Evaluation of Laboratory Performance with Quality Indicators in Infectious Disease Hospital, Kano, Nigeria

Jegede, Feyisayo Ebenezer; Mbah, Henry A.; Aminu, Mansur; Yakubu, Timothy Nathaniel; Torpey, Kwasi

doi:10.4236/ojcd.2015.51001

Cited by 16 publications

(17 citation statements)

References 27 publications

(31 reference statements)

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“…In Nigeria, it is not uncommon for physicians to be reluctant to follow guidance from medical laboratory professionals because of the prevailing power differential between physicians and other health care providers. 23 Healthcare workers’ attitudes 18 , 24 toward the completion of LRFs cannot be overlooked, following reports of poor documentation of laboratory processes. In Nigeria, it is common for staff to consider such documentation as unnecessary paperwork and an extra burden.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

Jegede

Mbah²,

Dakata

et al. 2016

Afr J Lab Med

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BackgroundThe laboratory request form (LRF) is a communication link between laboratories, requesting physicians and users of laboratory services. Inadequate information or errors arising from the process of filling out LRFs can significantly impact the quality of laboratory results and, ultimately, patient outcomes.ObjectiveWe assessed routinely-submitted LRFs to determine the degree of correctness, completeness and consistency.MethodsLRFs submitted to the Department of Haematology (DH) and Blood Transfusion Services (BTS) of Aminu Kano Teaching Hospital in Kano, Nigeria, between October 2014 and December 2014, were evaluated for completion of all items on the forms. Performance in four quality indicator domains, including patient identifiers, test request details, laboratory details and physician details, was derived as a composite percentage.ResultsOf the 2084 LRFs evaluated, 999 were from DH and 1085 from BTS. Overall, LRF completeness was 89.5% for DH and 81.2% for BTS. Information on patient name, patient location and laboratory number were 100% complete for DH, whereas only patient name was 100% complete for BTS. Incomplete information was mostly encountered on BTS forms for physician’s signature (60.8%) and signature of laboratory receiver (63.5%). None of the DH and only 9.4% of BTS LRFs met all quality indicator indices.ConclusionThe level of completion of LRFs from these two departments was suboptimal. This underscores the need to review and redesign the LRF, improve on training and communication between laboratory and clinical staff and review specimen rejection practices.

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Section: Discussionmentioning

confidence: 99%

“…In Nigeria, it is common for staff to consider such documentation as unnecessary paperwork and an extra burden. 18 , 24 …”

Section: Discussionmentioning

confidence: 99%

Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

Jegede

Mbah²,

Dakata

et al. 2016

Afr J Lab Med

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“…Clinical/Medical laboratories must be reliable in providing a correct diagnosis of continuing or past infections for proper disease management (WHO, 2008), thus laboratory quality assessment (LQA) in clinical laboratory become the stamina of laboratory performance as quality has impact on disease diagnosis and patient management [5]. Implementation and /or strengthening of Laboratory quality assurance (LQA) programs provide an objective measure of reliability of laboratory services [5].…”

Section: Laboratory Tests Involvedmentioning

confidence: 99%

Variations on External Quality Assessment Performance of Public Medical Laboratories: Experience from SLMTA Program in Morogoro and Iringa, Tanzania

Kaseha¹,

Manyilizu²

2019

Act Scie Medic

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Background:The International Organization for Standardization has recommended monitoring and evaluation of quality laboratory services to ensure accuracy and reliability of diagnoses. The extent of accuracy and reliability of medical laboratory diagnoses in Tanzania has been scarcely documented. Objective:The evaluation aimed at determining the effect of SLMTA program on external Quality assessment participation and proficiency test performance of public laboratories in Iringa and Morogoro in Tanzania. Methodology: A comparative laboratory-based cross-sectional design involved four medical laboratories was conducted in Kilosa and Turiani districts in Morogoro region and Iringa Municipal and Mufindi district in Iringa region. Participation in, and the number of individual programs assessed by External Quality assurance programs was determined. Data were analyzed using Excel software to prepare contingency tables for test sensitivities, specificities, and predictive values. Statistics such as percentage distributions and cross-tabulations were used to analyse data.Findings: SLMTA and non-SLMTA labs are participating regularly in EQA for HIV Rapid tests (RTs), however, their participation is not regular for malaria and Hb tests. Proficiency test performance for HIV RTs in SLMTA lab category was 64%, while in non-SLMTA was 85%. PT performance for malaria test in non SLMTA was 44%, while it was zero percent in SLMTA lab category. Proficiency tTest performance (percentage at which the particular laboratory is able to correctly get the true result as per the reference laboratory for a particular laboratory tests) for Hb was zero percent in SLMTA labs and no datum for Hb PTs available in non SLMTA labs. The true positive rate (sensitivity) and true negative rate (specificity) for HIV RTs was 100% in both laboratory categories (SLMTA and non-SLMTA).The current study, registered a sensitivity and specificity of 100% and 75% respectively for malaria tests in SLMTA labs, while in non-SLMTA labs sensitivity and specific were 94% and 100% respectively. Sensitivity for Hb level estimation in SLMTA labs was 87% and there was no Hb data in non-SLMTA. Hb level estimation tests were enrolled at baseline year in both lab categories but currently they are not performed in non-SLMTA labs. Despite that Hb is being done in SLMTA labs there is no feedback from the EQA agent.Both lab categories comply the required TAT for submission of the facility PT results. SLMTA labs observed to review the HIV RT and malaria PTs feedback, while non-SLMTA did not. No evidence of corrective actions were taken following HIV, malaria and Hb test results in both SLMTA and non-SLMTA labs. Conclusion:No variations on EQA participation for HIV RTs, Sensitivity and specificity of HIV RTs are acceptably high in both SLMTA and non-SLMTA labs. Proficiency test score performance for HIV RT and malaria test is higher in non-SLMTA labs than it is in SLMTA labs. There is a need to continuously assess LQIs and calls for an improved attempt on reviewing EQA. Much more ...

