RESUMEN
Access to laboratory test results through patient portals is a health equity issue for patients with limited English proficiency (LEP), particularly for Spanish-speaking patients, the largest minority group in the USA. Gaps ranging from linguistic, cultural, and socioeconomic disparities to lack of systematic approaches (e.g., implementation of specific support protocols, policies) are among the identified factors that limit LEP patients' access to patient portals. This paper summarizes initiatives healthcare providers, laboratory professionals, and portal developers can use to address disparities that affect >26 million LEPs while improving their health equity.
Asunto(s)
Equidad en Salud , Humanos , Barreras de Comunicación , Hispánicos o Latinos , Grupos MinoritariosRESUMEN
OBJECTIVES: This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits. DESIGN AND METHODS: The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. RESULTS: Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies' effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12). CONCLUSIONS: Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based "best practices" with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement.
Asunto(s)
Bacterias/aislamiento & purificación , Sangre/microbiología , Errores Diagnósticos/prevención & control , Flebotomía/normas , Guías de Práctica Clínica como Asunto/normas , Evaluación de Programas y Proyectos de Salud/métodos , Técnicas de Cultivo de Célula/normas , Centers for Disease Control and Prevention, U.S. , Contaminación de Equipos/prevención & control , Reacciones Falso Positivas , Humanos , Oportunidad Relativa , Mejoramiento de la Calidad/normas , Juego de Reactivos para Diagnóstico/normas , Estados UnidosRESUMEN
We have identified a potential quality control strain of Mycobacterium tuberculosis to monitor isoniazid susceptibility testing. This strain (strain A) has a stable phenotypic low-level resistance to isoniazid, has a mutation of C (-15) --> T in the inhA promoter region, and gave consistent susceptibility test results in 141 laboratories.
