Standards › Standard 53 › Standard operating procedures (SOPs)
SOP · ALR-SOP-003 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 53.3
At a glance
- Skin and blood allergy tests are performed with validated methods and reagents (LBT-REG-004 for external assessment).
- Each test run includes positive and negative controls, checked before results are reported (LBT-SOP-002).
- Results are interpreted by a qualified clinician with the clinical history (ALR-FRM-002).
- Results are reported with the clinical context and the limits of the test.
- Stop and get help straight away if: a result is reported from a test run whose controls failed.
1. Purpose
To make sure allergen tests are reliable and their results are interpreted with the clinical picture (53.3).
2. Scope
| Applies to | Clinical and support staff in the hospital |
| Locations | All wards, clinics and departments of the facility |
| When | Whenever the activity described is carried out |
| Does not apply to | Activities covered by another document listed in section 15 |
3. Definitions
| Term | Meaning |
|---|---|
| Clinical lead | The doctor or nurse in charge of the area at the time |
4. Background
To make sure allergen tests are reliable and their results are interpreted with the clinical picture (53.3).
5. Responsibilities
| Role | Responsibility | Competence |
|---|---|---|
| Allergologist | Interprets results with the clinical history and signs the report | Clinical lead |
| Laboratory lead | Runs quality control and the external assessment | Clinical lead |
6. Materials and equipment
| Item | Requirement | Condition |
|---|---|---|
| Records and forms named in this document | Current version | Checked before use |
7. Safety
- Stop and call for help if a patient is at immediate risk. Do not delay urgent care to complete paperwork.
8. Before you start
- Confirm the forms and equipment named in this document are available and current.
9. Procedure
Step 1. Control.
- Run the positive and negative controls with each test run, and check them before reporting.
Key point: Controlled.
Step 2. Interpret.
- Interpret each result with the clinical history and record it (ALR-FRM-002).
Key point: Interpreted.
Step 3. Report.
- Report with the clinical context and the limits of the test (LBT-SOP-008).
Key point: Reported.
10. Decision points
- No decision points in this procedure.
11. Special situations
| Situation | Action |
|---|---|
| Out of hours | Follow the same steps. Use the on-call contact on the wall of the area. |
12. Escalation
- Any serious problem goes to the duty clinical lead at once and to the clinical director the same day.
13. Monitoring
| Measure | Target | Frequency | Owner | If not met |
|---|---|---|---|---|
| Test runs with controls passing before reporting | 100% | Each run | Laboratory lead | Withhold the result and repeat the run |
| Results signed by a qualified clinician | 100% | Each result | Allergologist | Escalate to the clinical lead |
14. Records
| Record | Kept in | Retention |
|---|---|---|
| Record named in this document | Patient record or the area file | the period set by the facility’s records policy years |
15. Training
- Staff are trained in this document at induction and refreshed each year, with a recorded competency check.
16. Related documents
| ID | Title | Use |
|---|---|---|
| ALR-FRM-002 | Allergy test result and interpretation record | Record |
| LBT-SOP-002 | Internal quality control (existing, reused) | SOP |
17. Evidence
| Reference | Note |
|---|---|
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
18. Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)