WorldWideScience

Sample records for hospital laboratory monitoring

  1. Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia.

    Science.gov (United States)

    Mindaye, Tedla; Taye, Bineyam

    2012-07-04

    Despite the fact that Ethiopia has scale up antiretroviral treatment (ART) program, little is known about the patient satisfaction with ART monitoring laboratory services in health facilities. We therefore aimed to assess patient satisfaction with laboratory services at ART clinics in public hospitals. Hospital based, descriptive cross sectional study was conducted from October to November 2010 among clients attending in nine public hospitals ART clinics in Addis Ababa Ethiopia. Patients' satisfaction towards laboratory services was assessed using exit interview structured questionnaire. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). A total of 406 clients were involved in the study. Of these 255(62.8%) were females. The overall satisfaction rate for ART monitoring laboratory services was (85.5%). Patients were satisfied with measures taken by health care providers to keep confidentiality and ability of the person drawing blood to answer question (98.3% and 96.3% respectively). Moreover, the finding of this study revealed, statistical significant associations between the overall patients' satisfaction with waiting time to get blood drawing service, availability of ordered laboratory tests and waiting time to get laboratory result with (p ART monitoring laboratory services compared to those who underwent for more than 30 minutes. Overall, the satisfaction survey showed, most respondents were satisfied with ART monitoring laboratory services. However, factors such as improving accessibility and availability of latrines should be taken into consideration in order to improve the overall satisfaction.

  2. Clinical protein science developments for patient monitoring in hospital central laboratories.

    Science.gov (United States)

    Malm, Johan; Marko-Varga, György

    2016-12-01

    Patient care relies heavily on standardized tests performed in hospital laboratories, typically including clinical chemistry, pathology and microbiology. With the introduction of personalized medicine tremendous efforts have been made to identify new biomarkers of disease with various omics technologies, often including mass spectrometry. In order to validate new biomarkers and perform clinical studies high quality biobank samples are of key importance. In this editorial different aspects of mass spectrometry in future personalized medicine are discussed.

  3. [How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

    Science.gov (United States)

    Kawano, Seiji

    2014-12-01

    As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).

  4. The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring.

    LENUS (Irish Health Repository)

    Ryan, F

    2010-02-01

    The development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.

  5. Mining of hospital laboratory information systems

    DEFF Research Database (Denmark)

    Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas

    2015-01-01

    of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high...... in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods...... with pronounced heterogeneity and valid reference intervals. Furthermore, part of the heterogeneity in creatinine distribution is likely due to differences in biological and chronological age of children and should be considered when using age-specific reference intervals....

  6. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    Science.gov (United States)

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

  7. Impact of Laboratory Test Use Strategies in a Turkish Hospital.

    Directory of Open Access Journals (Sweden)

    Fatma Meriç Yılmaz

    Full Text Available Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH and calculate potential savings in costs.A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months.Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6-85.0% was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars.Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory tests.

  8. Monitoring system of the Tritium Research Laboratory, Sandia Laboratories, Livermore, CA

    International Nuclear Information System (INIS)

    Wall, W.R.; Hafner, R.S.; Westfall, D.L.; Ristau, R.D.

    1978-11-01

    Automated tritium monitoring is now in use at the Tritium Research Laboratory (TRL). Betatec 100 tritium monitors, along with several Sandia-designed accessories, have been combined with a PDP 11/40 computer to automatically read and record tritium concentrations of room air, containment, and cleanup systems. Each individual monitoring system, in addition to a local display in the area of interest, has a visible/audible display in the control room. Each system is then channeled into the PDP 11/40 computer, providing immediate assessment of the status of the entire laboratory from a central location. Measurement capability ranges from μCi/m 3 levels for room air monitoring to kCi/m 3 levels for glove box and cleanup systems monitoring. In this report the overall monitoring system and its capabilities are discussed, with detailed descriptions given of monitors and their components

  9. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    Science.gov (United States)

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  10. The monitoring system of the Tritium Research Laboratory, Sandia Laboratories, Livermore, California

    International Nuclear Information System (INIS)

    Hafner, R.S.; Westfall, D.L.; Ristau, R.D.

    1978-01-01

    Computerized tritium monitoring is now in use at the Tritium Research Laboratory (TRL). Betatec 100 tritium monitors, along with several Sandia designed accessories, have been combined with a PDP 11/40 computer to provide maximum personnel and environmental protection. Each individual monitoring system, in addition to a local display in the area of interest, has a visual/audible display in the control room. Each system is then channeled into the PDP 11/40 computer, providing immediate assessment of the status of the entire laboratory from a central location. Measurement capability ranges from uCi/m 3 levels for room air monitoring to KCi/m 3 levels for glove box and process system monitoring. The overall monitoring system and its capabilities will be presented

  11. [Medical microbiology laboratories in Dutch hospitals: essential for safe patient care].

    Science.gov (United States)

    Bonten, M J M

    2008-12-06

    The Netherlands Health Care Inspectorate investigated the quality of medical microbiology laboratories in Dutch hospitals. By and large the laboratories fulfilled the requirements for appropriate care, although some processes were unsatisfactory and some were insufficiently formalised. In the Netherlands, laboratories for medical microbiology are integrated within hospitals and medical microbiologists are responsible for the diagnostic processes as well as for co-treatment of patients, infection prevention and research. This integrated model contrasts to the more industrialised model in many other countries, where such laboratories are physically distinct from hospitals with a strong focus on diagnostics. The Inspectorate also concludes that the current position of medical microbiology in Dutch hospitals is necessary for patient safety and that outsourcing of these facilities is considered unacceptable.

  12. Case study: improving efficiency in a large hospital laboratory.

    Science.gov (United States)

    Bartel, Marilynn

    2004-01-01

    Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third

  13. Quality and Safety of Home ICP Monitoring Compared with In-Hospital Monitoring

    DEFF Research Database (Denmark)

    Andresen, Morten; Juhler, Marianne; Munch, Tina Nørgaard

    2012-01-01

    Introduction: Intracranial pressure (ICP) monitoring is usually conducted in-hospital using stationary devices. Modern mobile ICP monitoring systems present new monitoring possibilities more closely following the patients' daily life. We reviewed patient safety, quality of technical data...

  14. Radiation monitoring programme in a university hot laboratory

    International Nuclear Information System (INIS)

    Tillander, M.; Heinonen, O.J.

    1979-01-01

    The Department of Radiochemistry in the University of Helsinki is the only institute teaching radiochemistry at the university level in Finland. The research programme of the Deparment must therefore include the uses of radiation and radionuclides in many branches of science. The students must receive adequate instruction in radiation protection for safe work in laboratories. This also has the educational benefit that the radiochemists will subsequently be able to observe the necessary safety precautions when employing ionizing radiation professionally. The Department of Radiochemistry consists of the following laboratories: a radiotracer laboratory, a neutron/electron and a gamma irradiation laboratory, an environmental low activity level laboratory, a whole-body counting laboratory, a reactor chemistry laboratory and a waste-treatment facility. The radiation protection organization of the Department is presented. Various methods of monitoring, including advantages and disadvantages are discussed. Emphasis is placed on the reactor chemistry laboratory where transuranic elements are utilized. These elements are highly radiotoxic and their monitoring in most cases requires destructive analysis. Different methods of determining external and internal doses are evaluated with regard to sensitivity and accuracy. Detection limits for radionuclides utilized in the laboratory are presented for different measurement systems, including non-destructive monitoring, spectrometry after chemical analysis, liquid scintillation counting and low-energy gamma spectrometry using a CsI-NaI scintillation detector. The guidelines laid down in the IAEA Safety Series Manuals are discussed in the light of practical experience. (author)

  15. Idaho National Laboratory Environmental Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Joanne L. Knight

    2008-04-01

    This plan describes environmental monitoring as required by U.S. Department of Energy (DOE) Order 450.1, “Environmental Protection Program,” and additional environmental monitoring currently performed by other organizations in and around the Idaho National Laboratory (INL). The objective of DOE Order 450.1 is to implement sound stewardship practices that protect the air, water, land, and other natural and cultural resources that may be impacted by DOE operations. This plan describes the organizations responsible for conducting environmental monitoring across the INL, the rationale for monitoring, the types of media being monitored, where the monitoring is conducted, and where monitoring results can be obtained. This plan presents a summary of the overall environmental monitoring performed in and around the INL without duplicating detailed information in the various monitoring procedures and program plans currently used to conduct monitoring.

  16. [Critical role of clinical laboratories in hospital infection control].

    Science.gov (United States)

    Yagi, Tetsuya

    2010-11-01

    The hospital infection control and prevention is recognized to be more and more important according to the advances in modern medical treatment and care. Clinical microbiology laboratory play critical roles in the hospital infection control as a member of infection control team (ICT). They are the first in a hospital to identify outbreak of MRSA in NICU and molecular epidemiological analysis of the isolates lead proper intervention of ICT to the concerned ward. From a viewpoint of infectious disease specialist, rapid and precise microbiological information is essential for the appropriate diagnosis and treatment of infectious diseases. Each medical technologist need to make efforts to understand the characteristics of the examinations for infectious diseases and send out information useful for clinical practices. In our hospital, with the participation of all members of medical technologists, rapid reporting system was developed for blood culture examinations, which greatly contribute to the appropriate treatment of bloodstream infections. Collaborations of clinical microbiology laboratory with other members of ICT realize high quality hospital infection control. They also need to be aware of themselves as good practitioners of infection control measures to prevent hospital infections.

  17. Calibration and field evaluation of polar organic chemical integrative sampler (POCIS) for monitoring pharmaceuticals in hospital wastewater

    International Nuclear Information System (INIS)

    Bailly, Emilie; Levi, Yves; Karolak, Sara

    2013-01-01

    The Polar Organic Chemical Integrative Sampler (POCIS) is a new tool for the sampling of organic pollutants in water. We tested this device for the monitoring of pharmaceuticals in hospital wastewater. After calibration, a field application was carried out in a French hospital for six pharmaceutical compounds (Atenolol, Prednisolone, Methylprednisolone, Sulfamethoxazole, Ofloxacin, Ketoprofen). POCIS were calibrated in tap water and wastewater in laboratory conditions close to relevant environmental conditions (temperature, flow velocity). Sampling rates (R s ) were determined and we observed a significant increase with flow velocity and temperature. Whatever the compound, the R s value was lower in wastewater and the linear phase of uptake was shorter. POCIS were deployed in a hospital sewage pipe during four days and the estimated water concentrations were close to those obtained with twenty-four hour composite samples. -- Highlights: ► Calibration of POCIS for the monitoring of pharmaceuticals in hospital wastewater. ► Uptake profile presents a shorter linear phase in wastewater than in tap water. ► Influence of R s values by temperature, flow velocity and bio-fouling. ► Correlation between concentrations estimated from POCIS or measured in TWA samples. ► Deployment period should be no longer than five days. -- After calibration in tap water and hospital wastewater, POCIS were used to monitor pharmaceuticals in hospital sewage and were compared to TWA sampling

  18. [Immunological monitoring in kidney transplantation: 13 years experience of a Moroccan histocompatibility laboratory].

    Science.gov (United States)

    Brick, C; Atouf, O; Essakalli, M

    2016-05-01

    The quality of the immunological monitoring is crucial because it determines the success of the kidney transplantation. The scope of this work is to describe the experience of the department of immunological unity of the Ibn Sina university hospital in Rabat regarding the immunological monitoring of patients transplanted between 2001 and 2014. Patient samples were collected from nephrology services of different public and private hospitals of Morocco. The tests conducted in the context of immunological monitoring are ABO typing, HLA-A, B, DR, DQ typing, anti-HLA antibodies detection and identification and cross-match. One hundred and fourteen benefited from a pre- and post-transplant immunological monitoring in our laboratory. The percentage of recipients having between 2 and 5 stored sera is 60.5 before transplantation and 56.1 after transplantation. Immunized patients account for 22.8% before the transplant and 17.6% after transplantation. Ninety-seven patients still have a functional graft, while 4 of them had DSA of low intensity before transplantation. Five immunological rejections were reported while the cross-match were negative and no DSA was identified before transplantation. Patient survival and graft at 1 year was 98.2% and 92.7% respectively. Conducting regular immunological monitoring is sometimes difficult in our context, however, the results are satisfactory in terms of graft and patients survival. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.

    Science.gov (United States)

    Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda

    2014-10-01

    Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.

