2. Module 12 Managing supplies for a tuberculosis laboratory performing culture 1

3. Learning objectives At the end of this module, you will be able to:   list supplies required for culture;   explain ordering of supplies;   maintain proper records;   explain use of the stock book;   calculate supplies required;   inspect and verify supplies delivered;   explain storage of supplies. 2

4. Content outline Supply list for culture Record-keeping: stock book use and importance Calculation of supplies to order Receipt of supplies Storage and shelf-life of supplies 3

5. Supply management means… Properly maintaining adequate supplies to ensure uninterrupted service 4

6. Ordering and distribution of supplies What to order? From where? How much? How often? How to assess correctness of order? What is the lead time/reserve quantity? 5

7. Basic supplies required for culture Prepared media or components Prepared decontamination agents or components Disposable loops Transfer pipettes Screw-cap centrifuge tubes Cryotubes 6

8. Basic supplies required for culture for one specimen LJ media2 NaOH0.003 litre Sodium citrate0.003 litre NALC0.003 litre Na 2 HPO 4 0.025 litre KH 2 PO 4 0.025 litre Loops1.2 (buffer quantity included) Transfer pipettes1.2 (buffer quantity included) Centrifuge tubes1.1 (buffer quantity included) Cryotubes1.1 (buffer quantity included) 7

9. Supply management involves… Performing a “stock count” Maintaining proper inventory records Determining how much to order Placing orders properly Inspecting and verifying supplies received Ensuring proper storage of stock 8

10. Stock book 9

11. Perform a stock count What is it? Physically counting each item in the stock When is it done? Recommended at the end of each quarter Who does it? A designated person All items must be accounted for. Everything that comes in and goes out must be recorded. 10

12. Quantities requested/issued Round up the calculated quantity to a quantity consistent with the unit of issue. Example: if the calculated quantity of containers is 1300, round up to 2000 since the unit of issue is 1000 containers per bag (i.e. request 2 bags). 11

13. Scheme for calculating laboratory supplies Number of cultures done in the region during the previous quarter (A): 1000 ItemQuantity (litre) needed per culture Reagent Quantity (grams or litres) per litre Calculated requirements for 3 months (litres or grams) Reserve quantity for 3 months Stock on hand Calculated request Actual request (rounded up) Order unit (B)(B)(C)(C)(D) = AxBxC(E) = D(F)(F)(G) = D+E–F LJ media2 N/A2000 0400040Box of 100 tubes NaOH 0.003 40120 02403Bottle (100 g) Sodium citrate 0.003 2987 01742Bottle (100 g) NALC 0.003 515 0302Bottle (25 g) Na 2 HPO 4 0.025 9.47236.75 0473.55Bottle (100 g) KH 2 PO 4 0.025 9.07226.75 0453.55Bottle (100 g) Loops 1.2 N/A1200 024003 Box of 1000 Loops Transfer pipettes 1.2 N/A1200 024003 Box of 1000 Pipettes Centrifuge tubes 1.1 N/A1100 0220022 Box of 100 falcon tubes Cryotubes 1.1 N/A1100 022003 Box of 1000 cryotubes 12

14. Total specimens examined in previous quarter (A) The value A is the number of cultures performed during the previous quarter. 13

15. Quantity needed per culture (B) The value B is the quantity of an item that is used to perform the culture of one specimen. 14

16. Reagent quantity (grams or litres) per litre (C) The value C is the reagent quantity (grams or litres) per litre. 15

17. Calculated requirements for a quarter (litres or grams) (D) The value D is the quantity required for one quarter (A) multiplied by the quantity needed per culture (B) multiplied by the reagent quantity (grams or litres) per litre (C). D = A x B x C 16

18. Buffer stock (E) The value E is the one-quarter consumption quantity of an item that must be kept as a reserve. Thus E is equal to D, the quantity of an item calculated for one quarter: D = E 17

19. Stock in unit (F) The value F is the stock in the unit on the last day of the quarter. F is determined by an actual physical count of existing stock (inventory). 18

20. Calculated quantity (G) The value G is the quantity required for one quarter (D) plus the quantity required for one quarter reserve (E) less the stock in unit (F). G = D + E – F 19

21. Scheme for calculating laboratory supplies Number of cultures done in the region during the previous quarter (A): 1000 ItemQuantity (litre) needed per culture Reagent Quantity (grams or litres) per litre Calculated requirements for 3 months (litres or grams) Reserve quantity for 3 months Stock on hand Calculated request Actual request (rounded up) Order unit (B)(B)(C)(C)(D) = AxBxC(E) = D(F)(F)(G) = D+E–F LJ media2 N/A2000 0400040Box of 100 tubes NaOH 0.003 40120 02403Bottle (100 g) Sodium citrate 0.003 2987 01742Bottle (100 g) NALC 0.003 515 0302Bottle (25 g) Na 2 HPO 4 0.025 9.47236.75 0473.55Bottle (100 g) KH 2 PO 4 0.025 9.07226.75 0453.55Bottle (100 g) Loops 1.2 N/A1200 024003 Box of 1000 loops Transfer pipettes 1.2 N/A1200 024003 Box of 1000 Pipettes Centrifuge tubes 1.1 N/A1100 0220022 Box of 100 falcon tubes Cryotubes 1.1 N/A1100 022003 Box of 1000 cryotubes 20

22. Place orders properly This slide must be customized with site- specific information obtained beforehand EXPLAIN from the slide 21

23. Inspect and verify order deliveries Upon receipt: Check contents of order received against request. Check integrity of supplies received. Check expiry date on boxes of each item. Date each item received. Store newly delivered items behind existing items. Store the first-expiring items behind the last- expiring items. Create or update records. 22

24. Ensure proper storage of inventory Keep in a clean, dry, well-ventilated, and organized storage area. Store according to suppliers’ instructions. Place items on shelves or in refrigerators. Store away from direct sunlight. Organize existing and new shipments by date received or prepared. 23

25. Under-stocking implies: Insufficient supplies Interruption of the testing process Undermining of patients’ faith in the health system 24

26. Over-stocking implies: Laboratory space may be overwhelmed by excessive stock, compromising safety and security. Reagents deteriorate, causing waste. Use of old reagents could compromise test results. 25

27. True and false exercise 1. 1.Record and account for all items in the inventory. 2. 2.Use the newly arrived items first. 3. 3.Use of old reagents will not compromise test results. 26

28. Module review: take-home messages   Maintain an adequate inventory at all times to ensure uninterrupted service.   Do not let any item run out.   Never order more than you require in the next quarter.   Record and account for all items in the inventory.   Always inspect a new shipment before accepting it. 27

29. 28 What is supply management? Why is a physical stock count necessary? Why is it important to maintain inventory records? How do you calculate supplies required? Why must orders be inspected and verified? Why must supplies be stored properly? Self-assessment