Development of Quality Control and Analytical Systems for Complete Blood Count and Urine Analysis in Hematology and Microscopy Laboratory at Bamrasnaradura Infectious Diseases Institute

Abstract

          The development of quality control systems in clinical laboratories is essential for ensuring the accuracy and reliability of test results. This study aimed to enhance QC performance for Complete Blood Count (CBC) and Urine Analysis to support Auto Verification using IQC and EQA data from January 2024 to April 2025. Evaluation of the Mindray BC-6200 CBC analyzer for 14 parameters WBC, Hb, PLT, RBC, MCV, NEU, LYM, MON, EOS, BAS, HCT, MCH, MCHC, RDW-CV showed a reduction in mean %CV from (0.84–6.89) to (0.64–6.19), and mean SDI from (–0.81–1.63) to (–0.61–1.35). All %Bias values were within acceptable TEa limits. Sigma metric evaluation of five parameters showed excellent performance (Sigma ≥6) in three parameters WBC, Hb, and PLT and very good performance (Sigma ≥ 5) in two parameters RBC and MCV. Based on OPSpecs Charts, Westgard rule 1_3s was applicable for WBC, Hb, and PLT, while RBC and MCV required 1_3s, 2of2s, and R_4s. In practice, both analyzers achieved Sigma ≥ 6 for all five parameters using only the 1_3s rule, consistent with improved EQA Z-scores.
          For urine analysis, the LabMate2 analyzer was used for 10 parameters, including Specific Gravity, pH, Leukocyte, Nitrite, Protein, Glucose, Ketone, Bilirubin, Urobilinogen, and Blood. The Urised2 analyzer was used for three additional parameters: WBC, RBC, and Squamous epithelial cells. The proportion of IQC results conforming to target values improved from 80.9% to 95.4%, and EQA results improved from 99.8% to 100%, indicating excellent performance.
          The findings were applied to develop QC rules and data check systems for Auto Verification, resulting in reduced reporting time, minimized errors, and improved abnormal result screening by experts.