Medical Laboratory Technologists Research Articles

Kenya's Health Workforce Information System: A model of impact on strategic human resources policy, planning and management

ObjectiveCountries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. MethodsSources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. ResultsInterviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning, management, and development. ConclusionKHWIS data have impacted a range of improvements in health worker regulation, human resources management, and workforce policy and planning at Kenya's ministries of health.

A model of employee satisfaction amongst health-related professionals in South Africa: The case of Western Cape Province

The study’s main objective was to come up with a model of employee satisfaction for the health-related professionals in South Africa. Among the reasons for this were high levels of health-related professional attrition and low levels of employee satisfaction within the health-related professions of South Africa. This original study derives its relevance on the basis of lack of a model for measuring employee satisfaction in the health-related profession in South Africa. Also, studies on employee satisfaction in South Africa focus hugely on medical doctors and nurses, without a commensurate interest in health-related professionals such as pharmacists, emergency medical services personnel, optometrists, and laboratory technologists. A descriptive survey design was utilised in this study warranting the use of a questionnaire which combines facets of job satisfaction with organisational climate dimensions. Making use of exploratory factor analysis, the study realised a rotated component matrix, which then helped in grouping together all the items with high correlation to each other. From the grouped items emerged new factors. Each factor was then labelled differently. The new factors are role clarification and job design; equitable performance management; and integrated leadership and knowledge sharing. The others include self-efficacy; family-friendly work environments (FFWE’s), leader credibility and innovation and excellent customer relations and technology. These new factors represent a significant component of the model of employee satisfaction amongst the health-related professionals in South Africa. Key words: Model of employee satisfaction, health-related profession, allied health profession, exploratory factor analysis, South Africa.

Référentiel d’enseignement de la transfusion sanguine aux étudiants techniciens de laboratoire de biologie médicale

Purpose of the studyThe new French law about clinical laboratory medicine, the requirements of the ISO/CEI 15189 standard, the numerous abilities expected from the medical laboratory technologists and their involvement in blood bank management has led the working group “Recherche et démarche qualité” of the French Society of Blood Transfusion to initiate an inventory of blood transfusion teaching syllabus for medical laboratory technology students and to propose transfusion medicine teaching guidelines. Material and methodsSeven worksheets have been established for that purpose including red blood cell antigen typing and antibody screening, blood sampling in immunohaematology, automation, clinical practices, blood products, blood delivery and haemovigilance. ResultsThese guidelines aim at contributing to the harmonization of transfusion medicine teaching and at providing objective elements to the medical laboratory managers regarding the practical and theoretical skills of theirs collaborators.

Educating medical laboratory technologists: revisiting our assumptions in the current economic and health-care environment.

Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stake-holders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

Skilling-up Medical Laboratory Technologists for Higher Roles in Biomedical Sciences: A needs analysis

Abstract Context and Setting: Educational system for medical laboratory technologists in Uganda produced many technologists with diploma who cannot freely access postgraduate education. Biomedical scientists are in short supply and production needs scale up. Why the idea was necessary. Medical laboratory technologists with diploma lack the competence and qualifications required for admission to masters’ degree programmes, and are required to undertake lengthy undergraduate degrees as prerequisite. A postgraduate diploma programme that will form a link between the diploma and masters degree is therefore proposed. What was done: To develop a curriculum that will address this need, a nationwide needs assessment was conducted to determine stakeholders’ recognition of the need for the programme and the most appropriate modes of programme delivery. National stakeholders were identified and prioritised and a questionnaire was developed and piloted. The questionnaires were distributed to the stakeholders in Makerere University, Mbarara University of Science and Technology, and Kampala International University. Data were analysed using qualitative and quantitative methods. Results and Impact: A response rate of 83 % was recorded, 96 % agreed that the programme was needed, and 93 % wanted it implemented immediately. Reasons given for this need included scaling up manpower, production of better qualified scientists, more opportunities for medical laboratory sciences, technological development, and improving healthcare services. The study demonstrated the need for further training of medical laboratory technologists in Uganda. This will address the manpower shortages in biomedical sciences and empower the technologists to become biomedical scientists.

