title: Mechanisms to assess Gram stain interpretation proficiency of technologists at satellite laboratories.
abstract: To address Gram stain interpretation proficiency in a satellite/centralized microbiology laboratory paradigm, two programs were devised. In quality assurance program 1, nonmicrobiology technologists at satellite laboratories were required to interpret standardized Gram-stained specimens of clinical material prepared by an experienced microbiologist at a central laboratory. In quality assurance program 2, clinical Gram stains prepared and read by the satellite laboratorians were reviewed by experienced microbiologists at the central laboratory. Satisfactory performance (94%) was achieved in quality assurance program 1. In contrast, quality assurance program 2 had a significantly lower overall performance (89%; P < 0.0001) due to poorer identification of host cells (93%) and bacteria (84%). A variety of intervention mechanisms, including continuous monitoring, resulted in overall performance improvement (P < or = 0.006). While a technologist challenge has educational merit, having a microbiologist review previously read slides is a better indicator of the technologist's Gram stain interpretation proficiency.
authors.affiliation: Midwest Clinical Laboratories, Wauwatosa, WI 53226, USA. Erik.Munson@wfhc.org
authors.forename: Erik
authors.initials: E
authors.lastname: Munson
authors.forename: Timothy
authors.initials: T
authors.lastname: Block
authors.forename: Janice
authors.initials: J
authors.lastname: Basile
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Hryciuk
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Schell
mesh_terms: D002983:Clinical Competence; D005840:Gentian Violet / Q000592:standards*; D006801:Humans; D017056:Medical Laboratory Personnel; D010619:Phenazines / Q000592:standards*; D011785:Quality Assurance, Health Care
chemical_list: C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet