# Presentation: 003375

## The Department of Laboratory Medicine 

-          Angkor Hospital for Children
-           A Role Model in  Quality Laboratory Management

-                                                    by
- 		     Robyn Devenish and Sarin Eng

-                                                                    presented at the workshop
**“*****Building Laboratory Quality Systems: A Route to Reliable Laboratory Data*****”**

## The Department of Laboratory Medicine 

-             Angkor Hospital for Children

- Is a role model for full integration of quality laboratory services to provide –
- ■ Accurate and timely diagnostic test results for the clinicians
- ■ Accurate monitoring of patient results who have long term or chronic diseases
- ■ Safe and reliable blood products for the support of patient care.
-                                               **Serology**
**                                              ****Clinical chemistry**
**                                              ****Clinical microbiology**
**                                              ****Haematology and Coagulation**
**                                              ****Blood Transfusion Medicine**

##                                          H.I.V.

-                                          H.I.V.

**Diagnosis            Monitoring             Support**

- MayGrunwald/Geimsa x 1000

##                                          H.I.V.

-                                          H.I.V.

- HIV  can cause bone marrow dysfunction. These abnormal neutrophil inclusions are an indication of bone marrow dysplasia in AIDS patients.

- MayGrunwald/Geimsa x 1000

##                                          H.I.V.

-                                          H.I.V.

- Presence of dohle bodies indicates severe sepsis.

- MayGrunwald/Geimsa x 1000

##      DIAGNOSIS:  Serology department

-      DIAGNOSIS:  **Serology** department
-            HIV Screening test – Positive
-       Confirmatory HIV Test - Positive

- Method manual

-  Temperature monitor

- Maintenance manuals

- Text books

- Calibration

- Controls

## Quality Laboratory Management

- Maintenance of equipment

##  DIAGNOSIS of other infections in HIV patient:  Serology department

-  DIAGNOSIS of other infections in HIV patient:  **Serology** department
-                                       Hepatitis B
-                                       Hepatitis C
-                                       Syphilis

- Method manual

-  Temperature monitor

- Maintenance manuals

- Text books

- Calibration

- Controls

##      Monitoring of patient with HIV:  Biochemistry department

-      Monitoring of patient with HIV:  **Biochemistry** department
-            Liver function tests  e.g.    ALT
-            Renal function tests  e.g.  Creatinine
-            Diabetes - glucose

- Method manual

-  Temperature monitor

- Maintenance manuals

- Text books

- Calibration

- Controls

## Quality Laboratory Management

- Maintenance of equipment

## Quality Laboratory Management

- Internal Quality Control

## External Quality Assessent

- Quality Laboratory Management

##                   Monitoring of HIV patient:  Haematology department

- Full blood count – Anaemia, leucopenia, thrombocytopenia
- Blood film – Morphological changes in erythrocytes, neutrophils, lymphocytes
- CD4 count – To monitor the number of T4 lymphocytes “helper cells”
- Coagulation – Prothombin time (INR) in patients with liver dysfunction

- Method manual

-  Temperature monitor

- Maintenance manuals

- Text books

- Calibration

- Controls

## Quality Laboratory Management

- Maintenance of equipment

## Quality Laboratory Management

- Internal Quality Control

##                   Monitoring of HIV patient:  Microbiology department

- Examination of Stool – Parasitic infections
- Examination of Sputum – TB infections
- Examination of CSF, blood etc. – Other opportunistic infections
- Diagnosis of other sexually transmitted diseases – e.g. Gonorrhoea

- Method manual

-  Temperature monitor

- Text books

- Smooth bench tops

##                   Support of HIV patient:  Blood Transfusion department

-    Collection of blood donors    –       Blood grouping
- 				      Full blood count
- 				      Serology testing   (EQA by PBTC)

##                   Support of HIV patient:  Blood Transfusion department

- Crossmatching of blood products –  whole blood,
- 				      packed cells
- 				      fresh frozen plasma

-  Temperature monitor
- Fridge alarm
- Back up generator

##  Specimen Identification

-  Quality Laboratory Management

## Reporting Results

- Label for blood bag

- Quality Laboratory Management

## Quality Laboratory Management

-  Equipment manuals
-  Lecture notes
-  Journal articles

-  Stock control –
- Consumables
- Reagents
- Controls
- Stationery
- Equipment
- Glassware
- Furniture

## Quality Laboratory Management

-          Stock  Control

##      Quality Laboratory Management

-                                   An infectious free utility and storage room

##     Quality Laboratory Management

-                                       From  handwritten notes to a
-                    Computer Laboratory Information Management System

##  Quality Laboratory Management

-  Computer Laboratory Information Management System

-  Quality Laboratory Management

##                     Thank you to

-          Angkor Hospital for Children
-              and the laboratory staff