Quality assurance of laboratory work and clinical use of laboratory tests in general practice in Norway: A survey

Objective. Virtually all the general practices in Norway participate in the Norwegian Quality Improvement of Laboratory Services in Primary Care, NOKLUS. In order to assess and develop NOKLUS's services, it was decided to carry out an investigation in the largest participating group, general practices. Design. In autumn 2008 a questionnaire was sent to all Norwegian general practices asking for feedback on different aspects of NOKLUS's main services: contact with medical laboratory technologists, sending of control materials, use and maintenance of practice-specific laboratory binders, courses, and testing of laboratory equipment. In addition, attitudes were elicited towards possible new services directed at assessing other technical equipment and clinical use of tests. Results. Responses were received from 1290 of 1552 practices (83%). The great majority thought that the frequency of sending out control material should continue as at present, and they were pleased with the feedback reports and follow-up by the laboratory technologists in the counties. Even after many years of practical experience, there is still a need to update laboratory knowledge through visits to practices, courses, and written information. Practices also wanted quality assurance of blood pressure meters and spirometers, and many doctors wanted feedback on their use of laboratory tests. Conclusion. Services regarding quality assurance of point-of-care tests, guidance, and courses should be continued. Quality assurance of other technical equipment and of the doctor's clinical use of laboratory tests should be established as part of comprehensive quality assurance.

Country Leadership and Policy Are Critical Factors for Implementing Laboratory Accreditation in Developing Countries

Accreditation of laboratories is one means to promote quality laboratory services, underscoring the need to document factors that facilitate laboratory accreditation. A desk review and key informant's interviews were conducted to determine the roles of country leadership and policies in laboratory accreditation. Overall, the review revealed that Uganda has enabling factors for laboratory accreditation, putting the country in a state of accreditation-readiness and including strong leadership that provides stewardship and availability of a national health laboratory policy with an explicit statement on laboratory accreditation. A National Laboratory Technical and Policy Committee coordinated the development of the policy. Laboratory training schools provide leadership in training laboratory professionals, while the Association of Medical Laboratory Technologists provides professional leadership. Although there is no national accreditation system, some laboratories are participating in international laboratory accreditation. Key informants expressed strong support for and observed that laboratory accreditation is beneficial and can be implemented in Uganda. Lessons from this study can benefit countries planning to implement laboratory accreditation. Countries that have not developed national laboratory policies and strategic plans should do so to guide the strengthening of laboratory systems and services as a part of health systems strengthening, which would be a springboard for laboratory accreditation.

Standardized Evaluation of Nine Instruments for Self-Monitoring of Blood Glucose

Instruments for self-monitoring of blood glucose (SMBG) should undergo a standardized evaluation including a user-test before being marketed. In this study the results from standardized evaluations of nine different SMBG instruments are presented, and the standardized evaluation is discussed. Approximately 80 diabetes patients using three lots of test strips participated in each evaluation. Half of the patients were educated in how to use the meter, and the evaluations were carried out by both medical laboratory technologists (MLTs) and patients. Questionnaires were used to assess the user manual and the user-friendliness of the instrument. The imprecision obtained by the patients (coefficients of variation [CVs] of 3.2-8.1%) were generally higher compared to that by the MLT (CVs of 2.3-5.9%). Three of the nine instruments did not achieve the quality goal based on the recommendation in the International Organization for Standardization's ISO 15197 guideline in the hands of diabetes patients. The bias from the comparison method ranged from -10.4% to +3.2%. There were significant lot-to-lot variations and hematocrit effects for some of the instruments. Temperature difference between the instruments and the test strip caused deterioration of the quality in one instrument. The user-friendliness was in general acceptable. The quality of instruments for SMBG seems to have improved during recent years, although there are still analytical problems. A standardized evaluation protocol is necessary and should be regularly revised taking into account the development of new technology and the needs of the patients.

