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  • Stock Register at a Microscopy Centre

    Learning Objectives

    The learner will be able to 
    - Discuss the details of stock register maintained in DMC
    - Explain responsibiliyies for maintenance of stock register and 
    - Recall calculation of stocks required at DMC

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Content
  • Designated Microscopy Centres (DMCs) are the most peripheral laboratory under the National TB Elimination Programme (NTEP) network. Therefore, it is very important for the DMCs to maintain an adequate stock of all consumables.
  • A paper-based stock register is maintained at the DMC and submitted as a part of the ‘Monthly report on programme management, logistics and microscopy’.
  • All the DMCs as well as Peripheral Health Institute (PHI) that are a DMC need to fill the second part of this monthly report format for reporting the status of laboratory consumables and equipment (Figure below).

Figure: Monthly report format for reporting status of laboratory consumables and equipment, to be filled by PHI that is DMC.

 

  • The stock register for consumables at the DMC has the provision to enter the information about the stock of consumables that are available at the DMC on the first day of the month, stock received and consumed during the month and stock remaining on the last day of the month along with the requested quantity of new stock.
  • The Lab Technician (LT) of the DMC is responsible for exhausting the old supplies before the new ones.
  • The Medical Officer (MO) of the DMC is responsible for determining the stocks and the Senior Tuberculosis Lab Supervisor (STLS) should ensure these supplies are distributed in a timely manner, as and when required.

 

Table: Calculation of Stocks Required at the DMC

Sputum containers

For diagnosis:

  • During the first week of each quarter, the number of new smear-positive cases registered and treated during the last quarter should be determined and this number should be multiplied by 10.
  • Ten is the average number of symptomatic required to be examined for detecting one case of new pulmonary smear-positive tuberculosis.
  • Since two sputum specimens are taken for each symptomatic patient, further multiply the number obtained above by 2.

For follow-up:

  • Two follow-up specimens are taken for the majority of patients - one at the end of the intensive phase and the other at the end of treatment. One sputum container is needed for each follow-up.
  • Once the number of sputum containers required has been calculated, allow sufficient reserve stock for three months, add 10% to account for wastage of sputum containers, and account for the sputum containers in stock.
  • On the last working day of the quarter, count the number of sputum containers in stock and subtract from that needed for diagnosis and follow-up examinations as calculated above.
Slides
  • Once the number of sputum containers needed for the next quarter is determined, order a slightly higher number of slides than the required no. of sputum containers to account for unavoidable breakage of slides. 
Reagents
  • Reagents are supplied to the DMCs on monthly basis by the District TB Centre (DTC).
  • The stock register should have the mention of expiry dates of the reagents and the first expiring reagents must be exhausted first based on the First Expiry First Out (FEFO) principle.
  • The reagents should not be used beyond three months from the date of preparation.

CBNAAT/ Truenat Machines and Cartridges/ Chips

 
  • These are procured centrally and supplied to state/ district/ sites based on their requirement.
  • Recording, reporting and monitoring of cartridges/ chips is done through Nikshay-Aushadhi and they are supplied based on the stock availability, consumption and expected case load.
Binocular Microscopes (BM) and LED Fluorescence Microscopes (FM)
  • 1 BM is required for every DMC.
  • The no. of BM in place and no. of BM in working condition should be reported in the stock register.
  • LED FM is supplied to the high case load facilities where the workload is more than 25 slides per day.
Tuberculosis Laboratory Register
  • Each TB lab register allows for the registration of at least 2000 patients.
  • For each lakh population, 75 smear-positive patients are projected, requiring the examination of 750 patients (thrice each). Additional follow-up examinations will bring the number of registers needed to approximately one lab register/ lakh.
  • If there are blank pages in the register at the end of a year, it can be used the following year. However, every year should be started on a new page.
Laboratory Form for Sputum Examination
  • For diagnosis, approximately 10 laboratory forms for sputum examination are needed. (10 is the average number of symptomatic for each case of pulmonary smear-positive tuberculosis identified).
  • For follow-up, approximately 0.2 laboratory forms for sputum examination are needed for each pulmonary tuberculosis case. (1 out of 10 examined will be smear-positive, each needs two forms for follow-up. When calculated, out of 10 it will be 0.2)

 

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Assessment

Question​ Answer 1​ Answer 2​ Answer 3​ Answer 4​ Correct answer​ Correct explanation​ Page id​ Part of Pre-test​ Part of Post-test​
How many TB Laboratory Register/s is/are required in one year for each DMC? 1 2 3 4 1 Each Tuberculosis Laboratory Register allows for the registration of at least 2000 patients. For each lakh, 75 smear-positive patients are projected, requiring the examination of 750 patients (thrice each). Additional follow-up examinations will bring the number of registers needed to approximately one lab register/ DMC. ​ Yes Yes

 

For follow-up, approximately 0.2 laboratory forms for sputum examination are needed for each pulmonary tuberculosis case.

 True False     1

 

For diagnosis, approximately 10 laboratory forms for sputum examination are needed. 10 is the average number of symptomatic for each case of pulmonary smear-positive tuberculosis identified. 1 out of 10 examined will be smear-positive, each needs two forms for follow-up. When calculated, out of 10 it will be 0.2

  

 

Yes

 

Yes

 

LMS Page Link
https://cms.swasth-egurukul.in/en/page-preview/56794

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