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BEST PRACTICES IN
DIAGNOSTIC
MICROBIOLOGY
Dr.T.V.Rao MD
5/30/2016 Dr.T.V.Rao MD 1
Why to Rethink on Diagnostic
Microbiology
• Diagnostic Microbiology in India is at a critical juncture and needs
support f...
Why we need good practices
•All microbiology investigations require
the user to adopt good microbiology
practice. Whenever...
Plan your laboratory with
resources
5/30/2016 Dr.T.V.Rao MD 4
Organise the laboratory to the needs
5/30/2016 Dr.T.V.Rao MD 5
Organisation of Work
• Practise good housekeeping
policy at all times. Do not
keep tubes or reagents any
longer than neces...
Biosafety - Working with Microbes
a Concern
• It is essential that good
microbiology laboratory
practice is observed at al...
Safety guidelines
•The small size of
microbes and the
consequent need to
deal with cultures
that contain many
millions of ...
Record keeping and Documentation
• Proper recordkeeping is
critical for the Micro Lab.
A test should be
performed as per S...
The laboratory write-up should
include the following:
• Date
Material tested
Microbiologist's name
Procedure number
Docume...
There are areas for consideration when
embarking on practical microbiology
investigations which make planning
ahead essent...
5/30/2016 Dr.T.V.Rao MD 12
Steps for safety and optimal
results in Microbiology
•1. Preparation
and
sterilization of
equipment
and culture
media.5/30...
Stocking and utility of cultures
•2.Preparation of
microbial cultures
as stock culture
for future
investigations and
inocu...
Inoculation and incubation needs
aseptic methods
•3.Inoculation of
the media with
the prepared
culture.
•4.Incubation of
c...
Sterilization and disposal of infective
materials
•5.Sterilization and
safe disposal of all
cultures and
decontamination
o...
5/30/2016 Dr.T.V.Rao MD 17
Training the staff on documentation
•6 Diligent
recording and
evaluation of
data, and
training of the
laboratory stuff
5/3...
Protection
•Food or drink should
not be stored or
consumed in a
laboratory that is used
for microbiology. No
one should li...
Hand washing creates personal safety from
microbial Infections
Hands should be washed with
disinfectant soap after
handlin...
Wear a glove - protects against
many odds
•To ensure that any
wounds, cuts or abrasions
do not get infected or
infection i...
General personal
safety•The individual must
include in the planning
and performance of
the investigation a risk
assessment...
Aseptic technique
•Sterile equipment and
media should be used to
transfer and culture
micro-organisms.
Aseptic technique
s...
Aseptic techniques
• Contaminated equipment
should preferably be heat
sterilised by either
incineration or
autoclaving.
A ...
Major areas of audit in the
microbiological laboratory
• 1Reagents and Media
2. Reference Standards
3. Equipment and
Instr...
Sample Control Audit
Questions
• 1 Ask how Micro samples are
logged in and stored.
• 2. Does the sample log book (or
other...
5/30/2016 Dr.T.V.Rao MD 27
Matters on laboratory
variables• The question of laboratory variability
was central to this concern.
Microbiologists work ...
The Goal of best practices to
reduce errors
.The goal of “best
practices” would
then, be to
minimize
“avoidable”
microbiol...
Training man power for NABL and
NABH accreditations
• Since ‘competency’ is becoming a
buzzword in our industry, and
micro...
Auditing help us to know all the
lacunae in our practice
5/30/2016 Dr.T.V.Rao MD 31
It is certain that Everybody has a
Role to perform the best
practices
• No Good Hospital can
faction without good
practice...
•All the matters mentioned above are beneficial
to practice and understanding Microbiology in
its role in quality assessme...
