Laboratorio de diagnóstico clínico y/o de vigilancia epidemiológica: norma técnica No. 22-2019-DRACES / Laboratory for clinical diagnosis and / or epidemiological surveillance: technical standard No. 22-2019-DRACES

La tinta del documento está bastante opaca. DRACES [Departamento de Regulación, Acreditación y Control de Establecimientos de Salud] Este documento tiene como objeto: "la regulación, autorización y control de los laboratorios de diagnóstico clínico y/o de vigilancia epidemiológica, en concordancia con el Reglamento para la Regulación, Autorización, Acreditación y Control de Establecimientos de Atención para la Salud, Acuerdo Gubernativo 376-2007." Es de carácter obligatorio, por lo que se aplica tanto al sector público, privado, social o subsector de la seguridad social, en todo el territorio nacional. Contiene además, las definiciones de los conceptos relacionados al tema principal, además de la infraestructura que deberá tener cada clínica, incluidos el equipo y recurso humano y técnico. En el capítulo II, incluye una clasificación del nivel de laboratorios, describiendo sus características, servicios, horarios, materiales técnicos y equipos.

Citotécnico: análise do processo de trabalho em laboratórios de citopatologia e anatomopatologia no Estado do Rio de Janeiro / Cytology: analysis of the work process in cytopathology and pathology laboratories in the State of Rio de Janeiro

INTRODUÇÃO: Trata-se de um estudo sobre o processo de trabalho dos citotécnicos que atuam em laboratórios de Anatomopatologia e Citopatologia no Estado do Rio de Janeiro. OBJETIVOS: objetivo geral é: analisar a percepção dos citotécnicos sobre as competências necessárias à execução de sua atividade laboral; e específicos: (1) descrever a atividade laboral do citotécnico; (2) identificar o modo de produção da atividade por meio das inter-relações de trabalho; (3) conhecer e compreender as implicações do trabalho do citotécnico nas ações de controle do câncer. MATERIAL E MÉTODO: A investigação foi de abordagem qualitativa, de natureza descritiva e social, realizada em três laboratórios de Anatomopatologia e Citopatologia no Estado do Rio de Janeiro, com a participação de 33 citotécnicos. Os dados foram obtidos pela técnica de entrevista semiestruturada, aplicação de questionário, e grupo focal, no período de janeiro a agosto de 2014, e analisados com base na Análise de Conteúdo de Bardin, tendo como unidade de registro o tema. RESULTADOS: Os resultados revelaram: dos 33 citotécnicos, 73% são do sexo feminino; 34% estão distribuídos em igual percentual para as faixas etárias entre 41 a 50 anos e 51 a 60 anos. Com relação à variável do grau de escolaridade, 43% possuem especialização e 24% concluíram o curso superior. Em relação ao cargo exercido, 73% atuam como citotécnicos e 70% são funcionários públicos. O trabalho do citotécnico tem especificidade única desse trabalhador de nível técnico, que é a realização da primeira análise do exame citopatológico, com ações articuladas e complementares de natureza técnica, de gestão, e educativas vinculadas à equipe, com ênfase nos princípios de prevenção e promoção da saúde. Por meio da escala de avaliação do contexto de trabalho, foram avaliadas as condições físicas, materiais e organizacionais do processo de trabalho. O quesito clareza, na definição das tarefas, foi o maior valorado com 4,7% de média, seguido das relações socioprofissionais com média de 4,0%. Os resultados da análise de conteúdo revelaram: na trajetória da atividade laboral, emergiram quatro categorias associadas à motivação e ao ingresso na ocupação por pessoas de referência na formação, acesso ao mercado de trabalho, busca pelo aperfeiçoamento profissional e aprendizagem prática no trabalho; no conceito de modo de produção, emergiram cinco categorias: responsabilidade de salvar vidas, crítica em relação ao próprio trabalho com qualidade, características físicas, atividades distintas do citotécnico e do histotécnico, visão do trabalho com otimismo; nas condições de trabalho, emergiram quatro categorias: trabalho em equipe e responsabilidade individual, ambiguidade em relação à autonomia, precarização do trabalho, esperança no reconhecimento da profissão. CONCLUSÃO: O trabalho do citotécnico é uma ocupação fracamente regulamentada, que se caracteriza por ausência de perfil profissional específico compatível com o escopo de prática real observada no trabalho levando a condições de trabalho precário. O reconhecimento ocorre entre os próprios trabalhadores que se valorizam por serem responsáveis pela promoção da saúde tornando seu trabalho socialmente útil.

