scholarly journals Applying Best Practice to Converting Blood Collection Tube Suppliers: Overcoming Laboratory Supply Shortages

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S148-S149
Author(s):  
P C Tsang ◽  
S F Absar ◽  
D Gingrich
Keyword(s):  
Large Scale ◽  
Best Practice ◽  
Cost Savings ◽  
Ease Of Use ◽  
Blood Collection ◽  
Testing Methodology ◽  
Patient Consent ◽  
Collection Tube ◽  
Allowable Error ◽  
Supply Costs

Abstract Introduction/Objective Changing blood tube suppliers is a complex process that requires systematic validation. It can serve to expand a laboratory’s options during a supply shortage, and can lead to cost savings. Just prior to the pandemic, our laboratory underwent a large-scale conversion of blood tube suppliers after successful validation of serum, plasma, and whole blood tubes for blood bank, chemistry, immunology, hematology, coagulation, molecular diagnostics, and flow cytometry. Methods/Case Report First, we designed a patient consent form for collecting extra blood samples. Per CLSI standards, validation of blood tubes is needed for each testing methodology but not for each analyte. Hence, we selected high-impact assays to represent each testing methodology used by our instrument platforms. We designed comparison studies to test the new blood tubes for result accuracy, precision and specimen stability that covered an assay’s reportable range. Allowable error limits were set based on Westgard and CAP guidelines. Spiked specimens were used when positive patient samples were not feasible. We also took the opportunity to optimize the blood tube sizes, e.g., converting the lavender-top tubes from 2 ml (vendor A) to 3 ml (vendor B). We then confirmed with our reference labs the acceptability of the new vendor’s products, and administered an electronic survey to solicit staff feedback. Finally, we coordinated supply chain, formulary changes and test catalog updates. Results (if a Case Study enter NA) Data analyses showed 100% acceptable performance of the new supplier’s blood tubes. The survey showed that our phlebotomists supported the new products, citing their ease of use and good vacuum. Our hematology technologists provided favorable feedback on the larger lavender-top tubes that reduced the number of insufficient samples. On the economic front, this supplier conversion has yielded a 26% cost savings. Conclusion To our knowledge, our study is the most comprehensive of all blood collection device comparison analyses published. Our validation strategies that were designed to comply with best practice standards have led to our confidence in the interchangeability of the new and old blood tube products. This initiative serves to elucidate a protocol to add vendor options that can be replicated by other laboratories to mitigate blood tube supply shortages and backorders. It has helped us control supply costs without compromising quality.

scholarly journals A comparative evaluation of lithium estimation for samples collected in different tubes and its stability on storage

2018 ◽  
Vol 10 (01) ◽  
pp. 056-059
Author(s):  
Saidaiah Ikkurthi ◽  
Srinivas Balachander ◽  
Bela Goyal ◽  
Altaf Ahmad Mir ◽  
Subho Chakrabarti ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Therapeutic Index ◽  
Blood Collection ◽  
Narrow Therapeutic Index ◽  
Glass Vial ◽  
Reference Collection ◽  
Collection Tube ◽  
Allowable Error ◽  
Bipolar Affective Disorders ◽  
Clot Activator

