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CLIA WAIVED POINT OF CARE QUALITY CONTROL LOG
Point of Care QC Log
Michael
2018-06-02T09:59:49-05:00
Quality Control Entry Type
*
Select
Autoclave
Glucose Meter
HCG
Hemoccult
HemoCue
Influenza
Lead
Lipid
Mono
RSV
Strep
TCB
Urine
SARS-CoV-2 Antigen
Control Date
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MM slash DD slash YYYY
Clean / Maintenance Date
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MM slash DD slash YYYY
Was a sterilizer monitoring spore strip sent for testing?
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Yes
No
Lot Number
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Calibration Number
*
Expiration Date
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MM slash DD slash YYYY
Calibrated Date
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MM slash DD slash YYYY
Low Control Pass
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Yes
No
Normal Control Pass
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Yes
No
Abnormal Control Pass
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Yes
No
High Control Pass
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Yes
No
Neg(-) Control Pass
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Yes
No
Pos(+) Control Pass
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Yes
No
Was the equipment allowed to air dry for 15 minutes.
*
Yes
No
Run By Signature
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Run By
*
Select
Adamski, Rachel
Clark, Jodi
Covington, Shelby
Escalona, Giselle
Fedorczyk, Linsey
Goslin, Rebecca
Hayes, Kelly
Kuhlmann, Kinsey
Landry, Allison
Linck, Audra
Linck, Michael
Linck, Val
Mirbahaeddin, Anna Maria
Nelson, Haley
Simko, Sarah
Stafford, Jami
Wolf, Andrea
Verified By Signature
*
Verified By
*
Select
Adamski, Rachel
Covington, Shelby
Escalona, Giselle
Fedorczyk, Linsey
Goslin, Rebecca
Kuhlmann, Kinsey
Linck, Audra
Linck, Michael
Linck, Val
Mirbahaeddin, Anna Maria
Nelson, Haley
Simko, Sarah
Stafford, Jami
Tippetts, Jocelyn
Wolf, Andrea
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