INTRODUCTION: This study examines the work processes of cytotechnicians employed in Anatomic Pathology and Cytopathology laboratories in Rio de Janeiro State, Brazil. OBJECTIVES: general purpose is: to analyze perceptions among cytotechnicians of the skills needed to perform their jobs; and more specifically: (1) to describe the work activities of cytotechnicians; (2) to identify activity production modes through workplace relationships; and (3) to explore and understand the implications of the work of cytotechnicians on cancer control actions. MATERIAL AND METHODS: Conducted at three Anatomic Pathology and Cytopathology laboratories in Rio de Janeiro State, this qualitative, descriptive and social research project involved 33 cytotechnicians. Obtained between January and August 2014 through semi-structured interviews, questionnaires and focus groups, the data were subsequently analyzed through the Bardin Content Analysis technique, with the theme constituting the record unit. RESULTS: The findings showed that 73% of these 33 cytotechnicians were women and 34% were split equally between two age brackets: 41  50 years old and 51  60 years old. For the education variable, 43% held specialty qualifications and 24% were university graduates. In terms of their positions, 73% worked as cytotechnicians while 70% were civil servants. The work of the cytotechnician has a specific characteristic that is unique to these technical level employees: they handle the initial analyses of cytopathologic tests through tight-knit team-based complementary actions involving technical, administrative and educational aspects, grounded on health promotion and disease prevention principles. The physical, material and organizational conditions of their work processes were assessed on a work-place rating scale. The issue of task definition clarity ranked highest with a 4.7% mean score, followed by social and professional relationships at a 4.0% mean score. The Content Analysis findings showed that four categories appeared for their work-place activities, associated with: motivation and career choices steered by persons of influence while studying; access to the job market; quest for professional enhancement; and on-the-job training using a hands-on approach. CONCLUSION: The production mode concept gave rise to five categories: responsibility for saving lives; criticism of their own work and quality; physical characteristics; activities specific to cytotechnicians and histotechnicians; and positive views of their jobs. Their working conditions resulted in four categories: teamwork and individual responsibilities; ambiguity about autonomy; weak job security; and hope for better professional acknowledgment. The work of cytotechnicians is covered by lax labor regulations, undermining the presence of a specific professional profile compatible with the scope of their actual job routines as observed and resulting in poor working conditions. They affirm they see themselves as buttressing health promotion, appreciatively aware that their work is useful to society.

Against all odds: diagnosing tuberculosis in South Africa.

Clinical and logistic systems to support the timely diagnosis of tuberculosis are currently not preventing large numbers of tuberculosis deaths in South Africa. Context-appropriate systems for the diagnosis of tuberculosis are entirely dependent on effective and responsive management of human resources and an uninterrupted supply of clinical materials. Attention to these components of the tuberculosis program is urgently needed before new diagnostic technologies can be expected to impact on tuberculosis mortality in resource constrained settings.

Realistic technician staffing requirements in a histopathology laboratory via an innovative workload method.