Health research ethics review and needs of institutional ethics committees in Tanzania

This study was undertaken to describe the performance of health research ethics review procedures of six research centres in Tanzania. Data collection was done through a self-administered questionnaire and personal interviews. The results showed that there were on average 11 members (range = 8-14) in each Research Ethic Committee. However, female representation in the committees was low (15.2%). The largest proportion of the committee members was biomedical scientists (51.5%). Others included medical doctors (19.7%), social scientists (7.6%), laboratory technologists (10.6%), religious leaders (4.5%), statisticians (3.0%), teachers (1.5%) and lawyers (1.5). Committee members had different capacities to carry out review of research proposals (no capacity = 2%; limited capacity = 15%; moderate capacity = 20%; good capacity = 48%, excellent capacity = 13%). Only half of the respondents had prior ethics review training. Although the majority deemed that ethical guidelines were very important (66%), there were challenges in the use of ethical guidelines which included lack of awareness on the national accreditation mechanisms for ethics committee (59%). Adherence to ethical principles and regulations was influenced by being a scientist (OR = 42.47), being an employee of a professional organization (OR = 15.25), and having an interests in the use of ethical guidelines (OR = 10.85) These findings indicate the need for capacity strengthening (through training and resource support), inclusion of more female representation and other mandatory professions to the research ethics committees.

Allied health infection control coordinators: A new link to infection control

BACKGROUND: Infection control (IC) was once considered to be related only to nursing, but IC problem have come to be seen as related to many healthcare issues inside the hospital. In the past, allied health professionals (AHPs) were overlooked when IC topics and issues arose. In the post-SARS era, however, such myths have been totally destroyed. Further training about basic IC concepts and advanced applications is absolutely necessary for allied health professionals, as they are among the most important mobile staff in Hong Kong. PROJECT: With the formation of the Allied Health Infection Control Coordinators Group, AHPs will be invited as representatives to hospital infection control teams, and their concerns related to IC can be addressed. AHPs come from various disciplines, including physiotherapists, occupational therapists, speech therapists, medical laboratory technologists, podiatrists, prosthetists and orthotists, dietitians, medical physicists, and radiographers. RESULTS: A structured IC training program was designed in consultation with hospitals' senior staff and representatives. A 4-day basic and advanced training was run with hospital visits and international consultations in between. A train-the-trainer format was adopted so that, after completing the course, participants could provide further training and could monitor the application of IC knowledge and practices in their own environments. Besides, during the training program, an effort was made to formulate, standardize, and align IC practice within the Hospital Authority with the aim of ensuring the future quality and standard of IC implementation. RESULTS: A total of 189 AHPs attended a 1-day basic IC training. Only 26.5% reported having attended a formal IC training program previously, and 88% stated that they were satisfied with the overall training program. From the overall pre-course and post-course assessment of their IC knowledge, between 54.8% and 73.4% scored significantly higher (by McNemar test, p < 0.05). Eighty of the attendees are being recruited for a 3-day advanced IC application training in 2005. CONCLUSION: Structured, train-the-trainer-format IC training proved to be significantly effective and satisfactory for participants, enhancing staff IC knowledge applications and concepts.

Point-of-Care Testing for Heart and Cardiovascular Diseases in Finnish Health Care Units

The aim of this study was to describe how point-of-care testing (POCT) for heart and cardiovascular diseases is carried out in Finnish health care units. A questionnaire containing 50 questions was developed for this study and used to collect the data. In the autumn 2000, questionnaires addressed to the head nurses were sent to all of the 406 health care units in Finland. There were 301 responses, for a response rate of 74%. The use of internal quality control (IQC) and external quality assessment (EQA) in POCT for heart and cardiovascular diseases was rare. Many other professionals, such as medical laboratory technologists, often train nursing staff to use point-of-care tests. In many (41%) health care units, POCT is used to diagnose heart and cardiovascular diseases. The most frequently used tests are CRP, qualitative troponin T and quantitative troponin T. One third of the staff who use POC tests have not received additional training in POC testing. POCT should be administered by a multiprofessional team. Because of their extensive education in clinical laboratory science, clinical laboratory professionals should act as coordinators. It is important that the professionals who use point-of-care tests have received appropriate training. Representatives of the distributors can also provide training. The professionals who use POCT should have adequate basic education, which should be supplemented periodically.