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BEST PRACTICES IN DIAGNOSTIC MICROBIOLOGY

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BEST PRACTICES IN DIAGNOSTIC MICROBIOLOGY by Dr.T.V.Rao MD

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BEST PRACTICES IN DIAGNOSTIC MICROBIOLOGY

  1. 1. BEST PRACTICES IN DIAGNOSTIC MICROBIOLOGY Dr.T.V.Rao MD 5/30/2016 Dr.T.V.Rao MD 1
  2. 2. Why to Rethink on Diagnostic Microbiology • Diagnostic Microbiology in India is at a critical juncture and needs support from many in the health care, Recent and emerging trends such as changing demographics, exponential growth in medical discovery, raise of Superbugs, and new expectations about the way physicians and patients partner and interact are demanding innovative change in medical education and health care delivery. Clinicians need today greater support from Diagnostic Microbiology elaborates than the past, Superbugs continues to be challenge to all and to the society at large. Academic medicine is rising to the challenge. Medical schools and colleges, teaching hospitals and health systems are adapting education and training programs to meet these needs. The Diagnostic Microbiology has to improve in better direction with best practices Dr.T.V.Rao MD5/30/2016 Dr.T.V.Rao MD 2
  3. 3. Why we need good practices •All microbiology investigations require the user to adopt good microbiology practice. Whenever working with organisms there are practical procedures to ensure safe transfer and avoid contamination, which are common to most activities.5/30/2016 Dr.T.V.Rao MD 3
  4. 4. Plan your laboratory with resources 5/30/2016 Dr.T.V.Rao MD 4
  5. 5. Organise the laboratory to the needs 5/30/2016 Dr.T.V.Rao MD 5
  6. 6. Organisation of Work • Practise good housekeeping policy at all times. Do not keep tubes or reagents any longer than necessary. All reagents, reaction tubes etc. should be clearly labelled. Records of batch numbers of all reagent batches used in individual assays should be kept. 5/30/2016 Dr.T.V.Rao MD 6
  7. 7. Biosafety - Working with Microbes a Concern • It is essential that good microbiology laboratory practice is observed at all times when working with any microbes. Before any practical activity is undertaken a risk assessment should be performed to ensure there is minimal hazard to all concerned. 5/30/2016 Dr.T.V.Rao MD 7
  8. 8. Safety guidelines •The small size of microbes and the consequent need to deal with cultures that contain many millions of microbial cells require special procedures for their safe use5/30/2016 Dr.T.V.Rao MD 8
  9. 9. Record keeping and Documentation • Proper recordkeeping is critical for the Micro Lab. A test should be performed as per SOP, and the laboratory notebook should provide a record of all critical details needed to confirm the integrity of the data5/30/2016 Dr.T.V.Rao MD 9
  10. 10. The laboratory write-up should include the following: • Date Material tested Microbiologist's name Procedure number Document test results Deviations (if any) Documented parameters (equipment used, microbial stock culture nos. used, media lot nos. used) Management/Second review signature 5/30/2016 Dr.T.V.Rao MD 10
  11. 11. There are areas for consideration when embarking on practical microbiology investigations which make planning ahead essential. 5/30/2016 Dr.T.V.Rao MD 11
  12. 12. 5/30/2016 Dr.T.V.Rao MD 12
  13. 13. Steps for safety and optimal results in Microbiology •1. Preparation and sterilization of equipment and culture media.5/30/2016 Dr.T.V.Rao MD 13
  14. 14. Stocking and utility of cultures •2.Preparation of microbial cultures as stock culture for future investigations and inoculum for current investigation.5/30/2016 Dr.T.V.Rao MD 14
  15. 15. Inoculation and incubation needs aseptic methods •3.Inoculation of the media with the prepared culture. •4.Incubation of cultures and sampling during growth.5/30/2016 Dr.T.V.Rao MD 15
  16. 16. Sterilization and disposal of infective materials •5.Sterilization and safe disposal of all cultures and decontamination of all contaminated equipment5/30/2016 Dr.T.V.Rao MD 16
  17. 17. 5/30/2016 Dr.T.V.Rao MD 17