INTRODUCTION: It is well recognized that efficiency is one of the most important objectives of clinical governance. The correct determination of personnel required plays a central role in health economics. Inadequate staffing of clinical laboratories may compromise quality and throughput, whereas excess staff can uselessly increase costs. This study was undertaken to determine the most reliable and easily applicable method for determination of staffing requirements in a histopathology laboratory. METHODS: Three published methods, namely the weighted workload model, standard time-based and audit benchmarking methods, were compared. The strengths and weaknesses of each method is described with the purpose of identifying the best approach. RESULTS: There are only three relevant published methods, and even these are not appropriate for current requirements. In particular, they may be based on data that is not readily available (calculation of standard time) or may use outdated patterns (using weighted workload) or nonstatistical benchmarks. Although benchmarking was widely used in U.S. even in a period of a crisis in this area in the late 1990s, its major flaw consists of excluding the most influential variables. DISCUSSION: In summary, we tried to formulate a new method based on organizational activities and their categorization into sub-activities, each of which contributes to the calculation of the total time required to perform all activities and accurately determine the number of technicians required.

[Analysis and prospect of projects funded in discipline of microbiology (NSFC) from 2006 to 2010].

The overview of projects funded by general programs,key programs and national science fund for distinguished young scholars in discipline of microbiology, National Natural Science Foundation of China (NSFC) from 2006 to 2010 was recommended. Some important characters such as the distribution of projects in different subjects, organizations, regions and research fields were analyzed. Some important research fields which should be supported in "The Twelfth Five-Year Plan" was also put forward. The goal of the paper is to provide information of funding in NSFC for researchers in the field of microbiology.

[Laboratory alert value reporting by the clinical laboratory at an academic medical network]. / Aviso de valores de alerta por parte del laboratorio clínico en una red de salud universitaria.

BACKGROUND: An alert value is a result suggesting that the patient is at imminent danger unless appropriate remedial actions begin promptly. Report of alert values (AV) by the clinical laboratories has taken special relevance in recent years due to its contribution to patient's care. AIM: To report results of AV informed during 2007 within the Health Network of the Pontificia Universidad Católica de Chile. MATERIAL AND METHODS: Analysis of AV recorded in a centralized database of the laboratories of the health network, between January and December, 2007. RESULTS: Total number of AV was 5.366, which represented 0.3% of total examinations and corresponded mainly to the clinical chemistry area. Potassium levels generated the higher number of AV detected, followed by positive blood cultures. Eighty two percent of AV corresponded to hospitalized patients. The greater number of AV was reported to intermediate and intensive care services. Thirty two percent of AV was informed to the physician or professional in charge of the patient within 5 minutes of obtaining the results and 79% within 30 minutes. CONCLUSIONS: To obtain a real impact on patient management, it is fundamental to shorten the lapse between the obtainment of tests results and the warning, supported on appropriate computerized systems, and to spread the procedure to all personnel involved in patient's care.

Why are modern scientists so dull? How science selects for perseverance and sociability at the expense of intelligence and creativity.

QUESTION: why are so many leading modern scientists so dull and lacking in scientific ambition? ANSWER: because the science selection process ruthlessly weeds-out interesting and imaginative people. At each level in education, training and career progression there is a tendency to exclude smart and creative people by preferring Conscientious and Agreeable people. The progressive lengthening of scientific training and the reduced independence of career scientists have tended to deter vocational 'revolutionary' scientists in favour of industrious and socially adept individuals better suited to incremental 'normal' science. High general intelligence (IQ) is required for revolutionary science. But educational attainment depends on a combination of intelligence and the personality trait of Conscientiousness; and these attributes do not correlate closely. Therefore elite scientific institutions seeking potential revolutionary scientists need to use IQ tests as well as examination results to pick-out high IQ 'under-achievers'. As well as high IQ, revolutionary science requires high creativity. Creativity is probably associated with moderately high levels of Eysenck's personality trait of 'Psychoticism'. Psychoticism combines qualities such as selfishness, independence from group norms, impulsivity and sensation-seeking; with a style of cognition that involves fluent, associative and rapid production of many ideas. But modern science selects for high Conscientiousness and high Agreeableness; therefore it enforces low Psychoticism and low creativity. Yet my counter-proposal to select elite revolutionary scientists on the basis of high IQ and moderately high Psychoticism may sound like a recipe for disaster, since resembles a formula for choosing gifted charlatans and confidence tricksters. A further vital ingredient is therefore necessary: devotion to the transcendental value of Truth. Elite revolutionary science should therefore be a place that welcomes brilliant, impulsive, inspired, antisocial oddballs - so long as they are also dedicated truth-seekers.