Abstract PURPOSE: Lithium (Li) is a well-established drug for the treatment of bipolar affective disorders. Li as a drug is known to possess a narrow therapeutic index. Thus, regular monitoring of blood Li in patients receiving Li therapy is essential. Plain tubes with clot activator are known to interfere with Li estimation. The current study was planned to compare Li estimation in sera from vacutainers with clot activator, and plasma from sodium heparinized vacutainers with that of Li estimation in sera from glass vials. The time-dependant stability of Li estimation on storage at 2°C–8°C for 48 h in these three set of tubes was also evaluated. MATERIALS AND METHODS: Blood from the patients on Li therapy (n = 100) was collected in 3 different collection tubes: plain vacutainer with clot activator (S), Sodium heparinized vacutainer (P) and Glass vial (G) and was analyzed by ion selective electrode (ISE) analyzer for Li levels. Secondary aliquots were also taken from each type of collection tube and stored at 2°C–8°C. Time-dependant stability of Li estimation was checked at 12 h, 24 h, and 48 h. ANOVA followed by Tukey's posttest was performed to calculate statistical significance taking glass vial as reference collection tube. Bland–Altman plots were plotted to compare between three collection tubes at baseline. Stability on storage was defined when >95% of the samples were within allowable error limit for that time point taking baseline levels as reference. RESULTS: A mean bias of 0.18 mmol/L and mean percentage bias of 19.9% in Li levels was observed between serum from (S) than serum from (G). This difference was found to be statistically significant. However, statistically nonsignificant mean bias of 0.02 mmol/L and mean percentage bias of 3.34% in Li levels was observed between plasma from (P) and serum from (G). Time-dependant stability was observed more in glass vials as compared to vacutainers with clot activator or sodium heparin. CONCLUSION: Serum from glass vial should be the preferred method for blood collection to determine Li levels.

An evaluation of the performance of a large scale collaborative procurement initiative in the social housing sector

2016 ◽  
Vol 23 (1) ◽  
pp. 60-74 ◽  
Author(s):  
Graeme Bowles ◽  
James Morgan
Keyword(s):  
Social Housing ◽  
Large Scale ◽  
Best Practice ◽  
Behavioural Change ◽  
Cost Savings ◽  
Evidence Base ◽  
Structured Interviews ◽  
Content Type ◽  
Procurement Process ◽  
Procurement Programme

Purpose – The purpose of this paper is to understand the factors relating to the implementation of a new procurement initiative that affect performance and value for money (VFM). The study is based on a four-year research project carried out on behalf of the Scottish Government to monitor and evaluate the performance and efficiency of a bulk procurement vehicle for social housing. Design/methodology/approach – The researchers had a brief to monitor and evaluate the implementation of the procurement process and its influence on cost and efficiency targets. The study employed a mixed method approach with annual rounds of qualitative and quantitative data collection from project stakeholders including the contractors, consultants, clients and sponsor. Confidential semi-structured interviews were conducted on conclusion of the project to gauge views on how well the procurement process worked from the various perspectives and to reflect on the influence of the process on VFM. Findings – The procurement programme failed to achieve the capital cost and efficiency savings targets quantified at the outset and on this measure alone VFM was not demonstrated, although there were a number of reported benefits. A major factor was the extent of process and behavioural change required from the project team and, although a procurement consultant was engaged to facilitate this, the theoretical benefits of “best practice” were not realized. The picture was further complicated by rapidly changing economic conditions experienced, and debate about the robustness of original cost savings targets. Research limitations/implications – The findings and conclusions are of relevance and interest to clients and construction organisations undergoing change through adopting novel procurement processes. Originality/value – The empirical nature of the study provides a comprehensive evidence base for the performance of a collaborative procurement programme and an understanding of the potential difficulties in attaining the theoretical benefits of procurement innovation.

scholarly journals iConsent an Electronic Consent Platform with the MS Register

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Rod Middleton ◽  
David Ford ◽  
Daniel Naeh
Keyword(s):  
Informed Consent ◽  
Large Scale ◽  
Routine Data ◽  
Ethics Committee ◽  
Ease Of Use ◽  
Consent Form ◽  
Observational Research ◽  
Number Of Patients ◽  
Patient Consent ◽  
Patient Reported

