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Stonys R, Vitkus D. A survey on the practice of phlebotomy in Lithuania and adherence to the EFLM-COLABIOCLI recommendations: continuous training and clear standard operating procedures as tools for better quality. Biochem Med (Zagreb) 2024; 34:020702. [PMID: 38665875 PMCID: PMC11042562 DOI: 10.11613/bm.2024.020702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/17/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction The aim of this study was to determine the level of compliance of venous blood sampling (VBS) in Lithuania with the joint recommendations of the European Federation of Clinical Chemistry and Laboratory Medicine and the Latin American Confederation of Clinical Biochemistry (EFLM-COLABIOCLI) and to analyse possible causes of errors. A survey was conducted between April and September 2022. Materials and methods A self-designed questionnaire was distributed to the Lithuanian National Societies. Error frequencies and compliance score were computed. Differences between groups were analysed using Pearson's chi-square, Fisher's exact criterion, Mann-Whitney U (for two groups), or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The association between ordinal and discrete variables was assessed using Spearman's rank correlation coefficient. Statistical significance was determined at P < 0.05. Results A total of 272 respondents completed the questionnaire. Median error rate and compliance score were 31.5% and 13/19, respectively. Significant differences were found among professional titles, standard operating procedures availability, training recency, and tourniquet purpose opinions. A negative correlation was noted between compliance and time since training (rs = - 0.28, P < 0.001). Conclusions The findings of this study indicate that there is a significant need for improvement in compliance with the EFLM-COLABIOCLI recommendations on VBS among specialists in Lithuania. Essential measures include prioritizing ongoing phlebotomy training and establishing national guidelines. Harmonisation of blood collection practices across healthcare institutions is crucial.
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Affiliation(s)
- Ricardas Stonys
- Institute of Biomedical Sciences of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Laboratory Medicine of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Dalius Vitkus
- Institute of Biomedical Sciences of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Laboratory Medicine of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Dorosteh AP, Ghaffari M, Rakhshanderou S, Mehrabi Y, Ramezankhani A. Adolescents diabetes awareness test (ADAT): Tool development and psychometrics evaluation research. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:201. [PMID: 37545987 PMCID: PMC10402772 DOI: 10.4103/jehp.jehp_884_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/24/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND During the last two decades, several reports have indicated an increase in the number of type-2 diabetes among adolescents. Therefore, an assessment of adolescents' awareness of this disease deserves serious consideration. This study aims at designing a psychometric tool for assessing adolescents' awareness of type-2 diabetes. METHODS AND MATERIAL In this methodological research, 770 students attending 10 middle schools (five girls "schools and five boys" schools) from Tehran participated in the study. The questionnaire was designed by examining the relevant literature and the existing questionnaires, as well as considering the research team's comments, and the initial pool of items with 57 questions was designed. Face validity, content validity, and construct validity were calculated to determine the validity of the instrument. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured with Cronbach Alpha. SPSS 16 was used for data analysis. RESULTS The questionnaire was initially designed with 57 items. Based on the results of CVR and CVI, five questions were removed. The average CVR and CVI were 0.75 and 0.82, respectively. Following exploratory factor analysis, the 30 questions in the questionnaire were categorized into five dimensions: public awareness, symptoms, behavioral risk factors, long-term effects, and medium-term effects. The internal reliability was calculated for the whole questionnaire-ICC = 0.87 with a Cronbach alpha coefficient of 0.80. CONCLUSIONS The resulting questionnaire on adolescents' awareness of type-2 diabetes, with 30 questions in five dimensions, can be employed by researchers for its high factor loading in factor analysis and its standard psychometric properties.
