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Stonys R, Vitkus D. Assessing Non-Laboratory Healthcare Professionals' Attitude towards the Importance of Patient Preparation for Laboratory Tests. Healthcare (Basel) 2024; 12:989. [PMID: 38786400 PMCID: PMC11120851 DOI: 10.3390/healthcare12100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/21/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation. Recommendations provided by national societies or international organisations in the field of radiology, such as The Contrast Media Safety Committee of the European Society of Urogenital Radiology, or in the field of laboratory medicine, such as the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI), also guide this practice. There is a notable lack of understanding regarding the viewpoints held by non-laboratory healthcare professionals concerning the significance of patient preparation for laboratory testing and the impact of typical factors associated with patient preparation. This study endeavours to bridge this gap by assessing the attitude of non-laboratory healthcare professionals in Lithuania regarding these pivotal aspects. (2) Methods: A self-designed anonymous questionnaire was disseminated among 141 public healthcare institutions in Lithuania. The internal consistency of the questionnaire was evaluated by computing Cronbach's alpha. Descriptive statistics were utilised for the variables, while comparisons of attitude among groups were conducted using Mann-Whitney U (for two groups) or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The Kruskal-Wallis post-hoc test was employed for pairwise comparisons. A significance level of p-Value < 0.05 was applied to establish statistical significance. (3) Results: A total of 158 respondents constituted two distinct groups of healthcare professionals: nurses and physicians. Most of the participants either agreed or strongly agreed that patient preparation could introduce bias into laboratory test results. Professionals with less than 20 years of work experience or those who attended training in patient preparation for sampling within a 5-year timeframe exhibited stronger agreement regarding different preanalytical factors in patient preparation and their impact on laboratory test results compared to their counterparts. (4) Conclusions: Non-laboratory healthcare professionals who participated in this survey consider proper patient preparation for laboratory testing to be a significant step towards obtaining accurate test results. They also recognize the commonly acknowledged preanalytical factors as important for ensuring reliable test results. However, attitudes towards the importance of several preanalytical factors vary depending on whether non-laboratory healthcare professionals have more or less than 20 years of work experience, as well as whether they have attended any training on this topic within the last five years or have never attended such training.
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Affiliation(s)
- Ričardas Stonys
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
| | - Dalius Vitkus
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
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Jørgensen PE. What is happening to laboratory medicine in Denmark? Clin Chem Lab Med 2019; 57:349-352. [DOI: 10.1515/cclm-2018-0590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/06/2018] [Indexed: 11/15/2022]
Abstract
Abstract
A number of current trends will affect and probably change laboratory medicine, as we know it. Scientific and technological developments, digital health with big data and artificial intelligence, and centralization will change the interfaces among the specialties of laboratory medicine. They might even challenge the identity of some specialties. Other trends such as demographic changes, increased complexity of health care, digital health with electronic health records, and more demanding and well-informed patients will change the way laboratory medicine specialties deliver their services. This paper discusses the possible changes of laboratory medicine in Denmark – a Scandinavian country where almost all hospitals are public. If Danish laboratories grasp the new possibilities instead of trying to avoid them, laboratory medicine is likely to prosper. Such a positive development will call upon good leadership and a genuine willingness among laboratory specialist to adapt to a future where their own specialty might be very different from today.
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Affiliation(s)
- Per E. Jørgensen
- Management Board, Rigshospitalet , Copenhagen University Hospital , Blegdamsvej 9 , 2100 København Ø , Denmark
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Oosterhuis W. Adding clinical utility to the laboratory reports: automation of interpretative comments. ACTA ACUST UNITED AC 2018; 57:365-370. [DOI: 10.1515/cclm-2018-0623] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022]
Abstract
Abstract
In laboratory medicine, consultation by adding interpretative comments to reports has long been recognized as one of the activities that help to improve patient treatment outcomes and strengthen the position of our profession. Interpretation and understanding of laboratory test results might in some cases considerably be enhanced by adding test when considered appropriate by the laboratory specialist – an activity that was named reflective testing. With patient material available at this stage, this might considerably improve the diagnostic efficiency. The need and value of these forms of consultation have been proven by a diversity of studies. Both general practitioners and medical specialists have been shown to value interpretative comments. Other forms of consultation are emerging: in this time of patient empowerment and shared decision making, reporting of laboratory results to patients will be common. Patients have in general little understanding of these results, and consultation of patients could add a new dimension to the service of the laboratory. These developments have been recognized by the European Federation of Clinical Chemistry and Laboratory Medicine, which has established the working group on Patient Focused Laboratory Medicine for work on the matter. Providing proper interpretative comments is, however, labor intensive because harmonization is necessary to maintain quality between individual specialists. In present-day high-volume laboratories, there are few options on how to generate high-quality, patient-specific comments for all the relevant results without overwhelming the laboratory specialists. Automation and application of expert systems could be a solution, and systems have been developed that could ease this task.
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Affiliation(s)
- Wytze Oosterhuis
- Department of Clinical Chemistry and Hematology, EFLM–WG Patient Focused Laboratory Medicine , Zuyderland Medical Center , Heerlen , The Netherlands
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Watson ID. A patient focused relationship for specialists in laboratory medicine. ACTA ACUST UNITED AC 2018; 57:383-387. [DOI: 10.1515/cclm-2018-0604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 08/14/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Technological change is driving individualized healthcare delivery including laboratory medicine. Ensuring patients gain from their empowerment it is essential that they access data that enables them to utilize reliable information. The potential difficulties of comprehension, information retention and imperfect modes of communication can significantly impair utilization of information by patients. Support for understanding and decision-making needs to be clinically competent and integrated within the healthcare team. Specialists in laboratory medicine are well placed to undertake such a role, the issues around this are explored and proposals for better direct engagement with patients made.