ABSTRACT ObjectivesThe UK MS Register is a large scale observational research platform, capturing data from patients, NHS and carries out linkage with routine data from the SAIL databank. We have 14,000 People with MS (PwMS) submitting Patient Reported Outcome Measures (PRoMS) quarterly and over 3000 patients consenting at NHS Sites around the UK A differentiating factor between Register and previous attempts to capture PRoMS and clinical data was the goal that it be paperless. One area, where paper had to be used, was obtaining informed consent. Clinical participants are consented using a triplicate consent form, one copy for the patient, one for medical notes and one for the Register It’s desirable for patients to be able to electronically consent, providing the following benefits: Tablet computers already in use to collect PRoMS Printing costs Participant expectations Improved content and user experience: improved feedback, of multimedia elements about informed consent Increased familiarity with tablets ApproachChanging consent methodology is complex, all documentation, processes and changes are reviewed by the ethics committee. A privacy protecting, secure software package (iConsent) was developed by modifying an existing package from Welsh Cancer Bank. The software is server based, running on a Secured MS SQLServer 2014 and developed in .net to iOS/Android tablets The practitioner taking consent explains the process, participants then see the approved documentation and materials. Finally they fill in their email address and name, and are presented with the consent form, the participant uses a stylus to sign. The practitioner then countersigns. Once completed a digitally signed, secure pdf is generated on the server. Links are sent by email to the participant, the Register and unit administrator. The pdf is functionally identical to the paper. ResultsThe South West Central Bristol ethics committee approved the software following guidance on security and documentation design. Staff were trained in system usage. A number of patients were successfully e-consented, Of note was a potential issue with some patients and how MS impacts their ability to sign without resting a hand on the screen. ConclusionPatients who have been e-consented have expressed satisfaction in the ease of use and security of the software. Patients being unable to rest their hands on the screen is being examined. Newer tablets can ignore inputs other than the stylus. The MS Register intends to use the software in additional centres to capture patient consent.

scholarly journals Constrained Urban Airspace Design for Large-Scale Drone-Based Delivery Traffic

Aerospace ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 38
Author(s):  
Malik Doole ◽  
Joost Ellerbroek ◽  
Victor L. Knoop ◽  
Jacco M. Hoekstra
Keyword(s):  
Traffic Congestion ◽  
Urban Areas ◽  
Large Scale ◽  
Cost Savings ◽  
Future Research ◽  
Fast Time ◽  
Potential Cost ◽  
Horizontal Structure ◽  
Traffic Demand ◽  
Demand Patterns

Large-scale adoption of drone-based delivery in urban areas promise societal benefits with respect to emissions and on-ground traffic congestion, as well as potential cost savings for drone-based logistic companies. However, for this to materialise, the ability of accommodating high volumes of drone traffic in an urban airspace is one of the biggest challenges. For unconstrained airspace, it has been shown that traffic alignment and segmentation can be used to mitigate conflict probability. The current study investigates the application of these principles to a highly constrained airspace. We propose two urban airspace concepts, applying road-based analogies of two-way and one-way streets by imposing horizontal structure. Both of the airspace concepts employ heading-altitude rules to vertically segment cruising traffic according to their travel direction. These airspace configurations also feature transition altitudes to accommodate turning flights that need to decrease the flight speed in order to make safe turns at intersections. While using fast-time simulation experiments, the performance of these airspace concepts is compared and evaluated for multiple traffic demand densities in terms of safety, stability, and efficiency. The results reveal that an effective way to structure drone traffic in a constrained urban area is to have vertically segmented altitude layers with respect to travel direction as well as horizontal constraints imposed to the flow of traffic. The study also makes recommendations for areas of future research, which are aimed at supporting dynamic traffic demand patterns.

Electric Toothbrushes–For Whom are They Designed?

2002 ◽  
Vol 16 (1) ◽  
pp. 6-8 ◽  
Author(s):  
Sebastian Ciancio
Keyword(s):  
Clinical Studies ◽  
Large Scale ◽  
Economic Status ◽  
New Technology ◽  
Ease Of Use ◽  
Special Populations ◽  
Gingival Health

Powered toothbrushes were first introduced on a large scale in the early 1960s. However, because of a clear lack of superiority compared with manual brushes, and problems with mechanical breakdowns, their sales decreased significantly. However, recommendation for their use continued in special populations with dexterity and cognition problems. The 1990s ushered in an era of new technology, and studies began to suggest superiority of some powered brushes, particularly those using oscillating-rotating or counter-rotational actions. Some studies have shown interproximal cleansing abilities superior to those of manual brushes and yielding results similar to those achieved with the use of a manual brush and floss. Both controlled and open-labeled studies have suggested that electric brushes improve gingival health with patients who routinely used manual brushes prior to using these new powered brushes, and safety has been clearly established. In recommending powered toothbrushes, practitioners should familiarize themselves with the products available, with the clinical studies supporting their benefits compared with manual brushes, their safety and ease of use, and the patient's economic status.