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“…It can measure how well an organization meets the needs and requirements of users and the quality of all operational processes. Monitoring quality indicators in daily work can reduce laboratory errors and risk to patient safety by identifying problems in all phases of the laboratory process, allowing their correction [8].…”

Section: Introductionmentioning

confidence: 99%

“…Stock out of reagents, equipment down time, and sample rejection rates are common preanalytical phase quality indicators, whereas the performance of proficiency testing (PT) in external quality assessment (EQA) program, internal quality control (IQC) and contamination or error rates are analytical phase indicators. Minimum recommended quality indicators for the post-analytical phase are turnaround time (TAT), the percentage of incorrect laboratory test reports, and notification of critical results [8,9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of continuous quality improvement of tuberculosis and HIV diagnostic services in Amhara Public Health Institute, Ethiopia

Shiferaw¹,

Misganaw

2020

PLoS ONE

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BackgroundUnreliable laboratory results lead to unnecessary tests, procedures or treatments which may harm the patient. Continuous quality improvement (CQI) is a useful objective tool to improve processes and services. The use of quality indicators that meet requirements for effectiveness is an important quality improvement tool. However, the quality of critical aspects of pre-examination, examination, and post-examination processes have not been evaluated in Ethiopia including our setting. Hence, this study aimed to assess the performance of continuous quality improvement of TB and HIV laboratory tests in the Amhara Public Health Institute (APHI). MethodsA cross-sectional study was conducted to evaluate the quality indicators of advanced TB and HIV related laboratory tests in APHI from 01 January to 30 September 2019. HIV viral load, exposed infant diagnosis (EID), GeneXpert and TB culture quality indicators data were used as a quality improvement tool and evaluated in comparison to established targets. Data were extracted from excel database and record review of patient information, and entered and analyzed using SPSS V20 software. ResultsA total of 26,487 samples were received from 01 January to 30 September 2019. The overall specimen rejection rate was 0.43% (115/26,487). Specifically, viral load and TB culture had 0.43% and 1.14% rejection rates, respectively. The highest monthly rejection was documented for TB culture (5.3%) and viral load (2.4%) in September 2019. Centrifugation problems (46.1% [53/115]) and the use of the wrong container (40.9% [47/115]) were the main reasons for the rejections. Moreover, EID test was interrupted for a total of 54 days and 22 days due to reagent stock out and equipment down time, respectively. Similarly, about 82% PLOS ONEPLOS ONE | https://doi.org/10. ConclusionsThere were high rates of TB culture and viral load specimen rejection, and EID test interruptions. The TAT of viral load and EID tests were longer than the targeted goal (10 days) average TAT. Hence, training of sample collectors, functional equipment maintenance systems and supply chain management are recommended for continuous quality improvement. PLOS ONEQuality improvement of tuberculosis and HIV diagnostic services in APHI PLOS ONE | https://doi.org/10.

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Evaluation of Laboratory Performance with Quality Indicators in Infectious Disease Hospital, Kano, Nigeria

Cited by 16 publications

References 27 publications

Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

Variations on External Quality Assessment Performance of Public Medical Laboratories: Experience from SLMTA Program in Morogoro and Iringa, Tanzania

Evaluation of continuous quality improvement of tuberculosis and HIV diagnostic services in Amhara Public Health Institute, Ethiopia

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