scholarly journals Assessing Quality Indicators for the COVID-19 RTPCR in a Molecular Laboratory

Author(s):  
S. Vinod Kumar B. S. Prasad ◽  
Satish S. Patil V. L. Jayasimha ◽  
J. K. Veni Emilda V. R. Shwetha ◽  
K. G. Raghu Kumar M. Veena ◽  
N. K. Kalappanavar

A quality indicator is a tool that enables the user to quantify the quality of a selected aspect of care by comparing it with a set benchmark. The objective of this study was to review quality indicators for COVID-19 molecular testing at S.S. Institute of Medical Sciences and Research Centre and to compare with the predefined quality indicators in order to improve the performance of the molecular laboratory and to initiate the corrective and preventive measures. Over the period of one year we assessed different quality indicators collected from the molecular laboratory of a tertiary care hospital in Central Karnataka which has processed 36000 throat swabs for the diagnosis of COVID-19. Twelve quality indicators under pre-analytical, analytical and post analytical stage were assessed for the quality by referring it with the select criteria. Missing test request form / specimen (1.36/1000) was the most common inconsistency observed during the assessment of pre-analytical indicators followed by specimen inadequacy (0.194/1000), duplicate specimen referral forms (SRF) generated in ICMR portal (0.277/1000) and color change in the viral transport medium. In analytical phase, non-conformity with QC was seen in 2.83/1000 samples. In post analytical phase, excessive turnaround time was seen in 0.75/1000 samples followed by revised reports due to transcription error (0.38/1000) and duplicate reports (0.13/1000). The results of assessment of quality indicators in the molecular laboratory explicitly supports that laboratory could keep the incidence of errors to the minimum level by following proper corrective and preventive measures. Thus, catering quality laboratory services during devastated COVID pandemic year.

2021 ◽  
Vol 9 (01) ◽  
pp. 669-679
Author(s):  
Zaffar N. ◽  
◽  
Rashid H. ◽  
Hussain S. ◽  
Hakeem A ◽  
...  

Background: Laboratory turnaround time is considered one of the most important indicators of work efficiency in hospitals, physicians always need timely results to take effective clinical decisions especially in the emergency department where these results can guide physicians whether to admit patients to the hospital, discharge them home or do further investigations. Objectives:1. Calculate the turnaround time for the various biochemical investigations from accident and emergency of a tertiary care institute.2. To find the percentage contribution of pre-analytical, analytical and post analytical phases to TAT. Materials And Methods: This was a prospective, descriptive, single-center study of therapeutic TAT for biochemistry investigations in accident and emergency of a tertiary care hospital. The study was conducted for a period of 3 months from August 2020 to Oct 2020. During the present study period, all biochemistry investigations ordered from emergency department were studied. The Lundberg definition of TAT was used in this study. This means that the pre-analytical TAT used was from the point of order of tests to the receipt of samples at the laboratory. Similarly, the post-analytic phase started from the time results were available at the laboratory to the point where clinicians could access it for action. Results: The turnaround time (TAT) has been monitored in total of 7515 samples for biochemistry evaluation with mean TAT of 169.6 min. It was noted that the mean pre analytical time period was 120.6 min , Analytical time period 34 min while post analytical time period was 15 min. In our study of the pre-analytical phase 37.7%, 39.3%, and 22.9% tests were completed within 60, 60-120 and above 120 minutes, respectively. With respect to the analytical phase, 80.4% and 19.6% tests were completed below 45 minutes and above 45 minutes, respectively. Conclusion: Despite efficient analysis of results, the pre analytic period contributed the most delay in TAT. Collecting the blood samples under standard conditions, filling the test request slips, marking the samples with bar-codes contributed to long TAT.


Author(s):  
Kavita Aggarwal ◽  
Sumit Jhajharia ◽  
Tapaswini Pradhan ◽  
Viyatprajna Acharya ◽  
Saurav Patra ◽  
...  

Introduction: Medical and laboratory errors can be caused due to many reasons, including communication problem, inadequate training of the staff members, improper identification. Quality indicators can help in objective measurement of errors in various crucial steps. Aim: To determine the nature and frequency of preanalytical, some of the analytical and postanalytical errors in the clinical laboratory with the help of quality indicators. Materials and Methods: This was a retrospective study and data was collected for preanalytical, some of analytical and postanalytical errors from December 2020 to May 2021, from the central laboratory and were classified under various quality indicators. MS Excel was used to analyse the data and descriptive statistics such as number and percentage were used to present the data. Results: Out of the total 677,887 samples received from both Outpatient Department (OPD) and Inpatient Department (IPD) in the central laboratory for clinical chemistry, preanalytical error was found in 482 samples (0.071%) and most common was haemolysis and billing errors. Out of total 677,887 samples received repeat testing was done in 287 samples (0.042%), Turnaround Time (TAT) exceeded in total 2,29,629 samples (33.87%) and transcription errors/amended report were seen in 41 (0.006%). Conclusion: Sample haemolysis, billing errors, insufficient sample and clotted sample are the most common preanalytical errors encountered in clinical laboratory. The TAT was exceeded in one third of the samples. These errors can be minimised by repeated training, annual competency assessment and more automation in preanalytical phase.


