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Am I Overdoing It with my CAP Quality Cross Checks
Am I Overdoing It with my CAP Quality Cross Checks
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I would like to get some advice.
We have two (2) GEM 7000 in the main lab and also four (4) GEMs at the point of care. I ordered CAP Proficiency Testing (PT) and also CAP Quality Cross check.
I initially ordered the CAP Quality Cross solely for the instrument to instrument comparison but it has become a hassle to ask the end users to run it on the instrument. Quality cross checks has 3 pairs.
I was thinking... If I normally run calibration verification every 6 months material on all GEMs, and there is also internal QC traceable to NIST, run on the GEM itself which I can obtain. Patient blood specimen is preferred but when it comes to blood gases it is difficult to compare since timing is important, so the only way would be to use other materials where applicable.
Couldn't I use that data and do an instrument to instrument comparison and cancel the quality cross check next year? I feel like I'm overdoing the quality cross check and making my life more difficult.
Good morning, Jo Win. I believe your logic to be sound and on target. Quality Cross Check is one option to show how your devices compare to each other with a known result and acceptable range. It is extra work that is not required to be completed by use of that specific product. Correlation of gas testing can be difficult over multiple devices, especially since ALL of the devices must be tested and compared. Ensure that the QC material used for correlation calculations are from the same lot number and you should be all set for compliance with CAP and NY. While donor blood is best, it is not always practical. We use QC material or calibration verification material for correlations, adapting our acceptable limits to CAP peer acceptability criteria.
We have 12 GEM 5000's at our hospital and I use PVP and CAP's SOQ survey for my semi-annual instrument-to-instrument comparisons. Since I am using them for the purpose of calibration verification and instrument comparison, I run them myself (vs. having the staff run them - I have them run the actual surveys). I get the SOQ since the PVP doesn't include any of the coox.
We have 10 ABL90's set up as POC devices, and Respiratory has 11 devices in their department. We all use AQQ and SOQ as our instrument comparisons, so we too run them ourselves. In our scenario, it would be impossible for all QC lots to be identical, since the products are purchased by different departments.
We have 12 GEM5000 and use Levels 1-3 of the system evaluators for the multiple instrument comparison and PVP level 1-5 for linearity every 6 months. The system evaluators include acceptable range which we use as the mean.
We also have 75 iSTATs and use monthly QC for the multiple instrument comparison. The lots that we use usually last 10-12 months, so alot of data available.
We use cross checks AQQ and SOQ for comparability between our GEMs just because the samples have sufficient volume and ease of use. Patient samples wouldn't have enough volume for all our GEMs. We have 12 GEMs for the cross checks. Then to compare to Main Lab, we have a "reference" GEM that we use patient samples to compare to Main Lab.
Good luck!
We also have 75 iSTATs and use monthly QC for the multiple instrument comparison. The lots that we use usually last 10-12 months, so alot of data available.
Hope this helps!