Essential Considerations in the Provision of Near-Patient Testing Facilities

1988 ◽  
Vol 25 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Vincent Marks
Keyword(s):  
Quality Control ◽  
New Technologies ◽  
Clinical Laboratory ◽  
Sample Collection ◽  
Quality Assurance Programme ◽  
Laboratory Staff ◽  
Health Authorities ◽  
Laboratory Services ◽  
Analytical Services ◽  
Near Patient Testing

(1) Near-patient testing (NPT) is both practicable and in some situations desirable. (2) Like all new technologies its apparent simplicity often belies its complexity and masks the need for attention to detail in order to achieve optimum effects and avoid disasters. (3) Though technically unskilled individuals are capable of using it, they must undergo training in the elements of safety, sample collection, quality control, quantitation and documentation before being authorised to provide analytical services for patients. (4) Health Authorities should be encouraged to adopt a policy of integration of NPT and clinical laboratory services in order to reduce unplanned use and abuse of NPT facilities which is not only wasteful and divisive, but also dangerous. This has recently been emphasised in the United Kingdom by the release of a Hazard Notice (HN (Hazard) (87) 13) by the Department of Health and Social Security. The experienced clinical biochemist will, by virtue of training and experience, usually be the most suitable person in a Health District to advise on many of the issues involved in NPT. It should therefore, be the responsibility of laboratory staff to work with management, clinical, and nursing staff to: choose appropriate sites for the various levels of service to be provided to meet a clinical need; select the equipment and reagents to be employed; provide training in the use of the apparatus, quality control and safety; authorise accredited users and oversee the quality assurance programme. (5) Laboratory staff will need to involve themselves closely in the financial implications of NPT both for the laboratory's benefit and that of clinical practice within the hospital and/or community as a whole.

scholarly journals Appraisal of the domestic kit «MICMICRO » for antimicrobial susceptibility testing by serial microdilution method

2020 ◽  
pp. 231-236
Author(s):  
Anna A. Samoilova ◽  
L.A. Kraeva ◽  
I.V. Likhachev ◽  
E.V. Rogacheva ◽  
V.N. Verbov ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Quality Control ◽  
Susceptibility Testing ◽  
New Technologies ◽  
Clinical Laboratory ◽  
Clinical Isolates ◽  
Internal Quality ◽  
Diagnostic Efficiency ◽  
Microdilution Method ◽  
Reference Strains

Objective. To assess efficiency of the “MIC-MICRO” kit developed in the Department of New Technologies of the Saint-Petersburg Pasteur Institute, on reference strains and clinical bacterial isolates. Materials and Methods. In order to assess the “MIC-MICRO” kit, several options of its execution were used, including different groups of antibiotics: aztreonam, amikacin, gentamicin, colistin, meropenem, nitrofurantoin, chloramphenicol, cefotaxime, ceftriaxone, ciprofloxacin, erythromycin. In order to determine the range of antibiotic values, the EUCAST-2020 database was used. The quality control of adsorbed antibiotics was carried out using reference strains: Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213 and Escherichia coli NCTC 13846 (colistin-resistant). Acceptable and target ranges of MIC values for control strains are evaluated according to “Regular and extended internal quality control for determining MIC and disk diffusion according to EUCAST recommendations” (v10.0). A total of 28 clinical isolates of K. pneumoniae obtained from patients with nosocomial infections in St. Petersburg hospitals in 2018–2019 was used in the study. The coordination of test results was obtained in accordance with GOST R ISO 20776-1-2010. Susceptibility testing results were interpreted in accordance with EUCAST recommendations (v10.0). Results. The MIC values in relation to the reference strains obtained using the “MIC-MICRO” kit were determined in the range of recommended values of the EUCAST-2020 standard. The results obtained in relation to clinical isolates of K. pneumoniae showed that the sensitivity categories determined using the developed kit and the serial microdilution method were the same for all the studied strains. The percentage of colistin-resistant isolates (MIC > 2 mg/ml) in the serial microdilution method and determined using the “MIC-MICRO” kit was 35.7%. The percentage of susceptible strains was also similar for two types of methods (64.3%). Conclusions. Colistin susceptibility testing of K. pneumoniae strains using the “MIC-MICRO” diagnostic kit and the reference serial microdilution method in a tablet, showed comparable results. Diagnostic efficiency, ease to use and simple interpretation of results make it possible to use the developed “MIC-MICRO” kit in clinical laboratory practice.