  20. Perceptions and attitudes toward SLMTA amongst laboratory and hospital professionals in Ethiopia.

    Science.gov (United States)

    Lulie, Adino D; Hiwotu, Tilahun M; Mulugeta, Achamyeleh; Kebede, Adisu; Asrat, Habtamu; Abebe, Abnet; Yenealem, Dereje; Abose, Ebise; Kassa, Wondwossen; Kebede, Amha; Linde, Mary K; Ayana, Gonfa

    2014-01-01

    Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme. Assessing health professionals' views of SLMTA provides feedback to inform program planning, implementation and evaluation of SLMTA's training, communication and mentorship components. To assess laboratory professionals' and hospital chief executive officers' (CEOs) perceptions and attitudes toward the SLMTA programme in Ethiopia. A cross-sectional descriptive survey was conducted in March 2013 using a structured questionnaire to collect qualitative data from 72 laboratory professionals and hospital CEOs from 17 health facilities, representing all regions and two city administrations in Ethiopia. Focus groups were conducted with laboratory professionals and hospital administration to gain insight into the strengths and challenges of the SLMTA programme so as to guide future planning and implementation. Ethiopian laboratory professionals at all levels had a supportive attitude toward the SLMTA programme. They believed that SLMTA substantially improved laboratory services and acted as a catalyst for total healthcare reform and improvement. They also noted that the SLMTA programme achieved marked progress in laboratory supply chain, sample referral, instrument maintenance and data management systems. In contrast, nearly half of the participating hospital CEOs, especially those associated with low-scoring laboratories, were sceptical about the SLMTA programme, believing that the benefits of SLMTA were outweighed by the level of human resources and time commitment required. They also voiced concerns about the cost and sustainability of SLMTA. This study highlights the need for stronger engagement and advocacy with hospital administration and the importance of addressing concerns about the cost and sustainability of the SLMTA programme.

  1. Environmental monitoring report: Sandia Laboratories, 1976

    International Nuclear Information System (INIS)

    Simmons, T.N.

    1977-04-01

    Water and vegetation are monitored to determine Sandia Laboratories impact on the surrounding environment. Nonradioactive pollutants released are reported. Radioactive effluents are also reported and their person-rem contribution to the Albuquerque population is calculated. The environmental monitoring for calendar year 1976 shows that concentrations of radioactive materials in the Albuquerque area are typical of natural background for the area. An exception is a single onsite location where slightly abnormal uranium concentrations are expected. An estimated 0.044 person-rem Albuquerque area (80 km radius) population dose commitment results from calculated Sandia Laboratories releases. Over the same area 57,000 person-rem is accumulated from natural background. There were no measurable offsite radioactive effluent releases in CY 1976

  2. Environmental Monitoring Plan, Sandia National Laboratories, Livermore

    International Nuclear Information System (INIS)

    Holland, R.C.

    1992-06-01

    This Environmental Monitoring Plan was written to fulfill the requirements of DOE Order 5400.1 and DOE Environmental Regulatory Guide DOE/EH 0173T. This Plan documents the background, organizational structure, and methods used for effluent monitoring and environmental surveillance at Sandia National Laboratories, Livermore. The design, rationale, and historical results of the environmental monitoring system are discussed in detail. Throughout the Plan, recommendations for improvements to the monitoring system are made. 61 refs

  3. Perceptions and attitudes toward SLMTA amongst laboratory and hospital professionals in Ethiopia

    Directory of Open Access Journals (Sweden)

    Adino D. Lulie

    2014-11-01

    Full Text Available Background: Strengthening Laboratory Management Toward Accreditation (SLMTA is a competency-based management training programme. Assessing health professionals’ views of SLMTA provides feedback to inform program planning, implementation and evaluation of SLMTA's training, communication and mentorship components. Objectives: To assess laboratory professionals’ and hospital chief executive officers’ (CEOs perceptions and attitudes toward the SLMTA programme in Ethiopia. Methods: A cross-sectional descriptive survey was conducted in March 2013 using a structured questionnaire to collect qualitative data from 72 laboratory professionals and hospital CEOs from 17 health facilities, representing all regions and two city administrations in Ethiopia. Focus groups were conducted with laboratory professionals and hospital administration to gain insight into the strengths and challenges of the SLMTA programme so as to guide future planning and implementation. Results: Ethiopian laboratory professionals at all levels had a supportive attitude toward the SLMTA programme. They believed that SLMTA substantially improved laboratory services and acted as a catalyst for total healthcare reform and improvement. They also noted that the SLMTA programme achieved marked progress in laboratory supply chain, sample referral, instrument maintenance and data management systems. In contrast, nearly half of the participating hospital CEOs, especially those associated with low-scoring laboratories, were sceptical about the SLMTA programme, believing that the benefits of SLMTA were outweighed by the level of human resources and time commitment required. They also voiced concerns about the cost and sustainability of SLMTA. Conclusion: This study highlights the need for stronger engagement and advocacy with hospital administration and the importance of addressing concerns about the cost and sustainability of the SLMTA programme.

  4. Environmental monitoring report, Sandia Laboratories 1975

    International Nuclear Information System (INIS)

    Holley, W.L.; Simmons, T.N.

    1976-04-01

    Water and vegetation are monitored to determine Sandia Laboratories impact on the surrounding environment. Nonradioactive pollutants released are reported. Radioactive effluents are also reported and their person-rem contribution to the population is calculated

  5. A laboratory evaluation of color video monitors

    Energy Technology Data Exchange (ETDEWEB)

    Terry, P.L.

    1993-07-01

    Sandia National Laboratories has considerable experience with monochrome video monitors used in alarm assessment video systems. Most of these systems, used for perimeter protection, were designed to classify rather than to identify intruders. There is a growing interest in the identification function of security video systems for both access control and insider protection. Because color video technology is rapidly changing and because color information is useful for identification purposes, Sandia National Laboratories established a program to evaluate the newest relevant color video equipment. This report documents the evaluation of an integral component, color monitors. It briefly discusses a critical parameter, dynamic range, details test procedures, and evaluates the results.

  6. A laboratory evaluation of color video monitors

    International Nuclear Information System (INIS)

    Terry, P.L.

    1993-07-01

    Sandia National Laboratories has considerable experience with monochrome video monitors used in alarm assessment video systems. Most of these systems, used for perimeter protection, were designed to classify rather than to identify intruders. There is a growing interest in the identification function of security video systems for both access control and insider protection. Because color video technology is rapidly changing and because color information is useful for identification purposes, Sandia National Laboratories established a program to evaluate the newest relevant color video equipment. This report documents the evaluation of an integral component, color monitors. It briefly discusses a critical parameter, dynamic range, details test procedures, and evaluates the results

  7. Establishing a national biological laboratory safety and security monitoring program.

    Science.gov (United States)

    Blaine, James W

    2012-12-01

    The growing concern over the potential use of biological agents as weapons and the continuing work of the Biological Weapons Convention has promoted an interest in establishing national biological laboratory biosafety and biosecurity monitoring programs. The challenges and issues that should be considered by governments, or organizations, embarking on the creation of a biological laboratory biosafety and biosecurity monitoring program are discussed in this article. The discussion focuses on the following questions: Is there critical infrastructure support available? What should be the program focus? Who should be monitored? Who should do the monitoring? How extensive should the monitoring be? What standards and requirements should be used? What are the consequences if a laboratory does not meet the requirements or is not willing to comply? Would the program achieve the results intended? What are the program costs? The success of a monitoring program can depend on how the government, or organization, responds to these questions.

  8. Idaho National Laboratory Site Environmental Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Joanne L. Knight

    2012-08-01

    This plan describes environmental monitoring as required by U.S. Department of Energy (DOE) Order 450.1, “Environmental Protection Program,” and additional environmental monitoring currently performed by other organizations in and around the Idaho National Laboratory (INL). The objective of DOE Order 450.1 is to implement sound stewardship practices that protect the air, water, land, and other natural and cultural resources that may be impacted by DOE operations. This plan describes the organizations responsible for conducting environmental monitoring across the INL, the rationale for monitoring, the types of media being monitored, where the monitoring is conducted, and where monitoring results can be obtained. This plan presents a summary of the overall environmental monitoring performed in and around the INL without duplicating detailed information in the various monitoring procedures and program plans currently used to conduct monitoring.

  9. Idaho National Laboratory Site Environmental Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Joanne L. Knight

    2010-10-01

    This plan describes environmental monitoring as required by U.S. Department of Energy (DOE) Order 450.1, “Environmental Protection Program,” and additional environmental monitoring currently performed by other organizations in and around the Idaho National Laboratory (INL). The objective of DOE Order 450.1 is to implement sound stewardship practices that protect the air, water, land, and other natural and cultural resources that may be impacted by DOE operations. This plan describes the organizations responsible for conducting environmental monitoring across the INL, the rationale for monitoring, the types of media being monitored, where the monitoring is conducted, and where monitoring results can be obtained. This plan presents a summary of the overall environmental monitoring performed in and around the INL without duplicating detailed information in the various monitoring procedures and program plans currently used to conduct monitoring.

  10. Validation of a laboratory and hospital information system in a medical laboratory accredited according to ISO 15189.

    Science.gov (United States)

    Biljak, Vanja Radisic; Ozvald, Ivan; Radeljak, Andrea; Majdenic, Kresimir; Lasic, Branka; Siftar, Zoran; Lovrencic, Marijana Vucic; Flegar-Mestric, Zlata

    2012-01-01

    The aim of the study was to present a protocol for laboratory information system (LIS) and hospital information system (HIS) validation at the Institute of Clinical Chemistry and Laboratory Medicine of the Merkur University Hospital, Zagreb, Croatia. Validity of data traceability was checked by entering all test requests for virtual patient into HIS/LIS and printing corresponding barcoded labels that provided laboratory analyzers with the information on requested tests. The original printouts of the test results from laboratory analyzer(s) were compared with the data obtained from LIS and entered into the provided template. Transfer of data from LIS to HIS was examined by requesting all tests in HIS and creating real data in a finding generated in LIS. Data obtained from LIS and HIS were entered into a corresponding template. The main outcome measure was the accuracy of transfer obtained from laboratory analyzers and results transferred from LIS and HIS expressed as percentage (%). The accuracy of data transfer from laboratory analyzers to LIS was 99.5% and of that from LIS to HIS 100%. We presented our established validation protocol for laboratory information system and demonstrated that a system meets its intended purpose.

  11. [Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

    Science.gov (United States)

    Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

    2015-05-26

    The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

  12. Implementation of an occupational monitoring program in diagnostic radiology at the 'Hospital Universitario Clementino Fraga Filho'

    International Nuclear Information System (INIS)

    Oliveira, Sergio Ricardo de; Carvalho, Antonio Carlos Pires; Azevedo, Ana Cecilia Pedrosa de

    2003-01-01

    An occupational monitoring program in diagnostic radiology was implemented at the Hospital Clementino Fraga Filho of the Rio de Janeiro Federal University (UFRJ), Brazil, in accordance with the Brazilian legislation. Previously, a survey of all personnel involved with ionizing radiation was performed. Many problems were observed: the great majority of the workers were not properly monitored; only three departments of the hospital kept an independent survey of the occupational doses; there was not a follow-up control of the high doses. With the implementation of the program, a new laboratory was chosen to read the dosemeters and this initiative resulted in reduction of the hospital costs. The inclusion of seven more departments in the program represented an increase of 60% in the number of monitored workers. The program also provided a system to control the high doses, especially in the Hemodynamics department, which presented the highest mean dose value (0.32 mSv/month). An area survey program was performed during different periods in places considered of high risk for the workers and for the public as well. At the same time, a software was used to build a database with the aim of controlling all personnel data. The implementation of the program provided all personnel involved a better knowledge of the risks associated with ionizing radiation and of radioprotection, and also awareness of the need of correct use of the personal dose monitors. (author)

  13. Factors affecting the labor efficiency of hospital-based blood bank laboratories.

    Science.gov (United States)

    Lam, H C; Kominski, G F; Petz, L D; Sofaer, S

    1994-09-01

    A variety of financing mechanisms and managerial innovations have been developed in the past decade to control hospital costs. Some evidence suggests that those changes have not produced substantial improvements in labor efficiency among employees in the hospital's technical level, such as in the blood bank laboratories. This study measured labor efficiency in 40 hospital-based blood bank laboratories in Southern California during the year from July 1989 to June 1990 and explored the impact of financial, managerial, and operational factors on labor efficiency. With standardized output measures used in all blood bank laboratories, a wide variation of labor efficiency was found. Multivariate analyses indicate that the labor efficiency of blood bank employees was not influenced by organizational financial incentives, but was affected by the managerial styles of blood bank managers. Interpretation of the findings suggests that labor efficiency is affected by operational designs intended to improve responses to variable workloads and reduce slack time.