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Affiliation(s)
- Ameneh Pooresmaeil Dorosteh
- Departments of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Departments of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Departments of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Departments of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Departments of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gizaw Z, Yalew AW, Bitew BD, Lee J, Bisesi M. Development and validation of questionnaire to assess exposure of children to enteric infections in the rural northwest Ethiopia. Sci Rep 2022; 12:6740. [PMID: 35468977 PMCID: PMC9039032 DOI: 10.1038/s41598-022-10811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/12/2022] [Indexed: 11/09/2022] Open
Abstract
In areas where children have multiple environmental exposures to enteric pathogens, identifying the sources of exposure by measuring external and internal exposures to enteric pathogens and complementing by questionnaire and observational checklist to capture behaviors resulting risk of exposure is critical. Accordingly, this study was conducted to design valid and reliable questionnaire to assess behaviors and environmental conditions resulting exposure to enteric pathogens in the rural northwest Ethiopia. We began with a thorough exploration of relevant literature to understand the theoretical framework on the research objectives to identify variables to highlight what the questionnaire is measuring. We then generated items in each domain that can effectively address the study objectives and we refined and organized the items in a suitable format. Then after, we conducted face and content validity by involving experts on the research subject. After pre-testing a pre-final version of the instrument generated in the content validity study, we conducted a pilot study in 150 randomly selected rural households to test the internal consistency reliability. We used content validity ratio (CVR), item-level content validity index (I-CVIs), scale-level content validity index (S-CVI/UA), and modified kappa statistics to measure content validity of items. Moreover, we used agreement and consistency indices (i.e., Cronbach's alpha) to assess the internal consistency of items. The content validity test result showed that the value of CVR was 0.95, I-CVIs was 0.97, and modified kappa was 0.97 for the whole items, indicating all the items are appropriate. The scale-level content validity index (S-CVI/UA) was 0.95 for the whole items indicating the agreement among judges to each items is higher. The internal consistency reliability test result indicated that Cronbach's alpha for the pre-final version of the pre-final tool was 0.85, indicating the strong reliability of the tool. The final version of the questionnaire was, therefore, prepared with 8 dimensions and 80 items. In this study, we designed valid and reliable questionnaire to assess behaviors and environmental conditions that result high risk of exposure to enteric infections in rural settings. The questionnaire can be used as a tool in the rural settings of developing countries with some amendments to account local contexts. However, this questionnaire alone does not measure exposure of children to enteric infections. It only complements external and internal exposure assessments.
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Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,Addis Continental Institute of Public Health, Addis Ababa, Ethiopia. .,Global One Health Initiative (GOHi), the Ohio State University, Columbus, OH, USA.
| | | | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jiyoung Lee
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA.,Department of Food Science and Technology, The Ohio State University, Columbus, OH, USA
| | - Michael Bisesi
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
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Amedro P, Huguet H, Macioce V, Dorka R, Auer A, Guillaumont S, Auquier P, Abassi H, Picot MC. Psychometric validation of the French self and proxy versions of the PedsQL™ 4.0 generic health-related quality of life questionnaire for 8-12 year-old children. Health Qual Life Outcomes 2021; 19:75. [PMID: 33663527 PMCID: PMC7934389 DOI: 10.1186/s12955-021-01714-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Pediatric Quality of Life Inventory Version 4.0 (PedsQLTM4.0) is a generic health-related quality of life (HRQoL) questionnaire, widely used in pediatric clinical trials but not yet validated in France. We performed the psychometric validation of the self and proxy PedsQLTM4.0 generic questionnaires for French children aged 8-12 years old. METHODS This bicentric cross-sectional study included 123 children and their parents with congenital heart disease (CHD) and 97 controls. The psychometric validation method was based on the consensus-based standards for the selection of health measurement instruments (COSMIN). The reliability was tested using the intraclass correlation coefficient (ICC). To evaluate the validity of this scale, content, face, criterion, and construct validity psychometric proprieties were tested. Acceptability was studied regarding questionnaires' completion and the existence of a floor or a ceiling effect. RESULTS Test-retest reliability intra-class correlation coefficients were mainly in good range (0.49-0.66). Face validity was very good among parents (0.85) and children (0.75). Content validity was good (0.70), despite misinterpretation of some items. In construct validity, each subscale had acceptable internal consistency reliability (Cronbach's α > 0.72 in self-reports, > 0.69 in proxy-reports). In the confirmatory factor analysis, the goodness-of-fit statistics rejected the original structure with 4 factors. The exploratory factor analysis revealed an alternative two-factor structure corresponding to physical and psychological dimensions. Convergent validity was supported by moderate (> 0.41) to high correlations (0.57) between PedsQL and Kidscreeen questionnaires for physical, emotion and school dimensions. The ability of the PedsQL to discriminate CHD severity was better with physical, social and total scores for both self-reports and proxy-reports. CONCLUSIONS The PedsQLTM4.0 generic self and proxy HRQoL questionnaires found good psychometric properties, with regard to acceptability, responsiveness, validity, and reliability. This instrument appeared to be easy to use and comprehend within the target population of children aged 8 to 12 years old and their parents. TRIAL REGISTRATION This study was approved by the South-Mediterranean-IV Ethics Committee and registered on ClinicalTrials.gov (NCT01202916), https://clinicaltrials.gov/ct2/show/NCT01202916 .
