scholarly journals Is the hemolysis index always suitable for monitoring phlebotomy performance?

2018 ◽  
Vol 42 (3) ◽  
pp. 67-72
Author(s):  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Janne Cadamuro
Keyword(s):  
Clinical Chemistry ◽  
Intravascular Hemolysis ◽  
H Index ◽  
Sample Quality ◽  
Healthcare Settings ◽  
Reliable Evidence ◽  
Rare Phenomenon ◽  
Technical Features ◽  
New Generation

Abstract The new generation of clinical chemistry and coagulation analyzers is equipped with technical features allowing a systematic check of sample quality, including an assessment of the so-called HIL (“hemolysis”, “icterus”, “lipemia”) indices. These measures enable an accurate and reproducible assessment of sample hemolysis in serum or plasma, hence the hemolysis index (H-index) is now also increasingly used for monitoring and benchmarking phlebotomy performance. Reliable evidence attests that intravascular hemolysis is not such a rare phenomenon, and its prevalence may be especially higher in geographical areas where congenital hemolytic diseases are endemic, as well as in healthcare settings where patients with acquired hemolytic disorders are more frequently visited or hospitalized. It is hence conceivable that monitoring phlebotomy performance based on the rate of hemolyzed specimens received by the laboratory may not be so straightforward, provided that specimens drawn from patients with intravascular hemolysis can be identified and excluded from the analysis. The aim of this article is to provide an overview of potential drawbacks in using the H-index alone for monitoring phlebotomy performance, and to offer potential solutions to improve its efficiency for this scope. We therefore suggest that the H-index may only be used for purposes of benchmarking phlebotomy performance when the overall number of diagnoses of hemolytic diseases or the haptoglobin values measured by the laboratories are comparable across different healthcare settings or geographic areas.

A Guideline to Use Activity Theory for Collaborative Healthcare Information Systems Design

2017 ◽  
pp. 616-626
Author(s):  
Carolin Durst ◽  
Nilmini Wickramasinghe ◽  
Jana Riechert
Keyword(s):  
Information Systems ◽  
Activity Theory ◽  
Systems Design ◽  
Organizational Structures ◽  
Healthcare Information ◽  
Healthcare Information Systems ◽  
Traditional System ◽  
Healthcare Settings ◽  
Collaborative Information Systems ◽  
Technical Features

In healthcare, collaborative systems serve very different stakeholders: researchers, clinicians, nurses, patients, and administrators for instance. In order to design a collaborative healthcare information system that satisfies the stakeholders' needs, all individual requirements have to be mapped into the software. Traditional system design focuses at technical features and oftentimes ignores social requirements like human factors or organizational structures. Instead of integrating existing processes and working habits into a system, a technical-focused design approach tries to force new behaviors. As a result, stakeholders could refuse to use collaborative healthcare information systems. In line with Kuutti (1991), we recommend activity theory as a rich framework to study and design collaborative information systems. We believe that activity theory analysis is particularly useful for healthcare settings where diverse stakeholders pursue very different goals. This book chapter offers a structured approach to analyze collaborative activities and to design the IT-support accordingly.

A Guideline to Use Activity Theory for Collaborative Healthcare Information Systems Design

2020 ◽  
pp. 1-12
Author(s):  
Carolin Durst ◽  
Nilmini Wickramasinghe ◽  
Jana Riechert
Keyword(s):  
Information Systems ◽  
Activity Theory ◽  
Systems Design ◽  
Organizational Structures ◽  
Healthcare Information ◽  
Healthcare Information Systems ◽  
Traditional System ◽  
Healthcare Settings ◽  
Collaborative Information Systems ◽  
Technical Features

In healthcare, collaborative systems serve very different stakeholders: researchers, clinicians, nurses, patients, and administrators for instance. In order to design a collaborative healthcare information system that satisfies the stakeholders' needs, all individual requirements have to be mapped into the software. Traditional system design focuses at technical features and oftentimes ignores social requirements like human factors or organizational structures. Instead of integrating existing processes and working habits into a system, a technical-focused design approach tries to force new behaviors. As a result, stakeholders could refuse to use collaborative healthcare information systems. In line with Kuutti (1991), we recommend activity theory as a rich framework to study and design collaborative information systems. We believe that activity theory analysis is particularly useful for healthcare settings where diverse stakeholders pursue very different goals. This book chapter offers a structured approach to analyze collaborative activities and to design the IT-support accordingly.

