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Journal of Clinical Microbiology, November 2007, p. 3754-3758, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.01632-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Mechanisms To Assess Gram Stain Interpretation Proficiency of Technologists at Satellite Laboratories{triangledown}

Erik Munson,1,2* Timothy Block,1 Janice Basile,1 Jeanne E. Hryciuk,1 and Ronald F. Schell3,4,5

Wheaton Franciscan and Midwest Clinical Laboratories, Wauwatosa, Wisconsin 53226,1 College of Health Sciences, University of Wisconsin—Milwaukee, Milwaukee, Wisconsin 53201,2 Wisconsin State Laboratory of Hygiene,3 Departments of Bacteriology,4 Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin 537065

Received 15 August 2007/ Accepted 16 August 2007

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 ≤ 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.

* Corresponding author. Mailing address: Midwest Clinical Laboratories, 11020 West Plank Court, Suite 100, Wauwatosa, WI 53226. Phone: (414) 256-1479. Fax: (414) 256-5566. E-mail: Erik.Munson{at}wfhc.org

{triangledown} Published ahead of print on 29 August 2007.

Journal of Clinical Microbiology, November 2007, p. 3754-3758, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.01632-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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