EQA / proficiency-testing result evaluation template
A qc sheet in the External Quality Assessment procedure (PR24), mapped to ISO 15189:2022 clause 7.3.7.3. Fill it in whenever the task occurs. Used by the laboratory team.
Qc sheetISO 15189 · 7.3.7.3As needed
Calculated automaticallyRed = outside limits
Your LaboratoryEQA / proficiency-testing result evaluation | YL-LAB-FRM-24-T01 v1.0
Record: EQA / proficiency-testing result evaluation — October 2026
z = (your result − assigned value) ÷ SD for proficiency assessment. |z| ≤ 2 satisfactory · 2 < |z| < 3 questionable · |z| ≥ 3 unsatisfactory. If the scheme uses a % limit instead, enter it in "Allowable %".
Year2026
| No. | Survey / cycle | Sample ID | Analyte | Your result | Assigned value | SD (SDPA) | z-score | Deviation % | Allowable % | Performance | Investigation / action (if not satisfactory) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | S26-1041 | Glucose | 4.89 | 5.02 | 0.15 | -0.86667 | -2.5896 | 92.50 | Satisfactory | None required | |
| 2 | S26-1048 | Creatinine | 5.11 | 5.10 | 0.15 | 0.06667 | 0.1961 | 96.20 | Satisfactory | None required | |
| 3 | S26-1055 | ALT | 5.07 | 5.06 | 0.16 | 0.06250 | 0.1976 | 86.50 | Satisfactory | None required | |
| 4 | S26-1062 | Haemoglobin | 5 | 5.10 | 0.14 | -0.71429 | -1.9608 | 97.90 | Satisfactory | Investigated and repeated: within limits | |
| 5 | S26-1069 | Potassium | 4.92 | 5.07 | 0.16 | -0.93750 | -2.9586 | 94 | Satisfactory | None required | |
| 6 | S26-1076 | Glucose | 4.96 | 5.07 | 0.15 | -0.73333 | -2.1696 | 91.90 | Satisfactory | None required | |
| 7 | S26-1083 | Creatinine | 4.96 | 5.06 | 0.16 | -0.62500 | -1.9763 | 93.40 | Satisfactory | None required | |
| 8 | S26-1090 | ALT | 5.06 | 5 | 0.16 | 0.37500 | 1.2000 | 88.70 | Satisfactory | None required |
Summary
Results evaluated8
Satisfactory8
Questionable0
Unsatisfactory0
Satisfactory %100.0
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Completed by | |||
| Reviewed by |
Shaded cells are calculated automatically. Values in red are outside their limits. † marks a corrected value (see Corrections).
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
A4 landscape · first page · showing 8 of 8 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Survey / cycle
- Sample ID
- Analyte
- Your result
- Assigned value
- SD (SDPA)
- z-score
- Deviation %
- Allowable %
- Performance
- Investigation / action (if not satisfactory)
Instructions on the form
- z = (your result − assigned value) ÷ SD for proficiency assessment. |z| ≤ 2 satisfactory · 2 < |z| < 3 questionable · |z| ≥ 3 unsatisfactory. If the scheme uses a % limit instead, enter it in "Allowable %".
Sign-off
- Completed by
- Reviewed by
Related templates
- EQA Dashboard Tracker (PR24-F01)
- 5-year EQA Programme Plan (PR24-F02)
- EQA Report Review Checklist (PR24-F03)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.