Genet Akal Chalachew, Andualem Tesfaye
Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia.
J Trop Med. 2018 Aug 8;2018:9274127. doi: 10.1155/2018/9274127. eCollection 2018.
Role of laboratory service in patient care is well recognized in developed compared to developing countries like Ethiopia where most medical decisions are based on clinical judgment. Laboratory based medical decisions save life and resources. Thus, health facilities (HFs) having capacitated laboratories provide better health care service. Thus, this study assessed capacity of laboratories found in all nine HFs in zone one of Afar region, Ethiopia. Cross-sectional study was conducted from January to May 2015. Data were collected using questioner from medical laboratory professionals (MLPs) and using cheek list from laboratory registration books. Collected data was analyzed using SPSS. Availability of laboratory related national guidelines and standard operating procedure varies among HFs studied. In 42 selected laboratory equipment and materials assessed, their availability shows variations among HFs from 13 (30.2%) to 32 (74.4%). Among different laboratory tests recommended to be performed at health center (HC) level by World Health Organization (WHO), six tests were not performed in all HC laboratories. Moreover, 11 (31.4%) MLPs received in-service training in the past one year. Internal quality control measures were done in 3 (33.3%) laboratories. However, all laboratories were involved in external quality assurance with varied schedules. Specimens after testing and specimen with prolonged transit time were discarded using standard rejection criteria in 8 (88.9%) and 3 (33.3) laboratories, respectively. Study showed that laboratories assessed have good capacities in involving external quality assurance and having proper laboratory test request format. But capacity of laboratories assessed is limited and unsatisfactory in number of laboratory tests performed at HC laboratories, in internal quality control measure implementation, and in getting up-to-date in-service training to staff. Thus, to enhance capacity of laboratories in HC, responsible bodies shall avail basic laboratory materials and equipment, make fair distribution of MLPs, provide up-to-date training, and implement internal quality control measures in laboratories.
与埃塞俄比亚等发展中国家相比，实验室服务在患者护理中的作用在发达国家得到了充分认可，在埃塞俄比亚，大多数医疗决策是基于临床判断的。基于实验室的医疗决策可挽救生命并节省资源。因此，拥有功能完备实验室的医疗机构能够提供更好的医疗服务。因此，本研究评估了埃塞俄比亚阿法尔州一区所有九家医疗机构中实验室的能力。于2015年1月至5月进行了横断面研究。通过向医学实验室专业人员（MLP）发放问卷以及从实验室登记册中使用核对清单来收集数据。使用SPSS对收集到的数据进行分析。在所研究的医疗机构中，与实验室相关的国家指南和标准操作程序的可用性各不相同。在评估的42种选定实验室设备和材料中，其可用性在不同医疗机构之间存在差异，从13种（30.2%）到32种（74.4%）不等。世界卫生组织（WHO）建议在卫生中心（HC）层面进行的不同实验室检测中，有六项检测并非在所有HC实验室中都能进行。此外，11名（31.4%）MLP在过去一年接受了在职培训。3家（33.3%）实验室实施了内部质量控制措施。然而，所有实验室都参与了不同时间表的外部质量保证。分别有8家（88.9%）和3家（33.3%）实验室按照标准拒收标准丢弃了检测后的标本以及运输时间过长的标本。研究表明，所评估的实验室在参与外部质量保证和拥有适当的实验室检测申请格式方面具有良好能力。但所评估实验室的能力在HC实验室进行的实验室检测数量、内部质量控制措施实施以及为工作人员提供最新在职培训方面有限且不尽人意。因此，为提高HC实验室的能力，责任机构应提供基本的实验室材料和设备，合理分配MLP，提供最新培训，并在实验室实施内部质量控制措施。
