Chapter 3: CLIA Regulations and Procedures For minividas Users

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1 Chapter 3: CLIA Regulations and Procedures For minividas Users OBJECTIVES Upon completion of this chapter, you will be able to: Determine steps that must be completed before using the minividas to test patients Indentify CLIA procedures and requirements Discuss the purpose of QA activities (before, during, after) Describe Method Validation Explain the various Bulls Eye target results found in Method Validation PRINTING & VIEWING INSTRUCTIONS Print (preferably in color) and read the objectives and questions for each chapter prior to viewing the associated video. Questions may be answered as you view the video. For specific instructions on video viewing, please refer to the Getting Started link. GUIDED VIEWING QUESTIONS Clinical Laboratory Improvements (CLIA) Regulations have been in effect since 1992 and thousands of laboratories across the nation comply with these requirements. Laboratories must be CLIA accredited and participate in proficiency testing before using the biomérieux minividas. Chapter 3, Page 1 of 6

2 Read the statements below and put each action in sequential order, number one being the first step and four the last step. 1. There are certain steps that must be performed before you can begin testing patient samples. Place the following steps in sequential order. _ Annually enroll in any CLIA approved proficiency testing program and test unknown PT samples mailing the results back to the PT program. _ Read the CLIA Compliance Manual. _ Method validation is required by CLIA to verify that the minividas meets the manufacturer s claims for accuracy, precision and linearity in your laboratory. The method validation process must be performed over two days and is explained in the CLIA Compliance Manual. _ Contact your state Centers for Medicare and Medicaid Services (CMS) to enroll in the CLIA program or to upgrade your current CLIA certificate for immunoassay testing on the minividas. Determine whether each statement is correct or incorrect by circling either or. 2. Fees for CLIA certification are assessed annually. 3. In order to perform immunoassay testing on the minividas, it may be necessary to upgrade a current CLIA certificate. 4. It can take up to 12 weeks to receive a new CLIA identification number. Chapter 3, Page 2 of 6

3 5. When billing Medicare for tests run on the minividas, CLIA ID numbers must be put on Medicare claim forms as failure to do so results in denied claims that cannot be resubmitted. 6. For Method Validation, quality control samples are run several times to demonstrate that the instrument is accurate and precise and meets manufacturers claims for accuracy, precision and linearity in a lab. 7. To demonstrate the laboratory s compliance with CLIA requirements, use the policies, procedures and completed forms in the CLIA Compliance Manual. 8. CLIA inspections are punitive in nature. 9. To test your understanding of safety precautions found in the CLIA Manual, review and place a check mark next to those that apply. Disinfect countertops in the testing area at least once a day. Clean spills immediately. Discard blood specimens, used SPR s and strips into a biohazardous waste container. Do not store food in the refrigerator where reagents, controls, or specimens are kept. Use SPR to puncture foil on reagent strip. Splashes can occur when stoppers are removed from blood tubes and areas must be wiped clean upon completion of task. Chapter 3, Page 3 of 6

4 CLIA quality requirements or quality assessments (QA) are activities performed to minimize testing errors before, during and after patient testing. 10. Read each QA activity in the table below and determine whether the activity occurs before, during or after testing by placing an X in the appropriate column. QA Activity Before During After Check instrument each day of testing with quality control samples to insure it functions properly Review results, store instrument printouts, and report them to the caregiver Obtain test requests in writing Follow written test procedures Label blood tubes so that mix-ups do not occur Handle and process specimens so that test results are not affected Perform ongoing quality assessments to be sure you have the best systems in place to prevent errors Check reagents to insure they are not outdated or deteriorated Collect the right specimen from the right patient Periodically calibrate the instrument to set its electrical system Chapter 3, Page 4 of 6

5 Read the statements below and circle the correct letter for each answer. 11. During a CLIA inspection, a surveyor will ask to see evidence that the lab has performed proficiency testing, quality control and. A. quality assurance B. quality assessment C. quality inventory D. quality inspection Method Validation verifies accuracy, precision, reportable ranges and reference ranges. 12. _ tells how closely your instrument measures the true value of an analyte and is verified by running three levels of controls several times. A. Accuracy B. Precision C. Reference Range D. Reportable Range 13. _ defines how reproducible your results are over time, and is verified by running three levels of controls several times over two days. A. Accuracy B. Reference Range C. Precision D. Reportable Range 14. A Bullseye target can illustrate and. A. normal ranges and abnormal ranges B. accuracy and precision C. accuracy and reportable ranges D. quality assessment and accuracy Chapter 3, Page 5 of 6

6 15. _ are specified by accepting the manufacturer s suggestions or by stipulating your laboratory s ranges. A. Outlying ranges B. Reference/Normal ranges C. Obsolete ranges D. Reportable ranges 16. Who specifies acceptance parameters for accuracy, precision or reportable ranges? A. Lab director B. CLIA personnel C. Lab technician D. Surveyor 17. Below are quality control test results that have been plotted on a target. Determine accuracy and precision of each target by drawing a line matching each target with the accurate value description. Imprecise, Inaccurate Very Accurate, Precise Precise, Inaccurate Chapter 3, Page 6 of 6

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