Improving the Use of ICT Based Blood Tests of Pre and Post Analytical Medical Laboratory Practices to Enhance Patient Satisfaction in St. Paul’s Hospital, Addis Ababa, Ethiopia
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2014-06
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Addis Abeba University
Abstract
Background: Quality improvement is the practice of continuously assessing and adjusting performance using statistically and scientifically accepted tools and procedures. More than 6070% of the most important decisions on admission, discharge, and medication are based on laboratory test results. In laboratories most of their attention has been directed toward detecting and correcting defects in the analytical portion of the testing process, such that analytical mistakes now account for <10% of all mistakes. Ross and Boone found that mistakes made in laboratory testing were 46% in pre analytical, 7%, in analytical and 47 % in post analytical phases. The greatest impact for overall improvement would be to focus on pre- and post-analytic services where most errors occur. In most large clinical laboratories, test results are produced from and stored in the LIS. In these laboratories, test data may be entered manually into the LIS or automatically transferred to the LIS from automated systems. In case of manually entry of the test data into the LIS there are chances of transcription errors. For eg, an accurate and reliable result reported on the wrong patient, using the wrong value, and/or with the wrong units [eg, mg/L instead of mg/day]After the failarty of (Smart Care) St’ Paul’s Hospital with the help of John Hopkins University introduced PolyTAK for the laboratory Purpose only.
Objective: To assess ICT based Pre and post analytical Medical laboratory practices at St. Paul’s Hospital Addis Ababa, Ethiopia.
Methodology: Institutional cross sectional descriptive study design was conducted to assess Pre and post analytical Medical laboratory practices through ICT at St Paul’s Hospital from May 05, 2014-22, 2014. Quantitative and qualitative data collection methods were used. Pretested structured questionnaire and Check list was used to collect the necessary data.
By using Convenience sampling technique Nine hundred sixty data was collected during the studied period. Data was entered in to Microsoft excel sheet and exported to SPSS version 20.0 for analysis. And descriptive statistics has been used to see the frequency of errors.
Result: A total of Nine hundred sixty data were collected for the evaluation of occurrence of error in pre and post analytical laboratory practices from all OPD. Of these Majorities of them from Medical 334(34.8%), Surgical 165(17.2%) and 156(16.3%) were Gynecology. Out of all the required information Patient Hospital Number and Name were written in all forms (100%), the Patient age and Sex were present on 91.9% and92% of the request papers respectively. The patient’s Clinical Data was not stated on 683 (71.1%) forms, while the date of request was not present on 102(10.6%) of forms. The location of the patient was missing on 87(9.1%) forms. the
name and/or Signature of the physician ordering the test was not provided on 363(37.8%) of forms also the date of the test ordered was present on 89.4 % forms. Concerning the Phlebotomy Practices there was a high frequency of error on Patient identification 24(2.5%) and 13(1.4%)were lost. From the post analytical practices 5(0.5%) had error while the result transferred from paper to the LIS database. Whereas during creation 9(0.5%) of test request in to the database unrelated test request with the request paper were created whereas 24(2.5%) of the total request were repeatedly created and from the total, 13(1.4%) were lost.
Conclusion and recommendation: In general our study showed there were higher frequencies of gap on pre and post analytical practices that should be solved there for the organization should focus to improve Data quality, documentation, and Information flow of the clients.
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ICT, pre analytical, Post analytical, Error