Standard 3.9 Provision of laboratory services.

 Standard 3.9 Provision of laboratory services.

The provision of laboratory services is carried out in accordance with the provisions of statutory regulations.

Laboratory services are carried out in accordance with established policies and procedures.

a. Criterion 3.9.1

Laboratory services are managed in accordance with established policies and procedures.

1) Main Thoughts:

a) The Puskesmas determines the types of laboratory services available at the Puskesmas.

b) So that the implementation of laboratory services can provide accurate examination results, it is necessary to establish policies and procedures for laboratory services starting from requesting, receiving, collecting and storing specimens, managing reagents for carrying out examinations, and delivering examination results to parties who need them, as well as managing medical waste. and hazardous and toxic materials (B3).

c) High-risk examinations are examinations of specimens that pose a risk of infection in the officer, for example sputum specimens with suspected tuberculosis or blood from patients with suspected hepatitis B and HIV/AIDS.

d) Laboratory service regulations need to be prepared as a reference which includes policies and guidelines as well as laboratory service procedures that regulate

(1) the types of laboratory services provided are in accordance with community needs and the capabilities of the Community Health Center;

(2) time for submission of laboratory examination results;

(3) high-risk laboratory tests;

(4) request for examination, receipt of specimens, collection and storage of specimens;

(5) examination services outside working hours at inpatient health centers or community health centers that provide services outside working hours;

(6) laboratory examination;

(7) occupational health and safety in laboratory services; (8) use of personal protective equipment; And

(9) reagent management.

e) To ensure the quality of laboratory services, efforts need to be made to strengthen internal quality and strengthen external quality at the Community Health Center.

Quality assurance is carried out in accordance with the type and availability of laboratory equipment used and in accordance with statutory regulations.

f) Puskesmas are required to participate in periodic external quality assurance (PME) organized by institutions determined by the government.

g) If a laboratory examination cannot be carried out by the Community Health Center due to limited capacity, a referral for laboratory examination can be carried out using clear procedures.

h) Community Health Center leaders need to determine the time period required to report laboratory test results. Results are reported within a time frame based on patient needs and the needs of clinical care providers. Examinations in the emergency department and outside working hours and at weekends are included in this provision.

i) Urgent examination results, such as from the emergency unit, are given special attention. In addition, if laboratory services are carried out in collaboration with external parties, the examination results report must also be timely in accordance with the policies established or stated in the contract.

j) Reagents and other materials that must always be available for laboratory services for patients must be identified and specified.

k) Periodic evaluations are carried out on the availability and storage of all reagents to ensure the accuracy and precision of examination results.

l) Policies and procedures are established to ensure complete and accurate labeling for reagents and solutions used referring to statutory provisions.

m) In accordance with the equipment and procedures carried out in the laboratory, it is necessary to determine the normal value range and reference value range for each examination carried out.

n) Normal values and reference value ranges should be listed in the clinical notes, as part of the report or in a separate document

o) If the examination is carried out by an external laboratory, the examination result report must be accompanied by a range of values. If there is a change in the method or equipment used to carry out the examination or there are changes related to developments in science and technology, evaluation and revision of the provisions regarding the range of laboratory examination values must be carried out.

p) There is a procedure for referring specimens and patients, if laboratory tests cannot be carried out at the Puskesmas.

Assessment Elements:

a) The Head of the Community Health Center determines normal values, reference value ranges for each type of examination provided, and critical values for laboratory examinations (R).

b) Essential reagents and other materials are available according to the specified type of service, labeling and storage, including a process for stating if reagents are not available (R,D,W).

c) The provision of laboratory services, which includes (1) to (9), is carried out in accordance with established policies and procedures (R,D,O,W).

d) Internal quality control and external quality control are carried out on laboratory services in accordance with statutory provisions and corrections are made if deviations occur (R, D, O, W).

e) Evaluation and follow-up are carried out regarding the time of reporting laboratory examination results (D, W).