Assuring the quality of interpretative comments in clinical chemistry

2016 ◽  
Vol 54 (12) ◽  
Author(s):  
Samuel Vasikaran ◽  
Kenneth Sikaris ◽  
Eric Kilpatrick ◽  
Jane French ◽  
Tony Badrick ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Continuing Professional Development ◽  
Laboratory Staff ◽  
Laboratory Services ◽  
Method Of Assessment ◽  
The Impact ◽  
Eqa Schemes ◽  
Interpretative Comments

AbstractThe provision of interpretative advice on laboratory results is a post-analytic activity and an integral part of clinical laboratory services. It is valued by healthcare workers and has the potential to prevent or reduce errors and improve patient outcomes. It is important to ensure that interpretative comments provided by laboratory personnel are of high quality: comments should be patient-focused and answer the implicit or explicit question raised by the requesting clinician. Comment providers need to be adequately trained and qualified and be able to demonstrate their proficiency to provide advice on laboratory reports. External quality assessment (EQA) schemes can play a part in assessing and demonstrating the competence of such laboratory staff and have an important role in their education and continuing professional development. A standard structure is proposed for EQA schemes for interpretative comments in clinical chemistry, which addresses the scope and method of assessment including nomenclature and marking scales. There is a need for evidence that participation in an EQA program for interpretative commenting facilitates improved quality of comments. It is proposed that standardizing goals and methods of assessment as well as nomenclature and marking scales may help accumulate evidence to demonstrate the impact of participation in EQA for interpretative commenting on patient outcome.

Improvement of Clinical Laboratory Services through Quality

2013 ◽  
Vol 2 (2) ◽  
pp. 38-46 ◽  
Author(s):  
Antonia Mourtzikou ◽  
Marilena Stamouli ◽  
Elena Athanasiadi
Keyword(s):  
Quality Control ◽  
Health Care Providers ◽  
Clinical Laboratory ◽  
Internal Quality ◽  
Care Providers ◽  
Improvement Program ◽  
Laboratory Performance ◽  
Laboratory Services ◽  
Poor Individual ◽  
Eqa Schemes

Health care providers need test results that are relevant, accurate, and reliable for patient care. The term “quality control” is used to describe the set of procedures used to check that the results of laboratory tests are reliable for the intended clinical use. A laboratory might produce results that are considered unsatisfactory. While the cause for this might be immediately apparent, the identification of the underlying problem is neither always straightforward, nor easy because many factors can affect result quality. Internal quality control (IQC) and external quality assessment (EQA) are two distinct but complementary components of a laboratory quality improvement program. IQC ensures day-to-day laboratory consistency. EQA permits the identification of poor individual laboratory performance, as well as the detection of reagents, instruments and methods that produce unreliable or misleading results, by means of a retrospective analysis of data obtained by participating laboratories. Continuous participation in EQA schemes has been linked to improved laboratory performance.

scholarly journals Experience on how to implement a preanalytical and POCT unit in Madrid’s IFEMA field hospital during this unprecedented COVID-19 emergency

2020 ◽  
Vol 30 (3) ◽  
pp. 360-362
Author(s):  
Jorge Díaz–Garzón ◽  
Marta Gómez ◽  
Antonio Buño ◽  
Manuela Simón ◽  
Olaia Rodriguez-Fraga ◽  
...  
Keyword(s):  
Personnel Selection ◽  
University Hospital ◽  
Medical Decision ◽  
Blood Gas ◽  
Sample Collection ◽  
Field Hospital ◽  
La Paz ◽  
Health Authorities ◽  
Laboratory Services ◽  
Spanish Health

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab’s personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care.

scholarly journals Global biochemical analysis of plasma, serum and whole blood collected using various anticoagulant additives

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249797
Author(s):  
Adam D. Kennedy ◽  
Lisa Ford ◽  
Bryan Wittmann ◽  
Jesse Conner ◽  
Jacob Wulff ◽  
...  
Keyword(s):  
Whole Blood ◽  
Clinical Laboratory ◽  
Redox Balance ◽  
Matched Pair ◽  
Blood Collection ◽  
Sample Collection ◽  
Blood Draw ◽  
Laboratory Staff ◽  
Global Metabolomics ◽  
Blood Collection Tubes