Proposed guidance on cost-avoidance studies in pharmacy practice

2021 ◽  
Author(s):  
Asad E Patanwala ◽  
Sujita W Narayan ◽  
Curtis E Haas ◽  
Ivo Abraham ◽  
Arthur Sanders ◽  
...  
Keyword(s):  
Clinical Pharmacy ◽  
Best Practice ◽  
Pharmacoeconomic Analysis ◽  
Pharmacy Practice ◽  
Cost Savings ◽  
Sensitivity Analyses ◽  
Cost Assessment ◽  
Potential Consequence ◽  
Cost Avoidance ◽  
Pharmacist Interventions

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Cost-avoidance studies of pharmacist interventions are common and often the first type of study conducted by investigators to quantify the economic impact of clinical pharmacy services. The purpose of this primer is to provide guidance for conducting cost-avoidance studies pertaining to clinical pharmacy practice. Summary Cost-avoidance studies represent a paradigm conceptually different from traditional pharmacoeconomic analysis. A cost-avoidance study reports on cost savings from a given intervention, where the savings is estimated based on a counterfactual scenario. Investigators need to determine what specifically would have happened to the patient if the intervention did not occur. This assessment can be fundamentally flawed, depending on underlying assumptions regarding the pharmacists’ action and the patient trajectory. It requires careful identification of the potential consequence of nonaction, as well as probability and cost assessment. Given the uncertainty of assumptions, sensitivity analyses should be performed. A step-by-step methodology, formula for calculations, and best practice guidance is provided. Conclusions Cost-avoidance studies focused on pharmacist interventions should be considered low-level evidence. These studies are acceptable to provide pilot data for the planning of future clinical trials. The guidance provided in this article should be followed to improve the quality and validity of such investigations.

The adoption of biometric point-of-sale terminal for payments

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Siti Nurdiyana Atikah Sulaiman ◽  
Mohammad Nabil Almunawar
Keyword(s):  
Technology Acceptance ◽  
Large Scale ◽  
Time Frame ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Perceived Ease Of Use ◽  
Content Type ◽  
Point Of Sale ◽  
Scale Point ◽  
Acceptance Model

Purpose The purpose of this paper is to investigate factors that influence customers’ adoption of biometric-based point-of-sale in Brunei. Design/methodology/approach This paper extends technology acceptance model constructs with trust and some other variables as the framework to investigate their influence on the attitude toward the usage of a biometric point-of-sale terminal for payments in Brunei. Nine variables may influence user’s perception toward usage. The nine variables are needed, perceived ease of use, perceived usefulness, experience, innovativeness, privacy, security, trust and attitude toward usage. Multiple regression analysis was conducted to test hypotheses related to these nine variables. Findings It is found that the innovativeness of an individual and similar experience corresponds toward trust, which is positively related to attitude toward usage. Perceived usefulness and trust have significantly influenced the intention of individuals to use biometrics as an authentication method for payment. Research limitations/implications The nature of this research is to gather the public’s opinion and perception as much as it is deemed possible to get a bigger and clearer picture of the study. As the target respondence is citizens and residents of Brunei without any specification or exclusion, a large response would be needed to have a more reliable and accurate result. However, only 205 respondents can be gathered in this study. Had there been a longer time frame, it would be best to gather a lot more responses. Originality/value This paper explores the adoption of biometric authentication in large-scale point-of-terminals. It identifies factors that influence adoption. The results of this study could assist future researchers in which direction to take to further explore biometric as an authentication method for payment. In addition to this, it could also provide banks and financial technology in Brunei a clearer picture of the Brunei market and Bruneians perspective on the biometric system.

