Assessment of Gram Stain Competency and Associated Factors among Laboratory Professional in Clinical Laboratories at Mekelle City Health Facility

Abstract

Background: Gram stains are initially used as a pre-analytical indicator of specimen quality and acceptability for culture. It also gives the clinician preliminary information regarding the nature of potential pathogens present in the patient specimen and thus serve to guide empirical therapy. This procedure is still considered a high-complexity procedure by the Clinical Laboratory Improvement Amendments (CLIA) program. The manual nature of the staining process and the subjectivity of Gram stain interpretation contribute to the incidence of errors. Methodology: A cross-sectional study was conducted from January 2020 to March 2020 on 77 different health facilities present at Mekelle City. Convenient sampling method was used to collect qualitative data from 148 medical laboratory professional through a structured self-administered questionnaire and panel slide at on-site assessment of their performance. Question and panel slide was used to assess knowledge and skill of laboratory professionals respectively. Panel slides were prepared from American Type Culture Collection by using known bacterial strains and no organism slides were prepared from patient sample. Bloom’s cut off point was used to describe the knowledge and practical skills of the respondents. Result: Among 155 eligible medical laboratory professionals, 148 (95.5%) of them participated. Ninety five (95) (64.2%) and one hundred twenty seven (127) (85.2%) participants had low knowledge and skill level respectively. The level of skills of medical laboratory professional had significant associated with educational level, accreditation status of health facility and training and also Education level, accreditation status of health facility, higher institution type and sex had significant association with knowledge level of study participant about gram stain (p<0.05). Conclusion: The present study showed that the majority of medical laboratory professional had low knowledge and skill in gram stain examinations. Attention should be given to develop training strategies that can improve laboratory professional knowledge and skill level. This could be achieved through pre service and in service training and also giving adequate emphasis to gram stain related practical training, continuous follow up and regular competence assessment (supervision).