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Affiliation(s)
- Pascal Amedro
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Center, Arnaud De Villeneuve University Hospital, 371 Avenue du Doyen Giraud, 34295, Montpellier, France. .,PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier, France. .,Department of Public Health, Aix-Marseille University, EA 3279 Research Unit, Marseille, France.
| | - Helena Huguet
- Epidemiology and Clinical Research Department, University Hospital, Montpellier, France.,Clinical Investigation Center, INSERM-CIC 1411, University of Montpellier, Montpellier, France
| | - Valerie Macioce
- Epidemiology and Clinical Research Department, University Hospital, Montpellier, France
| | - Raphael Dorka
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Center, Arnaud De Villeneuve University Hospital, 371 Avenue du Doyen Giraud, 34295, Montpellier, France
| | - Annie Auer
- Pediatric Cardiology and Rehabilitation Center, Institut-Saint-Pierre, Palavas-Les-Flots, France
| | - Sophie Guillaumont
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Center, Arnaud De Villeneuve University Hospital, 371 Avenue du Doyen Giraud, 34295, Montpellier, France.,Pediatric Cardiology and Rehabilitation Center, Institut-Saint-Pierre, Palavas-Les-Flots, France
| | - Pascal Auquier
- Department of Public Health, Aix-Marseille University, EA 3279 Research Unit, Marseille, France
| | - Hamouda Abassi
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Center, Arnaud De Villeneuve University Hospital, 371 Avenue du Doyen Giraud, 34295, Montpellier, France.,Department of Public Health, Aix-Marseille University, EA 3279 Research Unit, Marseille, France
| | - Marie-Christine Picot
- Epidemiology and Clinical Research Department, University Hospital, Montpellier, France.,Clinical Investigation Center, INSERM-CIC 1411, University of Montpellier, Montpellier, France
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Rajiah K, Venaktaraman R. The Effect of Demographic and Social Factors on the Decision-Making of Community Pharmacists in Ethical Dilemmas. J Res Pharm Pract 2019; 8:174-177. [PMID: 31728350 PMCID: PMC6830021 DOI: 10.4103/jrpp.jrpp_19_15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/26/2019] [Indexed: 11/21/2022] Open
Abstract
Objective: The objective of the study is to investigate the effect of demographic and social factors on the decision-making of community pharmacists when confronted with ethical dilemmas during their professional practice. Methods: This was a questionnaire-based, cross-sectional study. A total of 1057 community pharmacists were approached. The final participants were 742. Independent-sample t-test and one-way analysis of variance were used to analyze the factors (age, gender, work experience, education qualification, number of pharmacists per pharmacy, and pharmacy location). Findings: Older pharmacists, experienced pharmacists, and urban pharmacists have less ethical dilemma compared to the younger pharmacists, less work experience pharmacists, and rural pharmacists, respectively. Conclusion: Individual factors such as age, gender, work experience, and educational level and organizational factors such as the number of pharmacists in a pharmacy and location of pharmacy may influence the ethical dilemma of community pharmacists.
