FRANCISCA APAO UY MEMORIAL HOSPITAL

Hospital License No. 10-08-15-15-1-2 Accreditation No. H10016808

Naga, Jimenez, Misamis Occidental,
Philippines, 7204
Telephone: (63) (88) 545-0106
Email: FAUMH96@yahoo.com

INTERNAL QUALITY ASSESMENT AND AUDIT

DATE:
Pre-analytical Yes No Remarks Corrective Actions Target Date Remarks
REQUEST FORMS
1. Are they easy to use?
2. Are all relevant details provided?
a. Name with middle name
b. Age
c. Sex
d. Date of birth
e. OPD or In-patient
3. Are all requests forms sufficient and easy to used?
SPECIMEN
1. Does the medtech on duty received specimen
and perform at required time?
2. Does the medtech on duty performed ALTERATION EXTRACT ANOTHER IMMEDIATELY FRESH BLOOD
hemolyzed sample? OF RESULTS SAMPLE DRAWN
3. Do they collect at the right time?
4. Does the laboratory operate based on SOP
PHLEBOTOMY
1. Do they observe hematoma?
2. Are they collecting correct amount of sample?
3. Do they use the proper collecting tubes per test?
PERSONNEL
1. Does the laboratory staff overload with workload?
2. Is the medtech on duty approachable and friendly?
3. Are they showing politeness towards patient?
 FRANCISCA APAO UY MEMORIAL HOSPITAL

Hospital License No. 10-08-15-15-1-2 Accreditation No. H10016808

Naga, Jimenez, Misamis Occidental,
Philippines, 7204
Telephone: (63) (88) 545-0106
Email: FAUMH96@yahoo.com

ANALYTICAL
1. Are the tests requested available in the laboratory?
2. Send out laboratory test follows the correct procedure?
3. Handling of infectious specimen
a. Staff wears PPEs
b. Staff observes proper disposal of infectious material?
c. Are they recording incident reports?
4. Laboratory staff
a. Has completed the BS Medtech degree?
b. Has successfully passed the Philippine Licensure
Examination for Medical Technologist?
c. Has at least one year of relevant training?
d. Has attended relevant seminars, training and conferences?
5. Laboratory Reports
a. It is precise and clear?
6. Storage of reagents and specimens?
a. Are they updating temperature monitoring?
b. Are they doing inventories?
c. Is it sufficient?
d. Is the storage are enough?
7. Equipment
a. Are they maintained in good condition?
b. Are they all calibrated and well-equipped?
c. Are the records of maintenance updated?
d. Does the medtech update the office promptly
for any concerns or faulty equipment?
e. Are all documents available at designated location?
 FRANCISCA APAO UY MEMORIAL HOSPITAL

Hospital License No. 10-08-15-15-1-2 Accreditation No. H10016808

Naga, Jimenez, Misamis Occidental,
Philippines, 7204
Telephone: (63) (88) 545-0106
Email: FAUMH96@yahoo.com

POST-ANALYTICAL
1. Are the results transcribed for machines correctly?
2. Are all machines copies and manuals kept for future references?
3. Are results written in correct results forms?
4. Are all tests request done?
5. Are all results recorded properly?
6. Has results released and endorsed at the right time?
7. Has waste receptacle of the machines emptied
and water tank refilled?
8. Does the things in the laboratory good
and convenient to the staff on duty?
9. Is the laboratory good and convenient to the staff on duty?
10. Do they conduct regular inspection of electric wirings?
11. Do the hazardous waste disposed in accordance
with FAUMH management?