سیما توکلی

Audit is an organized and documented process in which qualified and trained auditors evaluate the laboratories using tools such as checklists. This study was designed and conducted to survey the audit process in medical laboratories of Hamadan province.

This study was cross-sectional and retrospective research. Laboratories of Hamadan province were studied during the period of 2014 to 2021. Data were entered into SPSS software version 16 based on the checklists and records of medical laboratories in the reference laboratory. Data were analyzed using Cairo test by comparing the significance level of P-value <0.05.

The number of audits performed in a period of 7 years (2014 to 2021) had a significant difference with respect to the P-value = 0.024. The most audits were performed in 2016 with an average of 20.9% (P-value 0.021). The highest nonconformities were related to 2020 with an average of 26.5% (P value = 0.0001). The most corrective action was done in 2020 with an average of 70% (P-value = 0.0001).
Discussion and

The audit process has been established during this period. The most corrective action has been done in 2021, which indicates the concern of laboratories to fix nonconformities and more supervision of relevant organizations.

The studied region is located at 8 kilometer of west Mojen in the south of Mojen waterfall, a part of the Shahrood county. In order to study the hydrogeological and hydrogeochemical characteristics of springs in the area, discharge, electrical conductivity and temperature were measured from October 2017 to November 2018. Also, the concentrations of the main ions including Ca2+, Mg2+, Na+, K+, HCO3-, SO42- and Cl- have been measured in the water and environment laboratory of Shahroud University of Technology. The obtained results showed that the coefficients of variations for the physical and chemical characteristics for all springs are negligible and confirm the dominant diffuse flow system in the study area. Recession curve of the studied springs has solely one coefficient of discharge (α) with a gradient of 0.009 which indicates the dominant diffuse flow system in that karstic aquifer. One of the main reasons for the emergence of the springs in the studied region is contact of groundwater in the karstic catchment of these springs (Limestone rock formations of the Cretaceous and Lar) with impervious units (marls and marly limestone). According to the springs of the area are overflow springs and all these springs are drained from an aquifer. Hydrochemical diagrams related to samples prepared from the studied springs in June 2017 show that all samples are high in Ca2+ and HCO3-, and are located in a specific range of karst waters. The ratio of Ca2+ ion to Mg2+ ion concentration is used to determine the predominant aquifer in karst areas. The average ratio of Ca2+ ion to Mg2+ ion for the studied samples is about 2.60, which can be concluded that the predominant lithology of the studied karstic aquifer is limestone. Also in this research, the primary catchment area of the springs was drawed. Then precision of this primary catchment area was evaluated by the water budget method and comparing its values of annual discharge and recharge volumes. According to the mentioned comparison a relative error of 0.8 percent was obtained. Due to the negligible relative error between annually recharge and discharge volumes and as well as the stratigraphic status in the regionin the region, the drawn catchment area is quite accurate.

The purpose of laboratory test quality control establishment is to ensure the daily stability of the test system. Considering the defined principles guarantees laboratory performance improvement and patients’ confidence in the results of their tests. This study was conducted to survey laboratory test quality control establishment in public and private medical laboratories in Hamedan province.

In this cross-sectional and retrospective study, data of 184 laboratories (117 private and 67 public) was entered to SPSS software version 16 based on the quality system of medical laboratory evaluating check list, available in the reference laboratory of Hamadan province from 2016 to 2019. Data were analyzed using nonparametric equation of Kruskal-Wallis test by comparing the significance level of P-value <0.05.

The highest percentage of non-conformities belonged to the quality control records index with an average of %23.88 (P-value = 0.002). Mean of laboratory test quality control onconformities were %31.72 and %18.81 in public and private laboratories respectively which were not significantly different from each other. However, there was a significant difference in comparison of each of them with all laboratories in Hamadan province (P-value = 0.031 and 0.041).
Discussion and

The assessment of 6 indicators during 4 years showed that private laboratories had better performance than public laboratories in term of laboratory test quality control establishment.