  14. Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia

    Directory of Open Access Journals (Sweden)

    Ibrahim MI

    2014-03-01

    Full Text Available Background: Therapeutic drug monitoring (TDM makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective: In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods: We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i cost of laboratory and clinical investigations, (ii cost associated with each gentamicin dose, (iii fixed and operating costs of TDM service, (iv cost of providing medical care, and (v cost of hospital stay during gentamicin treatment. Results: There were 1920 patients admitted with bronchopneumonia of which 67 (3.5% had TDM service for gentamicin. Seventy-three percent (49/67 patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02. Conclusion: Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization.

  15. Annual environmental monitoring report of the Lawrence Berkeley Laboratory, 1986

    International Nuclear Information System (INIS)

    Schleimer, G.E.

    1987-04-01

    The Environmental Monitoring Program of the Lawrence Berkeley Laboratory is described. Data for 1986 are presented and general trends are discussed. Topics include radiation monitoring, wastewater discharge monitoring, dose distribution estimates, and ground water monitoring. 9 refs., 8 figs., 20 tabs

  16. Water Quality & Pollutant Source Monitoring: Field and Laboratory Procedures. Training Manual.

    Science.gov (United States)

    Office of Water Program Operations (EPA), Cincinnati, OH. National Training and Operational Technology Center.

    This training manual presents material on techniques and instrumentation used to develop data in field monitoring programs and related laboratory operations concerned with water quality and pollution monitoring. Topics include: collection and handling of samples; bacteriological, biological, and chemical field and laboratory methods; field…

  17. Tritium monitoring at the Sandia Tritium Research Laboratory

    International Nuclear Information System (INIS)

    Devlin, T.K.

    1978-10-01

    Sandia Laboratories at Livermore, California, is presently beginning operation of a Tritium Research Laboratory (TRL). The laboratory incorporates containment and cleanup facilities such that any unscheduled tritium release is captured rather than vented to the atmosphere. A sophisticated tritium monitoring system is in use at the TRL to protect operating personnel and the environment, as well as ensure the safe and effective operation of the TRL decontamination systems. Each monitoring system has, in addition to a local display, a display in a centralized control room which, when coupled room which, when coupled with the TRL control computer, automatically provides an immediate assessment of the status of the entire facility. The computer controls a complex alarm array status of the entire facility. The computer controls a complex alarm array and integrates and records all operational and unscheduled tritium releases

  18. Environmental monitoring systems: a new type of mobile laboratory

    International Nuclear Information System (INIS)

    Bruecher, L.; Langmueller, G.; Tuerschmann, G.

    1999-01-01

    Nuclear facilities are obligated to monitor the environmental radiation in their vicinity, which is often fulfilled by monitoring cars, combined with fixed monitoring stations. The MOLAR Mobile Laboratory for Environmental Radiation Monitoring as described here is being used under normal and accident conditions as a spot check monitoring system or to perform continuous measurements along a driving track. The mobile laboratories are continuously connected with the control centre's CRCS Central Radiological Computer System, where the RIS Radiological Information System provides corresponding evaluation functions. The mobile labs contain measuring and controlling units like γ-dose rate monitors, γ-spectrometer with a HpGe High Purity Germanium detector, a lead shielded measuring cell and MCA Multi-Channel Analyser, portable β-contamination monitor, α/β/γ multipurpose quick measuring unit, aerosol and iodine sampling units. The collected samples are safely stored for the transport to the environmental laboratory for being analysed later. The geographical location of the moving car is continuously determined by the satellite based GPS Global Positioning System and transferred in the on-board rack mounted computer system for being stored and locally displayed. Real-time data transmission via radio and mobile phone is continuously performed to supply the RIS Radiological Information System in the control centre via radio and mobile phone. The latter also serves for voice communication. Currently three MOLAR systems can be operated parallel and independent from the control centre. The system is ready to be extended to more mobile labs. This combination of mobile monitoring, sample analysis and radiological assessment of environmental data in combination with process occurrences has turned out to be a powerful instrument for emergency preparedness and environmental supervising. (orig.) [de

  19. Test plan for demonstration of Rapid Transuranic Monitoring Laboratory

    International Nuclear Information System (INIS)

    McIsaac, C.V.; Sill, C.W.; Gehrke, R.J.; Killian, E.W.; Watts, K.D.

    1993-06-01

    This plan describes tests to demonstrate the capability of the Rapid Transuranic Monitoring Laboratory (RTML) to monitor airborne alpha-emitting radionuclides and analyze soil, smear, and filter samples for alpha- and gamma-emitting radionuclides under field conditions. The RTML will be tested during June 1993 at a site adjacent to the Cold Test Pit at the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. Measurement systems installed in the RTML that will be demonstrated include two large-area ionization chamber alpha spectrometers, an x-ray/gamma-ray spectrometer, and four alpha continuous air monitors. Test objectives, requirements for data quality, experimental apparatus and procedures, and safety and logistics issues are described

  20. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  1. Quality management system in hospital radiopharmacy laboratory

    International Nuclear Information System (INIS)

    Poch, Carolina; Rabiller, Graciela; Basualdo, Daniel A.; El Tamer, Elias A.

    2009-01-01

    Objective: 1) To determine the necessary conditions for increasing the complexity of the Radiopharmacy Laboratory and reach an operational level defined by the IAEA as 3a (Operational Guidance on Hospital Radiopharmacy). Our aim is that, within a framework of quality, last generation radiopharmaceuticals can be used, by sophisticated techniques such as labeling with bifunctional chelating agents, like HYNIC; 2) Consequently, we decided to implement a Quality Management System (QMS) in the field of Hospital Radiopharmacy in order to guarantee the safe and effective preparation and handling of radiopharmaceuticals for the diagnosis of patients, based on recommendations of the IAEA. Procedure For the implementation of the QMS, the sector of Radiopharmacy was capacitated in the application of ISO 9001. In a first stage it had begun with the formulation of the main documents and their enumeration. According to the recommendations of the IAEA Operational Guide, this year we proceeded to the optimization of the documents produced in the first stage and formulation of new documents essential to the improvement of work in the Radiopharmacy Laboratory. Results: Corrections were made to the performed procedures, and new ones were composed such as: Reception of raw materials, Control dose calibrator (Activity meter), General procedure of dosage, Procedure for decontamination, for Using the bio safety cabinet, for Cleaning the hot laboratory, etc. The Quality Controls were added to each of the Work Instructions of radiopharmaceuticals to be undertaken and how and when to carry out, with their respective references. Records were modified and new ones incorporated, in order to ensure traceability of the results before and after injection. Finally, the require documentation has been completed with the addition of the Staff Training Plan, and other records such as Nonconformance and Corrective and Preventive Actions. Conclusion: With the application of a QMS correctly implemented

  2. Sandia National Laboratories 1979 environmental monitoring report

    International Nuclear Information System (INIS)

    Simmons, T.N.

    1980-04-01

    Sandia National Laboratories in Albuquerque is located south of the city on two broad mesas. The local climate is arid continental. Radionuclides are released from five technical areas from the Laboratories' resarch activities. Sandia's environmental monitoring program searches for cesium-137, tritium, uranium, alpha emitters, and beta emitters in water, soil, air, and vegetation. No activity was found in public areas in excess of local background in 1979. The Albuquerque population receives only 0.076 person-rem (estimated) from airborne radioactive releases. While national security research is the laboratories' major responsibility, energy research is a major area of activity. Both these research areas cause radioactive releases

  3. Assessing hospitals' clinical risk management: Development of a monitoring instrument

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2010-12-01

    Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  4. Assessing hospitals' clinical risk management: Development of a monitoring instrument.

    Science.gov (United States)

    Briner, Matthias; Kessler, Oliver; Pfeiffer, Yvonne; Wehner, Theo; Manser, Tanja

    2010-12-13

    Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  5. Radiation exposure of non-monitored hospital personnel

    International Nuclear Information System (INIS)

    Renaud, L.; Blanchette, J.; Galand, C.

    1993-02-01

    This project investigated the radiological impact of nuclear medicine patients on non-monitored personnel in hospital environments. More than 800 workers and 135 specific areas in three Quebec hospitals were surveyed daily during a six-month period with Geiger counters, TLD badges, and TLD chips. Average dose rates of up to 2.2 μSv/h were measured in some waiting areas. The radiation level of a nursing unit is a direct function of the ambulatory radioactivity carried by nuclear medicine patients. Three percent of the workers surveyed had a work-related dose in excess of 0.3 mSv/6 months (maximum 1.4 mSv/6 months). Over 88 percent were in the range between local background and 0.3 mSv/6 months. Less than 4 percent belong to groups of workers who were exposed to a level indistinguishable from background. Thus many workers surveyed in this study receive a work-related dose similar to those of medical workers monitored by Health and Welfare Canada. The average annual dose for these workers was 104 person-millisieverts. The authors recommend: better management of radioactive patients; the provision of information and education for all hospital workers having regular contact with radioactive patients; and the facilitation of the identification of nuclear medicine patients within the hospital environment. (28 tabs., 23 figs.)

  6. Knowledge, attitude and practice of aspects of laboratory safety in Pathology Laboratories at the University of Port Harcourt Teaching Hospital, Nigeria.

    Science.gov (United States)

    Ejilemele, A A; Ojule, A C

    2005-12-01

    To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital. Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge--related hazards, infective hazards waste disposal and provision and use of First Aid Kits. Issues pertaining to laboratory safety are not yet given adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/AIDS and Hepatitis Band C, is emphasized.

  7. Improving Gram stain proficiency in hospital and satellite laboratories that do not have microbiology.

    Science.gov (United States)

    Guarner, Jeannette; Street, Cassandra; Matlock, Margaret; Cole, Lisa; Brierre, Francoise

    2017-03-01

    Consolidation of laboratories has left many hospitals and satellite laboratories with minimal microbiologic testing. In many hospitals and satellite laboratories, Gram stains on primary specimens are still performed despite difficultly in maintaining proficiency. To maintain Gram stain proficiency at a community 450-bed hospital with an active emergency room we designed bimonthly challenges that require reporting Gram staining and morphology of different organisms. The challenges consist of five specimens prepared by the reference microbiology laboratory from cultures and primary specimens. Twenty to 23 medical laboratory scientists participate reading the challenges. Results from the challenges are discussed with each medical laboratory scientists. In addition, printed images from the challenges are presented at huddle to add microbiology knowledge. On the first three challenges, Gram staining was read correctly in 71%-77% of the time while morphology 53%-66%. In the last six challenges correct answers for Gram stain were 77%-99% while morphology 73%-96%. We observed statistically significant improvement when reading Gram stains by providing frequent challenges to medical laboratory scientists. The clinical importance of Gram stain results is emphasized during huddle presentations increasing knowledge and motivation to perform the test for patients.

  8. Annual environmental monitoring report of the Lawrence Berkeley Laboratory, 1980

    International Nuclear Information System (INIS)

    Schleimer, G.E.

    1981-04-01

    The Environmental Monitoring Program of the Lawrence Berkeley Laboratory is described. Data on air and water sampling and continuous radiation monitoring for 1980 are presented, and general trends are discussed

  9. Boston City Hospital and the Thorndike Memorial Laboratory: the birth of modern haematology.

    Science.gov (United States)

    Elrod, Jeffrey M; Karnad, Anand B

    2003-05-01

    Established in 1923, the Thorndike Memorial Laboratory at Boston City Hospital was the first clinical research laboratory in a municipal hospital in the United States of America. Minot and Castle, who were the second and third directors of the Laboratory, were pioneer haematologists and clinical investigators of the highest calibre who created an atmosphere at the Laboratory that would foster patient-centred research and attract the best physician-scientists to work and train there. The haematology research division of the Laboratory made important original contributions to the understanding of the pathophysiology of anaemia, the mechanisms of red cell and platelet destruction and the phagocytic role of the spleen, the nature of haemoglobin (normal and sickle cell), the nature of haemophilia and its therapy and the early classification of lymphoma. It contributed to the Thorndike Memorial Laboratory's worldwide reputation as a model research laboratory and established its reputation as the birthplace of modern haematology.

  10. When are fume-cupboards necessary in hospital radioisotope laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Birks, J L [Singleton Hospital, Swansea (UK)

    1976-06-01

    Suggestions are made for procedures likely to require the provision of efficient fume-cupboards in hospital radioisotope laboratories. All such departments undertaking in vivo radioisotope procedures will require a supply of sterile materials, but only some of these will also require a fume-cupboard, since the use of a relatively inexpensive aseptic cabinet, without air flow and exhaust system, may suffice for such procedures as the labelling of blood cells or plasma. Efficient fume-cupboards may be required in hospital laboratories that are routinely concerned with the elution of generators of isotopes such as /sup 99/Tcsup(m) and /sup 113/Insup(m), the sterilization of radiopharmaceuticals (e.g. technetium-sulphur colloid) requiring the use of a pressure cooker, and the storage and handling of therapeutic quantities of /sup 131/I. Copious general ventilation of isotope rooms may be preferable to the too frequent incorporation of unnecessary fume-cupboards.

