Part I: Organisation and management
laboratory administration and record keeping

The purpose of a laboratory recording and reporting system is to provide information to improve the management of the National Tuberculosis Programme at all levels (national, regional and district).

Accurate record-keeping of specimens received, specimen processed, laboratory results and specimens sent to referral or regional laboratories for culture and susceptibility testing is essential for the proper management of the control programme strategy.

Standardised records should be simple, practical and limited to essential information. Laboratory Supervisors should assess the quality, review the specimen request forms, laboratory register, and reporting of the laboratory results for completeness, consistency and credibility.

Standard operating procedures
Written operating and cleaning instructions must be kept in a file for all equipment. Dated service records must be kept for all equipment. Laboratory procedures used routinely should be those that have been published in reputable microbiological books, manuals or journals. Every procedure performed in the laboratory must be written out exactly as carried out and be kept in the laboratory for easy reference. Any changes must be dated and initiated by the Laboratory Supervisor.

All laboratory records should be retained for two years.

Laboratory request forms
This form is sent with the specimen (or patient), requesting the appropriate examination. The patient?s data must be completed in full and the examination requested should be noted eg. sputum microscopy, culture, etc.

Laboratory registers
This is a record book maintained by the technician/technologist in the laboratory responsible for sputum smear examination and/or sputum culture of tuberculosis suspects and follow-up examinations. For each tuberculosis suspect, the Tuberculosis Laboratory Register should contain the following:

• Date of specimen received
• Laboratory reference number
• Type of specimen received
• Patient name, gender, age
• Patient register number (if available)
• Smear and/or culture results
• Results of confirmatory tests for M. tuberculosis (if applicable)
• Date results reported
• Name of person responsible for tests

Laboratory report forms
These forms contain the results of microscopic and/or culture examination and should clearly state the outcomes as described in the Technical Series on Microscopy and the Technical Series on Culture. It is also important to indicate whether results are preliminary (eg. awaiting culture) or final.

Laboratory accident book
This book should be kept by the Laboratory Supervisor and should contain extensive details about laboratory accidents and the necessary measures taken. Each laboratory accident should be reported to the person in charge and full details entered into the laboratory accident book, noting the following:

• Date of the accident
• Name of person concerned
• Description of accident
• Laboratory number of specimen/strain involved
• Extent of injury
• Containment and follow-up measures taken

Both the laboratory supervisor and the person who caused the accident should sign the statement.