scholarly journals Use of laboratory test results in patient management by clinicians in Malawi

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Kundai Moyo ◽  
Carol Porter ◽  
Ben Chilima ◽  
Reuben Mwenda ◽  
Mark Kabue ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Patient Management ◽  
Cross Sectional Study ◽  
Laboratory System ◽  
Test Results ◽  
Cross Sectional ◽  
Key Informants ◽  
Laboratory Test Results

Background: Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment.Objectives: To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services.Methods: A cross-sectional study was conducted in 2012 to survey practising clinicians.Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted.Results: A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility (P < 0.001). Ninety-one percent of clinicians reported that laboratories required infrastructure improvement. During 97 observations of clinicians’ use of laboratory test results, 80 tests were ordered, and 73 (91%) of these were used in patient management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable.Conclusion: Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

scholarly journals Utilisation of laboratory test results for patient management by clinicians at two large referral hospitals in Zambia

2020 ◽  
Author(s):  
Sabe Mwape ◽  
Victor Daka ◽  
Scott Matafwali ◽  
Kapambwe Mwape ◽  
Jay Sikalima ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
Medical Laboratory ◽  
Test Results ◽  
Cross Sectional ◽  
Childrens Hospital ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Referral Hospitals

Background Medical laboratory diagnosis is a critical component of patient management in the healthcare setup. Despite the availability of laboratory tests, clinicians may not utilise them to make clinical decisions. We investigated utilsation of laboratory tests for patient management among clinicians at Ndola Teaching Hospital (NTH) and Arthur Davison Childrens Hospital (ADCH), two large referral hospitals in the Copperbelt Province, Ndola, Zambia. Method We conducted a descriptive cross-sectional study among clinicians. The study deployed self-administered questionnaires to evaluate clinician utilisation, querying and confidence in laboratory results. Additional data on demographics and possible laboratory improvements were also obtained. Data were entered in Microsoft excel and exported to SPSS version 16 for statistical analysis. Results Of the 80 clinicians interviewed, 96.2% (77) reported using laboratory tests and their results in patient management. 77.5% (62) of the clinicians indicated they always used laboratory results to influence their patient management decisions. Of the selected laboratory tests, clinicians were more confident in using haemoglobin test results (91.2%). There was no statistically significant association between the clinicians gender or qualification and use of test results in patient management. Conclusion Our findings show that despite the majority querying laboratory results, most of the clinicians use laboratory results for patient management. There is need for interactions between the laboratory and clinical area to assure clinician confidence in laboratory results. Key words: utilisation, clinicians, laboratory tests, Ndola Teaching Hospital, Arthur Davison Childrens Hospital

scholarly journals Primary care use of laboratory tests in Northern Ireland’s Western Health and Social Care Trust: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026647
Author(s):  
Magda Bucholc ◽  
Maurice O’Kane ◽  
Ciaran Mullan ◽  
Siobhan Ashe ◽  
Liam Maguire
Keyword(s):  
Northern Ireland ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Social Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics ◽  
Health And Social Care ◽  
Test Ordering

ObjectivesTo describe the laboratory test ordering patterns by general practitioners (GPs) in Northern Ireland Western Health and Social Care Trust (WHSCT) and explore demographic and socioeconomic associations with test requesting.DesignCross-sectional study.SettingWHSCT, Northern Ireland.Participants55 WHSCT primary care medical practices that remained open throughout the study period 1 April 2011–31 March 2016.OutcomesTo identify the temporal patterns of laboratory test ordering behaviour for eight commonly requested clinical biochemistry tests/test groups in WHSCT. To analyse the extent of variations in laboratory test requests by GPs and to explore whether these variations can be accounted for by clinical outcomes or geographical, demographic and socioeconomic characteristics.ResultsThe median number of adjusted test request rates over 5 consecutive years of the study period decreased by 45.7% for urine albumin/creatinine ratio (p<0.000001) and 19.4% for lipid profiles (p<0.000001) while a 60.6%, 36.6% and 29.5% increase was observed for HbA1c(p<0.000001), immunoglobulins (p=0.000007) and prostate-specific antigen (PSA) (p=0.0003), respectively. The between-practice variation in test ordering rates increased by 272% for immunoglobulins (p=0.008) and 500% for HbA1c(p=0.0001). No statistically significant relationship between ordering activity and either demographic (age and gender) and socioeconomic factors (deprivation) or Quality and Outcome Framework scores was observed. We found the rural–urban differences in between-practice variability in ordering rates for lipid profiles, thyroid profiles, PSA and immunoglobulins to be statistically significant at the Bonferroni-adjusted significance level p<0.01.ConclusionsWe explored potential factors of the interpractice variability in the use of laboratory tests and found that differences in requesting activity appear unrelated to either demographic and socioeconomic characteristics of GP practices or clinical outcome indicators.