  11. Implementation of ISO 17025 in the Eletronuclear Environmental Monitoring Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Baliza, Ana Rosa; Caetano, Carla de Brito, E-mail: baliza@eletronuclear.gov.br [Eletrobrás Termonuclear S.A. (ELETRONUCLEAR), Angra dos Reis, RJ (Brazil)

    2017-07-01

    In order to grant Angra 3 power plant operation license, the Brazilian Institute for the Environment and Renewable Natural Resources (IBAMA), in the IBAMA Installation License 591/2009 condition 2.24, required that Eletronuclear has to obtain the Environmental Monitoring Laboratory accreditation, in accordance with the requirements of NBR ISO / IEC 17025 standard. The accreditation is the formal recognition that a laboratory has a quality assurance system and technical competence to perform specific tests, evaluated according to the criteria based on NBR ISO/IEC 17025 (General requirements for testing and calibration laboratories competence) standard. In Brazil, the General Accreditation Coordination (CGCRE), according to the guidelines already explained by the Brazilian System of Conformity Assessment (INMETRO), does accreditation. The INMETRO is the only official accrediting body in Brazil and internationally recognized by the International Accreditation Forum (IAF). The Environmental Monitoring Laboratory at Eletronuclear is an analytical laboratory of chemical, radiochemical and biological tests, which analyzes several matrices, such as seawater, river water, marine sediment, beach sand, soil, pasture, banana, milk, besides marine sea life, around the Central Almirante Álvaro Alberto power plant station. It is licensed by CNEN, INEA, IBAMA and it follows national and international standards in the performance of the tests as well as in the collection and preparation of samples. This article describes the main steps that the Eletronuclear Environmental Monitoring Laboratory followed to implement ISO 17025. (author)

  12. Implementation of ISO 17025 in the Eletronuclear Environmental Monitoring Laboratory

    International Nuclear Information System (INIS)

    Baliza, Ana Rosa; Caetano, Carla de Brito

    2017-01-01

    In order to grant Angra 3 power plant operation license, the Brazilian Institute for the Environment and Renewable Natural Resources (IBAMA), in the IBAMA Installation License 591/2009 condition 2.24, required that Eletronuclear has to obtain the Environmental Monitoring Laboratory accreditation, in accordance with the requirements of NBR ISO / IEC 17025 standard. The accreditation is the formal recognition that a laboratory has a quality assurance system and technical competence to perform specific tests, evaluated according to the criteria based on NBR ISO/IEC 17025 (General requirements for testing and calibration laboratories competence) standard. In Brazil, the General Accreditation Coordination (CGCRE), according to the guidelines already explained by the Brazilian System of Conformity Assessment (INMETRO), does accreditation. The INMETRO is the only official accrediting body in Brazil and internationally recognized by the International Accreditation Forum (IAF). The Environmental Monitoring Laboratory at Eletronuclear is an analytical laboratory of chemical, radiochemical and biological tests, which analyzes several matrices, such as seawater, river water, marine sediment, beach sand, soil, pasture, banana, milk, besides marine sea life, around the Central Almirante Álvaro Alberto power plant station. It is licensed by CNEN, INEA, IBAMA and it follows national and international standards in the performance of the tests as well as in the collection and preparation of samples. This article describes the main steps that the Eletronuclear Environmental Monitoring Laboratory followed to implement ISO 17025. (author)

  13. A prospective survey of air and surface fungal contamination in a medical mycology laboratory at a tertiary care university hospital.

    Science.gov (United States)

    Sautour, Marc; Dalle, Frédéric; Olivieri, Claire; L'ollivier, Coralie; Enderlin, Emilie; Salome, Elsa; Chovelon, Isabelle; Vagner, Odile; Sixt, Nathalie; Fricker-Pap, Véronique; Aho, Serge; Fontaneau, Olivier; Cachia, Claire; Bonnin, Alain

    2009-04-01

    Invasive filamentous fungi infections resulting from inhalation of mold conidia pose a major threat in immunocompromised patients. The diagnosis is based on direct smears, cultural symptoms, and culturing fungi. Airborne conidia present in the laboratory environment may cause contamination of cultures, resulting in false-positive diagnosis. Baseline values of fungal contamination in a clinical mycology laboratory have not been determined to date. A 1-year prospective survey of air and surface contamination was conducted in a clinical mycology laboratory during a period when large construction projects were being conducted in the hospital. Air was sampled with a portable air system impactor, and surfaces were sampled with contact Sabouraud agar plates. The collected data allowed the elaboration of Shewhart graphic charts. Mean fungal loads ranged from 2.27 to 4.36 colony forming units (cfu)/m(3) in air and from 0.61 to 1.69 cfu/plate on surfaces. Strict control procedures may limit the level of fungal contamination in a clinical mycology laboratory even in the context of large construction projects at the hospital site. Our data and the resulting Shewhart graphic charts provide baseline values to use when monitoring for inappropriate variations of the fungal contamination in a mycology laboratory as part of a quality assurance program. This is critical to the appropriate management of the fungal risk in hematology, cancer and transplantation patients.

  14. Annual environmental monitoring report of the Lawrence Berkeley Laboratory

    International Nuclear Information System (INIS)

    Schleimer, G.E.

    1989-06-01

    The Environmental Monitoring Program of the Lawrence Berkeley Laboratory (LBL) is described. Data for 1988 are presented and general trends are discussed. In order to establish whether LBL research activities produced any impact on the population surrounding the laboratory, a program of environmental air and water sampling and continuous radiation monitoring was carried on throughout the year. For 1988, as in the previous several years, dose equivalents attributable to LBL radiological operations were a small fraction of both the relevant radiation protection guidelines (RPG) and of the natural radiation background. 16 refs., 7 figs., 21 tabs

  15. Annual environmental monitoring report of the Lawrence Berkeley Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Schleimer, G.E. (ed.)

    1989-06-01

    The Environmental Monitoring Program of the Lawrence Berkeley Laboratory (LBL) is described. Data for 1988 are presented and general trends are discussed. In order to establish whether LBL research activities produced any impact on the population surrounding the laboratory, a program of environmental air and water sampling and continuous radiation monitoring was carried on throughout the year. For 1988, as in the previous several years, dose equivalents attributable to LBL radiological operations were a small fraction of both the relevant radiation protection guidelines (RPG) and of the natural radiation background. 16 refs., 7 figs., 21 tabs.

  16. Monitoring of performance management using Quality Assurance Indicators and ISO requirement

    Directory of Open Access Journals (Sweden)

    Dargahi H

    2007-06-01

    Full Text Available Background: Quality assurance is a prevention-oriented system that can be used to improve the quality of care, increase productivity and monitor the performance management in clinical laboratories. ISO 9001: 2000 requirements are a collection of management and technical systems designed to implement quality assurance and monitor performance management in organizations. Methods: A checklist was prepared to monitor the preanalytical, analytical and postanalytical stages of laboratory performance management in 16 areas and all laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical Sciences (TUMS hospitals. Collected data were stored and statistically analyzed using SPSS software. Results: The best performance, in which 77.73% of quality assurance indicators were observed, was found in Sina Hospital. However, only 57.56% of these indicators were fulfilled at Farabi Hospital, with the lowest-level performance among the clinical laboratories of TUMS hospitals. The highest level of compliance with quality assurance indicators was in the hematology departments and for facility demands in management areas. Overall, quality assurance indicators were appropriately followed in only 7% of the clinical laboratories. Conclusion: The average quality assurance observation rate in the clinical laboratories studied was 67.22%, which is insufficient and must be remedied with stricter enforcement of the ISO 9001: 2000 regulations.

  17. [Monitoring evaluation system for high-specialty hospitals].

    Science.gov (United States)

    Fajardo Dolci, Germán; Aguirre Gas, Héctor G; Robledo Galván, Héctor

    2011-01-01

    Hospital evaluation is a fundamental process to identify medical units' objective compliance, to analyze efficiency of resource use and allocation, institutional values and mission alignment, patient safety and quality standards, contributions to research and medical education, and the degree of coordination among medical units and the health system as a whole. We propose an evaluation system for highly specialized regional hospitals through the monitoring of performance indicators. The following are established as base thematic elements in the construction of indicators: safe facilities and equipment, financial situation, human resources management, policy management, organizational climate, clinical activity, quality and patient safety, continuity of care, patients' and providers' rights and obligations, teaching, research, social responsibility, coordination mechanisms. Monitoring refers to the planned and systematic evaluation of valid and reliable indicators, aimed at identifying problems and opportunity areas. Moreover, evaluation is a powerful tool to strengthen decision-making and accountability in medical units.

  18. Computerized plutonium laboratory-stack monitoring system

    International Nuclear Information System (INIS)

    Stafford, R.G.; DeVore, R.K.

    1977-01-01

    The Los Alamos Scientific Laboratory has recently designed and constructed a Plutonium Research and Development Facility to meet design criteria imposed by the United States Energy Research and Development Administration. A primary objective of the design criteria is to assure environmental protection and to reliably monitor plutonium effluent via the ventilation exhaust systems. A state-of-the-art facility exhaust air monitoring system is described which establishes near ideal conditions for evaluating plutonium activity in the stack effluent. Total and static pressure sensing manifolds are incorporated to measure average velocity and integrated total discharge air volume. These data are logged at a computer which receives instrument data through a multiplex scanning system. A multipoint isokinetic sampling assembly with associated instrumentation is described. Continuous air monitors have been designed to sample from the isokinetic sampling assembly and transmit both instantaneous and integrated stack effluent concentration data to the computer and various cathode ray tube displays. The continuous air monitors also serve as room air monitors in the plutonium facility with the primary objective of timely evacuation of personnel if an above tolerance airborne plutonium concentration is detected. Several continuous air monitors are incorporated in the ventilation system to assist in identification of release problem areas

  19. Environmental Monitoring Of Microbiological Laboratory: Expose Plate Method

    International Nuclear Information System (INIS)

    Yahaya Talib; Othman Mahmud; Noraisyah Mohd Yusof; Asmah Mohibat; Muhamad Syazwan Zulkifli

    2013-01-01

    Monitoring of microorganism is important and conducted regularly on environment of microbiological laboratory at Medical Technology Division. Its objective is to ensure the quality of working environment is maintained according to microbial contamination, consequently to assure the quality of microbiological tests. This paper presents report of environmental monitoring since year 2007. The test involved was bacterial colony counts after the growth media was exposed to air at identified location. (author)

  20. Clinical and laboratory signs associated to serious dengue disease in hospitalized children

    Directory of Open Access Journals (Sweden)

    Sheila Moura Pone

    2016-09-01

    Conclusions: Lethargy, abdominal distension, pleural effusion, and hypoalbuminemia were the best clinical and laboratorial markers of serious dengue disease in hospitalized children, while bleeding, severe hemorrhage, hemoconcentration and thrombocytopenia did not reach adequate diagnostic accuracy. In pediatric referral hospitals, the absence of hemoconcentration does not imply absence of plasma leakage, particularly in children with previous fluid replacement. These findings may contribute to the clinical management of dengue in children at referral hospitals.

  1. The future of hospital laboratories. Position statement from the Royal Belgian Society of Clinical Chemistry (RBSCC).

    Science.gov (United States)

    Langlois, Michel R; Wallemacq, Pierre

    2009-01-01

    To face the economic pressures arising from the current socio-economic conjuncture, hospital laboratories are endangered by an increasing trend towards the outsourcing of clinical laboratory tests to external (mega-) laboratories. This should allow hospitals to meet their economic requirements, but with an increased risk of loss of medical quality and, mid- to long-term, loss of cost effectiveness of healthcare at the national level. To anticipate current developments (economical and technological) that inevitably will affect the future of laboratory medicine, hospital laboratories should be proactive and enhance efficiency, reduce costs by consolidation, integrate into regional networks, and form alliances or partnerships. To create additional value, the core competency of laboratory professionals must be refocused to provide medical knowledge services (consultative support to clinicians) related to in vitro diagnostic testing. To integrate cost-efficiency with medical quality, implementation of a matricial organization - operational vs. biomedical level - could be an interesting approach. This integrated structure should create total quality of laboratory testing, managing the entire medical diagnostic cycle from the pre-preanalytical to post-postanalytical phase.

  2. Costs of examinations performed in a hospital laboratory in Chile.

    Science.gov (United States)

    Andrade, Germán Lobos; Palma, Carolina Salas

    2018-01-01

    To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.

