scholarly journals State of Harmonization of 24 Serum Albumin Measurement Procedures and Implications for Medical Decisions

2017 ◽  
Vol 63 (3) ◽  
pp. 770-779 ◽  
Author(s):  
Lorin M Bachmann ◽  
Min Yu ◽  
James C Boyd ◽  
David E Bruns ◽  
W Greg Miller
Keyword(s):  
Serum Albumin ◽  
Renal Dialysis ◽  
Measurement Procedure ◽  
Albumin Concentration ◽  
Serum Samples ◽  
Medical Decisions ◽  
Immunochemical Method ◽  
Quality Of Patient Care ◽  
Heparin Plasma

Abstract BACKGROUND Measurements of serum and plasma albumin are widely used in medicine, including as indicators of quality of patient care in renal dialysis centers. METHODS Pools were prepared from residual patient serum (n = 50) and heparin plasma (n = 48) from patients without renal disease, and serum from patients with kidney failure before hemodialysis (n = 53). Albumin was measured in all samples and in ERM-DA470k/IFCC reference material (RM) by 3 immunochemical, 9 bromcresol green (BCG), and 12 bromcresol purple (BCP) methods. RESULTS Two of 3 immunochemical procedures, 5 of 9 BCG, and 10 of 12 BCP methods recovered the RM value within its uncertainty. One immunochemical and 3 BCG methods were biased vs the RM value. Random error components were small for all measurement procedures. The Tina-quant immunochemical method was chosen as the reference measurement procedure based on recovery and results of error analyses. Mean biases for BCG vs Tina-quant were 1.5% to 13.9% and were larger at lower albumin concentrations. BCP methods' mean biases were −5.4% to 1.2% irrespective of albumin concentration. Biases for plasma samples were generally higher than for serum samples for all method types. For most measurement procedures, biases were lower for serum from patients on hemodialysis vs patients without kidney disease. CONCLUSIONS Significant differences among immunochemical, BCG, and BCP methods compromise interpretation of serum albumin results. Guidelines and calculations for clinical management of kidney and other diseases must consider the method used for albumin measurement until harmonization can be achieved.

scholarly journals Comparison Between Measured and Calculated Free Calcium Values at Different Serum Albumin Concentrations

2016 ◽  
Vol 8 (02) ◽  
pp. 071-076 ◽  
Author(s):  
Altaf Ahmad Mir ◽  
Bela Goyal ◽  
Sudip Kumar Datta ◽  
Saidaiah Ikkurthi ◽  
Arnab Pal
Keyword(s):  
Serum Albumin ◽  
Tertiary Care ◽  
Free Calcium ◽  
Albumin Concentration ◽  
Care Hospital ◽  
Serum Samples ◽  
Spectrophotometric Methods ◽  
Significant Difference ◽  
Clinical Biochemistry Laboratory ◽  
The One

ABSTRACT Introduction: Free ionic calcium is the metabolically active component of total calcium (TCa) in blood. However, most laboratories report TCa levels that are dependent on serum albumin concentration. Hence, several formulae have evolved to calculate free calcium levels from TCa after adjustment for albumin. However, free calcium can directly be measured using direct ion selective electrodes rather than spectrophotometric methods used in autoanalyzers. Objectives: This study compares the levels of free calcium obtained by measurement by direct ion selective electrode (ISE) and the one calculated as a function of TCa by formulae. Materials and Methods: A total of 254 serum samples submitted to clinical biochemistry laboratory of a tertiary care hospital were analyzed for total protein, albumin, and TCa by standard spectrophotometric methods and for free calcium by direct ISE. Three commonly used formulae viz. Orrell, Berry et al. and Payne et al. were used to calculate adjusted TCa. Calculated free calcium was obtained by taking 50% of these values. Results: A significant difference (P < 0.05) was observed between calculated free calcium by all the three formulae and measured free calcium estimated by direct ISE using paired t-test and Bland–Altman plots. Conclusion: Formulae for predicting free calcium by estimating TCa and albumin lacks consistency in prediction and free calcium should be evaluated by direct measurement.

Evaluation of the Greiner Bio-One serum separator BCA Fast Clot tube

2017 ◽  
Vol 55 (8) ◽  
pp. 1135-1141 ◽  
Author(s):  
Goce Dimeski ◽  
Julie Johnston ◽  
Paul P. Masci ◽  
Kong-Nan Zhao ◽  
Nigel Brown
Keyword(s):  
Renal Dialysis ◽  
Hospital Environment ◽  
Prolonged Storage ◽  
Serum Samples ◽  
Becton Dickinson ◽  
Blood Samples ◽  
Storage Study ◽  
Heparin Plasma ◽  
Comparable Performance ◽  
Comparison Data