scholarly journals Population-based Study of Repeat Laboratory Testing

2003 ◽  
Vol 49 (12) ◽  
pp. 1997-2005 ◽  
Author(s):  
Carl van Walraven ◽  
Michael Raymond ◽  
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Databases ◽  
Baseline Testing ◽  
Test Repetition ◽  
Common Laboratory

Abstract Background: Test repetition could be a readily modifiable component of laboratory utilization. Laboratory test repetition has not been rigorously studied at a population-based level. Our objective was to determine the prevalence of, and charges associated with, repetition of eight common laboratory tests. Methods: We performed a cross-sectional study using high-quality, population-based clinical databases that included adults in Eastern Ontario, Canada, between September 1999 and September 2000 for incidence of repeating eight common laboratory tests (hemoglobin, sodium, creatinine, thyrotropin, total cholesterol, HDL-cholesterol, ferritin, and hemoglobin A1C). Tests were classified as potentially redundant if repeated within the test’s baseline testing interval. For creatinine, sodium, and hemoglobin, only tests repeated in the community were considered. For a sensitivity analysis, we varied the repeat interval by 25%, excluded tests repeated by different physicians, and excluded repeats of normal tests. Results: Almost 4 million tests were conducted during the study year. Most tests (76%) were conducted on patients in the community. More than one-half of all people in the population had at least one laboratory test, with an overall testing rate of 367 tests per 100 people per year. Repeat testing within 1 month accounted for 30% of all utilization (109 repeat tests per 100 people per year). Repetition was more common in hospitalized patients, varied extensively among tests, and was concentrated in a limited number of people. For the eight tests included in the study, charges of potentially redundant repetition in adults totaled between $13.9 and $35.9 million (Canadian) annually. Conclusions: Laboratory test repetition is very common, makes up a significant component of overall test utilization, and is costly.

Reduction of Laboratory Utilization in the Intensive Care Unit

2016 ◽  
Vol 32 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Samih Raad ◽  
Rachel Elliott ◽  
Evan Dickerson ◽  
Babar Khan ◽  
Khalil Diab
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Routine Laboratory ◽  
Test Results ◽  
Staff Education ◽  
Arterial Blood ◽  
Laboratory Test Results ◽  
Order Sets

Objective: In our academic intensive care unit (ICU), there is excess ordering of routine laboratory tests. This is partially due to a lack of transparency of laboratory-processing costs and to the admission order plans that favor daily laboratory test orders. We hypothesized that a program that involves physician and staff education and alters the current ICU order sets will lead to a sustained decrease in routine laboratory test ordering. Design: Prospective cohort study. Setting: Academic closed medical ICU (MICU). Patients: All patients admitted to the MICU. Methods: We consistently educated residents, faculty, and staff about laboratory test costs. We removed the daily laboratory test option from the admission order sets and asked residents to order needed laboratory test results every day. We only allowed the G3+I-STAT (arterial blood gas only) cartridges in the MICU in hopes of decreasing duplicative laboratory test results. We added laboratory review to the daily rounding checklist. Measurement and Main Results: Total number of laboratory tests per patient-day decreased from 39.43 to an average of 26.74 ( P <.001) over a 9-month period. The number of iSTAT laboratory tests per patient-day decreased from 7.37 to an average of 1.16 ( P < .001) over the same time period. The number of iSTAT/central laboratory processing duplicative laboratory tests per patient-day decreased from 0.17 to an average of 0.01 ( P < .001). The percentage of patients who have daily laboratory test orders decreased from 100% to an average of 11.94% ( P <. 001). US$123 436 in direct savings and US$258 035 dollars in indirect savings could be achieved with these trends. Intensive care unit morbidity and mortality were not impacted. Conclusion: A simple technique of resident, nursing, and ancillary staff education, combined with alterations in order sets using electronic medical records, can lead to a sustained reduction in laboratory test utilization over time and to significant cost savings without affecting patient safety.

scholarly journals Analisa Kandungan Merkuri (Hg) Di Wilayah Penambangan Emas Danau Payawan Desa Tumbang Panggo Kecamatan Tasik Payawan Kabupaten Katingan

PROMINE ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 59-64
Author(s):  
Fahrul Indrajaya ◽  
Lisa Virgiyanti
Keyword(s):  
Water Quality ◽  
Laboratory Test ◽  
Mercury Content ◽  
Quality Parameters ◽  
Test Results ◽  
Central Kalimantan ◽  
River Water Samples ◽  
Quality Of Water ◽  
Laboratory Test Results