Kan det professionella jaget matas?: En granskning av instrumenten &lt;&lt;Nurse Self Description Form&gt;&gt; [NSDF]/ &lt;&lt;Professional Self Description Form&gt;&gt; [PSDF

The professional self-concept of different health care workers is an important component in the professional development. In Sweden recent interest has been expressed in the measurement of the professional self–concept of nurses, occupational therapists and medical laboratory technologists. This paper reports an effort to refine our understanding of the instruments NSDF and PSDF measuring the professional self-concept to evaluate them according to Scientific Advisory Committe of the Medical Outcomes Trust [SAC]. Five different studies, using the NSDF or PSDF instruments, have been analysed.The findings are discussed in relation to the SAC instrument and to literature about measurement and analysis. The comparison between those five studies reveals that there are some doubts related to the construct and criterion validity of the instruments. This as a result of the vague prerequisites of the definition of the construct from relevant theories, for example only one item, resourcefulness is stable in relation...

Attitudes, Concerns, and Knowledge of Taiwanese Medical Laboratory Technologists and Students Regarding HIV and AIDS

Attitudes, Concerns, and Knowledge of Taiwanese Medical Laboratory Technologists and Students Regarding HIV and AIDS

Acquired immune deficiency syndrome and human immunodeficiency virus: Taiwanese medical laboratory technologists and students’ attitudes, concerns and knowledge

Acquired immune deficiency syndrome and human immunodeficiency virus: Taiwanese medical laboratory technologists and students’ attitudes, concerns and knowledge

Operator dependent variability in quantitative analysis of myocardial perfusion images

The purpose of this study was to evaluate variability in the quantification of myocardial perfusion images obtained by a group of experienced operators using two widely used programs. The Cedars Emory quantitative analysis program (CEqual) was used to quantify the size of perfusion defects and the Cedars-Sinai quantitative gated single-photon emission tomography program was used to quantify left ventricular function. Five patients with reversible apical defects, five with fixed apical defects and three patients with normal perfusion were selected. Eight experienced medical laboratory technologists processed the studies from raw projection data. The manual steps consisted of defining two alignment axes parallel to the long axis of the left ventricle, and for the CEqual program selecting apex and base in the short axis slices in the rest and stress studies. Wide variability between the operators in the quantification of reversibility could be seen in all three vascular territories. A range >10% was found in at least one vascular territory for nine of the 13 patients. The differences in left ventricular ejection fraction (LVEF) between operators were <5% for all 13 patients. The large variability in the quantification of reversible apical perfusion defects may influence the clinical interpretation and cause false conclusions. In contrast, inter-operator variability for the quantification of the LVEF was low.

Clinical Laboratory Medicine, 2nd Edition. Kenneth D. McClatchey. Philadelphia: Lippincott Williams Wilkins, 2002, 1936 pp., $120.00, hardcover. ISBN 0-683-30751-7.Clinical Laboratory Medicine: Self-Assessment and Review, 2nd Edition. Kenneth D. McClatchey, Hesham M. Amin, and Jonathan L. Curry. Philadelphia: Lippincott Williams Wilkins, 2002, 336 pp., $39.95, softcover. ISBN 0-7817-3150-X.

The eagerly awaited second edition of this important textbook of laboratory medicine meets and exceeds expectations. It is of approximately the same weight and page length (the type face is smaller and lighter but still easy to read) as the first edition of 1994 and has the same format of 11 major sections prepared under the supervision of well-recognized authorities, with individual chapters contributed by authors of considerable experience. As stated in the editor’s preface, the book is intended for a wide variety of readers, including medical laboratory technicians and technologists, medical students, residents in pathology and internal medicine, clinical laboratory scientists, pathologists, and other physicians. It is comprehensive and well written and clearly meets its objective of providing a single volume reference and learning source for the intended audience. The opening general laboratory section has outstanding …

Age, skill, and contextual cuing in target detection.