Integrity of serum samples is changed by modified centrifugation conditions

2019 ◽  
Vol 57 (12) ◽  
pp. 1882-1887
Author(s):  
Marijana Miler ◽  
Nora Nikolac Gabaj ◽  
Jelena Culej ◽  
Adriana Unic ◽  
Alen Vrtaric ◽  
...  
Keyword(s):  
Turnaround Time ◽  
Serum Samples ◽  
P Values ◽  
H Index ◽  
Sample Quality

Abstract Background Serum samples should be centrifuged for at least 10 min at 1300–2500 × g. Changed centrifugation conditions could compromise sample quality. The objective of this study was to compare the serum quality and turnaround time (TAT) using different centrifugation conditions. Methods The study was done in four different periods (A, B, C and D) at different conditions: for 10, 5 and 7 (A, B and C, respectively) at 2876 × g, and 7 (D) min at 4141 × g. Sample quality was assessed as the proportion of samples with: (a) aspiration errors, (b) H index >0.5 g/L and (c) suppressed reports of potassium (K) due to hemolysis. TAT was calculated for emergency samples. The proportions of samples (a), (b) and (c) were compared according to period A. Results The number of aspiration errors was significantly higher in samples centrifuged at 2876 × g for 5 min (p = 0.021) and remained unchanged when centrifuged for 7 min (p = 0.066 and 0.177, for periods C and D, respectively). In periods B, C and D, the proportion of samples with hemolysis was higher than that in period A (p-values 0.039, 0.009 and 0.042, respectively). TAT differed between all periods (p < 0.001), with the lowest TAT observed for B and D. The lowest number of samples exceeding 60-min TAT was observed in period D (p = 0.011). Conclusions The integrity of serum samples is changed with different centrifugation conditions than those recommended. Our study showed that shorter centrifugation at higher force (7 min at 4141 × g) significantly decreases TAT, with unchanged proportion of samples with aspiration errors.

The Potential of Phosphorescence Spectrometry in Clinical Chemistry—The New Generation of Instrumentation and Methodology

1975 ◽  
Vol 21 (3) ◽  
pp. 285-299 ◽  
Author(s):  
C M O'Donnell ◽  
J D Winefordner
Keyword(s):  
Clinical Laboratory ◽  
Decay Curve ◽  
Rapid Determination ◽  
Clinical Chemistry ◽  
Clinical Importance ◽  
Use Of Time ◽  
Recent Advances ◽  
Large Numbers ◽  
New Generation

Abstract We review recent advances in instrumentation and methodology in phosphorimetry that should facilitate the use of phosphorimetry for clinical analyses and recent phosphorescence studies of interest to the clinical chemist. We indicate recent advances, particularly improvements in instrumentation, novel methodologies, and new chemical processes that result in either an increase in sensitivity or selectivity (or both) of measurement of compounds of clinical importance. The greatest use of phosphorimetry in the clinical laboratory will not be for the analysis of very large numbers of samples for one species via automatic instrumentation, but rather will be for the analysis of those molecular species difficult or impossible to measure by conventional methods (colorimetry, fluorometry, etc.). Although various instrumental and methodological advances are discussed separately here, the most important use of these advances in clinical chemistry will undoubtedly be when two or more of them are combined, for example, in the use of time- or frequency-resolved phosphorimetry for the selective measurement of the phosphorescence resulting with inorganic probes and the appropriate choice of solvent and pH (of course, the instrument could contain an image vidicon detector for rapid determination of the spectrum, the decay curve, or both).

scholarly journals Improved Sample Quality and Decreased Turnaround Time When Using Plasma Blood Collection Tubes with a Mechanical Separator in a Large University Hospital

2020 ◽  
Author(s):  
Pierre-Olivier Hétu ◽  
Sacha Hobeila ◽  
François Larivière ◽  
Marie-Claire Bélanger
Keyword(s):  
Clinical Chemistry ◽  
Turnaround Time ◽  
Error Rates ◽  
University Hospital ◽  
Blood Collection ◽  
Sample Quality ◽  
Paired Samples ◽  
Deming Regression ◽  
Before And After ◽  
The Impact

Abstract Background Serum is commonly used for clinical chemistry testing but many conditions can affect the clotting process, leading to poor sample quality and impaired workflow. With serum gel tubes, we found a high proportion of sample probe aspiration errors on our Beckman AU5800 analyzers. We decided to implement the BD Barricor™ plasma tubes, and we validated an off-specification centrifugation scheme and verified that results obtained for 65 chemistry and immunochemistry tests were comparable to those obtained in serum gel tubes. Finally, we evaluated the impact of this new tube on sample error rate and laboratory turnaround time. Methods To validate centrifugation settings, 50 paired samples were collected in Barricor tubes and centrifuged at 1912 × g for 10 min or 5 min (off-specification). To compare serum gel tubes with Barricor plasma tubes, 119 paired samples were collected from volunteers and results were analyzed using weighed Deming regression. Finally, the proportion of aspiration errors and laboratory TAT for potassium were measured before and after implementing Barricor tubes. Results Barricor tubes showed clinically acceptable equivalence to serum gel tubes for the studied analytes, and the off-specification centrifugation scheme did not affect the results. Implementing Barricor tubes improved the laboratory workflow by decreasing the aspiration error rates (2.01% to 0.77%, P &lt; 0.001) and lowering hemolysis (P &lt; 0.001). The laboratory TAT for potassium were also significantly lowered (P &lt; 0.001). Conclusion Use of Barricor tubes instead of serum gel tubes leads to better sample quality, shorter more reproducible laboratory TAT, and decreases costs associated with error management.