  3. Environmental monitoring at the Lawrence Livermore Laboratory. 1979 annual report

    International Nuclear Information System (INIS)

    Silver, W.J.; Lindeken, C.L.; White, J.H.; Buddemeir, R.W.

    1980-01-01

    Information on monitoring activities is reported in two sections for EDB/ERA/INIS. The first section covers all information reported except Appendix D, which gives details of sampling and analytical procedures for environmental monitoring used at Lawrence Livermore Laboratory. A separate abstract was prepared for Appendix D

  4. A test for monitoring under- and overtreatment in Dutch hospitals

    OpenAIRE

    Lenz, Oliver Urs; Oberski, Daniel L

    2017-01-01

    Over- and undertreatment harm patients and society and confound other healthcare quality measures. Despite a growing body of research covering specific conditions, we lack tools to systematically detect and measure over- and undertreatment in hospitals. We demonstrate a test used to monitor over- and undertreatment in Dutch hospitals, and illustrate its results applied to the aggregated administrative treatment data of 1,836,349 patients at 89 hospitals in 2013. We employ a random effects mod...

  5. Environmental monitoring at the Lawrence Livermore National Laboratory: 1980 annual report

    International Nuclear Information System (INIS)

    Toy, A.J.; Lindeken, C.L.; Griggs, K.S.; Buddemeier, R.W.

    1981-01-01

    The results of environmental monitoring for 1980 at the Livermore National Laboratory are presented. Radioactivity in air, soil, sewage, water, vegetation and food, and milk was measured. Noise pollution, beryllium, heavy metals, and pesticides were monitored

  6. Microbiological Standardization in Small Laboratory Animals and Recommendations for the Monitoring

    Directory of Open Access Journals (Sweden)

    Meral Karaman

    2014-03-01

    Full Text Available Microbiological standardization in laboratory animal breeding is based on the classification according to the microorganisms that the animals host and consequently their upbringing environment, as well as the certification of their microbiological status and the protection of their properties. Although there are many different classifications for microbiological standardization of laboratory animals, they can be basically classified as; gnotobiotic animals, animals bred with a complete barrier system (Germ free, GF, with Colonization-Resistant Flora; CRF, animals bred with a partial barrier system (Specified Pathogen Free, SPF, and animals bred by conventional methods in units without barriers (Conventional; CV. Monitoring of microbiological standardization is carried out in two ways. One is controlling barrier systems (process control and the other is controlling laboratory animals (product control. In controlling barrier systems samples are taken routinely from ambient air, surfaces, base plate materials of animals, foods and waters, and microbiological tests are carried out. FELASA guidelines are frequently used in monitoring laboratory animals. These guidelines where the monitoring frequency, sample size, micro-organisms to be tested, vary according to the microbiological quality of the animals, and test methods and are frequently updated by FELASA and shared in their web pages. In our country, in general, laboratory animals used for experimental studies present no microbiological standardization, and follow-up protocols are not implemented. Therefore, construction of facilities for the production of microbiologically standard animals and establishment of backup laboratories testing microbiological quality should be established.

  7. Idaho National Laboratory Site Environmental Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Nordstrom, Jenifer [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-02-01

    This plan provides a high-level summary of environmental monitoring performed by various organizations within and around the Idaho National Laboratory (INL) Site as required by U.S. Department of Energy (DOE) Order 435.1, Radioactive Waste Management, and DOE Order 458.1, Radiation Protection of the Public and the Environment, Guide DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance, and in accordance with 40 Code of Federal Regulations (CFR) 61, National Emission Standards for Hazardous Air Pollutants. The purpose of these orders is to 1) implement sound stewardship practices that protect the air, water, land, and other natural and cultural resources that may be impacted by DOE operations, and 2) to establish standards and requirements for the operations of DOE and DOE contractors with respect to protection of the environment and members of the public against undue risk from radiation. This plan describes the organizations responsible for conducting environmental monitoring across the INL Site, the rationale for monitoring, the types of media being monitored, where the monitoring is conducted, and where monitoring results can be obtained. Detailed monitoring procedures, program plans, or other governing documents used by contractors or agencies to implement requirements are referenced in this plan. This plan covers all planned monitoring and environmental surveillance. Non-routine activities such as special research studies and characterization of individual sites for environmental restoration are outside the scope of this plan.

  8. Facility Effluent Monitoring Plan for the 325 Radiochemical Processing Laboratory

    International Nuclear Information System (INIS)

    Shields, K.D.; Ballinger, M.Y.

    1999-03-01

    This Facility Effluent Monitoring Plan (FEMP) has been prepared for the 325 Building Radiochemical Processing Laboratory (RPL) at the Pacific Northwest National Laboratory (PNNL) to meet the requirements in DOE Order 5400.1, ''General Environmental Protection Programs.'' This FEMP has been prepared for the RPL primarily because it has a ''major'' (potential to emit >0.1 mrem/yr) emission point for radionuclide air emissions according to the annual National Emission Standards for Hazardous Air Pollutants (NESHAP) assessment performed. This section summarizes the airborne and liquid effluents and the inventory based NESHAP assessment for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements. The RPL at PNNL houses radiochemistry research, radioanalytical service, radiochemical process development, and hazardous and radioactive mixed waste treatment activities. The laboratories and specialized facilities enable work ranging from that with nonradioactive materials to work with picogram to kilogram quantities of fissionable materials and up to megacurie quantities of other radionuclides. The special facilities within the building include two shielded hot-cell areas that provide for process development or analytical chemistry work with highly radioactive materials and a waste treatment facility for processing hazardous, mixed radioactive, low-level radioactive, and transuranic wastes generated by PNNL activities

  9. Facility Effluent Monitoring Plan for the 325 Radiochemical Processing Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Shields, K.D.; Ballinger, M.Y.

    1999-04-02

    This Facility Effluent Monitoring Plan (FEMP) has been prepared for the 325 Building Radiochemical Processing Laboratory (RPL) at the Pacific Northwest National Laboratory (PNNL) to meet the requirements in DOE Order 5400.1, ''General Environmental Protection Programs.'' This FEMP has been prepared for the RPL primarily because it has a ''major'' (potential to emit >0.1 mrem/yr) emission point for radionuclide air emissions according to the annual National Emission Standards for Hazardous Air Pollutants (NESHAP) assessment performed. This section summarizes the airborne and liquid effluents and the inventory based NESHAP assessment for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements. The RPL at PNNL houses radiochemistry research, radioanalytical service, radiochemical process development, and hazardous and radioactive mixed waste treatment activities. The laboratories and specialized facilities enable work ranging from that with nonradioactive materials to work with picogram to kilogram quantities of fissionable materials and up to megacurie quantities of other radionuclides. The special facilities within the building include two shielded hot-cell areas that provide for process development or analytical chemistry work with highly radioactive materials and a waste treatment facility for processing hazardous, mixed radioactive, low-level radioactive, and transuranic wastes generated by PNNL activities.

  10. Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

    Science.gov (United States)

    Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

    2014-12-01

    The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

  11. Development of personnel radiation monitoring program for occupationally exposed workers in Malawian Hospitals : A case study of Kamuzu Central, Bwaila and Mtengo Wa Nthenga Hospitals

    International Nuclear Information System (INIS)

    Chinangwa, Getrude

    2016-07-01

    Malawi became an IAEA member state in 2006 and developed the Atomic Energy Act and Regulations in 2011 and 2012 respectively. However, regulatory authority and personnel monitoring services have not yet been established. As such, hospitals operating radiological services in Malawi do not have personnel monitoring programme. This study aimed at developing the personnel radiation monitoring program for three hospitals in Malawi namely; Kamuzu Central Hospital, Bwaila Hospital, and Mtengo wa Nthenga Hospital. A radiation protection questionnaire was administered to the X-ray Departments involved in the study to investigate radiation protection practices in the hospitals. Dose rate measurements in the facilities were taken using survey meters and doses to individuals were recorded using personal dosimeters. The results showed that the hospitals lack radiation protection program which covers the critical issues of quality assurance and control as well as the personnel dose monitoring. Average ambient dose rate values were 0.39 μSv/hr for Mtengo wa Nthenga Hospital, 5.03 μSv/hr for Bwaila Hospital and 4μSv/hr for Kamuzu Central Hospital. Average monthly dose for workers was 0.247 mSv. The study recommends the establishment of a regulatory authority, consistent dose assessment, quality control tests and structural shielding assessment in these and probably all the diagnostic facilities in Malawi. The personnel monitoring programme developed from this study is intended to guide diagnostic facilities and personnel monitoring service providers in Malawi in tracking and reporting exposure record for their occupationally exposed workers. (au)

  12. Clinical and laboratory signs associated to serious dengue disease in hospitalized children

    Directory of Open Access Journals (Sweden)

    Sheila Moura Pone

    Full Text Available Abstract Objective: To evaluate the validity of clinical and laboratory signs to serious dengue disease in hospitalized children. Methods: Retrospective cohort of children (19 and negative likelihood ratio <0.6. Pleural effusion and abdominal distension had higher sensitivity (82.6%. History of bleeding (epistaxis, gingival or gastrointestinal bleeding and severe hemorrhage (pulmonary or gastrointestinal bleeding in physical examination were more frequent in serious dengue disease (p < 0.01, but with poor accuracy (positive likelihood ratio = 1.89 and 3.89; negative likelihood ratio = 0.53 and 0.60, respectively. Serum albumin was lower in serious dengue forms (p < 0.01. Despite statistical significance (p < 0.05, both groups presented thrombocytopenia. Platelets count, hematocrit, and hemoglobin parameters had area under the curve <0.5. Conclusions: Lethargy, abdominal distension, pleural effusion, and hypoalbuminemia were the best clinical and laboratorial markers of serious dengue disease in hospitalized children, while bleeding, severe hemorrhage, hemoconcentration and thrombocytopenia did not reach adequate diagnostic accuracy. In pediatric referral hospitals, the absence of hemoconcentration does not imply absence of plasma leakage, particularly in children with previous fluid replacement. These findings may contribute to the clinical management of dengue in children at referral hospitals.

  13. The Coordinating Laboratories for monitoring of environmental radioactivity. History, activities, perspectives

    International Nuclear Information System (INIS)

    Wiechen, A.; Bayer, A.

    2000-10-01

    The article reviews the development of the monitoring of environmental radioactivity in the former Federal Republic of Germany and from 1990 onwards in re-unified Germany. This monitoring originated in the need to investigate the radioactive fallout from the testing of atomic bombs in the atmosphere in the 1950's and 1960's. Monitoring was intensified and became increasingly regulated by law as a response to the large scale use of atomic power and in accordance with the Euratom Treaty of 1957. The necessity of evaluating the radiological effects in old mining regions in some of the new Laender was recognised in 1990. Since then legislation and official monitoring have been extended to include this source of radiation exposure. Also described is the way in which those institutions now termed Coordinating Laboratories were involved in all of the developments mentioned above. They tested and developed sampling, analysis and measurement techniques, carried out research projects on the various contamination pathways, reported regularly on environmental radioactivity and radiation exposure, organised and evaluated interlaboratory comparisons, assisted in the setting up of the Federal Integrated Measurement and Information System (IMIS), and advised the appropriate Federal and Laender Ministries. Some of the Coordinating Laboratories also manage Federal Monitoring Networks. The Precautionary Radiation Protection Act stipulates these tasks and names the institutions appointed as Coordinating Laboratories. (orig.) [de

  14. Monitoring technology and firm boundaries: physician-hospital integration and technology utilization.

    Science.gov (United States)

    McCullough, Jeffrey S; Snir, Eli M

    2010-05-01

    We study the relationship between physician-hospital integration and its relation to monitoring IT utilization. We develop a theoretical model in which monitoring IT may complement or substitute for integration and test these relationships using a novel data source. Physician labor market heterogeneity identifies the empirical model. We find that monitoring IT utilization is increasing in integration, implying that expanded firm boundaries complement monitoring IT adoption. We argue that the relationship between monitoring IT and firm boundaries depends upon the contractibility of the monitored information.

  15. Urine Creatinine Concentrations in Drug Monitoring Participants and Hospitalized Patients.

    Science.gov (United States)

    Love, Sara A; Seegmiller, Jesse C; Kloss, Julie; Apple, Fred S

    2016-10-01

    Urine drug testing is commonly performed in both clinical and forensic arenas for screening, monitoring and compliance purposes. We sought to determine if urine creatinine concentrations in monitoring program participants were significantly different from hospital in-patients and out-patients undergoing urine drug testing. We retrospectively reviewed urine creatinine submitted in June through December 2015 for all specimens undergoing urine drug testing. The 20,479 creatinine results were categorized as hospitalized patients (H) and monitoring/compliance groups for pain management (P), legal (L) or recovery (R). Median creatinine concentrations (interquartile range, mg/dL) were significantly different (P creatinine concentrations were significantly lower in the R vs. L group (Pcreatinine concentration and may indicate participants' attempts to tamper with their drug test results through dilution means. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Evaluating effectiveness of infection control efforts in hospitals using information in microbiological laboratory databases.