Abstract Background: Current commercial tubes have difficulties in producing “true” serum from all blood samples even within the recommended clotting times. Hence, Becton Dickinson (BD) and now Greiner have produced tubes containing thrombin as the procoagulant to reduce the clotting time and increase the possibility of producing serum from anticoagulated blood samples. Methods: The Greiner BCA Fast Clot (GBBCAFC) tube was evaluated in a hospital environment using 40 participants, (30 healthy and 10 undergoing renal dialysis) for 32 analytes against the Greiner lithium heparin tube and the BD Rapid Serum Tubes (BD RST) tube measured on Beckman DxC 800 and DxI 800 analyzers. Clotting strength was also examined using thromboelastography (TEG). Results: The analytes results showed there was a very close agreement between the BD RST tube and GBBCAFC tube in comparison with lithium heparin plasma. The result comparison data showed equivalent performance with lower levels of hemolysis. The prolonged storage study also showed very similar agreement between the BD RST and the GBBCAFC tubes. Likewise, the TEG data showed there was very little difference in clotting ability between the tubes, and neither was capable of producing true serum from blood spiked with 2 U heparin/mL of blood. Conclusions: The study showed the GBBCAFC tube with the combination of the two procoagulants blood clotting activator and thrombin produced comparable performance with the lithium heparin plasma and the BD RST serum samples.

Effect of albumin concentration on the assay of serum free thyroxin by equilibrium radioimmunoassay with labeled thyroxin analog (Amerlex Free T4).

1983 ◽  
Vol 29 (2) ◽  
pp. 321-325 ◽  
Author(s):  
N Amino ◽  
K Nishi ◽  
K Nakatani ◽  
H Mizuta ◽  
K Ichihara ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Pregnant Women ◽  
Binding Proteins ◽  
Solid Phase ◽  
Albumin Concentration ◽  
Serum Concentrations ◽  
Serum Samples ◽  
Free T4 ◽  
Serum Free

Abstract Serum free thyroxin (FT4) in normal nonpregnant and pregnant subjects was measured by radioimmunoassay (RIA) with Amerlex FT4 RIA (Amersham International) and LiquiSol FT4 RIA (Damon Diagnostics) kits. Amerlex FT4 values in serum from pregnant women were lower than those in serum from nonpregnant women, but LiquiSol FT4 values were similar in serum from both groups. Amerlex FT4 values were directly correlated with the concentrations of albumin in serum and inversely correlated with those of thyroxin-binding globulin, but not with prealbumin concentrations. No significant correlations were observed between LiquiSol FT4 values and serum concentrations of thyroxin-binding proteins. Amerlex FT4 values were normal in patients with excess, deficient, or decreased thyroxin-binding globulin. Albumin added to serum samples increased Amerlex FT4 values but not LiquiSol FT4 values. Albumin inhibited the binding of labeled thyroxin analog to the solid-phase thyroxin antibody. These data indicate that the albumin concentration influences FT4 values as measured by an RIA involving a thyroxin analog and that Amerlex FT4 values should be carefully interpreted when the patient has an abnormal concentration of serum albumin.

Continuous-flow serum albumin determination by reaction with picrate ions, with use of a flow-through picrate ion electrode.

1981 ◽  
Vol 27 (3) ◽  
pp. 427-430 ◽  
Author(s):  
E P Diamandis ◽  
D S Papastathopoulos ◽  
T P Hadjiioannou
Keyword(s):  
Serum Albumin ◽  
Continuous Flow ◽  
Peak Height ◽  
Ion Concentration ◽  
Screening Tests ◽  
Albumin Concentration ◽  
Serum Samples ◽  
Factors Affecting ◽  
Analytical Recovery ◽  
Flow Through

Abstract An automated potentiometric method for serum albumin determination by use of the picrate/albumin reaction is described. A continuous-flow system and a specially designed flow-through picrate ion electrode were used in making the measurements. Various factors affecting the reaction, such as pH, picrate ion concentration, and reaction time, were studied. Peak height in millivolts and albumin concentration were linearly related in the range 10-70 g/L. Both within-run and day-to-day, the CV for the method was about 2%. Analytical recovery of albumin added to serum samples ranged from 97.0 to 110.3%, averaging 102.2%. Results compare favorably with those by the established bromcresol green method. The proposed method is suitable for routine use and for screening tests.

scholarly journals Comparative Study of Burnout in Professional Caregivers of Institutionalized Elderly with Dementia and other Diseases

2011 ◽  
Vol 1 (2) ◽  
pp. 61-70
Author(s):  
Inmaculada Méndez ◽  
Esther Secanilla ◽  
Juan P. Martínez ◽  
Josefa Navarro
Keyword(s):  
Quality Of Life ◽  
Ad Hoc ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
Measuring Instruments ◽  
Global Approach ◽  
People With Dementia ◽  
Quality Of Patient Care ◽  
Psychoeducational Programs

In a global approach about the need of paying attention to staff working with and for older people with dementia and other diseases in residential care, it is necessary to investigate their emotional well-being to provide strategies to improve their quality of life and therefore their quality of patient care. Professional caregivers of people with dementia and other diseases have specific psycho-sociological problems. They are more prone to stress which can sometimes lead to the “burnout” due to specific functions in the workplace. To define the sample was decided to compare two residential centers of two regions, Murcia and Barcelona. We proceeded to the administration of the following measuring instruments: the scale Maslach Burnout Inventory (MBI) and an ad hoc survey conducted for professional caregivers. Finally, the results offer the possibility of carrying out programs to prevent emotional exhaustion in professional carers, as well as the possibility of designing psychoeducational programs for staff care and even future proactive and reactive interventions.