This study examined the extent to which structural regularities inherent in visual arrays help to guide target detection and reduce age-related differences in skilled visual search performance. The target-detection performance of medical laboratory technologists in 2 age groups (M = 24.3 years and M = 49.0 years) and age-matched novices was assessed using images of bacterial morphology taken from Gram's stain photomicrographs as targets and search arrays. For skilled observers, response times were longer for middle-aged adults than for young adults except when external location cues were available, or when contextual cues inherent in the array were available to guide target detection. These results demonstrate that contextual information aids the skilled search of middle-aged experts, and suggest that contextual cuing is 1 means by which middle-aged adults can circumvent the effects of normally age-deficient processes on performance in a skilled domain.

Knowledge, assessment and management of pain related to nursing procedures used with premature babies: questionnaire study for caregivers.

The aim of the study was to discover how much Finnish nursing staff know about the pain experienced by premature babies and about pain assessment. The types of helping methods used by caregivers in the nursing of premature babies were also studied. A semistructured questionnaire was sent in autumn 1995 to all registered nurses, practical children's nurses and medical laboratory technologists who take heel blood samples (n = 280) working in paediatric intensive care units in all Finnish university hospitals. The response rate was 70.4%. The structured questions were processed quantitatively at Kuopio University with the SPSS/PC+ data processing program (SPSS, Chicago, IL, USA), and the open questions were processed using quantitative content analysis. The results indicate that the respondents have rather extensive knowledge about the pain experienced by premature babies, pain assessment, pain management and about nursing and helping methods. Pain was assessed mostly on the basis of behaviour and physiological changes, and only infrequently on the basis of biochemical changes. The respondents described the helping methods they use in considerable detail. The most common was to increase the baby's feeling of security. The answers to the open questions revealed that the actions used by the respondents in pain assessment and pain management were not completely consistent with their knowledge. The results demonstrate that caregivers do not use their knowledge adequately in their pain management practices. Future studies should observe the three groups of caregivers in order to discover how they treat premature babies' pain.

Pain Relieving Measures for Prosedural Pain in Premature Babies. An Observational Study

The data for this study were collected in autumn 1995 at Kuopio University Hospital in Finland. During a period of three weeks, nursing procedures and examinations carried out on premature babies were videotaped at the hospital's neonatal intensive care unit. Material covers 30 different procedures and runs up to 60 hours in total. The observations focused on the actions of the premature babies' practical children's nurses, medical laboratory technologists and registered nurses (N=70) representing different nursing fields. The main concern was with the methods used by different professional groups to help alleviate pain in various procedures, such as taking blood samples. Interpretation was based on the method of qualitative content analysis. The results showed that the technical performance of staff members was quite adequate, but efforts invested in human interaction and pain alleviation were quite scarce.

Correlates of Job Satisfaction among Health Care Professionals in Kuwait

Objectives: Job satisfaction of health care providers (physicians, nurses, pharmacists, and medical laboratory technologists) was analyzed in relation to specific background and work environment characteristics in a multicultural setting. Methods: A stratified random sample was used to collect the data from six general hospitals in Kuwait. Data were collected through a self-administered questionnaire distributed to 500 health care providers, of whom 370 (74%) responded. Results: In bivariate analysis, nationality, education, age, and total experience were found to be significant determinants of job satisfaction. However, in multivariate analysis, three work environment characteristics emerged as significant determinants of job satisfaction. The nationality of the supervisor and in-service training showed a positive relationship with job satisfaction while the existence of unhealthy competition decreased job satisfaction. Conclusions: In view of the findings, employee job satisfaction can be improved through control of unhealthy competition, provision of an orientation to the job, and provision of effective in-service training.