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    Assessment Checklist - Docx Edited

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    yordanosezerihun07

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    Assessment Checklist - Docx Edited

    Uploaded by

    yordanosezerihun07
    27 views2 pages

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    Assessment checklist.docx Edited (1)

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    27 views2 pages

    Assessment Checklist - Docx Edited

    Uploaded by

    yordanosezerihun07

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Facility Assessment check list for Placement Laboratory machines

    Purpose: To assess Beckman Coulter Unicel DXH 800 Hematology Analyzer Types of Test
    Requested, Daily reagent usage, Available stock and Facility daily test
    volume.

    Facility Name: ___St. Peter specialized hospital___________Facility Telephone: _____________

    Name of Laboratory Head Yonas Tafa Telephone: 0911811118

    Name of Working on Analyzer __Moges (train on the analyzer)__ Telephone: 0912373736

    Supplying EPSA hub: __Central EPSA

    Date of Visit: 11/10/19

    Section 1. General Data of Hematology Test Volume and Type of Tests Requested.
    (They don’t begin working on Beckman Coulter Unicel DXH 800) Work on sysmex
    No Question Detail Answer of the responder
    1 For how many days did you use one (1) Diluent? N/A
    2 For how many days did you use one (1) Cell Lyse? N/A
    3 For how many days did you use one (1) Diff Pack? N/A
    4 For how many days did you use one (1) Retic Pack? N/A
    5 For how many days did you use one (1) Cleaner? N/A
    Item No Question Detail Quantity (Amount) (sysmex)
    1 Patient Sample per Day (the average patient sample 200
    you work per day)
    2 Repeat Rate per Day (Average amount of samples Don’t known
    repeated per day)
    3 Working Days a week 07
    4 Startups/Shutdowns per day (How many times the 02
    analyzer shutdown in 24 hour)
    5 CBC per Day (Only CBC test done from the total one 200
    day sample)
    6 CBC/Diff per Day (Critical Question) (CBC and 200
    Differential test requested at the same time per day )
    7 CBC/Diff/Retic per Day (CBC, Differential and Retics Don’t known
    test requested at the same time per day)
    8 Retic per Day (Only Retics test per day) Don’t known
    9 Body Fluids per Day (Only Body Fluid tests per day) Don’t known

    Section 4. Beckman Coulter Unicel DHX 800 Haematology Analyzer Available


    Reagents at the Facility.
    No Reagent Name Available on Stock
    1 COULTER® DxH Diluent (10L) 156
    2 COULTER® DxH Cell Lyse (5L) 09
    3 COULTER® DxH Diff Pack (3L) 06
    4 COULTER® DxH Retic Pack (3L) 06
    5 COULTER® DxH Cleaner (5L) 15

    Section 5. Other Comments and/or Observations


    The hospital didn’t begin work on. Beckman Coulter Unicel DHX 800 Hematology
    Analyzer but begin at the time of assessment we can find consumption data on
    the next assessment.

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