Unexpected High Glucose QC Failure

During your morning QC check, the glucose QC result is unexpectedly high. Expected QC range: 4.5 - 6.0 mmol/L Observed QC result: 8.2 mmol/L (Too high) Your Task: Investigate the root cause, apply corrective actions, and document your findings. [[Repeat the QC Test]]

(text-style:"underline")[''Step 1: Repeat the QC Test''] ''Why?'' To determine if this was a one-time error or a consistent issue. ''Task:'' 1. Retrieve a fresh aliquot of the QC sample. 2. Rerun the QC test. 3. Record the result. [[If QC passes]] [[If QC fails again (still high)]]

(text-style:"underline")[''If QC Passes''] The first test may have been a one-off issue (e.g. pipetting error). For the first time running the QC Test - [[Repeat the QC Test]] ''If this is a repeat QC test, then the sample has passed - Return to [[Start]]''

(text-style:"underline")[''If QC Fails Again (Still High)''] The problem is real, and further investigation is needed. [[Check Calibration Records]]

(text-style:"underline")[''Check Calibration Records''] ''Why? ''Calibration ensures the analyzer correctly measures glucose concentrations. ''Task:'' 1. Review the last calibration date. 2. Check for any recent calibration failures or adjustments. 3. Determine if recalibration is necessary. [[If Calibration is off]] [[If Calibration is fine]]

(text-style:"underline")[''If Calibration is Off''] Perform recalibration and rerun QC. [[Repeat the QC Test]]

(text-style:"underline")[''If Calibration is Fine''] Continue investigating. [[Inspect Reagents]]

(text-style:"underline")[''Inspect Reagents''] ''Why? ''Contaminated, expired, or improperly stored reagents can cause falsely high readings. ''Task:'' 1. Locate the glucose reagent and check: * Expiry date * Lot number (compare with previous successful QC tests) * Storage conditions (Was the reagent stored at the correct temperature?) 2. Try using a fresh bottle of reagent. 3. Run a QC test with the new reagent. [[If QC passes with new reagent]] [[If QC still fails]]

(text-style:"underline")[''If QC Passes with New Reagent''] The previous reagent was likely contaminated or expired. [[Repeat the QC Test]]

(text-style:"underline")[''If QC Still Fails''] Reagent is likely not the issue, continue troubleshooting. [[Review Instruments Logs & Alerts]]

(text-style:"underline")[''Review Instruments Logs & Alerts''] ''Why? ''Analyzer malfunctions can cause incorrect glucose readings. ''Task:'' 1. Check the instrument error log for any alerts. 2. Look for issues such as: * Pipetting errors (e.g., air bubbles in the sample) * Contaminated optical system (e.g., dried reagent blocking light detection) * Sample carryover from previous tests (residual glucose from another sample) [[If an error is found]] [[If no errors are found]]

(text-style:"underline")[''If an Error is Found''] Resolve it (e.g., clean the pipette, flush the system) and rerun QC. [[Repeat the QC Test]]

(text-style:"underline")[''If No Errors are Found''] Continue investigating. [[Check for Contamination or Sample Handling Issues]]

(text-style:"underline")[''Check for Contamination or Sample Handling Issues ''] ''Why? ''Improper sample handling can lead to falsely high glucose readings. ''Task:'' 1. Check if QC vials were handled correctly. 2. Verify that the QC material was not contaminated with a high-glucose sample. 3. Check if the QC material was inverted and mixed properly before use (glucose can settle at the bottom if not mixed). [[If contamination is detected]] [[If the QC run stills fail]]

(text-style:"underline")[''If Contamination is Detected''] Discard affected QC material and retest with a fresh vial. [[Repeat the QC Test]]

(text-style:"underline")[''If the QC Run Still Fails''] Consider escalating the issue. Return to [[Start]]