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Affiliation(s)
- Kingston Rajiah
- Department of Pharmacy Practice, Institute of Pharmacy, Shri Jagdishprasad Jhabarmal Tibrewala University, Jhunjhunu, Rajasthan, India
| | - Rajesh Venaktaraman
- Department of Pharmacy Practice, Adichunchanagiri College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
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Grankvist K, Gomez R, Nybo M, Lima-Oliveira G, von Meyer A. Preanalytical aspects on short- and long-term storage of serum and plasma. ACTA ACUST UNITED AC 2019; 6:51-56. [PMID: 30138113 DOI: 10.1515/dx-2018-0037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 07/19/2018] [Indexed: 12/13/2022]
Abstract
Following an ordered clinical chemistry plasma/serum test, ideally the venous blood specimen is adequately collected at a health care facility, then swiftly transported to and readily handled, analyzed and sometimes interpreted at a clinical chemistry laboratory followed by a report of the test result to the ordering physician to finally handle the result. However, often there are practical as well as sample quality reasons for short- or long-term storage of samples before and after analysis. If there are specific storage needs, the preanalytical handling practices are specified in the laboratory's specimen collection instructions for the ordered test analyte. Biobanking of specimens over a very long time prior to analysis includes an often neglected preanalytical challenge for preserved quality of the blood specimen and also involves administrative and additional practical handling aspects (specified in a standard operating procedure - SOP) when demands and considerations from academic, industry, research organizations and authorities are included. This short review highlights some preanalytical aspects of plasma/serum short- and long- term storage that must be considered by clinicians, laboratory staff as well as the researchers.
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Affiliation(s)
- Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Ruben Gomez
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
| | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Gabriel Lima-Oliveira
- Clinical Biochemistry Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alexander von Meyer
- Institute for Laboratory Medicine, Kliniken Nordoberpfalz AG and Klinikum St. Marien, Weiden and Amberg, Germany
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7
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Niknami M, Mirbalouchzehi A, Zareban I, Kalkalinia E, Rikhtgarha G, Hosseinzadeh H. Association of health literacy with type 2 diabetes mellitus self-management and clinical outcomes within the primary care setting of Iran. Aust J Prim Health 2019; 24:162-170. [PMID: 29622058 DOI: 10.1071/py17064] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/28/2017] [Indexed: 11/23/2022]
Abstract
This study explores the potential association of health literacy with type 2 diabetes mellitus (T2DM) self-management and clinical outcomes in the primary care setting of Iran. A total of 347 T2DM patients, mostly female (52.4%), 50 years old or younger (63.1%), unemployed (53.6%) and rural residents (55.6%) participated in this study. Most of the respondents had type 2 diabetes mellitus (T2DM) for 2-5 years (63.1%) and did not receive any T2DM education (52.2%). Approximately 19.0% were hospitalised due to uncontrolled T2DM. Participants mainly found managing T2DM self-management behaviours difficult. Approximately half of the participants had poor fasting blood sugar (FBS) (47.0%) and haemoglobin A1c (HbA1c) (59.4%) control and were overweight or obese (77.6%). The level of health literacy was poor and most of the participants had difficulties reading hospital materials (66.0%), understanding medical materials (62.5%) and engaging in medical conversations (63.7%). Health literacy could predict 22.5% variance in difficulty of T2DM self-management and 3.8-23.3% variance in T2DM clinical outcomes after controlling for sociodemographic factors. Participants with higher health literacy were more likely to find managing T2DM less challenging and their clinical outcomes were within the normal range. This implies that interventions targeting patient's health literacy can be a promising tool for addressing the burden of T2DM.
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Affiliation(s)
- Marzieh Niknami
- School of Public Health and Community Medicine, Room 215, Level 2, Samuels Building, School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, NSW 2052, Australia
| | - Ali Mirbalouchzehi
- Iranshahr University of Medical Sciences, Noor Street, Iranshahr, Sistan and Baluchestan Province, Iran
| | - Iraj Zareban
- Zahedan University of Medical Sciences, School of Public Health, Dr Hesabi Roundabout, Paradise Campus, Sistan and Baluchestan Province, Zahedan, Iran
| | - Elahibakhsh Kalkalinia
- Iranshahr University of Medical Sciences, Noor Street, Iranshahr, Sistan and Baluchestan Province, Iran
| | - Gasem Rikhtgarha
- Iranshahr University of Medical Sciences, Noor Street, Iranshahr, Sistan and Baluchestan Province, Iran
| | - Hassan Hosseinzadeh
- School of Health & Society, Building 15, Room G26, University of Wollongong NSW 2522, Australia
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Echevarría-Guanilo ME, Gonçalves N, Romanoski PJ. PSYCHOMETRIC PROPERTIES OF MEASUREMENT INSTRUMENTS: CONCEPTUAL BASIS AND EVALUATION METHODS - PART II. ACTA ACUST UNITED AC 2019. [DOI: 10.1590/1980-265x-tce-2017-0311] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
ABSTRACT Objective: to present and discuss conceptual bases and methods for evaluating the content, construct and criterion validity of self-reported measuring instruments. Method: theoretical study based on the concepts of the Consensus-based Standards for the Selection of Health Measurement Instruments and those evaluated in the Evaluating the Measurement of Patient-Reported Outcomes, which includes concepts of instrument assessment to assess patient-reported outcomes. Results: validity is significant for the methodological quality of an instrument; however, it is a relative criterion, since it depends on the adequacy of the instrument to be measured. There are three different validity measurement properties described in the literature: content, construct and criterion validity. Conclusions: as validity is an important property, it is recommended that it be verified in studies that aimed to develop new scales and in those that adapted and validated for another culture or population.
