple packaging
59
Inclusions in triple packaging
primary container (watertight with positive screw-on cap)
primary container wrapped with enough absorbent material
secondary container (leakproof)
60
when was the Needlestick Safety and Prevention Act signed into law?
2001
61
When was the Needlestick Safety and Prevention Act revised by OSHA?
June 2022
(all blood holders with needles attached should be immediately discarded into sharps container after the device's safety feature is activated
62
how should acid and water be combined?
add acid to water
63
what to do when skin or eye gets in contact with chemicals?
flush area with water for 15 minutes then seek medical attention
(do not try to neutralize chemicals spilled on skin)
64
Safety Data Sheet is required for chemicals and reagents containing hazardous ingredients in a concentration of _________.
greater than 1%
65
Chemical Hygiene Plan include:
```
appropriate work practices
SOPs
PPE
engineering controls
employee training requirements
medical consultation guidelines
```
66
Many kits used in the immunologic testing often contain what preservative
sodium azide
67
exposure to radiation is dependent on the combination of what three elements
time, distance, shielding
68
disposal of medical radioactive waste is regulated by the
Nuclear Regulatory Commission (NRC)
69
actions to be taken once a fire is discovered
Rescue
Alarm
Contain
Extinguish/Evacuate
70
Steps in opening a fire extinguisher
Pull pin
Aim at the base of the fire
Squeeze handles
Sweep nozzle side to side
71
symbol system for hazardous material and classification
NFPA 704
72
Hazardous Materials Classification:
BLUE
Health Hazard
73
Hazardous Materials Classification:
RED
Fire Hazard
74
Hazardous Materials Classification:
WHITE
Specific Hazard
75
Hazardous Materials Classification:
YELLOW
Reactivity
76
refers to the overall process of guaranteeing quality patient care
Quality Management
77
continual monitoring of the entire test process from test ordering and specimen collection through reporting and interpreting results
Quality Management
78
Normally, QA records are maintained for how long?
2 years
79
T/F:
A procedure manual may be in the form of paper or digital
TRUE
80
provides the basis for all testing in the laboratory
procedure manual
81
defined as anything that can be changed or altered
variable
82
defined as the amount of time required between the point which a test is ordered by the health care provider and the results are reported to the healthcare provider
TAT
83
processes that directly affect the testing of specimens
Examination variables
84
Reagents should be checked against how many levels of commercial control solutions on each shift?
two
85
When should reagents be checked against commercial control solutions
minimum once a day
each shift or;
whenever a new reagent is opened
86
Deionized water used for reagent preparation is quality controlled by checking its ph and purity meter resistance every when?
weekly
87
Who is responsible for signing and dating new procedures and all modification of procedures before they are used?
laboratory director
88
refers to the materials, procedures and techniques that monitor the accuracy, precision, and reliability of a laboratory test
Quality control (WC)
89
these procedures are performed to ensure that acceptable standards are met during the process of patient testing
QC
90
these controls are used to verify the accuracy and precision of a test
External controls
91
the ability to obtain the expected result
accuracy
92
the ability to obtain same results on the same specimen
precision
93
T/F:
The control material is exposed to the same conditions as the patient samples
TRUE
94
referred to as the ability to maintain both precision and accuracy
Reliability
95
FDA standards require that control material test negative for _______.
HBV, HIV
96
refers to the spread in the values that indicate the ability to repeat the analysis and obtain the same value
Gaussian distribution
97
refers to the average of all data points
control mean
98
a measurement statistic that describes the average distance each data point in a normal distribution is from the mean
standard deviation (SD)
99
SD expressed as a percentage of the mean; this indicates that whether the distribution of values about the mean is ina narrow versus broad range and should be less than 5%
coefficient of variation (CV)
100
refers to the limits between which the specified proportion or percentage of results will lie
Confidence intervals
101
in plotting control values, changes in accuracy of results are indicated by a ______, defined as the gradual changing in the mean in one direction that may be caused by a gradual deterioration of reagents or deterioration of instruments performance
trend
102
in plotting control values, changes in accuracy of results are indicated by a ______, defined as an abrupt change in the mean that may be caused by a malfunction of the instrument or a new lot number of reagents
shift
103
In conducting QC procedures, values are plotted on what type of control charts for visualization of control values
Levey-Jennings
104
internal controls are also termed as __________.
procedural contols
105
are used to monitor the sufficient addition of a patient specimen or reagent, instruments' and reagents' interaction and proper migration of samples in test strips.
Internal controls
106
These controls verify the functional ability of a testing device, but does not verify the integrity of testing supplies
Electronic control
107
the testing of unknown samples received from an outside agency
External Quality Assessment (EQA)
108
External Quality Assessment is also called __________.
proficiency testing
109
processes that affect the reporting of results and correct interpretation of data
Post-examination variables
110
most common method for reporting results
electronic/automated
111
this organization stipulates that all labs that perform testing on human specimens for the purposes of diagnosis, treatment, monitoring, or screening must be licensed and obtain a certificate form the CMS.
Clinical Laboratory Improvement Amendments (CLIA)
112
CMS stands for
Centers for Medicare and Medicaid Services
113
three categories of laboratory tests according to CLIA
waived
provider-performed microscopy procedures (PPMP)
nonwaived testing
114
Nonwaived testing is separated into the categories of _____ complexity with regard to requirements for personnel performing the tests.
High and moderate
115
which CLIA Test classification pertains to tests considered easy to perform by following the manufacturer's instructions that have little risk of error
Waived
116
which CLIA Test classification pertains to microscopy tests performed by a physician, mid-level practitioner or a dentist
Provider-Performed Microscopy Procedure
117
which CLIA Test classification pertains to tests that require documentation of training in test principles, instrument calibration, periodic proficiency testing, and on-site inspections
Moderate complexity tests
118
which CLIA Test classification pertains to tests that require sophisticated instrumentation and a high degree of interpretation
High complexity tests
119
designed to coordinate activities to direct and control an organization with regard to quality and the reduction of medical errors
Quality Management System
120
basis of a quality management system (QMS)
Quality system essentials (QSEs)
121
how many QSEs are there?
12
122
What tool is being utilized by the lean system?
```
6S:
sort
straighten
scrub
safety
standardize
sustain
```
123
focuses on the elimination of waste to allow a facility to do more with less and at the same time increase customer and employee satisfaction
Lean System
124
primary goal is to reduce variables and decrease errors to a level of 3.4 defects per 1 million opportunities
Six Sigma
125
6 Sigma Methodology
Define goals and current processes
Measure current processes and collect data
Analyze the data for cause-and-effect information
Improve the process using the data collected
Control the correction of concerns displayed in the data
