Policies and practices in the field of laboratory hematology in Croatia – a current overview and call for improvement

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Vanja Radišić Biljak ◽  
Ivana Lapić ◽  
Valentina Vidranski ◽  
Ivona Herceg ◽  
Franciska Tomić ◽  
...  
Keyword(s):  
National Level ◽  
Daily Basis ◽  
Internal Quality ◽  
Routine Practice ◽  
Medical Laboratories ◽  
Routine Work ◽  
Comprehensive Survey ◽  
Total Testing Process ◽  
Laboratory Hematology ◽  
Hematology Analyzers

Abstract Objectives In 2019 The Croatian Working Group for Laboratory Hematology, on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine, wanted to explore the background in field of laboratory hematology routine practice among Croatian laboratories in order to develop future strategies for producing national recommendations, if needed. Methods During April and May 2019, a comprehensive survey covering all main parts of the total testing process within the field of laboratory hematology among Croatian medical laboratories was conducted. The survey comprised 49 inquiries. Data was collected using Survey Monkey (Palo Alto, CA, USA). All collected data was anonymized. Results The response rate was 72%. There is still a substantial number of laboratories that have only three-part differential hematology analyzers (9%). Furthermore, a very high number of laboratories did not perform analyzer verification prior to implementation into routine work (31%). Out of those who have verified their analyzers, a diversity of guidelines and recommendations were used. Nearly 10% of the laboratories do not have a defined policy regarding specimen rejection. The majority of the participants perform internal quality control daily (83%), however, only 51% of respondents evaluate the agreement between different hematology analyzers on daily basis. Although more than 90% of Croatian laboratories have a defined policy regarding specimen rejection, only 61% of respondents continuously monitor quality indicators in routine practice. Conclusions The survey revealed substantial differences in all aspects of laboratory hematology practices among Croatian medical laboratories, indicating the need for universal recommendations at the national level.

Heat stress and inadequate toilet access at work places in India – a potential hazard to working women in a changing climate

2019 ◽  
Author(s):  
Vidhya Venugopal ◽  
Rekha Shanmugam ◽  
Priscilla Johnson ◽  
Rebekah Ann Isabel Lucas ◽  
Kristina Jakobsson
Keyword(s):  
Women Workers ◽  
Informal Economy ◽  
National Level ◽  
Working Women ◽  
Daily Basis ◽  
Potential Hazard ◽  
Disaster Victims ◽  
Female Workers ◽  
Global Trend ◽  
Modifiable Factors

In the past few decades, increasingly blistering heat due to climate change has created more illnesses and claimed more lives worldwide, an issue mostly ignored because it's an invisible hazard and hard-to-document disaster. Victims are usually vulnerable populations, including workers exposed on a daily basis to heat, who not only suffer from heat illnesses but also from an exacerbation of existing health problems aggravated by heat and dehydration. Research has proved that heat is a higher risk for female workers, who are affected far more often than their male counterparts. India’s informal economy is dominated by the female workforce and many informal workplaces have minimal welfare facilities including toilets. One of the modifiable factors that influence workplace psychology is the lack of access to a private toilet. To avoid embarrassment or harassment, many women refrain from drinking water during the day in order to limit their trips to the toilet, a potentially deadly strategy during hot seasons which has adverse health consequences. A global trend especially in developing nations evidences a higher number of women entering the workforce. With this trend and rising temperatures, the issue is expected to escalate to significant proportions unless workplace interventions and policy level actions are taken at a national level to protect women workers.

Assessment of laboratory errors and best laboratory practices

2016 ◽  
Vol 5 (07) ◽  
pp. 4704
Author(s):  
Syed Riaz Mehdi* ◽  
Sharique Ahmad ◽  
Noorin Zaidi
Keyword(s):  
External Quality Control ◽  
External Quality ◽  
Iso 15189 ◽  
Laboratory Errors ◽  
Control Programs ◽  
Medical Laboratories ◽  
Laboratory Error ◽  
Active Communication ◽  
Total Testing Process ◽  
Five Phases