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Willman B, Grankvist K, Bölenius K. Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices. Clin Chem Lab Med 2018; 56:1870-1877. [PMID: 29750640 DOI: 10.1515/cclm-2018-0051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/06/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND When performed erroneously, the venous blood specimen collection (VBSC) practice steps patient identification, test request management and test tube labeling are at high risk to jeopardize patient safety. VBSC educational programs with the intention to minimize risk of harm to patients are therefore needed. In this study, we evaluate the efficiency of a large-scale online e-learning program on personnel's adherence to VBSC practices and their experience of the e-learning program. METHODS An interprofessional team transformed an implemented traditional VBSC education program to an online e-learning program developed to stimulate reflection with focus on the high-risk practice steps. We used questionnaires to evaluate the effect of the e-learning program on personnel's self-reported adherence to VBSC practices compared to questionnaire surveys before and after introduction of the traditional education program. We used content analysis to evaluate the participants free text experience of the VBSC e-learning program. RESULTS Adherence to the VBSC guideline high-risk practice steps generally increased following the implementation of a traditional educational program followed by an e-learning program. We however found a negative trend over years regarding participation rates and the practice to always send/sign the request form following the introduction of an electronic request system. The participants were in general content with the VBSC e-learning program. CONCLUSIONS Properly designed e-learning programs on VBSC practices supersedes traditional educational programs in usefulness and functionality. Inclusion of questionnaires in the e-learning program is necessary for follow-up of VBSC participant's practices and educational program efficiency.
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Affiliation(s)
- Britta Willman
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Karin Bölenius
- Department of Nursing, Umeå University, Umeå, Sweden, Phone: +46 90 786 9115
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Bölenius K, Vestin C, Saveman BI, Gyllencreutz L. Validating a questionnaire - prehospital preparedness for pediatric trauma patients. Int Emerg Nurs 2017; 34:2-6. [PMID: 28545931 DOI: 10.1016/j.ienj.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 05/05/2017] [Indexed: 11/20/2022]
Abstract
In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs' preparedness for caring for pediatric trauma patients. OBJECTIVE The development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting. METHODS Questionnaire development included face and content validity tests resulting in 38 questions. Eighteen of these questions were analyzed by test-retest. The content of the questionnaire was statistically analyzed. RESULTS Fifteen questions were considered valid after reliability and validity tests. Three questions did not fulfill the stability criteria. The content analyses show a low degree of experience with pediatric trauma patients and half of the participants reported stress symptoms when responding to such alarms. CONCLUSION The questionnaire assessing PENs preparedness caring for pediatric trauma patients in Sweden is considered to be suitable for research and clinical practice to improve the care of pediatric trauma patients and the health of PENs, although further testing of the questionnaire is required.