    Science.gov (United States)

    Saito, Norihiro; Itoga, Masamichi; Kimura, Masahiko; Inoue, Fumio; Minakawa, Satoko; Kimura, Toshiyuki; Ozaki, Hiromi; Saito, Yumiko; Takahashi, Mikiko; Fujishima, Tetsuhiro; Mizuno, Sumie; Ogawa, Shin; Kitayama, Yuko; Kudo, Kazumi; Minami, Kazushi; Abo, Fumiko; Takano, Yasuyuki; Ohdaira, Naotake; Hamada, Satoshi; Ueki, Shigeharu; Hirokawa, Makoto; Kayaba, Hiroyuki

    2017-12-01

    To analyze the quality of infection control activities, bacteriological data relevant to infection control was evaluated through the microbiological data warehouse networking hospitals in two medical regions. Data regarding bacterial test results of 19 hospitals were extracted from two microbiological laboratory information data bases. The rate of MRSA among total S. aureus was used as a general indicator of infection control activities. The occupancy rate of nasal or pharyngeal swabs among MRSA-positive bacteriological samples was used as an indicator of attention paid for infection control in intensive care wards. The number of blood culture sets per examined patient was utilized as an indicator for life-long vocational education on updated medical practice relevant to infectious diseases. The rate of MRSA was significantly higher in secondary private hospitals. The occupancy rate of nasal or pharyngeal swabs was significantly higher in tertiary hospitals. The average number of blood culture set per examined patient were 1.55, 1.54 and 1.39 in tertiary, secondary public and secondary private hospitals, respectively; however, there were no statistical differences between groups. Data bases of microbiological test results shared by hospital laboratories are useful for evaluating regional infection control activities.

  17. Experience of TLD personnel monitoring laboratory

    International Nuclear Information System (INIS)

    Jakhete, Prashant

    2002-01-01

    Full text: Renentech Laboratories is the first Private Enterprise in India to have been chosen to provide Personnel radiation monitoring services to radiation workers at different parts of the country. Since 1992 the Company has been manufacturing TLD phosphor powder of requisite quality and from 1995 commenced the production of TLD cards for radiation monitoring. After getting the necessary approval from the competent authorities in the country, the company undertook a rigorous quality assurance programme and received the accreditation in 1999 to carry out the personnel monitoring of radiation. Since then the trained staff of the Company is covering 1200 institutions in 16 states where radiation is being used. This translates to processing of 60,000 Till cards annually, the maximum limit permitted by BARC. Processing of exposure data is done strictly according well-laid guidelines. Any cases of overexposure are immediately referred to Calibration and Dose Record Section of BARC to meet the regulatory requirements. Necessary procedural guidelines are followed to handle such cases. In this lecture, learning, operation and implementation experience of a typical Private Company in a task, which, hitherto had been regarded as exclusive responsibility of state owned institution, is enumerated

  18. Prevalence and associated factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Ministry of Health Malaysia (MOH) Hospitals in Kelantan.

    Science.gov (United States)

    Aziah, B D; Rusli, B N; Winn, T; Naing, L; Tengku, M A

    2004-06-01

    Karasek's job strain model postulates that workers chronically exposed to adverse psychosocial work environment (high strain job)--high psychological job demands and low job control, including poor social support, increased physical demand and hazardous work condition--will eventually develop both physical illnesses such as cardiovascular diseases and psychological disorders such as depression. In order to determine the prevalence and associated factors of job-related depression, a cross-sectional study was conducted among laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan between September 2001 and February 2002. One hundred and two laboratory technicians in HUSM and 79 laboratory technicians in 7 KKM Hospitals were selected; 84/102 (82.4%) in HUSM and 71/79 (89.9%) in KKM Hospitals responded. Data was collected using self-administered questionnaires of the validated Malay version of the Job Content Questionnaire (JCQ) originally developed by Robert Karasek. Results indicated that the prevalence of high job strain in laboratory technicians in HUSM and KKM hospitals was 33.3% (28/84) and 26.8% (19/71), respectively (p>0.05). Significantly higher proportion (59.5%) (50/84) of laboratory technicians in HUSM compared to those in KKM Hospitals (39.4%) (28/71) (p = 0.016) experienced job-related depression. Significant associated factors of job-related depression were low social support (HUSM: adjusted OR 4.7, 95% CI 1.2-18.8; KKM: adjusted OR 14.8, 95%CI 2.4-89.3), high psychological demand (HUSM: adjusted OR 3.0, 95%CI 1.0-8.8), and low decision authority (KKM: adjusted OR 9.7, 95%CI 1.0-91.1). We conclude that strengthening the social support network (supervisors' and coworkers' support), reducing psychological job demand, and increasing decision-making authority of laboratory technicians may go a long way towards reducing job-related depression.

  19. Using preventive home monitoring to reduce hospital admission rates and reduce costs

    DEFF Research Database (Denmark)

    Dinesen, Birthe Irene; Haesum, Lisa K E; Soerensen, Natascha

    2012-01-01

    We studied whether preventive home monitoring of patients with chronic obstructive pulmonary disease (COPD) could reduce the frequency of hospital admissions and lower the cost of hospitalization. Patients were recruited from a health centre, general practitioner (GP) or the pulmonary hospital ward....... They were randomized to usual care or tele-rehabilitation with a telehealth monitoring device installed in their home for four months. A total of 111 patients were suitable for inclusion and consented to be randomized: 60 patients were allocated to intervention and three were lost to follow...... of admissions was €3461 per patient in the intervention group and €4576 in the control group; this difference was not significant. The Kaplan-Meier estimates for time to hospital admission were longer for the intervention group than the controls, but the difference was not significant. Future work requires...

  20. 1985 Effluent and environmental monitoring report for the Bettis Atomic Power Laboratory

    International Nuclear Information System (INIS)

    1985-01-01

    The results of the radiological and non-radiological environmental monitoring programs for 1985 at the Bettis Laboratory are presented. The results obtained from the monitoring programs demonstrate that the existing procedures ensure that all environmental releases during 1985 were in accordance with applicable State and Federal regulations. Evaluation of the environmental data indicates that operation of the Laboratory continued to have no adverse effect on the quality of the environment. Furthermore, a conservative assessment of radiation exposure to the general public as a result of Laboratory operations demonstrated that the dose received by any member of the public was well below the most restrictive dose limits prescribed by the Environmental Protection Agency and the Department of Energy

  1. Laboratory versus industrial cutting force sensor in tool condition monitoring system

    International Nuclear Information System (INIS)

    Szwajka, K

    2005-01-01

    Research works concerning the utilisation of cutting force measures in tool condition monitoring usually present results and deliberations based on laboratory sensors. These sensors are too fragile to be used in industrial practice. Industrial sensors employed on the factory floor are less accurate, and this must be taken into account when creating a tool condition monitoring strategy. Another drawback of most of these works is that constant cutting parameters are used for the entire tool life. This does not reflect industrial practice where the same tool is used at different feeds and depths of cut in sequential passes. This paper presents a comparison of signals originating from laboratory and industrial cutting force sensors. The usability of the sensor output was studied during a laboratory simulation of industrial cutting conditions. Instead of building mathematical models for the correlation between tool wear and cutting force, an FFBP artificial neural network was used to find which combination of input data would provide an acceptable estimation of tool wear. The results obtained proved that cross talk between channels has an important influence on cutting force measurements, however this input configuration can be used for a tool condition monitoring system

  2. 1992 Environmental monitoring report, Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Culp, T.; Cox, W.; Hwang, H.; Irwin, M.; Jones, A.; Matz, B.; Molley, K.; Rhodes, W.; Stermer, D.; Wolff, T.

    1993-09-01

    This 1992 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, envirorunental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque, New Mexico, are included. The maximum offsite dose impact was calculated to be 0.0034 millirem. The total population within a 50-mile radius of Sandia National Laboratories/New Mexico received an estimated collective dose of 0.019 person-rem during 1992 from the laboratories' operations. As in the previous year, the 1992 operations at Sandia National Laboratories/New Mexico had no discernible impact on the general public or on the environment

  3. Radioactive effluent monitoring at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Simpson, O.D.

    1975-01-01

    The Effluent and Radiation Measurements Laboratory at the Idaho National Engineering Laboratory (INEL) has recently upgraded capabilities in the field of monitoring and analysis of radioactive airborne and liquid effluents using the techniques of gamma-ray spectrometry. The techniques and equipment used include remotely-operated, computer-based Ge(Li) spectrometers which obtain data on a real-time basis. Permanent record files are maintained of both the effluent release values and the gamma-ray data from which the release values are calculated. Should values for release levels ever be challenged, the gamma-ray spectral information for any measurement can be recalled and analyzed as needed. Daily effluent release reports are provided to operating personnel which contributes to prompt correction of any operational problems. Monthly, quarterly, and annual reports are compiled which provide inventories of the radionuclides released. A description of the effluent monitoring, reporting and records system developed at INEL for this application will be presented

  4. Environmental monitoring for EG and G Idaho facilities at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Tkachyk, J.W.; Wright, K.C.; Wilhelmsen, R.N.

    1990-08-01

    This report describes the 1989 environmental-monitoring activities of the Environmental Monitoring Unit of EG ampersand G Idaho, Inc., at EG ampersand G-operated facilities at the Idaho National Engineering Laboratory (INEL). The major facilities monitored include the Radioactive Waste Management Complex, the Waste Experimental Reduction Facility, the Mixed Waste Storage Facility, and two surplus facilities. Additional monitoring activities performed by Environmental Monitoring are also discussed, including drinking-water monitoring and nonradiological liquid-effluent monitoring, as well as data management. The primary purposes of monitoring are to evaluate environmental conditions and to provide and interpret data, in compliance with applicable regulations, to ensure protection of human health and the environment. This report compares 1989 environmental-monitoring data with derived concentration guides and with data from previous years. This report also presents results of sampling performed by the Radiological and Environmental Sciences Laboratory and by the United States Geological Survey. 17 refs., 49 figs., 11 tabs

  5. Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals

    Directory of Open Access Journals (Sweden)

    Rasmussen TB

    2018-04-01

    Full Text Available Thomas Bøjer Rasmussen, Sinna Pilgaard Ulrichsen, Mette Nørgaard Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark Background: Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes.Objective: The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses.Materials and methods: We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations.Results: Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals’ estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54. In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease.Conclusion: The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most

  6. Test plan for preparing the Rapid Transuranic Monitoring Laboratory for field deployment

    International Nuclear Information System (INIS)

    McIsaac, C.V.; Sill, C.W.; Gehrke, R.J.; Killian, E.W.; Watts, K.D.

    1994-04-01

    This plan describes experimental work that will be performed during fiscal year 1994 to prepare the Rapid Transuranic Monitoring Laboratory (RTML) for routine field use by US Department of Energy (DOE) Environmental Restoration and Waste Management programs. The RTML is a mobile, field-deployable laboratory developed at the Idaho National Engineering Laboratory (INEL) that provides a rapid, cost-effective means of characterizing and monitoring radioactive waste remediation sites for low-level radioactive contaminants. Analytical instruments currently installed in the RTML include an extended-range, germanium photon analysis spectrometer with an automatic sample changer; two, large-area, ionization chamber alpha spectrometers; and four alpha continuous air monitors. The RTML was field tested at the INEL during June 1993 in conjunction with the Buried Waste Integrated Demonstration's remote retrieval demonstration. The major tasks described in this test plan are to (a) evaluate the beta detectors for use in screening soil samples for 90 Sr, (b) upgrade the alpha spectral analysis software programs, and (c) upgrade the photon spectral analysis software programs

  7. Treatment, monitoring, and economic outcomes of venous thromboembolism among hospitalized patients in China.

    Science.gov (United States)

    Wu, Eric Q; Xie, Jipan; Wu, Chun; Du, Ella Xiaoyan; Li, Nanxin; Tan, Ruoding; Liu, Yuanli

    2014-03-01

    The prevalence of venous thromboembolism (VTE) has been increasing in China. However, the treatment pattern and economic burden of these patients have not been well-understood. The objective of this study was to examine the patient characteristics, treatment pattern, anticoagulant monitoring, and economic burden of VTE among hospitalized patients in China. Hospitalizations with a diagnosis of VTE [including deep vein thrombosis (DVT) or pulmonary embolism (PE)] between 1 January 2010 and 30 June 2013 were included. Descriptive analysis was conducted for patients' characteristics, anticoagulant treatment, international normalized ratio (INR) monitoring, and hospitalization cost [in 2013 Chinese yuan (Y) and US dollars (US$)]. Multivariate regressions were performed to assess factors associated with oral anticoagulant use and total costs of inpatient care. A total of 1,047 VTE-related hospitalizations were selected. The sample had a mean age of 62.4 years, with 45.9 % female. About 46.3 % of hospitalizations used heparin only, 35.0 % used warfarin, 0.8 % used rivaroxaban, and 18.0 % did not use anticoagulants. Among hospitalizations where warfarin was used, 90.8 % received at least one INR test and only 30 % had the last INR within the target therapeutic range (2-3) before discharge. The mean (standard deviation) total cost per hospitalization was Y29,114 (43,772) [US$4,757 (7,152)]. PE, VTE as primary diagnosis, female, insurance coverage, anticoagulant treatment, co-morbidities, admission condition, and surgical procedure were significantly associated with inpatient costs. Conventional anticoagulants were most commonly used in the study sample. Under-monitoring and suboptimal care may be an issue for patients treated with warfarin. The average total inpatient cost of VTE-related hospitalizations is high.

