2022 Volume 71 Issue 1 Pages 138-142
With the Partial Amendment of Medical Care Act (Act No. 57 of 2017), the preparation of a system securing the accuracy of specimen inspection in medical institutions has become necessary. It is required to perform internal quality control in all specimen inspections performed. For this quality control, it is important to evaluate technologists who are not in charge of routine work of general cerebrospinal fluid examination requiring microscope operation and morphological differentiation on the basis of the accuracy of internal quality control and educate them depending on the necessity. We developed an internal quality control method for general cerebrospinal fluid examination targeting technologists in charge of after-hour inspection and evaluated the outcome of the method performed for 5 years. In this method, a photo test, in which cells in photographs of cerebrospinal fluid taken in our hospital were classified, and a cell classification test, in which microscopy images of cells in pseudo specimens of cerebrospinal fluid prepared from peripheral blood were classified, were performed once a year. Technologists in charge who did not meet the passing criteria set for each test were re-educated until they passed. The percentage of technologists who passed the photo test was 100% excluding the results in 2016. On the other hand, the highest and lowest percentages of technologists who passed the cell classification test were 76.5 and 27.3%, respectively, showing a large variation, and the percentage of technologists who passed did not improve from 57.1% over the last 2 years. It was confirmed that internal quality control in general cerebrospinal fluid examination based on photographs alone was insufficient, and internal quality control using a practical method including microscope operation is necessary. In addition, it may also be necessary to reconsider the method and interval of re-education.