Exploring professional-related outcome differences between phlebotomy technicians, medical laboratory technicians, and medical technologists.

As part of a large scale practice analysis on Phlebotomy Technicians (PBTs), Medical Laboratory Technicians (MLTs), and Medical Technologists (MTs), additional data on four "home made measures" of professional-related outcomes, i.e., professional development, quality assurance monitoring, employer reimbursement, and types of continuing education, were also collected. In order to maximize data use from the overall sample of 3,097 respondents (constituting only 18% of the population surveyed), pairwise deletion of data was utilized. No a priori differences between PBTs, MLTs and MTs on these outcomes were hypothesized, and none were found for professional development and employer reimbursement. The finding that PBTs were lower than MLTs and MTs on quality assurance monitoring was interpreted as being job expected. Despite the study limitations, professional development for not just laboratory professionals but all allied health professionals remains an important recruitment and retention issue, as demand for all health services is expected to increase.

The role of the medical laboratory director.

The American Medical Association notes in its Principles of Medical Ethics that a physician "shall be dedicated to provide competent medical service with compassion and respect for human dignity." As physicians whose profession involves the medical direction of pathology and clinical laboratory services, pathologists strive to provide high-quality, cost-effective services to support the needs of patient care. These services must be provided under the aegis of extensive legal and regulatory mandates of various governmental and nongovernmental entities. To accomplish his/her task, the pathologist can use tools of evidence-based medicine and clinical practice guidelines together with his/her medical and scientific training and experience. At the same time, the Medical Director must be able to measure and demonstrate the value of his/her contribution in today's competitive environment.

Guidelines for implementing automation in a hospital laboratory setting--part II.

Laboratories entering into a discussion regarding automation of their facility have a number of key issues that need to be considered right away. What is the financial impact going to be? How do we know which processes we should automate and which ones we shouldn't? Which vendor is going to best align with the goals of our organization? Developing a thorough and robust plan at the start of the automation process is vital to the overall success of the project. It requires dedicated staff members who are willing to do the research, crunch the numbers, and present the data effectively. In Part II of this manuscript, issues such as cost analyses, business plans, and purchasing decisions are each covered thoroughly.

Strategies for improving employee retention.

This article proposes a solution to the perennial problem of talent retention in the clinical laboratory. It includes the presentation of 12 strategies that may be used to significantly improve institutional identity formation and establishment of the psychological contract that employees form with laboratory management. Identity formation and psychological contracting are deemed as essential in helping reduce employee turnover and increase retention. The 12 conversational strategies may be used as a set of best practices for all employees, but most importantly for new employees, and should be implemented at the critical moment when employees first join the laboratory. This time is referred to as "retention on-boarding"--the period of induction and laboratory orientation. Retention on-boarding involves a dialogue between employees and management that is focused on the psychological, practical, cultural, and political dimensions of the laboratory. It is placed in the context of the modern clinical laboratory, which is faced with employing and managing Generation X knowledge workers. Specific topics and broad content areas of those conversations are outlined.

The role, duties and responsibilities of technologists in the clinical laboratory.

Within the United Kingdom, the job functions of the technologist are carried out by Biomedical Scientists who account for the greater proportion of staff employed within clinical laboratories. Their traditional responsibilities have involved providing a quality service through their scientific, technical and clinical skills. During the 1990s, a number of factors combined, leading to a change in the way which quality was viewed within the National Health Service (NHS). This has changed the role of the technologist, encouraging them to broaden their knowledge and take on new skills and responsibility.