EVALUATION OF PRE AND POST ANALYTICAL VARIABLES IN CLINICAL MICROBIOLOGY SERVICES IN MULTIDISCIPLINARY ICU OF A MEDICAL COLLEGE AND TERTIARY CARE HOSPITAL
2016
Optimal outcome of clinical microbiology services is dependent on vertical, horizontal and internal integration involving various specialties, patient care wards and out-patient services. The pre and post analytical variables are difficult to assess and address due to variable structure of wards, laboratories and processes in hospital setups and often fall beyond the purview of accreditation processes. The pre and post analytical variables of clinical microbiology services of a developing country medical college and tertiary care hospital located in Western India were evaluated under a cross-sectional study. Pre-analytical evaluation revealed antimicrobial exposure, incomplete requisition forms, improper labelling of containers, delay in dispatch and transport of samples to the laboratory, inadequacy of samples in varying proportions. Post-analytical evaluation revealed delay from report generation to receipt in ICU. A strength, weaknesses, opportunities and challenges (SWOC) analysis revealed the strengths of a robust ICU and laboratory infrastructure, competent and disciplined clinicians, nurses, microbiologists and lab technicians, well laid down policies and procedures and supportive top management. The weaknesses included numerical deficiency of trained nurses and lab technicians, lack of knowledge about quality, lack of sustained enthusiasm and motivation, inadequate supervision at all levels and inertia to behavioral change. Opportunities exist at ensuring knowledge, high motivation levels and efficiency of human resource as well as successful implementation of change. Challenges of delay at various levels, improving TAT, wastage of resources and improving knowledge in patients need to be addressed.
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