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3.
Lab Med ; 49(3): e52-e61, 2018 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-29982577

RESUMEN

Introduction: In an effort to identify professional trends while offering meaningful resources to support decision making in the cytopathology community, the ASC/ASCP Workgroup: Focusing on Emerging Roles in Cytopathology conducted several data collection activities to assess the current state and professional trends of cytotechnologist (CT) practice. This information is intended to inform evidence- based development of education and workforce model(s). Materials and Methods: Research was conducted through mixed-method data collection processes. These included the ASCP Board of Certification (BOC) Practice Analysis, focus groups used to gather qualitative data regarding the perceptions and experiences of current stakeholders in cytopathology through face-to-face discussion, and a RAND Delphi study conducted to gather qualitative data regarding the perspectives and "pulse" of decision makers influencing cytopathology practice. Results: Research findings reveal that practice patterns with new and emerging technologies are changing the workplace for many cytotechnologists. Cytotechnologists are increasingly performing tasks within the laboratory that extend beyond their formal training and are looking to professional societies to bridge the gap. Although many laboratory leaders embrace the use of cytotechnologists in expanded roles, regulatory restrictions and reimbursement rules are among acknowledged barriers to change. Conclusions: This study examines current marketplace needs and cytotechnologists' perceptions of their evolving workplace demands through qualitative data collection. This study provides a snapshot of the cur- rent climate of cytopathology and data that will help direct future education, personnel training needs, and staffing decisions.


Asunto(s)
Personal de Laboratorio Clínico/organización & administración , Ciencia del Laboratorio Clínico/organización & administración , Pautas de la Práctica en Medicina/organización & administración , Técnicas Citológicas , Humanos , Rol Profesional
5.
Clin Lab Med ; 38(1): 131-140, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29412877

RESUMEN

The Strengthening Laboratory Management Toward Accreditation (SLMTA) program and subsequent Stepwise Laboratory Quality Improvement Process Toward Accreditation (SLIPTA) checklist were a response to the need for high-quality laboratories to combat the human immunodeficiency virus (HIV) epidemic and provide patients with the highest-quality care. The two tools work together to create a culture of quality in laboratories and allow the identification of gaps. The ultimate goal for any laboratory is to achieve a standard benchmark for quality and these programs have been highly successful in initially affecting the HIV epidemic but continuously improving laboratory quality across all diseases.


Asunto(s)
Acreditación , Servicios de Laboratorio Clínico , Laboratorios , Personal de Laboratorio Clínico , Mejoramiento de la Calidad , Servicios de Laboratorio Clínico/organización & administración , Servicios de Laboratorio Clínico/normas , Humanos , Laboratorios/organización & administración , Laboratorios/normas , Ensayos de Aptitud de Laboratorios , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/normas
6.
J Occup Environ Med ; 59(5): 467-473, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28486343

RESUMEN

OBJECTIVE: The objective of this study was to examine whether fractional exhaled nitric oxide (FeNO) and spirometry can be used as indices to evaluate adverse health effects of low-concentrated chemical inhalation exposure, mainly to formaldehyde. METHODS: Thirty-three subjects (pathology technicians) and 30 controls (workers without handling any chemicals in the same hospitals) participated in this study. All participants underwent FeNO measurement and spirometry before and after 5 days of work. RESULTS: FeNO significantly increased in the subjects with a history of asthma (P < 0.05), whereas forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) decreased in the subjects (P < 0.05). Furthermore, work duration and pre-work levels of FEV1 in the subjects had a significant association. CONCLUSION: The results suggest that FeNO, FVC, and FEV1 represent effective health-effect indices of low-concentrated chemical inhalation exposure.


Asunto(s)
Fijadores/toxicidad , Formaldehído/toxicidad , Personal de Laboratorio Clínico , Óxido Nítrico/análisis , Exposición Profesional/efectos adversos , Servicio de Patología en Hospital , Médicos , Acetona/toxicidad , Adulto , Anciano , Asma/fisiopatología , Derivados del Benceno/toxicidad , Pruebas Respiratorias , Estudios de Casos y Controles , Femenino , Volumen Espiratorio Forzado , Humanos , Exposición por Inhalación/efectos adversos , Masculino , Personal de Laboratorio Clínico/organización & administración , Persona de Mediana Edad , Servicio de Patología en Hospital/organización & administración , Ápice del Flujo Espiratorio , Admisión y Programación de Personal , Médicos/organización & administración , Espirometría , Factores de Tiempo , Capacidad Vital , Xilenos/toxicidad , Adulto Joven
7.
Lab Med ; 48(1): e4-e13, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28138090

RESUMEN

BACKGROUND: The University of Maryland Medical System, like all other medical systems, is faced with providing the highest quality care in an environment of increased demands and competition for resources. Some responses to this pressure include improved integration, coordination, and efficiency. Laboratory integration has been highlighted by our medical system as a promising area for improvement. Standardization of practices, including job descriptions, is an important step on this journey. METHODS: With the help of the Human Resources department and the laboratory directors, we conducted an assessment of existing titles and practices from across our medical system. Analysis and evaluation of job descriptions demonstrated some inconsistencies and opportunities for standardization. Discussion and dialogue allowed us to reach consensus on a standard philosophy, format, and approach. RESULTS: We created a system wide Phlebotomist job description, based on current practice, which reflected the needs of our medical system. We will be able to use this tool to standardize other job titles, as well as for recruitment and as a basis for retention. CONCLUSION: This methodology can be easily duplicated and followed to evaluate and design job descriptions, as well as to reach consensus in an efficient and organized approach to job standardization in the laboratory.


