UCL Centre for PG&D, Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK.
Hum Reprod. 2010 Apr;25(4):1051-65. doi: 10.1093/humrep/dep450. Epub 2010 Jan 23.
Accreditation according to an internationally recognized standard is increasingly acknowledged as the single most effective route to comprehensive laboratory quality assurance, and many countries are progressively moving towards compulsory accreditation of medical testing laboratories. The ESHRE PGD Consortium and some regulatory bodies recommend that all PGD laboratories should be accredited or working actively towards accreditation, according to the internationally recognized standard ISO 15189, 'Medical laboratories-Particular requirements for quality and competence'. ISO 15189 requires comprehensive quality assurance. Detailed management and technical requirements are defined in the two major chapters. The management requirements address quality management including the quality policy and manual, document control, non-conformities and corrective actions, continual improvement, auditing, management review, contracts, referrals and resolution of complaints. Technical requirements include personnel competence (both technical and medical), equipment, accommodation and environment, and pre-analytical, analytical and post-analytical processes. Emphasis is placed on the particular requirements of patient care: notably sample identification and traceability, test validation and interpretation and reporting of results. Quality indicators must be developed to monitor contributions to patient care and continual improvement. We discuss the implementation of ISO 15189 with a specific emphasis on the PGD laboratory, highlight elements of particular importance or difficulty and provide suggestions of effective and efficient ways to obtain accreditation. The focus is on the European environment although the principles are globally applicable.
认证按照国际认可的标准越来越被认为是实现全面实验室质量保证的最有效途径,许多国家正在逐步朝着强制性认证医学检测实验室的方向发展。ESHRE PGD 联盟和一些监管机构建议所有 PGD 实验室都应按照国际认可的标准 ISO 15189“医学实验室-质量和能力的特殊要求”进行认证或积极开展认证工作。ISO 15189 需要全面的质量保证。在两个主要章节中定义了详细的管理和技术要求。管理要求包括质量管理,包括质量方针和手册、文件控制、不符合项和纠正措施、持续改进、审核、管理评审、合同、转介和投诉解决。技术要求包括人员能力(技术和医疗)、设备、设施和环境以及分析前、分析中和分析后过程。重点放在患者护理的特殊要求上:特别是样品识别和可追溯性、测试验证和解释以及结果报告。必须制定质量指标来监测对患者护理和持续改进的贡献。我们将讨论 ISO 15189 的实施,特别强调 PGD 实验室,突出特别重要或困难的要素,并提供获得认证的有效和高效方法的建议。重点是欧洲环境,尽管原则具有全球适用性。