2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None


Author(s):  
Mgbahurike AA ◽  
Oduogu SO ◽  
Bagbi BM

Background to study: Effective management of hypertension is influenced by several factors that center on social and economic status of the patient. Identification of these factors will enable informed intervention in the management of hypertensive patients. Objective: The study aimed to determine possible association between blood pressure control and socioeconomic status of patients who are managed in community pharmacies in Rivers State. Method: A descriptive cross-sectional survey of thirty-nine community pharmacies was conducted between July and December 2018.  A total of 195 respondents participated in the study. Every patient’s consent was obtained. Further information on patients’ demographics were extracted from pharmacists’ documentation files. Such include age, medication patient is on, duration of hypertension, co-morbidity, income/ social status, and habits like smoking, alcohol consumption, educational status, and mean blood pressure over the study period. The outcome measure taken as controlled blood pressure was mean BP ≤140/90 mm Hg for the general population and BP 130/80 mmHg for patients with diabetes as co-morbidity. BP >140/90 mm Hg was considered as uncontrolled blood pressure. Result: A total of 195 respondents participated in the study, of which 105(53.8%) were male and 90(46.2%) were female. Out of this number 75(38.5%) were below 40yrs of age, 105(53.8%) were between 41–50yrs of age and only 15(7.7%) were 60yrs and above. More female had BP control compared to the male (OR 1.89, 95% CI (1.16 - 3.0), P=0.009. Patients within ages 41 - 59yrs had more controlled BP compared to older age, 60yrs and above, OR 1.48, 95% CI (0.84 - 2.42) p 0.18. Uncontrolled BP was found more among employed patients and patients with highest monthly income, OR 1.05 95% CI (0.58 - 2.00); OR 1.16 95% CI (0.49 - 2.78) P, 0.36 respectively. Exercise activities have significant impact on BP control as alcohol consumption increased OR of BP control with no significant difference in OR on amount of monthly expenditure on medications. Conclusion: Male gender, employment, and high income earning have negative effect on BP control while exercise is associated with BP control.                    Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 21 October, Available online: 15 November 2021 Academic Editor:  Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: PRESCRIPTION PATTERN OF ANTI-HYPERTENSIVE DRUGS IN A TERTIARY CARE HOSPITAL IN KERALA AND ADHERENCE TO JNC-8 GUIDELINES


2016 ◽  
Vol 4 (1) ◽  
pp. 43-46
Author(s):  
Manisha Sharma ◽  
Narayan Dutt Pant ◽  
Pratikshya Pandey

The main objective of this study was to determine the prevalence of non-albicans Candida among the patients attending a tertiary care hospital in Kathmandu, Nepal. Candida spp. isolated from different clinical samples (sputum, urine, vaginal swab, blood, endotracheal (ET) secretion, pus) from 250 patients between the period of February 2013 and December 2015 were included in the study. Of those 250 patients, 20% were immunocompromised. Sabouraud dextrose agar was used for the isolation of Candida spp. and the identification was performed on the basis of colony morphology, Gram’s stain, India ink preparation, germ tube test, temperature tolerance test, characteristic color change in CHROMagar, chlamydospore production, sugar fermentation test and sugar assimilation test.Out of total 300 Candida spp., majority were isolated from sputum (43.33%) followed by urine (40%) and vaginal swab (6.67%). Of total 151 (50.33%) non-albicans Candida, the most common species isolated were C. tropicalis (62.25%) followed by C. glabrata (23.84%). High prevalence of non-albicans Candida among the patients attending a hospital in Kathmandu, Nepal was noted.


Author(s):  
Asawari Raut ◽  
Tirzah Cherian ◽  
Shreepa Chauhan ◽  
Atmaram Pawar

Objective: The present study aims to determine the pattern of antibiotic utilization at the surgery department of a tertiary care hospital.Method: A prospective observational study was conducted over a period of 6 months period in surgical ward at Bharti Hospital and Research Centre, Pune, a 1000 bedded teaching hospital. Patients above 18 years and receiving antibiotic therapy pre and post-surgery were included in the study.Results:160 patients with surgical operations were included in the study.The disease spectrum was classified into respective system-wise surgical procedures of which 49.37% cases are skin & soft tissue infections, 25.62% cases of general surgical procedure, 12.5% cases of gastrointestinal surgical procedure, 11.25% cases of urinary system and 1.25% case of head neck system. 20.62% of the study patients had hernia, 18.12% patients had cellulitis, 16.87% patients had diabetic foot ulcer, 16.25% patients had abscess, and 10.62% patients had appendicitis and cholelithiasis. In this study, it was found that 471 antibiotics were used in total of 160 patients, among which highest group of antibiotics prescribed were third generation Cephalosporin (28.23%) followed by Penicillins (23.56%). The most frequently prescribed antibiotics were Metronidazole − 19.74% among the Nitroimidazoles followed by Ceftriaxone − 19.53% of the class Cephalosporins.Conclusion: The rate of prescribing of broad-spectrum antibiotics has increased demonstrably which may result in development of bacterial resistance; however development of guidelines for antibiotic prescription and use of appropriate drugs for the diseases can minimize the unfavourable use of antibiotics and cost of healthcare. 


2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.


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