Asunto(s)
Perfil Laboral/normas , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/normas , Flebotomía/normas , Humanos , Selección de Personal/normas
9.
BMJ Qual Saf ; 26(6): 466-474, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27707869

RESUMEN

BACKGROUND: Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. METHODS: We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. RESULTS: Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. CONCLUSIONS: Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine.


Asunto(s)
Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/estadística & datos numéricos , Servicio de Medicina Nuclear en Hospital/organización & administración , Servicio de Medicina Nuclear en Hospital/estadística & datos numéricos , Análisis y Desempeño de Tareas , Australia , Eficiencia Organizacional , Hospitales de Enseñanza/organización & administración , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Seguridad del Paciente , Radiofármacos , Carga de Trabajo , Lugar de Trabajo/organización & administración , Lugar de Trabajo/estadística & datos numéricos
10.
Lab Med ; 48(1): 97-103, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27744341

RESUMEN

BACKGROUND: The 2015 Institue of Medicine report Improving Diagnosis in Health Care highlighted that diagnostic errors cause patient harm and that improvement in the diagnostic process requires better collaboration among physicians and laboratory professionals. The purpose of this study is to understand why physicians do not contact laboratory professionals when facing diagnostic challenges and identify opportunities for laboratory professionals to become more recognized members of the clinical care team. METHODS: A random sample of 31,689 physicians from the American Medical Association Masterfile were surveyed about diagnostic challenges in laboratory test ordering and results interpretation, solutions to these challenges, and interactions with laboratory professionals. RESULTS: We received responses from 1768 physicians (5.6%). When faced with diagnostic challenges, they reported using electronic resources because they find it difficult and time-consuming to contact the laboratory. Only 20% had an effective way to access laboratory professionals, mostly seeking help for logistical but less for clinical issues. Continuing medical education, professional articles, and updates from the laboratory were helpful. CONCLUSIONS: Laboratory professionals have an opportunity to play a greater role in the diagnostic process by becoming active members of the clinical care team, beyond providing results. This study provides strategies to increase laboratory professionals' role in the diagnostic process.


Asunto(s)
Laboratorios , Personal de Laboratorio Clínico , Técnicas de Laboratorio Clínico/normas , Humanos , Laboratorios/organización & administración , Laboratorios/normas , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/normas , Personal de Laboratorio Clínico/estadística & datos numéricos
16.
Bull Soc Pathol Exot ; 108(1): 36-40, 2015 Feb.
Artículo en Francés | MEDLINE | ID: mdl-25012097

RESUMEN

The Fondation Mérieux, in partnership with the Ministries of Health of Burkina Faso, Mali and Senegal, implemented for four years a project to reinforce the laboratory sector in the three participating countries: the RESAOLAB project (West African Network of Biomedical Analysis Laboratories).The objective of RESAOLAB project, in partnership with the WHO Office for West Africa and the West African Health Organization, was to strengthen the systems of biomedical laboratories to improve diagnostic services, access, monitoring and management of infectious diseases. Following the successful results achieved under the RESAOLAB project and due to the demand of the neighbour countries ministries, the RESAOLAB project is now extended to four other countries of the West African region: Benin, Guinea-Conakry, Niger and Togo. The RESAOLAB project has become the RESAOLAB programme, its purpose is to strengthen the quality of the medical biology services thanks to a regional and transversal approach.


Asunto(s)
Técnicas de Laboratorio Clínico/normas , Laboratorios/organización & administración , Mejoramiento de la Calidad/organización & administración , África Occidental , Benin , Conducta Cooperativa , Guinea , Humanos , Personal de Laboratorio Clínico/educación , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/estadística & datos numéricos , Niger , Garantía de la Calidad de Atención de Salud/organización & administración , Mejoramiento de la Calidad/normas , Togo , Recursos Humanos
17.
Rio de Janeiro; s.n; 2015.
Tesis en Portugués | LILACS, Repositorio RHS | ID: biblio-878546

RESUMEN

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.


Asunto(s)
Humanos , Habilitación Profesional/estadística & datos numéricos , Fuerza Laboral en Salud/estadística & datos numéricos , Personal de Laboratorio Clínico/organización & administración , Neoplasias del Colon/química
18.
Bone Marrow Transplant ; 49(8): 1098-105, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24933209

RESUMEN

The Graft Processing subcommittee of the Worldwide Network for Blood and Marrow Transplantation wrote this guideline to assist physicians and laboratory technologists with the setting up of a cell processing laboratory (CPL) to support a hematopoietic stem cell transplant program, thereby facilitating the start-up of a transplant program in a new location and improving patient access to transplantation worldwide. This guideline describes the minimal essential features of designing such a laboratory and provides a list of equipment and supply needs and staffing recommendations. It describes the typical scope of services that a CPL is expected to perform, including product testing services, and discusses the basic principles behind the most frequent procedures. Quality management (QM) principles specific to a CPL are also discussed. References to additional guidance documents that are available worldwide to assist with QM and regulatory compliance are also provided.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas , Laboratorios de Hospital/organización & administración , Laboratorios de Hospital/normas , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/normas , Humanos , Personal de Laboratorio Clínico/provisión & distribución , Guías de Práctica Clínica como Asunto
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