Laboratory error is defined by ISO 22367 as “Failure of planned actions to be completed as intended or use a wrong plan to achieve an aim”. Lundeberg in 1981 outlined the concept of Total Testing Process (TTP) and Plebani elaborated it further and classified the whole testing process into five phases of Pre-Pre Analytic, Pre Analytic, Analytic, Post Analytic and Post - Post Analytic. The errors have to be identified and resolved in each phase of the process. The medical laboratories have to run Internal and External Quality Control programs and abide by the guidelines of ISO 15189 in order to be accredited by bodies like JCI, CAP or NABL. Active communication and regular interaction between the clinicians and the laboratory is recommended during Pre Analytic and Post Analytic phases of TTP in order to achieve the target of Best Laboratory Practices. 

scholarly journals Identification of care tasks for the use of wearable transfer support robots – an observational study at nursing facilities using robots on a daily basis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kenji Kato ◽  
Tatsuya Yoshimi ◽  
Shohei Tsuchimoto ◽  
Nobuaki Mizuguchi ◽  
Keita Aimoto ◽  
...  
Keyword(s):  
Extended Period ◽  
Daily Basis ◽  
Trial Registration ◽  
Direct Care ◽  
Nursing Facilities ◽  
Time Motion ◽  
Physical Burden ◽  
Routine Work ◽  
Effective Performance ◽  
Sustained Operation

Abstract Background To reduce the physical burden of caregivers, wearable transfer support robots are highly desirable. Although these robots are reportedly effective for specific tasks in experimental environments, there is little information about their effectiveness at nursing care facilities. The aim of this study was to identify care tasks and operations suitable for the use of these robots among caregivers in nursing facilities where these robots have been in use on a daily basis. Methods A 1-min observational time-motion analysis was conducted to examine care tasks and operations in two nursing facilities where wearable transfer support robots, namely Muscle Suit or HAL® Lumbar Type for Care Support, have been used routinely on a daily basis for more than 24 months. Results Analysis of the care tasks and their time ratio while wearing the equipment revealed that both robots were used conspicuously for direct care in over 70% of transits, especially during transfer assistance and toileting care. Furthermore, these robots were used intensively in the morning along with wake-up calls to care recipients, where pre-assigned wearers used them as part of their “routine work.” Conclusions We found that these wearable transfer support robots enabled effective performance of care tasks and operations in nursing facilities where these robots have been used on a daily basis for an extended period of time. These results may lead to the effective implementation and sustained operation of other types of care robots in the future. Trial registration UMIN Clinical Trials Registry no. UMIN000039204. Trial registration date: January 21, 2020. Interventional study. Parallel, non-randomized, single blinded.

scholarly journals Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs

2016 ◽  
Vol 44 (4) ◽  
pp. 536-547 ◽  
Author(s):  
Robert G. Weaver ◽  
Justin B. Moore ◽  
Brie Turner-McGrievy ◽  
Ruth Saunders ◽  
Aaron Beighle ◽  
...  
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Healthy Eating ◽  
Vigorous Physical Activity ◽  
Statistical Significance ◽  
National Level ◽  
Routine Practice ◽  
Afterschool Programs ◽  
Point Increase ◽  
The Relationship

Background. The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies’ effectiveness. Aims. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. Method. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Results. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Conclusions. Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.

scholarly journals Secondary uses of patient information

2003 ◽  
Vol 9 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Patient Information ◽  
Clinical Care ◽  
National Level ◽  
Patient Data ◽  
Direct Patient Care ◽  
Routine Practice ◽  
Secondary Use ◽  
The People ◽  
Information Management Systems ◽  
Potential Benefits

The pace of development and implementation of good information management systems has been disappointingly slow and the potential benefits of using patient information for secondary purposes have not been fully realised. The secondary use of patient data might be at the level of individual practitioners or teams, or at a local-service, regional or national level. Using patient data for purposes other than direct patient care requires an understanding of the principles of case-mix, standards for recording data, the limits of accuracy of data collected in routine practice and of the principles of data security and confidentiality. The alternatives to secondary use of information are to manage the mental health service without information about the people who use it or to gather this information through channels that run in parallel to the process of clinical care.

scholarly journals MEMBACA MIN MALANG I DENGAN TOTAL QUALITY MANAJEMEN

2015 ◽  
Vol 13 (3) ◽  
Author(s):  
Wahid Khozin
Keyword(s):  
School Environment ◽  
Educational Institution ◽  
National Level ◽  
Life Quality ◽  
Internal Quality ◽  
Total Quality ◽  
Academic Communities ◽  
Management Quality ◽  
A Chain

