1 why are three levels used for quality control of pH , blood gases and to evalu
ID: 84213 • Letter: 1
Question
1 why are three levels used for quality control of pH , blood gases and to evaluate electrolyte assessments? (Please relate the discussion to systematic error, analytical accuracy and laboratory protoco.
2Laboratory personnel performed a fingerstick glucose test on the Accu-Chek glucose monitor obtaining a glucose value of 200 mg/dL. A plasma sample drawn within a 30 min interval of this fingerstick by a phlebotomist and run in the laborratory resulted in a glucose value of 225 mg/dL. Are these two results significantly different? Please explain your answer.
Explanation / Answer
1. Blood gas analysis is performed to assess the acid-base balance and to evaluate the respiratory oxygenation status of the patient. pH, pCO2, and pO2 are measured directly from the specimen by using electrodes. Level One, Level Two, and Level Three controls are tested daily. At least one quality control specimen is run every 8 hours. The purpose of using three levels for QC is that the
*systematic errors can be detected earlier than with 2 controls.
*To evaluate analytical processes, detect critical analytical errors and to determine the analytical accuracy of analytes used.
*To deliver quality healthcare and ensure patients’safety, laboratories cannot assume that simply following manufacturers directions and trusting the instrument automatically will ensure that quality test results are generated. Because of the criticality of blood gases, QC must prequalify the instrument before patient samples are analyzed to avoid delays due to instrument problems, reporting incorrect results, and collecting additional patient samples for reanalysis.
2. In fingerstick method , the finger of the personnel is pricked and enough blood is squeezed to run the sample through Accu-check glucose monitor. The glucose value obtained through this method is immediate and is good for general baseline data. It can lead to misclassification of a participants risk categorization based on potential accuracy and total error issues.
Where as a plasma sample drawn within a 30min interval of this fingerstick by a phlebotomist and run in the laboratory indicates venipuncture method. The results obtained by this method requires 2-3 days.
The values obtained by two methods are significantly different. This is beacuse, venipuncture is the reliable measurement tool for validating results with greater accuracy and precision compared to fingerstick method of evaluation.
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