scholarly journals Interlaboratory comparison of the TransFix®/EDTA Vacuum Blood Collection tube with the 5 mL Cyto‐Chex® BCT

2018 ◽  
Vol 96 (6) ◽  
pp. 496-507 ◽  
Author(s):  
Daniel Harrison ◽  
Rosalie Ward ◽  
Sarah Bastow ◽  
Andrew Parr ◽  
Susan Macro ◽  
...  
Keyword(s):  
Interlaboratory Comparison ◽  
Blood Collection ◽  
Collection Tube ◽  
Blood Collection Tube

scholarly journals Preliminary Serological Study of Helicobacter pylori Infection in Some University Students

2020 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Abdullah A Mahrazi ◽  
Mohammad A Khibrani ◽  
Khatib S Ismail ◽  
Emad Abada ◽  
◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
University Students ◽  
Large Scale ◽  
Confirmatory Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Collection ◽  
Igg Antibodies ◽  
Igm Antibodies ◽  
H Pylori

Helicobacter pylori has been associated with peptic ulcer and gastric carcinoma. This study aimed to find the seroprevalence of H. pylori infection in some male students of Jazan University, Saudi Arabia. Twenty students were enrolled in the study (n = 20). Informed consent was obtained from the students. About 2 ml blood was collected intravenously in Improvacuter® evacuated blood collection tubes. The blood was allowed to clot at room temperature. The serum was collected and stored at –20°C for further use. The separated serum was used to detect IgG and IgM antibodies by Enzyme Linked Immunosorbent Assay (ELISA) against H. pylori for the in vitro diagnosis. A total of 11 (55.00%) students tested positive for IgG antibodies against H. pylori indicating previous infection. All the samples tested negative for IgM antibodies against H. pylori indicating no active infection. The seroprevalance of IgG antibodies against H. pylori was found to be very high in some male university students and is a cause of concern regarding their health. Obesity (p < 0.05; Value statistically significant), stress and bad eating habits, eating out, drinking carbonated beverages, and eating spicy food were some of the factors found to be associated with IgG seropositive students. The students were counseled and were instructed to undergo a confirmatory test and get medical intervention. Further large-scale studies need to be performed to plan action against this disease causing organism and to improve the health of students.

scholarly journals The potential for large-scale, subsurface geological CO2 storage in Denmark

1969 ◽  
Vol 17 ◽  
pp. 13-16 ◽  
Author(s):  
Peter Frykman ◽  
Lars Henrik Nielsen ◽  
Thomas Vangkilde-Pedersen
Keyword(s):  
Carbon Capture ◽  
Large Scale ◽  
Best Practice ◽  
Co2 Storage ◽  
Carbon Capture And Storage ◽  
The European Union ◽  
Geological Storage ◽  
Geological Co2 Storage ◽  
Research Programmes ◽  
Capture Techniques

Carbon capture and storage (CCS) is increasingly considered to be a tool that can significantly reduce the emission of CO2. It is viewed as a technology that can contribute to a substantial, global reduction of emitted CO2 within the timeframe that seems available for mitigating the effects of present and continued emission. In order to develop the CCS method the European Union (EU) has supported research programmes for more than a decade, which focus on capture techniques, transport and geological storage. The results of the numerous research projects on geological storage are summarised in a comprehensive best practice manual outlining guidelines for storage in saline aquifers (Chadwick et al. 2008). A detailed directive for geological storage is under implementation (European Commission 2009), and the EU has furthermore established a programme for supporting the development of more than ten large-scale demonstration plants throughout Europe. Geological investigations show that suitable storage sites are present in most European countries. In Denmark initial investigations conducted by the Geological Survey of Denmark and Greenland and private companies indicate that there is significant storage potential at several locations in the subsurface.

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