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Nilsson K, Brulin C, Grankvist K, Juthberg C. Factors associated with nursing students' adherence to venous blood collection practice guidelines - A cross sectional study. Nurse Educ Pract 2017; 23:92-98. [PMID: 28278444 DOI: 10.1016/j.nepr.2017.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 05/25/2016] [Accepted: 02/02/2017] [Indexed: 11/30/2022]
Abstract
Venous blood specimen collection is a common procedure that nursing students perform during pre-registration courses, and training for such collections takes place on campus as well as at clinical placements. However, levels of adherence to practice guidelines are still suboptimal among both nursing students and healthcare staff. We aimed to explore nursing students' adherence to the Swedish national venous blood specimen collection practice guidelines regarding patient identification and test request management and how this adherence is related to clinical experience, capability beliefs, research use, and the perceived social climate in clinical contexts. A survey with a cross-sectional design was conducted among 305 nursing students at a medium-sized university in Sweden. Descriptive statistics and logistic regression were used for data analysis. The survey showed that 82% of the students adhered to patient identification guideline practices and 80% to test request management practices. Factors associated with correct patient identification procedures were semester and frequency of research use. Factors associated with correct test request management were previous healthcare work experience, semester, and capability beliefs regarding academic abilities and evidence-based practice. We conclude that there is a need to develop educational tools to train students in research use and evidence-based practice in order to enhance guideline practice adherence and improve patient safety.
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Affiliation(s)
- Karin Nilsson
- Department of Nursing, Umeå University, S-901 87 Umeå, Sweden.
| | | | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, S-901 85 Umeå, Sweden
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Nilsson K, Juthberg C, Söderberg J, Bölenius K, Grankvist K, Brulin C, Lindkvist M. Associations between workplace affiliation and phlebotomy practices regarding patient identification and test request handling practices in primary healthcare centres: a multilevel model approach. BMC Health Serv Res 2015; 15:503. [PMID: 26552430 PMCID: PMC4640357 DOI: 10.1186/s12913-015-1157-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/30/2015] [Indexed: 12/16/2022] Open
Abstract
Background Clinical practice guidelines aim to enhance patient safety by reducing inappropriate variations in practice. Despite considerable efforts to enhance the use of clinical practice guidelines, adherence is often suboptimal. We investigated to what extent workplace affiliation explains variation of self-reported adherence to venous blood specimen collection regarding patient identification and test request handling practices, taking into consideration other primary healthcare centre and individual phlebotomist characteristics. Methods Data were collected through a questionnaire survey of 164 phlebotomy staff from 25 primary healthcare centres in northern Sweden. To prevent the impact of a large-scale education intervention in 2008, only baseline data, collected over a 3-month period in 2006–2007, were used and subjected to descriptive statistics and multilevel logistic analyses. Results In two patient identification outcomes, stable high median odds ratios (MOR) were found in both the empty model, and in the adjusted full model including both individual and workplace factors. Our findings suggest that variances among phlebotomy staff can be largely explained by primary healthcare centre affiliation also when individual and workplace demographic characteristics were taken in consideration. Analyses showed phlebotomy staff at medium and large primary healthcare centres to be more likely to adhere to guidelines than staff at small centres. Furthermore, staff employed shorter time at worksite to be more likely to adhere than staff employed longer. Finally, staff performing phlebotomy every week or less were more likely to adhere than staff performing phlebotomy on a daily basis. Conclusion Workplace affiliation largely explains variances in self-reported adherence to venous blood specimen collection guidelines for patient identification and test request handling practices among phlebotomy staff. Characteristics of the workplace, as well as of the individual phlebotomist, need to be identified in order to design strategies to improve clinical practice in this and other areas.
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Affiliation(s)
- Karin Nilsson
- Department of Nursing, Umeå University, Umeå, Sweden.
| | | | - Johan Söderberg
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden.
| | | | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden.
| | | | - Marie Lindkvist
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden. .,Department of Statistics, Umeå University, Umeå, Sweden.
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Milutinović D, Andrijević I, Ličina M, Andrijević L. Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals. Biochem Med (Zagreb) 2015; 25:401-9. [PMID: 26527124 PMCID: PMC4622195 DOI: 10.11613/bm.2015.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/08/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION This study aimed to assess confidence level of healthcare professionals in venipuncture and their knowledge on the possible causes of in vitro hemolysis. MATERIALS AND METHODS A sample of 94 healthcare professionals (nurses and laboratory technicians) participated in this survey study. A four-section questionnaire was used as a research instrument comprising general information for research participants, knowledge on possible causes of in vitro hemolysis due to type of material used and venipuncture technique and specimen handling, as well as assessment of healthcare professionals' confidence level in their own ability to perform first and last venipuncture. RESULTS The average score on the knowledge test was higher in nurses' than in laboratory technicians (8.11±1.7, and 7.4±1.5, respectively). The difference in average scores was statistically significant (P=0.035) and Cohen's d in the range of 0.4 indicates that there is a moderate difference on the knowledge test among the health care workers. Only 11/94 of healthcare professionals recognized that blood sample collection from cannula and evacuated tube is method which contributes most to the occurrence of in vitro hemolysis, whereas most risk factors affecting occurrence of in vitro hemolysis during venipuncture were recognized. There were no significant differences in mean score on the knowledge test in relation to the confidence level in venipuncture (P=0.551). CONCLUSION Confidence level at last venipuncture among both profiles of healthcare staff was very high, but they showed insufficient knowledge about possible factors affecting hemolysis due to materials used in venipuncture compared with factors due to venipuncture technique and handling of blood sample.