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Affiliation(s)
- Ian D. Watson
- Department of Clinical Biochemistry , University Hospital Aintree , Liverpool , UK
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Dugué B, Lombardi G, Banfi G. What everybody should know about postural changes. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:407-410. [DOI: 10.1080/00365513.2018.1473634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Benoit Dugué
- Faculty of Sport Sciences, University of Poitiers, Laboratoire Mobilité Vieillissement Exercice (MOVE–EA6314), Poitiers, France
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Role of laboratory medicine in collaborative healthcare. ACTA ACUST UNITED AC 2018; 57:134-142. [DOI: 10.1515/cclm-2017-0853] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/28/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Healthcare delivery and responsibility is changing. Patient-centered care is gaining international acceptance with the patient taking greater responsibility for his/her health and sharing decision making for the diagnosis and management of illness. Laboratory medicine must embrace this change and work in a tripartite collaboration with patients and with the clinicians who use clinical laboratory services. Improved communication is the key to participation, including the provision of educational information and support. Knowledge management should be targeted to each stakeholder group. As part of collaborative healthcare clinical laboratory service provision needs to be more flexible and available, with implications for managers who oversee the structure and governance of the service. Increased use of managed point of care testing will be essential. The curriculum content of laboratory medicine training programs will require trainees to undertake practice-based learning that facilitates interaction with patients, clinicians and managers. Continuing professional development for specialists in laboratory medicine should also embrace new sources of information and opportunities for collaborative healthcare.
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Lippi G. The risk of unjustified BRCA testing after the "Angelina Jolie effect": how can we save (laboratory) medicine from the Internet? Clin Chem Lab Med 2018; 56:e33-e35. [PMID: 28753535 DOI: 10.1515/cclm-2017-0551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 07/01/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University Hospital of Verona, Piazzale LA Scuro, 37100 Verona, Italy
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Orth M, Averina M, Chatzipanagiotou S, Faure G, Haushofer A, Kusec V, Machado A, Misbah SA, Oosterhuis W, Pulkki K, Twomey PJ, Wieland E. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine'). J Clin Pathol 2017; 72:191-197. [PMID: 29273576 PMCID: PMC6580792 DOI: 10.1136/jclinpath-2017-204734] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/22/2017] [Accepted: 12/01/2017] [Indexed: 11/12/2022]
Abstract
The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.
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Affiliation(s)
- Matthias Orth
- Vinzenz von Paul Kliniken gGmbH, Institut für Laboratoriumsmedizin, Stuttgart, Germany.,Medizinische Fakultät Mannheim, Ruprecht Karls Universität, Mannheim, Germany
| | - Maria Averina
- Diagnostisk klinikk, Laboratoriemedisin, Universitessykehuset Nord-Norge HF, Tromsø, Norway
| | - Stylianos Chatzipanagiotou
- Department of Clinical Microbiology and Medical Biopathology, National and Kapodistrian University of Athens, Medical School - Aeginition Hospital, Athens, Greece
| | - Gilbert Faure
- Laboratoire d'Immunologie, Pole Laboratoires, Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France
| | - Alexander Haushofer
- Klinikum Wels - Grieskirchen GmbH, Institut für Medizinische und Chemische Labordiagnostik mit Blutbank, Wels, Austria
| | - Vesna Kusec
- Klinicki Zavod za Laboratorijsku Dijagnostiku, Klinicki Bolnicki Centar Zagreb, Zagreb, Croatia
| | - Augusto Machado
- Department of Botelho Moniz Análises Clínicas, SA, Porto, Portugal
| | - Siraj A Misbah
- Department of Clinical Immunology, Oxford University Hospitals, Oxford, UK
| | - Wytze Oosterhuis
- Department of Clinical Chemistry and Haematology, Atrium Medical Center, PC Heerlen, Netherlands
| | - Kari Pulkki
- Department of Clinical Chemistry, Eastern Finland Laboratory Centre and University of Eastern Finland, Kuopio, Finland
| | - Patrick J Twomey
- Department of Clinical Chemistry, St. Vincent's University Hospital/St Vincent's Group Healthcare Group, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Eberhard Wieland
- Klinikum Stuttgart, Zentrum für Diagnostik, Zentralinstitut für Klinische Chemie und Laboratoriumsmedizin, Stuttgart, Germany
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Jørgensen PE. Leadership and Management in Clinical Biochemistry. J Med Biochem 2017; 36:216-219. [PMID: 30564058 PMCID: PMC6287210 DOI: 10.1515/jomb-2017-0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 04/26/2017] [Indexed: 12/19/2022] Open
Abstract
Challenging times lay ahead for laboratory medicine in Europe due to at least three factors. 1) The scientific and technological developments increase the diagnostic possibilities but at the same time they will also change the interfaces among the different specialties of laboratory medicine. 2) The demographic changes with a more elderly population increase the demands for laboratory tests. 3) The increased complexity of the health care system combined with more well-informed patients calls for more coherent clinical pathways across the different sectors, for an increased focus on patient safety, and for a stronger involvement of patients and relatives. These issues cause both threats and opportunities for laboratory medicine - and they have to be handled in a situation with limited economic growth and shortage of money. This calls for a new organization of laboratory medicine in many hospitals as well as for a more active involvement of laboratory medicine in the clinical work and in the contact with the patients. Laboratory medicine will need dedicated and skillful leadership in order to prosper and grow during these challenging changes.
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Affiliation(s)
- Per E Jørgensen
- Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
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Plebani M. Harmonization in laboratory medicine: Requests, samples, measurements and reports. Crit Rev Clin Lab Sci 2015; 53:184-96. [DOI: 10.3109/10408363.2015.1116851] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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