AbstractAs an educational institution, MIN Malang I has obtained an achievement that makes proud either at local or national level. This research digs up on how MIN Malang 1is known with a concept on total management quality which is urged on three aspects namely focusing on customer, continual process improvement and involvement of all organization members. This research discovers that MIN Malang 1 always cooperates with outside parties in a good manner as a user to find out a trend or change of their needs so that it can serve well. In the context of internal quality improvement, MIN Malang 1 applies a chain system either among leaders, teachers, employees or student. Meanwhile, to maintain a life quality of the Islamic elementary school, (environment and learning process) is built a system to control each other over among leaders, teachers, students and themselves. This system is able to build togetherness and sense of belonging among academic communities of MIN Malang 1 which respect each other and no one is abandoned.AbstrakSebagai lembaga pendidikan, MIN Malang I telah memiliki prestasi yang membanggakan baik di tingkat lokal maupun nasional. Penelitian ini menggali bagaimana MIN Malang 1dibaca dengan konsep total quality manajemen yang di tekankan pada tiga aspek yaitu fokus pada pelanggan, perbaikan proses terus menerus dan ketrlibatan total seluruh anggota organisasi. Penelitian ini menemukan bahwa MIN Malang 1 selalu menjalin kerja sama dengan pihak luar sebagai pengguna untuk mengetahui tren atau perubahan kebutuhan mereka sehingga bisa melayani dengan baik. Dalam konteks peningkatan kualitas internal, MIN Malang 1 menerapkan sistem berantai baik antar pimpinan, guru, karyawan maupun siswa. Sedangkan untuk menjaga kualitas kehidupan madrasah (lingkungan dan pembelajaran), dibangun suatu sistem saling kontrol mulai dari antar pemimpin, antar guru, antar siswa dan saling silang diantara mereka. Sistem saling kontrol ini mampu membangun kebersamaan dan rasa memiliki diantara sivitas akademika MIN Malang 1 yang berujung pada saling menghargai dan tidak ada yang merasa diabaikan 

scholarly journals Processing and storage of blood components during the COVID-19 pandemic

2020 ◽  
Vol 1 (3) ◽  
pp. 114-118
Author(s):  
Ana Antić ◽  
Sanja Živković-Đorđević ◽  
Marija Jelić ◽  
Miodrag Vučić ◽  
Nebojša Vacić ◽  
...  
Keyword(s):  
Shelf Life ◽  
Blood Donors ◽  
National Level ◽  
Blood Component ◽  
Blood Collection ◽  
Routine Practice ◽  
Blood Components ◽  
Pathogen Inactivation ◽  
Blood Processing ◽  
Number Of Patients

The spread of the COVID-19 virus has a strong influence on blood collection, maintaining a stable supply of all blood components and the safety of the transfusion itself. SARS-CoV-2 has a long incubation period (1-14 days, on average 5-6 days, longest reported 24 days) and causes asymptomatic infection in a large number of patients, which is a great challenge in a recruitment of blood donors and achieving a safe transfusion. Precise recommendations and precautions have been adopted regarding the criteria for temporary refusal of blood donors during the COVID-19 pandemic, organization of mobile teams and collection sites, disposal of medical waste, examination of potential donors and mandatory body temperature measurement. Although transmission of COVID-19 via blood and blood components has not been demonstrated, some countries have also introduced mandatory NAT testing for SARS-CoV-2 as a part of blood screening testing. Also, proactive measures have been taken, such as temporary storage of blood in quarantine for 14 days after collection, while special attention is paid to efficient management of blood component stocks and development of a collection plan, in order to avoid shortage of certain blood components or their expiration. The first step in this regard is to revise the measures which have the aim for improving the usability of blood components, ie reducing waste of stocks, which primarily refers to the temporary extension of the shelf life of blood components. Extending the shelf life of erythrocytes (longer than 35 to 49 days, which is defined at the national level) should be considered as early as possible, because once a shortage of erythrocytes occurs, they will be issued long before the expiration date. Previous studies have not shown significant side effects of erythrocyte transfusion with extended shelf life, so it is possible to consider the flexibility of blood processing and erythrocyte storage conditions with mandatory internal process validation and component quality control. The shelf life of platelet concentrate should be extended from 5 days to 7 or even 8 days, with mandatory bacteriological testing or pathogen inactivation. Another option to increase the platelet supply for prophylactic purposes is to reduce the platelet dose by dividing the existing components. Frozen fresh plasma has the longest shelf life (up to 3 years), so maintaining stable reserves is much safer than for cellular components. Liquid plasma (never previously frozen) has a shelf life of 7-40 days, and can be used in conditions of reduced freezer capacity, shortage of staff working on blood processing or for the production of convalescent plasma. Pathogen inactivation of plasma and platelets allows 3-6 log reduction of SARS-CoV-2 and MERS-CoV. The decision to introduce some of the methods of pathogen inactivation should be made taking into account the costs and resources required for implementation. For countries that do not have pathogenic inactivation already in routine practice, its rapid introduction is a big task. For now, the risk of SARS-CoV-2 transmission through the blood appears to be very low, although our understanding of the virus and behavior during a pandemic will improve over time. In this regard, pathogen inactivation of convalescent plasma should also be considered.