scholarly journals Intravascular hemolysis in patients with new-generation prosthetic heart valves: A prospective study

2002 ◽  
Vol 123 (3) ◽  
pp. 550-556 ◽  
Author(s):  
Gianclaudio Mecozzi ◽  
Aldo D. Milano ◽  
Marco De Carlo ◽  
Flavia Sorrentino ◽  
Stefano Pratali ◽  
...  
Keyword(s):  
Prospective Study ◽  
Heart Valves ◽  
Prosthetic Heart Valves ◽  
Intravascular Hemolysis ◽  
A Prospective Study ◽  
New Generation

scholarly journals Discrepancy between visual and spectrophotometric assessment of sample haemolysis

2002 ◽  
Vol 39 (5) ◽  
pp. 521-522 ◽  
Author(s):  
Robert Hawkins
Keyword(s):  
Visual Inspection ◽  
Clinical Chemistry ◽  
Weighted Kappa ◽  
Kappa Coefficient ◽  
Sample Type ◽  
Visual Grading ◽  
H Index ◽  
Index Measurement ◽  
Edta Plasma ◽  
Weighted Kappa Coefficient

Background: This study assessed the agreement between visual grading of sample haemolysis with automated haemolysis index (H index) measurement on the Roche 917 clinical chemistry analyser. Methods: The H indices of 800 serum potassium samples and 800 EDTA plasma troponin I samples were compared with routine visual grading of sample haemolysis by technologists. Photographs of mild (haemoglobin 1 g/L), moderate (2·5 g/L) and severe (5 g/L) haemolysis were available for reference. Results: For serum samples, the weighted kappa coefficient was 0·42 with an 8·0% haemolysis rate determined by visual inspection and 3·4% by H index. For EDTA-plasma samples, the weighted kappa coefficient was 0·35 with a 4·5% haemolysis rate determined by visual inspection and 7·9% by H index. Conclusion: Visual assessment of sample haemolysis is unreliable and can give variable results depending on sample type. Laboratories should consider investigating sample haemolysis using automated haemolysis index measurement as an alternative to visual grading whenever it is available.

Evaluation of a new generation of plastic evacuated blood-collection tubes in clinical chemistry, therapeutic drug monitoring, hormone and trace metal analysis

2004 ◽  
Vol 42 (1) ◽  
Author(s):  
Jean-Marie Boeynaems ◽  
Anne De Leener ◽  
Barbara Dessars ◽  
Hector Rodriguez Villa-Lobos ◽  
Jean-Claude Aubry ◽  
...  
Keyword(s):  
Trace Metal ◽  
Clinical Chemistry ◽  
Therapeutic Drug ◽  
Steady Increase ◽  
Blood Collection ◽  
Suitable Alternative ◽  
Trace Metal Analysis ◽  
Trace Metal Determination ◽  
Glass Tubes ◽  
New Generation

AbstractPolyethylene terephthalate (PET) tubes have several advantages over glass tubes: they are unbreakable, lighter and more easily disposed of. Despite a steady increase in their use and an expansion of the range of available tubes, few studies validating their use have been published in the literature. This paper describes the various studies that have been performed to compare VENOJECT glass, VENOSAFE PET and VENOSAFE PET/heparin tubes for the assay of a panel of analytes in routine clinical chemistry, immunochemistry, hormone and tumor marker analysis and trace metal determination. These studies demonstrate that VENOSAFE PET tubes are a suitable alternative to glass tubes.

scholarly journals Review on Smart Electro-Clothing Systems (SeCSs)

Sensors ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 587 ◽  
Author(s):  
Abu Sadat Muhammad Sayem ◽  
Siew Hon Teay ◽  
Hasan Shahariar ◽  
Paula Luise Fink ◽  
Alhussein Albarbar
Keyword(s):  
Health Monitoring ◽  
Review Paper ◽  
Social Activities ◽  
Wearable Sensor ◽  
Design Development ◽  
Electronic Components ◽  
Literature Research ◽  
Fitness Tracking ◽  
Technical Features ◽  
New Generation

This review paper presents an overview of the smart electro-clothing systems (SeCSs) targeted at health monitoring, sports benefits, fitness tracking, and social activities. Technical features of the available SeCSs, covering both textile and electronic components, are thoroughly discussed and their applications in the industry and research purposes are highlighted. In addition, it also presents the developments in the associated areas of wearable sensor systems and textile-based dry sensors. As became evident during the literature research, such a review on SeCSs covering all relevant issues has not been presented before. This paper will be particularly helpful for new generation researchers who are and will be investigating the design, development, function, and comforts of the sensor integrated clothing materials.

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