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Affiliation(s)
| | - Ilija Andrijević
- University of Novi Sad; Faculty of Medicine; Department of Nursing, Serbia ; The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Milijana Ličina
- University of Novi Sad; Faculty of Medicine; Department of Nursing, Serbia
| | - Ljiljana Andrijević
- University of Novi Sad; Faculty of Medicine; Department of Biochemistry, Serbia ; The Institute for Oncology of Vojvodina, Sremska Kamenica, Serbia
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Personnel's Experiences of Phlebotomy Practices after Participating in an Educational Intervention Programme. Nurs Res Pract 2014; 2014:538704. [PMID: 25530877 PMCID: PMC4230197 DOI: 10.1155/2014/538704] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/08/2014] [Accepted: 10/11/2014] [Indexed: 12/22/2022] Open
Abstract
Background. Blood specimen collection is a common procedure in health care, and the results from specimen analysis have essential influence on clinical decisions. Errors in phlebotomy may lead to repeated sampling and delay in diagnosis and may jeopardise patient safety. This study aimed to describe the experiences of, and reflections on, phlebotomy practices of phlebotomy personnel working in primary health care after participating in an educational intervention programme (EIP). Methods. Thirty phlebotomists from ten primary health care centres participated. Their experiences were investigated through face-to-face interviews. Findings were analysed using qualitative content analysis. Results. The participants perceived the EIP as having opened up opportunities to reflect on safety. The EIP had made them aware of risks in relation to identification procedures, distractions from the environment, lack of knowledge, and transfer of information. The EIP also resulted in improvements in clinical practice, such as a standardised way of working and increased accuracy. Some said that the training had reassured them to continue working as usual, while others continued as usual regardless of incorrect procedure. Conclusions. The findings show that EIP can stimulate reflections on phlebotomy practices in larger study groups. Increased knowledge of phlebotomy practices improves the opportunities to revise and maximise the quality and content of future EIPs. Educators and safety managers should reflect on and pay particular attention to the identification procedure, distractions from the environment, and transfer of information, when developing and implementing EIPs. The focus of phlebotomy training should not solely be on improving adherence to practice guidelines.
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Lippi G, Becan-McBride K, Behúlová D, Bowen RA, Church S, Delanghe J, Grankvist K, Kitchen S, Nybo M, Nauck M, Nikolac N, Palicka V, Plebani M, Sandberg S, Simundic AM. Preanalytical quality improvement: in quality we trust. Clin Chem Lab Med 2014; 51:229-41. [PMID: 23072858 DOI: 10.1515/cclm-2012-0597] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 11/15/2022]
Abstract
Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.