scholarly journals The internal quality control in the traceability era

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Federica Braga ◽  
Sara Pasqualetti ◽  
Elena Aloisio ◽  
Mauro Panteghini
Keyword(s):  
Quality Control ◽  
Internal Quality Control ◽  
Internal Quality ◽  
Clinical Samples ◽  
Test Results ◽  
Clinical Validity ◽  
Measuring Systems ◽  
Medical Laboratories ◽  
Laboratory Results

AbstractTo be accurate and equivalent, laboratory results should be traceable to higher-order references. Furthermore, their quality should fulfill acceptable measurement uncertainty (MU) as defined to fit the intended clinical use. With this aim, in vitro diagnostics (IVD) manufacturers should define a calibration hierarchy to assign traceable values to their system calibrators. Medical laboratories should know and verify how manufacturers have implemented the traceability of their calibrators and estimate the corresponding MU on clinical samples. Accordingly, the internal quality control (IQC) program should be redesigned to permit IVD traceability surveillance through the verification by medical laboratories that control materials, provided by the manufacturer as a part of measuring systems, are in the clinically suitable validation range (IQC component I). Separately, laboratories should also monitor the reliability of employed IVD measuring systems through the IQC component II, devoted to estimation of MU due to random effects and to obtaining MU of provided results, in order to apply prompt corrective actions if the performance is worsening when compared to appropriate analytical specifications, thus jeopardizing the clinical validity of test results.

Identification of Care Tasks for the Use of Wearable Transfer Support Robots – An Observational Study at Nursing Facilities Using Robots on A Daily Basis

2020 ◽  
Author(s):  
Kenji Kato ◽  
Tatsuya Yoshimi ◽  
Shohei Tsuchimoto ◽  
Nobuaki Mizuguchi ◽  
Keita Aimoto ◽  
...  
Keyword(s):  
Extended Period ◽  
Daily Basis ◽  
Trial Registration ◽  
Direct Care ◽  
Nursing Facilities ◽  
Time Motion ◽  
Physical Burden ◽  
Routine Work ◽  
Effective Performance ◽  
Sustained Operation

Abstract Background: To reduce the physical burden of caregivers, wearable transfer support robots are highly desirable. Although these robots are reportedly effective for specific tasks in experimental environments, there is little information about their effectiveness at nursing care facilities. The aim of this study was to identify care tasks and operations suitable for the use of these robots among caregivers in nursing facilities where these robots have been in use on a daily basis.Methods: A 1-min observational time-motion analysis was conducted to examine care tasks and operations in two nursing facilities where wearable transfer support robots, namely Muscle Suit or HAL®, Lumbar Type for Care Support, have routinely been used on a daily basis for more than 24 months.Results: Analysis of the care tasks and their time ratio while wearing the equipment revealed that both robots were conspicuously used for direct care in over 70% of transits, especially during transfer assistance and toileting care. Furthermore, these robots were used intensively in the morning along with wake-up calls to care recipients, where pre-assigned wearers used them as part of their “routine work.”Conclusions: We found that these wearable transfer support robots enabled effective performance of care tasks and operations in nursing facilities where these robots have been used on a daily basis for an extended period of time. These results may lead to the effective implementation and sustained operation of other types of care robots in the future.Trial registration: UMIN Clinical Trials Registry no. UMIN000039204. Trial registration date: January 21, 2020. Interventional study. Parallel, non-randomized, single blinded.

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