  8. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures

  9. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    Science.gov (United States)

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping

  10. Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture

    DEFF Research Database (Denmark)

    Norgaard, Astrid; De Lichtenberg, Trine Honnens; Nielsen, Jens

    2014-01-01

    -transfusion haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels...

  11. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

    Science.gov (United States)

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-04-12

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

  12. Authorization for the functioning of service laboratories for personal monitoring

    International Nuclear Information System (INIS)

    1981-10-01

    The requirements of the Brazilian CNEN (Comissao Nacional de Energia Nuclear) are established for the construction licensing and operation authorization of laboratories offering personnel monitoring services for external exposures to X-and gamma radiation. (I.C.R.) [pt

  13. 1986 environmental monitoring program report for the Idaho National Engineering Laboratory Site

    International Nuclear Information System (INIS)

    Hoff, D.L.; Chew, E.W.; Rope, S.K.

    1987-05-01

    This report presents onsite and offsite data collected in 1986 for the routine environmental monitoring program conducted by the Radiological and Environmental Sciences Laboratory (RESL) of the Department of Energy (DOE) at the Idaho National Engineering Laboratory (INEL) Site. The purpose of this routine program is to monitor radioactive and nonradioactive materials resulting from INEL Site operations which may reach the surrounding offsite environment and population. This report is prepared in accordance with the DOE requirements in draft DOE Order 5484.1 and is not intended to cover the numerous special environmental research programs being conducted at the INEL by RESL and others

  14. Elaboration of a program for monitoring the ionizing radiations in a large hospital

    International Nuclear Information System (INIS)

    Carreira, Mauricio Costa

    1996-11-01

    Personnel monitoring data collected in the Radiotherapy, Diagnostic Radiology and Hemodynamics Departments of the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP during the interval from 1986 to 1995 were analyzed. The data were classified according to the profession of the workers and compared to those collected in a previous period (1973-1982). Internationally established criteria, published published in the ICRP 35 and 60 were used together with additional Brazilian criteria (CNEN NE 3.01) to optimize personnel monitoring such that the required radioprotection is provided. The results show that 80% of the workers need not be monitored because their doses will not exceed 3/10 the annual limits. An economy of about US$10,200 in monitoring cost per year could be realized as well as reduction in the hospital clerical costs expended to maintain the records. The improvements gaining by reducing the number of monitored persons will not compromise the safety standard required for radiation protection. (author)

  15. Nonradioactive Ambient Air Monitoring at Los Alamos National Laboratory 2001--2002

    Energy Technology Data Exchange (ETDEWEB)

    E. Gladney; J.Dewart, C.Eberhart; J.Lochamy

    2004-09-01

    During the spring of 2000, the Cerro Grande forest fire reached Los Alamos National Laboratory (LANL) and ignited both above-ground vegetation and disposed materials in several landfills. During and after the fire, there was concern about the potential human health impacts from chemicals emitted by the combustion of these Laboratory materials. Consequently, short-term, intensive air-monitoring studies were performed during and shortly after the fire. Unlike the radiological data from many years of AIRNET sampling, LANL did not have an adequate database of nonradiological species under baseline conditions with which to compare data collected during the fire. Therefore, during 2001 the Meteorology and Air Quality Group designed and implemented a new air-monitoring program, entitled NonRadNET, to provide nonradiological background data under normal conditions. The objectives of NonRadNET were to: (1) develop the capability for collecting nonradiological air-monitoring data, (2) conduct monitoring to develop a database of typical background levels of selected nonradiological species in the communities nearest the Laboratory, and (3) determine LANL's potential contribution to nonradiological air pollution in the surrounding communities. NonRadNET ended in late December 2002 with five quarters of data. The purpose of this paper is to organize and describe the NonRadNET data collected over 2001-2002 to use as baseline data, either for monitoring during a fire, some other abnormal event, or routine use. To achieve that purpose, in this paper we will: (1) document the NonRadNET program procedures, methods, and quality management, (2) describe the usual origins and uses of the species measured, (3) compare the species measured to LANL and other area emissions, (4) present the five quarters of data, (5) compare the data to known typical environmental values, and (6) evaluate the data against exposure standards.

  16. Outbreak of chikungunya in Johor Bahru, Malaysia: clinical and laboratory features of hospitalized patients.

    Science.gov (United States)

    Chew, L P; Chua, H H

    2009-09-01

    In 2008, an outbreak of chikungunya infection occurred in Johor. We performed a retrospective review of all laboratory confirmed adult chikungunya cases admitted to Hospital Sultanah Aminah, Johor Bahru from April to August 2008, looking into clinical and laboratory features. A total of 18 laboratory confirmed cases of chikungunya were identified with patients presenting with fever, joint pain, rash and vomiting. Haemorrhagic signs were not seen. Lymphopenia, neutropenia, thrombocytopenia, raised liver enzymes and deranged coagulation profile were the prominent laboratory findings. We hope this study can help guide physician making a diagnosis of chikungunya against other arborviruses infection.

  17. Advantages of a Web-Based Real-Time Bed-Management System for Hospital Admission Monitoring in Iran.

    Science.gov (United States)

    Abedian, Somayeh; Bitaraf, Ehsan; Askari, Marjan

    2018-01-01

    Lack of up-to-date information of hospitals beds, specifically in emergencies, is a significant problem in many large countries; The Ministry of Health and Medical Education of Iran (MOHME) designed and implemented a dynamic system that reports the status of beds in 2012. This system created great opportunities for national bed management, including real-time hospital admission monitoring, especially for emergency departments, ICUs and CCUs. Therefore, an additional online system was planned to be implemented for monitoring hospital admissions, including a national alert system. Prior to the design of this system, a study was done using literature study and expert opinion to investigate the advantages and features that this monitoring system was required to have. We used the MoSCoW method to prioritize the requirements of the system. This system was designed to have the following advantages, among other things: the hospitals as well as government should be able to track the patients, manage patient distribution in healthcare centers, and make policy for supplying extra beds. It should also be possible for the hospitals executive board, as well as the government, to monitor the performance of the hospitals regarding patient admissions (i.e., the rate of rejection of patients with severe conditions).

  18. Impact of professionalism in nursing on in-hospital bedside monitoring practice

    DEFF Research Database (Denmark)

    Bunkenborg, Gitte; Samuelson, Karin; Akeson, Jonas

    2013-01-01

    practice) and two sub-themes (Knowledge and skills and Involvement in clinical practice through reflections) were identified. Three categories (Decision-making, Sharing of knowledge, and Intra- and interprofessional interaction) were found to be associated with the theme, the sub-themes, and with each...... other. CONCLUSION: Clinical monitoring practice varies considerably between nurses with different individual levels of professionalism. Future initiatives to improve patient safety by further developing professionalism among nurses need to embrace individual and organizational attributes to strengthen......AIM: This article reports a study exploring nursing practice of monitoring in-hospital patients including intra- and interprofessional communication and collaboration. BACKGROUND: Sub-optimal care in general in-hospital wards may lead to admission for intensive care, cardiac arrest, or sudden death...

  19. Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories.

    Science.gov (United States)

    Wallin, Olof; Söderberg, Johan; Van Guelpen, Bethany; Stenlund, Hans; Grankvist, Kjell; Brulin, Christine

    2010-09-01

    Scand J Caring Sci; 2010; 24; 581-591 
 Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories   Most errors in venous blood testing result from human mistakes occurring before the sample reach the laboratory.   To survey venous blood sampling (VBS) practices in hospital wards and to compare practices with hospital laboratories.   Staff in two hospitals (all wards) and two hospital laboratories (314 respondents, response rate 94%), completed a questionnaire addressing issues relevant to the collection of venous blood samples for clinical chemistry testing.   The findings suggest that instructions for patient identification and the collection of venous blood samples were not always followed. For example, 79% of the respondents reported the undesirable practice (UDP) of not always using wristbands for patient identification. Similarly, 87% of the respondents noted the UDP of removing venous stasis after the sampling is finished. Compared with the ward staff, a significantly higher proportion of the laboratory staff reported desirable practices regarding the collection of venous blood samples. Neither education nor the existence of established sampling routines was clearly associated with VBS practices among the ward staff.   The results of this study, the first of its kind, suggest that a clinically important risk of error is associated with VBS in the surveyed wards. Most important is the risk of misidentification of patients. Quality improvement of blood sample collection is clearly needed, particularly in hospital wards. © 2009 The Authors. Journal compilation © 2009 Nordic College of Caring Science.

  20. Knolls Atomic Power Laboratory annual environmental monitoring report, calendar year 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) sites are summarized and assessed in this report. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each site and at off-site background locations.

  1. Knolls Atomic Power Laboratory annual environmental monitoring report, calendar year 1997

    International Nuclear Information System (INIS)

    1997-01-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) sites are summarized and assessed in this report. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each site and at off-site background locations

  2. Facility Effluent Monitoring Plan for the 222-S Laboratory

    International Nuclear Information System (INIS)

    Robinson, A.V.

    1991-11-01

    A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems against applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. The current operation of the 222-S facilities includes the provision of analytical and radiological chemistry services in support of Hanford Site processing plants. The emphasis is on waste management, chemical processing, environmental monitoring effluent programs at B Plant, the Uranium Oxide Plant, Tank Farms, the 242-A Evaporator, the Waste Encapsulation and Storage Facility, the Plutonium-Uranium Extraction Facility, the Plutonium Finishing Plant, process development/impact activities, and essential materials. The laboratory also supplies analytical services in support of ongoing waste tank characterization

  3. Status of eye lens radiation dose monitoring in European hospitals

    International Nuclear Information System (INIS)

    Carinou, Eleftheria; Ginjaume, Merce; O’Connor, Una; Kopec, Renata; Sans Merce, Marta

    2014-01-01

    A questionnaire was developed by the members of WG12 of EURADOS in order to establish an overview of the current status of eye lens radiation dose monitoring in hospitals. The questionnaire was sent to medical physicists and radiation protection officers in hospitals across Europe. Specific topics were addressed in the questionnaire such as: knowledge of the proposed eye lens dose limit; monitoring and dosimetry issues; training and radiation protection measures. The results of the survey highlighted that the new eye lens dose limit can be exceeded in interventional radiology procedures and that eye lens protection is crucial. Personnel should be properly trained in how to use protective equipment in order to keep eye lens doses as low as reasonably achievable. Finally, the results also highlighted the need to improve the design of eye dosemeters in order to ensure satisfactory use by workers. (paper)

  4. Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals.

    Science.gov (United States)

    Edmisten, Catherine; Hall, Charles; Kernizan, Lorna; Korwek, Kimberly; Preston, Aaron; Rhoades, Evan; Shah, Shalin; Spight, Lori; Stradi, Silvia; Wellman, Sonia; Zygadlo, Scott

    2017-08-01

    Measuring and providing feedback about hand hygiene (HH) compliance is a complicated process. Electronic HH monitoring systems have been proposed as a possible solution; however, there is little information available about how to successfully implement and maintain these systems for maximum benefit in community hospitals. An electronic HH monitoring system was implemented in 3 community hospitals by teams at each facility with support from the system vendor. Compliance rates were measured by the electronic monitoring system. The implementation challenges, solutions, and drivers of success were monitored within each facility. The electronic HH monitoring systems tracked on average more than 220,000 compliant HH events per facility per month, with an average monthly compliance rate >85%. The sharing of best practices between facilities was valuable in addressing challenges encountered during implementation and maintaining a high rate of use. Drivers of success included a collaborative environment, leadership commitment, using data to drive improvement, consistent and constant messaging, staff empowerment, and patient involvement. Realizing the full benefit of investments in electronic HH monitoring systems requires careful consideration of implementation strategies, planning for ongoing support and maintenance, and presenting data in a meaningful way to empower and inspire staff. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Evolution of a residue laboratory network and the management tools for monitoring its performance.