Introduction Analysis of blood for the evaluation of clinically relevant biomarkers requires precise collection and sample handling by phlebotomists and laboratory staff. An important consideration for the clinical application of metabolomics are the different anticoagulants utilized for sample collection. Most studies that have characterized differences in metabolite levels in various blood collection tubes have focused on single analytes. We define analyte levels on a global metabolomics platform following blood sampling using five different, but commonly used, clinical laboratory blood collection tubes (i.e., plasma anticoagulated with either EDTA, lithium heparin or sodium citrate, along with no additive (serum), and EDTA anticoagulated whole blood). Methods Using an untargeted metabolomics platform we analyzed five sample types after all had been collected and stored at -80°C. The biochemical composition was determined and differences between the samples established using matched-pair t-tests. Results We identified 1,117 biochemicals across all samples and detected a mean of 1,036 in the sample groups. Compared to the levels of metabolites in EDTA plasma, the number of biochemicals present at statistically significant different levels (p<0.05) ranged from 452 (serum) to 917 (whole blood). Several metabolites linked to screening assays for rare diseases including acylcarnitines, bilirubin and heme metabolites, nucleosides, and redox balance metabolites varied significantly across the sample collection types. Conclusions Our study highlights the widespread effects and importance of using consistent additives for assessing small molecule levels in clinical metabolomics. The biochemistry that occurs during the blood collection process creates a reproducible signal that can identify specimens collected with different anticoagulants in metabolomic studies. Impact statement In this manuscript, normal/healthy donors had peripheral blood collected using multiple anticoagulants as well as serum during a fasted blood draw. Global metabolomics is a new technology being utilized to draw clinical conclusions and we interrogated the effects of different anticoagulants on the levels of biochemicals from each of the donors. Characterizing the effects of the anticoagulants on biochemical levels will help researchers leverage the information using global metabolomics in order to make conclusions regarding important disease biomarkers.

scholarly journals From grass to grace: How SLMTA revolutionised the Bamenda Regional Hospital Laboratory in Cameroon

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Siyem C. Nkwawir ◽  
Nakeli N. Batumani ◽  
Talkmore Maruta ◽  
Charles N. Awasom
Keyword(s):  
Clinical Laboratory ◽  
Regional Hospital ◽  
Quality Of Services ◽  
Quality Management Systems ◽  
Hospital Laboratory ◽  
Laboratory Staff ◽  
Quality Improvement Process ◽  
Laboratory Services ◽  
Training Activities

Background: Public health laboratories form the foundation on which today’s clinical laboratory practice in Cameroon is built. The advent of the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in 2009 empowered the Bamenda Regional Hospital Laboratory (BRHL) to improve its working culture, practices and management.Objectives: To evaluate the results of SLMTA implementation at BRHL and discuss lessons learned.Method: In 2010, the SLMTA programme was rolled out in Cameroon to improve laboratory quality management systems in five laboratories, including BRHL. Three workshops were conducted (the first centralised, the remaining two on-site at each laboratory) and improvement projects were implemented after each workshop with the assistance of mentors. Audits were used in order to evaluate performance and to identify areas for further improvement.Results: BRHL had the lowest score (18%) amongst the cohort at the baseline audit and the highest (81%) at the official Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit conducted in August 2013 by the African Society for Laboratory Medicine. Improvements were observed in each of the 12 Quality System Essentials; improvement was especially noteworthy in the areas of facilities and safety, and purchasing and inventory. Staff investment and pride in the quality of laboratory services increased.Conclusion: BRHL’s remarkable improvement was achieved with a combination of SLMTA training activities, intensive on-site mentorship and the collective focus of all laboratory staff. The experience at Bamenda Hospital illustrates what can be achieved when a laboratory successfully harnesses the energy of its staff and implements changes to improve the quality of services in a transformation taking them from grass to grace.

DATA MINING AS A MEANS OF QUALITY CONTROL IN PRODUCTION AND ORGANIZATION MANAGEMENT

2020 ◽  
Vol 1 (5) ◽  
pp. 130-138
Author(s):  
L. S. ZVYAGIN ◽  
Keyword(s):  
Data Mining ◽  
Quality Control ◽  
New Technologies ◽  
Data Interpretation ◽  
Organization Management

The article deals with data mining (IAD), which is widely used both in business and in various studies. IAD methods are used to create new ways to solve problems of forecasting, segmentation, data interpretation, etc. The problems to be solved by creating new technologies and methods of IAD are analyzed.

scholarly journals A cross-case analyses of laboratory professionals-patients interaction for patients accessing laboratory services at University of Cape Coast hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patrick Adu
Keyword(s):  
Laboratory Testing ◽  
Sampling Period ◽  
Turnaround Time ◽  
Sub Saharan Africa ◽  
Cape Coast ◽  
Microsoft Excel ◽  
Laboratory Staff ◽  
Laboratory Services ◽  
Staff Interactions ◽  
Sub Saharan

Abstract Background There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the test requester has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-test requester engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.

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