Saudi Licensing Exam Prep

Laboratory (Microbiology) - Technician

Hind Bandar & Reem Alali

 Course Summary

- Day 1: Bacteriology
- Day 2: Parasitology
- Day 3: Virology + Mycology
- Day 4: Immunology
- Day 5: Lab safety + Quality control

Quality Control

Hind Bandar & Reem Alali

 Function of Clinical Laboratory

• To carry out tests and investigations on patients specimens upon the doctors
request and produce meaningful and timely results which help in the
diagnosis of disease, treatment and management of the patient.
• Meaningful results: Reliable results which are Expressed in Acceptable
(correct) units.
• Reliable results
- Accurate: close to the real “true” value
- Precise: similar results if repeated on same specimen
• Timely results: Available to the doctor when needed (routine or urgent)

 Quality

• QC (Quality Control): Is the type of system/s that are speci ically

applied to ensure the conformity of the results (outcome,
products) to established criteria or standards.
• QA (Quality Assurance): Is the total efforts and activities by a
group of specialists to achieve quality results (products,
outcome).

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 Application of QC systems

• Levey–Jennings chart: is a graph that quality control data is plotted

on to give a visual indication whether a laboratory test is working
well. The distance from the mean is measured in standard deviations.
• Standard deviation (SD): is a measure of imprecision. It indicates the
variability or dispersion around the mean.
• Mean: the average of the data points.
• Westgard Rules: are multi-rule QC rules to help analyze whether or
not an analytical run is in-control or out-of-control.

 Warning

RE/SE
Westgard rules

Reject
RE

Reject
SE

Reject
RE

Reject SE

Reject SE
 Components of Quality Assurance

• Pre analytical (~ 68-86% sources of errors) - obtaining patient

information and receiving samples.
• Analytical (~ 40 % sources of errors) - examining and testing the
sample.
• Post analytical (~ 20 % sources of errors) - analyzing the test
results and creating an o icial report.

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 Types of Errors

1. QUALITATIVE ERRORS (UNMEASURABLE)

- Clerical/ Secretarial errors, such as mis-matching of request form and specimen.
- Administrative & managerial errors, such as appointments.
- Typographical errors, such as typing error.
- Communication errors, such as phoning of results.
2. QUANTITATE (MEASURABLE) (ANALYTICAL) relates to errors in the analysis.
- Random error
- Systematic error

 Analytical Error

a) Random error: ✓ Value= ±1.96 SD (2SD)

✓ Occurs by chance ✓ Values ± 2SD - ± 3SD indicate the

presence of RE
✓ In every procedure
✓ Values ≥ ± 3SD indicate the
✓ Fluctuates about the mean presence of large RE & considered
✓ No predictable magnitude as outliers (result rejected)
✓ Sources: Normal variations in:
✓ No predictable direction
vibration, pipetting, temperature,
✓ It shifts the SD air current, humidity, skill,
experience.
✓ A ects the precision
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 Analytical Error

b) Systematic error:
✓ Should not occur in the procedure
✓ It has magnitude
✓ It has direction
✓ It shifts the mean
✓ A ects accuracy
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 Systematic Error
1. Constant SE (CSE)
The size of the error is the same regardless of the causative factor. Due to:
- Interference
- Permanent damage
- Expired reagents
- Extreme variations in vibration, temperature, air current, humidity
- Inadequate skill
- Lack of experience
[Shift: four or more consecutive control points above or below 1SD at one side of the mean]

 Systematic Error
2. Proportional SE (PSE)
The size of the error depends on the size of the causative factor.
Due to; deteriorating reagents, components, etc.
[Trend: four or more consecutive control points gradually increasing or
decreasing]
EXCEPT for interference.

Quality Control in Microbiology Lab

 Quality Control in Culture media
• Media performance is checked by inoculating standard strains and
incubating it at the desired temperature. Whenever a new batch of
media is prepared 10% of new plates should be projected to sterility
testing. For example, 400 agar plates were prepared, only 40 plates
undergo sterility tests.
• If you receive a new batch from culture media (Petri dishes), place the
new batch in back and old batch in front according to expiry date.

 Petri Dish Contamination

• Petri dishes need to be incubated
upside-down to lessen contamination
risks from airborne particles landing on
them and to prevent the accumulation of
water condensation that could disturb or
compromise a culture.
 CDC
Centers for Disease Control and Prevention

• The Centers for Disease Control and

Prevention (CDC) is the national public
health agency of the United States. The
agency's main goal is the protection of
public health and safety through the
control and prevention of disease, injury,
and disability in the US and worldwide.
The CDC focuses national attention on
developing and applying disease control
and prevention.
 Thank you

Any questions ?