Assessment of the proficiency of gram stain interpretation at QML pathology, Queensland

Abstract

All Australian laboratories are required to participate in quality assurance (QA) exercises. Most have internal QA programs as well as external programs. The Gram stain is the basic stain used in the microbiology laboratory. It is fundamental to the processing of specimens and the interpretation of cultures. The aim of this study is to assess the internal proficiency of the technicians and/or scientists at QML Pathology at interpreting Gram stain. Gram stains prepared at three regional laboratories and a random number of Gram stains from the central laboratory were read by the microbiology registrar. This was compared with the reported results. Any discrepancy between the two results was reviewed by a senior scientist at the central laboratory. A total of 419 slides were read. There was 37% concordance between the registrar and the four study sites. A representative selection of slides in this study was photographed. All technicians/scientists involved in the initial reporting of the study slides reported on the photographed images. The discrepancies from the study slides were compared to the photographed slides to look for correlation. The limitations of this study and the deficiencies of the staff were identified. A new ‘Test and Teach’ kit for Gram stains was developed for internal QA. All Australian laboratories are required to participate in quality assurance (QA) exercises. Most have internal QA programs as well as external programs. The Gram stain is the basic stain used in the microbiology laboratory. It is fundamental to the processing of specimens and the interpretation of cultures. The aim of this study is to assess the internal proficiency of the technicians and/or scientists at QML Pathology at interpreting Gram stain. Gram stains prepared at three regional laboratories and a random number of Gram stains from the central laboratory were read by the microbiology registrar. This was compared with the reported results. Any discrepancy between the two results was reviewed by a senior scientist at the central laboratory. A total of 419 slides were read. There was 37% concordance between the registrar and the four study sites. A representative selection of slides in this study was photographed. All technicians/scientists involved in the initial reporting of the study slides reported on the photographed images. The discrepancies from the study slides were compared to the photographed slides to look for correlation. The limitations of this study and the deficiencies of the staff were identified. A new ‘Test and Teach’ kit for Gram stains was developed for internal QA.