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Affiliation(s)
- Giuseppe Lippi
- U.O. Diagnostica Ematochimica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
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Nilsson K, Grankvist K, Juthberg C, Brulin C, Söderberg J. Deviations from venous blood specimen collection guideline adherence among senior nursing students. NURSE EDUCATION TODAY 2014; 34:237-242. [PMID: 23870690 DOI: 10.1016/j.nedt.2013.06.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 05/02/2013] [Accepted: 06/12/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Despite considerable efforts to increase patient safety by supporting the use of best practice medical and nursing guidelines by healthcare staff, adherence is often suboptimal. Swedish nurses often deviate from venous blood specimen collection (VBSC) guideline adherence. We assessed the adherence to national VBSC guidelines among senior nursing students. METHODS We conducted a cross-sectional, self-reported questionnaire survey among 101 out of 177 senior nursing students consisting of web-based students in their fifth semester and campus-based students in their fifth or sixth semester out of six. In regard to the VBSC procedures, we asked about adherence to the patient identification, test request handling, and test tube labelling protocols that the students had learned during their second semester and practiced thereafter. RESULTS Guideline adherence to patient identification was reported by 81%, test request handling by 74%, and test tube labelling by 2% of the students. Students with no prior healthcare education reported to a higher extent that they operated within the guidelines regarding labelling the test tube before entering the patient's room compared to students with prior healthcare education. Using multiple logistic regression analysis, we found that fifth semester web-based program students adhered better to VBSC guidelines regarding comparing patient ID/test request/tube label compared to campus-based students. CONCLUSIONS Senior nursing students were found to adhere to VBSC guidelines to a similar extent as registered nurses and other hospital ward staff in clinical healthcare. Thus student adherence to VBSC guidelines had deteriorated since their basic training in the second semester, and this can impact patient safety during university/clinical studies. The results of our study have implications for nursing practice education.
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Affiliation(s)
- Karin Nilsson
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | | | | | - Johan Söderberg
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
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Bölenius K, Lindkvist M, Brulin C, Grankvist K, Nilsson K, Söderberg J. Impact of a large-scale educational intervention program on venous blood specimen collection practices. BMC Health Serv Res 2013; 13:463. [PMID: 24192426 PMCID: PMC4228245 DOI: 10.1186/1472-6963-13-463] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phlebotomy performed with poor adherence to venous blood specimen collection (VBSC) guidelines jeopardizes patient safety and may lead to patient suffering and adverse events. A first questionnaire study demonstrated low compliance to VBSC guidelines, motivating an educational intervention of all phlebotomists within a county council. The aim was to evaluate the impact of a large-scale educational intervention program (EIP) on primary health care phlebotomists' adherence to VBSC guidelines. We hypothesised that the EIP would improve phlebotomists' VBSC practical performance. METHODS The present study comprise primary health care centres (n = 61) from two county councils in northern Sweden. The final selected study group consisted of phlebotomists divided into an intervention group (n = 84) and a corresponding control group (n = 79). Both groups responded to a validated self-reported VBSC questionnaire twice. The EIP included three parts: guideline studies, an oral presentation, and an examination. Non-parametric statistics were used for comparison within and between the groups. RESULTS Evaluating the EIP, we found significant improvements in the intervention group compared to the control group on self-reported questionnaire responses regarding information search (ES = 0.23-0.33, p < 0.001-0.003), and patient rest prior to phlebotomy (ES = 0.27, p = 0.004). Test request management, patient identity control, release of venous stasis, and test tube labelling had significantly improved in the intervention group but did not significantly differ from the control group (ES = 0.22- 0.49, p = < 0.001- 0.006). The control group showed no significant improvements at all (ES = 0-0.39, p = 0.016-0.961). CONCLUSIONS The present study demonstrated several significant improvements on phlebotomists' adherence to VBSC practices. Still, guideline adherence improvement to several crucial phlebotomy practices is needed. We cannot conclude that the improvements are solely due to the EIP and suggest future efforts to improve VBSC. The program should provide time for reflections and discussions. Furthermore, a modular structure would allow directed educational intervention based on the specific VBSC guideline flaws existing at a specific unit. Such an approach is probably more effective at improving and sustaining adherence to VBSC guidelines than an EIP containing general pre-analytical practices.
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Affiliation(s)
- Karin Bölenius
- Department of Nursing, Umeå University, Building A, 4th floor, 901 87 Umeå, Sweden.
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Simundic AM, Cornes M, Grankvist K, Lippi G, Nybo M, Kovalevskaya S, Sprongl L, Sumarac Z, Church S. Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA). Clin Chem Lab Med 2013; 51:1585-93. [DOI: 10.1515/cclm-2013-0283] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 04/18/2013] [Indexed: 12/13/2022]
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Bölenius K, Söderberg J, Hultdin J, Lindkvist M, Brulin C, Grankvist K. Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention. Clin Chem Lab Med 2013; 51:303-10. [DOI: 10.1515/cclm-2012-0159] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 07/03/2012] [Indexed: 11/15/2022]
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