JCAHO chapter on waived testing
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I need input regarding the QC in the medical record for manual tests. Do you enter it along with the patient's results? How do you accomplish that? Is it a pop up window and you enter the QC results/lot# and expiration date before entering the patient's result? We keep the QC log for urine pregnancy, urine blood and gastric pH.
Appreciated,
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When we enter our manual tests we have it set up in patient record to ask if QC was valid . Then you answer yes or no. We have a log book on hand that has patient name, all the lot numbers, and when monthly QC was done.
We enter these manually in either Epic or Cerner (depending on the hospital). There is a spot to put that the internal QC was acceptable. We also put in the lot# and expiration with the results.
For urine pregnancy, daily QC results are stored in RALS.
For manual tests, like Hemoccult and pH, daily QC results are documented on a log.