  18. 18. Training the staff on documentation •6 Diligent recording and evaluation of data, and training of the laboratory stuff 5/30/2016 Dr.T.V.Rao MD 18
  19. 19. Protection •Food or drink should not be stored or consumed in a laboratory that is used for microbiology. No one should lick labels, apply cosmetics, chew gum, suck pens or pencils or smoke in the laboratory.5/30/2016 Dr.T.V.Rao MD 19
  20. 20. Hand washing creates personal safety from microbial Infections Hands should be washed with disinfectant soap after handling microbial cultures and whenever leaving the laboratory. If hand contamination is suspected, then the hands should be washed immediately with disinfectant soap. 5/30/2016 Dr.T.V.Rao MD 20
  21. 21. Wear a glove - protects against many odds •To ensure that any wounds, cuts or abrasions do not get infected or infection is passed on, protect them by the use of waterproof dressings or wear disposable surgical gloves 5/30/2016 Dr.T.V.Rao MD 21
  22. 22. General personal safety•The individual must include in the planning and performance of the investigation a risk assessment to assess any hazard that the investigation may pose and ways of minimising it 5/30/2016 Dr.T.V.Rao MD 22
  23. 23. Aseptic technique •Sterile equipment and media should be used to transfer and culture micro-organisms. Aseptic technique should be observed whenever micro- organisms are transferred from one container to another.5/30/2016 Dr.T.V.Rao MD 23
  24. 24. Aseptic techniques • Contaminated equipment should preferably be heat sterilised by either incineration or autoclaving. A suitable chemical disinfectant can be used but this may not ensure complete sterilization. 5/30/2016 Dr.T.V.Rao MD 24
  25. 25. Major areas of audit in the microbiological laboratory • 1Reagents and Media 2. Reference Standards 3. Equipment and Instruments 4. Method Validation 5. Laboratory Controls 6. Recordkeeping and Documentation 7. Employee Training 8. Sample Control 5/30/2016 Dr.T.V.Rao MD 25
  26. 26. Sample Control Audit Questions • 1 Ask how Micro samples are logged in and stored. • 2. Does the sample log book (or other record) provide spaces for who delivered the sample and who then took it for testing (chain of custody)? • 3. What type of samples might be temporarily stored while awaiting testing 5/30/2016 Dr.T.V.Rao MD 26
  27. 27. 5/30/2016 Dr.T.V.Rao MD 27
  28. 28. Matters on laboratory variables• The question of laboratory variability was central to this concern. Microbiologists work every day with variability in the detection, recovery and growth of microbiological species. This variability can be thought of in two categories, “avoidable” variability (variability due to poor practice) and inherently unavoidable variability (variability due to limitations of the methods and the vagaries of dealing with biological samples - see Jarvis, 1989). 5/30/2016 Dr.T.V.Rao MD 28
  29. 29. The Goal of best practices to reduce errors .The goal of “best practices” would then, be to minimize “avoidable” microbiological errors. 5/30/2016 Dr.T.V.Rao MD 29
  30. 30. Training man power for NABL and NABH accreditations • Since ‘competency’ is becoming a buzzword in our industry, and microbiologists do have options to prove their competency, this discussion is important to develop ways of meeting the regulatory inspection requests as well as the quality improvement approaches of the laboratories 5/30/2016 Dr.T.V.Rao MD 30
  31. 31. Auditing help us to know all the lacunae in our practice 5/30/2016 Dr.T.V.Rao MD 31
  32. 32. It is certain that Everybody has a Role to perform the best practices • No Good Hospital can faction without good practices in Laboratory Medicine, • As it matters Microbiology continue to be game changer to life and death As it can reduce mortality if done with caution and dedication • Dr.T.V.Rao MD 5/30/2016 Dr.T.V.Rao MD 32
  33. 33. •All the matters mentioned above are beneficial to practice and understanding Microbiology in its role in quality assessment and be incorporated at Better practices •Email •doctortvrao@gmail.com 5/30/2016 Dr.T.V.Rao MD 33

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