Field activities conducted to determine the level of mercury content in the water flow of Lake Payawan,Tumbang Panggo Village, Tasik Payawan District, Katingan Regency, Central Kalimantan Provincebased on laboratory test results to obtain the results of mercury content in upstream to downstream ofLake Payawan. From this research, it is necessary to test the quality of water in the laboratory in orderto analyze the water quality parameters so it can be known mercury content (Hg) in Lake Payawanwater flow. From the test results on 6 points river water samples in the laboratory of the IndustrialResearch and Standardization Center of Banjarbaru City showed the highest mercury content found insample number 3 with P. 2076 test code taken at the location of the middle Lake Payawan TasikPayawan District with mercury levels located At a rate of 0.069 μg / l or 0.000069 mg / l, this reflectsthe presence of other factors that may also affect the level of mercury content in Lake Payawan flow.

scholarly journals Association of Test Results for 33 Frequently Used Laboratory Tests with Body Mass Index (BMI)

2020 ◽  
pp. 1-4
Author(s):  
Anders Larsson ◽  
Anders Larsson ◽  
Johan Ärnlöv ◽  
Johanna Helmersson-Karlqvist ◽  
Lars Lind ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Laboratory Test ◽  
Body Mass ◽  
Cystatin C ◽  
Apolipoprotein B ◽  
Laboratory Tests ◽  
Hdl Cholesterol ◽  
Apolipoprotein A1 ◽  
Test Results ◽  
Laboratory Test Results

Once considered a problem only for high-income countries, obesity rates are now rising worldwide. When evaluating test results from obese patients it is important to be aware of the effect of obesity on individual laboratory test results. The aim of the present study was to study the association between body mass index (BMI) and a group of frequently requested laboratory tests to evaluate which of these analytes that are affected by BMI. We analyzed the association between body mass index (BMI) and Alanine aminotransaminase (ALT), Albumin, Alkaline phosphatase, Pancreatic amylase, Apolipoprotein A1, Apolipoprotein B, Apolipoprotein B/Apolipoprotein A1 ratio, Aspartate aminotransferase (AST), AST/ALT ratio, Bilirubin, Calcium, Calprotectin, Cholesterol, HDL-cholesterol, Creatinine kinase (CK), Creatinine, C-reactive protein, Cystatin C, Gamma-glutamyl transferase (GGT), Iron, Iron saturation, Lactate dehydrogenase (LDH), Magnesium, Phosphate, Transferrin, Triglycerides, Urate, Urea, Zink, Hemoglobin, Platelet count and White blood cell count in an 80-year old population (n=531, 266 females and 265 males). There were significant Spearman rank associations between BMI and laboratory test results for several of the studied markers in both females and males. The strongest associations with BMI were noted for ALT, Apolipoprotein A1, HDL-cholesterol, Hemoglobin, CRP, Cystatin C, Triglycerides and Urate. In conclusion, several of the most frequently used laboratory markers are significantly associated with BMI. To be able to correctly interpret a test result it is important to be aware of the effects of BMI on the test results.

scholarly journals OPTIMASI PARAMETER PROSES PEMBUATAN BIOETANOL SORGUM DAN PENGARUH TERHADAP UNJUK KERJA MOTOR BENSIN

Otopro ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. 39
Author(s):  
Teng Sutrisno ◽  
Willyanto Anggono ◽  
Kurniawaan Lay ◽  
Melvin Emil Simanjuntak
Keyword(s):  
Laboratory Test ◽  
Raw Materials ◽  
Test Results ◽  
Alcohol Content ◽  
Fermentation Time ◽  
Renewable Fuel ◽  
Gasoline Engines ◽  
Laboratory Test Results

Bioethanol is a renewable fuel that resembles gasoline, bioethanol is produced from fermentation and distillation processes. One of the raw materials that produce bioethanol is Sorghum. Sorghum was chosen because it is superior to other plants. This study aims to analyze fermentation longtime and enzyme composition for the best composition to produce bioethanol from sorghum, and determine the quality of sorghum bioethanol. This research Sorghum  bioethanol produced with an alcohol content of 94%. The test and analysis variables used were 31 samples. The results of this study are as follows : The best fermentation time is 4 days, the enzyme and yeast variable for the most volume of alcohol is 7% yeast 5% enzyme, the enzyme and yeast variable for the highest alcohol content is 7% yeast 7% enzyme. Laboratory test results when compared with PERTAMINA's standard regulations, especially Pertalite RON 90, Several parameters have rejected the regulations. Therefore sorghum bioethanol is used as an additive for Gasoline. Sorghum bioethanol is made addictive to gasoline RON 90, namely B10 (bioethanol sorghum 10%) and B20 (bioethanol sorghum 20%). It would cause an increase in the performance of gasoline engines.

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