scholarly journals Hospital chaplains as ethical consultants in making difficult medical decisions

2021 ◽  
pp. medethics-2020-107096
Author(s):  
Waldemar Głusiec
Keyword(s):  
Roman Catholic ◽  
Medical Decision ◽  
Medical Decisions ◽  
Hospital Chaplains ◽  
Specialist Knowledge ◽  
Hospital Ethics ◽  
Bioethical Education ◽  
Further Development

Background and aimsFew Polish hospitals have Hospital Ethics Committee (HECs) and the services are not always adequate. In this situation, the role of HECs, in providing, among others, ethical advice on the discontinuation of persistent therapies, may be taken over by other entities. The aim of our research was to investigate, how often and on what issues hospital chaplains are asked for ethical advice in reaching difficult medical decisions.MethodsA survey of 100 Roman Catholic chaplains was conducted, that is, at least 10% of all chaplains currently working in Polish hospitals.ResultsOf the participants, 29% confirmed receiving requests for advice in making a morally difficult medical decision. Receiving this type of request was not conditional on the place of their service, duration of their pastoral mission or HEC membership. The largest group of chaplains (21%) encounter questions concerning the ethical dilemmas associated with discontinuing persistent therapy. Patients and their families most often raise issues related to the methods of birth control, and the medical staff raise the issue of termination of pregnancy—as reported by 9% and 15% of chaplains, respectively. Most of the chaplains asked for help (79%) experience a deficit of specialist knowledge in the area of medicine or ethics.ConclusionsIn order to improve the quality of ethical consultations in Polish hospitals, in addition to further development of HECs, it is postulated to develop a system for bioethical education of chaplains.

494 Streamlining the Minor Operations Process - The Effect of Better Documentation

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Schrire ◽  
C Estela
Keyword(s):  
Patient Care ◽  
Plastic Surgery ◽  
Patient Experience ◽  
Patient Flow ◽  
Vital Part ◽  
Rapid Turnover ◽  
Quality Of Patient Care ◽  
New Form ◽  
Minor Operations

Abstract Introduction Plastic Surgery Minor Operations is a fast paced, rapid turnover operative environment. It is reliant on effective communication, accurate surgery, and time efficiency. It was noticed in our department that there was confusion regarding booking and operative intentions leading to delays in surgery and over-running lists. This was worsening patient experience and leading to delays in patient care. Method In response to the delays and confusion in booking, a new booking form was created, so all patients have a standardised booking containing the necessary information. This form was disseminated across all the booking clinics and formed a vital part of the pre-operative check in process. Results The audit was carried out at the time of introduction, and then re-audited a year later to see if the form has improved care for patients. Results showed that with the new booking form, people were not having to cancel or rearrange patients. Patient booking forms were sufficient, and a copy of the clinic letter no longer required for the operation to proceed or for clarity. It was noted that more senior advice was sought. Conclusions The new form has improved patient flow and quality of patient care, whilst streamlining the booking process.

scholarly journals Organisational Commitment in Healthcare Systems: A Bibliometric Analysis

2021 ◽  
Vol 18 (5) ◽  
pp. 2271
Author(s):  
Carlos de las Heras-Rosas ◽  
Juan Herrera ◽  
Mercedes Rodríguez-Fernández
Keyword(s):  
Psychological Contract ◽  
Job Dissatisfaction ◽  
Burnout Syndrome ◽  
Future Research ◽  
Organisational Commitment ◽  
High Turnover ◽  
Staff Burnout ◽  
Quality Of Patient Care ◽  
Organisational Factors

Business organisations are subject to high pressure to ensure their sustainability and competitiveness. In the case of healthcare institutions, moreover, there are unique characteristics where human resource management is of vital importance. The workforce in these institutions is at a critical moment where the shortages of qualified staff, burnout, or job dissatisfaction represent some of the detrimental aspects for the performance of the organisation, and more importantly, they diminish the quality of patient care. The promotion of organisational commitment is positioned as one of the tools that organisations have to face this problem. This paper aims to increase knowledge about research trends that analyse organisational commitment in healthcare institutions. To this end, using bibliometric techniques, a sample of 448 publications on this subject from journals indexed in Web of Science between 1992 and 2020 is analysed. The results obtained suggest a growing interest in this subject and a visible concern for the management of human resources in these institutions. Research has focussed mainly on organisational factors related to nursing staff. The most analysed topics have been job satisfaction, the implications of stress and high turnover, burnout syndrome, and the possibility of leaving the job. On the other hand, issues emerged such as empowerment in the workplace and others related to organisational management such as quality of service or performance. Finally, there is a lack of research that deals more deeply with other groups working in health centres, such as doctors or administrative staff. There is also a need for further development in the analysis of the implications of the ideological psychological contract in relation to normative organisational commitment in the field of healthcare organisations. The contribution of this work focusses on expanding knowledge about commitment in healthcare organisations and creating points of support for future research as well as helping healthcare managers make decisions in HR management.

Sign in / Sign up

Export Citation Format

Share Document