    Science.gov (United States)

    Lins, E S; Conceição, E S; Mauricio, A De Q

    2012-01-01

    Since 2005 the National Residue & Contaminants Control Plan (NRCCP) in Brazil has been considerably enhanced, increasing the number of samples, substances and species monitored, and also the analytical detection capability. The Brazilian laboratory network was forced to improve its quality standards in order to comply with the NRCP's own evolution. Many aspects such as the limits of quantification (LOQs), the quality management systems within the laboratories and appropriate method validation are in continuous improvement, generating new scenarios and demands. Thus, efficient management mechanisms for monitoring network performance and its adherence to the established goals and guidelines are required. Performance indicators associated to computerised information systems arise as a powerful tool to monitor the laboratories' activity, making use of different parameters to describe this activity on a day-to-day basis. One of these parameters is related to turnaround times, and this factor is highly affected by the way each laboratory organises its management system, as well as the regulatory requirements. In this paper a global view is presented of the turnaround times related to the type of analysis, laboratory, number of samples per year, type of matrix, country region and period of the year, all these data being collected from a computerised system called SISRES. This information gives a solid background to management measures aiming at the improvement of the service offered by the laboratory network.

  6. Performance evaluation of the food and environmental monitoring radio-analytical laboratory in Ghana

    International Nuclear Information System (INIS)

    Agyeman, Lilian Ataa

    2016-06-01

    Since the establishment of the Radiation Protection Institute’s Food and Environmental Laboratory in 1988, there has never been any thorough evaluation of the activities of the facility to provide assurance of the quality of analytical results produced by the laboratory. The objective of this study, therefore, was to assess the performance level of the Food and Environmental monitoring laboratory with respect to the requirements for a standard analytical laboratory (IAEA, 1989) and ISO 17025. The study focused on the performance of the Gamma Spectrometry laboratory of the Radiation Protection Institute, Ghana Atomic Energy Commission which has been involved in monitoring of radionuclides in food and environmental samples. In doing that, data from 1988 to 2015 was reviewed to ascertain whether the Laboratory has being performing as required in providing quality results on food and environmental samples measured. Besides this data (records kept), the evaluation also covered some Technical Quality Control measures, such as Energy and Efficiency Calibration, that need to be put in place for such laboratories. The laboratory meets almost all conditions and equipment requirements of IAEA (1989), however the laboratory falls short of the management requirements of ISO 17025. Based on the results it was recommended, among others, that management of the laboratory should ensure there are procedures for how calibration and testing is performed for different types of equipment and also the competence of all who operate specific equipment, perform tests, evaluate results and sign test reports ensured. (au)

  7. Tritium monitor calibration at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Bjork, C.J.; Aikin, D.J.; Houlton, T.W.

    1997-08-01

    Tritium in air is monitored at Los Alamos National Laboratory (LANL) with air breathing instruments based on ionization chambers. Stack emissions are continuously monitored from sample tubes which each connect to a Tritium bubble which differentially collects HTO and HT. A set of glass vials of glycol capture the HTO. The HT is oxidized with a palladium catalyst and the resultant HTO is captured in a second set of vials of glycol. The glycol is counted with a liquid scintillation counter. All calibrations are performed with tritium containing gas. The Radiation Instrumentation and Calibration (RIC) Team has constructed and maintains two closed loop gas handling systems based on femto TECH model U24 tritium ion chamber monitors: a fixed system housed in a fume hood and a portable system mounted on two two wheeled hand trucks. The U24 monitors are calibrated against tritium in nitrogen gas standards. They are used as standard transfer instruments to calibrate other ion chamber monitors with tritium in nitrogen, diluted with air. The gas handling systems include a circulation pump which permits a closed circulation loop to be established among the U24 monitor and typically two to four other monitors of a given model during calibration. Fixed and portable monitors can be calibrated. The stack bubblers are calibrated in the field by: blending a known concentration of tritium in air within the known volume of the two portable carts, coupled into a common loop; releasing that gas mixture into a ventilation intake to the stack; collecting oxidized tritium in the bubbler; counting the glycol; and using the stack and bubbler flow rates, computing the bubbler's efficiency. Gas calibration has become a convenient and quality tool in maintaining the tritium monitors at LANL

  8. Hawaii Munitions Monitoring Station and Natural Laboratory

    Science.gov (United States)

    Edwards, M.; Trimble, A. Z.; Rognstad, M. R.

    2017-12-01

    Hundreds of thousands of tons of conventional munitions were fired into the ocean at military ranges or deliberately disposed at sea during the twentieth century. Potential contaminants from munitions and explosives of concern (MEC) affect virtually every coast in the United States, including Alaska, the Hawaiian Islands, Guam, American Samoa and other U.S. territories as well as inland waterways. It is necessary to develop methods to assess the concentrations of munitions constituents present at a site to address concerns about the presence of environmentally relevant concentrations and their potential impacts. Having a well-characterized site to test instruments and methods is important for continued development and refinement of technology. Most sites are too big to characterize comprehensively in three dimensions over time periods lasting days or longer. We are working to develop a monitoring station and natural laboratory near Oahu, Hawaii to create a cost-effective demonstration and validation natural laboratory where emerging technologies can be evaluated and compared. Ordnance Reef (OR) is an ideal location to establish a munitions monitoring station for historical, logistical and environmental reasons. OR is an area of shallow fringing reef measuring approximately 4.2 km by 2.2 km along the Waianae coast of Oahu that was used as a disposal area for military munitions following World War II. OR has been the subject of multiple investigations including an inventory of munitions conducted by the U.S. Army Corps of Engineers in 2002 and a screening-level risk investigation conducted by the National Oceanic and Atmospheric Administration and the University of Hawaii in 2006. As a result, there are multiple datasets collected over the past fifteen years that can be leveraged to serve as a baseline for the natural laboratory. These extant datasets are being supplemented with data from integrated unmanned systems deployed at OR to characterize and visualize the

  9. Monitoring and information management system at the Underground Research Laboratory

    International Nuclear Information System (INIS)

    Strobel, G.S.; Chernis, P.J.; Bushman, A.T.; Spinney, M.H.; Backer, R.J.

    1996-01-01

    Atomic Energy of Canada Limited (AECL) has developed a customer oriented monitoring and information management system at the Underground Research Laboratory (URL) near Lac du Bonnet, Manitoba. The system is used to monitor instruments and manage, process, and distribute data. It consists of signal conditioners and remote loggers, central schedule and control systems, computer aided design and drafting work centres, and the communications linking them. The monitoring and communications elements are designed to meet the harsh demands of underground conditions while providing accurate monitoring of sensitive instruments to rigorous quality assured specifications. These instruments are used for testing of the concept for the deep geological disposal of nuclear fuel waste as part of the Canadian Nuclear Fuel Waste Management Program. Many of the tests are done in situ and at full-scale. The monitoring and information management system services engineering, research, and support staff working to design, develop, and demonstrate and present the concept. Experience gained during development of the monitoring and information management system at the URL, can be directly applied at the final disposal site. (author)

  10. Monitoring and information management system at the Underground Research Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, G.S.; Chernis, P.J.; Bushman, A.T.; Spinney, M.H.; Backer, R.J. [Atomic Energy of Canada Limited, Pinawa, Manitoba (Canada)

    1996-07-01

    Atomic Energy of Canada Limited (AECL) has developed a customer oriented monitoring and information management system at the Underground Research Laboratory (URL) near Lac du Bonnet, Manitoba. The system is used to monitor instruments and manage, process, and distribute data. It consists of signal conditioners and remote loggers, central schedule and control systems, computer aided design and drafting work centres, and the communications linking them. The monitoring and communications elements are designed to meet the harsh demands of underground conditions while providing accurate monitoring of sensitive instruments to rigorous quality assured specifications. These instruments are used for testing of the concept for the deep geological disposal of nuclear fuel waste as part of the Canadian Nuclear Fuel Waste Management Program. Many of the tests are done in situ and at full-scale. The monitoring and information management system services engineering, research, and support staff working to design, develop, and demonstrate and present the concept. Experience gained during development of the monitoring and information management system at the URL, can be directly applied at the final disposal site. (author)

  11. Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Ballinger, Marcel Y.; Gervais, Todd L.

    2004-11-15

    The Pacific Northwest National Laboratory (PNNL) operates a number of Research & Development (R&D) facilities for the U.S. Department of Energy (DOE) on the Hanford Site. Facility effluent monitoring plans (FEMPs) have been developed to document the facility effluent monitoring portion of the Environmental Monitoring Plan (DOE 2000) for the Hanford Site. Three of PNNL’s R&D facilities, the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling, and individual FEMPs were developed for these facilities in the past. In addition, a balance-of-plant (BOP) FEMP was developed for all other DOE-owned, PNNL-operated facilities at the Hanford Site. Recent changes, including shutdown of buildings and transition of PNNL facilities to the Office of Science, have resulted in retiring the 3720 FEMP and combining the 331 FEMP into the BOP FEMP. This version of the BOP FEMP addresses all DOE-owned, PNNL-operated facilities at the Hanford Site, excepting the Radiochemical Processing Laboratory, which has its own FEMP because of the unique nature of the building and operations. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R&D. R&D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in Appendix A. Potential radioactive airborne emissions in the BOP facilities are estimated annually using a building inventory-based approach provided in federal regulations. Sampling at individual BOP facilities is based on a potential-to-emit assessment. Some of these facilities are considered minor emission points and thus are sampled routinely, but not continuously, to confirm the low emission potential. One facility, the 331 Life Sciences Laboratory, has a major emission point and is sampled continuously. Sampling systems are

  12. A locally designed mobile laboratory for radiation analysis and monitoring in qatar. Vol. 4

    Energy Technology Data Exchange (ETDEWEB)

    Abou-Leila, H; El-Samman, H; Mahmoud, H [Physics Department, University of qatar, Doha (Qatar)

    1996-03-01

    A description of a mobile laboratory for radiation analysis and monitoring, completely designed in qatar and equipped at qatar university, is given. It consists of a van equipped with three scintillation detectors mounted on the front bumper. The detectors can monitor gamma radiations along the path of the laboratory over an angle range 120 degree. One Eberline radiation monitoring station is mounted on the roof. The laboratory is also equipped with several, and neutron survey meters in addition to some sampling equipment. All equipment used are powered with solar panels. The characteristics and performance of solar power/stabilized A C conversion is given. Data acquisition from the three scintillation detectors is performed by adding the outputs of the three detectors and storing the total as a function of time in a computer based multi-channel analyzer (MCA) operated in the MSC mode. The acquisition can be switched easily to the PHA mode to analyze gamma spectra from any possible contamination source. The laboratory was used in several environmental and possible contamination missions. Some results obtained during some of these missions are given. 4 figs.

  13. A locally designed mobile laboratory for radiation analysis and monitoring in qatar. Vol. 4

    International Nuclear Information System (INIS)

    Abou-Leila, H.; El-Samman, H.; Mahmoud, H.

    1996-01-01

    A description of a mobile laboratory for radiation analysis and monitoring, completely designed in qatar and equipped at qatar university, is given. It consists of a van equipped with three scintillation detectors mounted on the front bumper. The detectors can monitor gamma radiations along the path of the laboratory over an angle range 120 degree. One Eberline radiation monitoring station is mounted on the roof. The laboratory is also equipped with several, and neutron survey meters in addition to some sampling equipment. All equipment used are powered with solar panels. The characteristics and performance of solar power/stabilized A C conversion is given. Data acquisition from the three scintillation detectors is performed by adding the outputs of the three detectors and storing the total as a function of time in a computer based multi-channel analyzer (MCA) operated in the MSC mode. The acquisition can be switched easily to the PHA mode to analyze gamma spectra from any possible contamination source. The laboratory was used in several environmental and possible contamination missions. Some results obtained during some of these missions are given. 4 figs

  14. Effluent and environmental monitoring of Chalk River Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Pilgrim, T.; De Waele, C.; Gallagher, C. [Atomic Energy of Canada Limited, Chalk River, ON (Canada)

    2014-07-01

    Atomic Energy of Canada Limited's (AECL's) Environmental Protection Program has been gathering environmental monitoring data at its Chalk River Laboratories (CRL) for over 60 years. The comprehensive effluent and environmental monitoring program at CRL consists of more than 600 sampling locations, including the Ottawa River, with approximately 60,000 analyses performed on air and liquid effluent parameters each year. Monitoring for a variety of radiological and non-radiological parameters is regularly conducted on various media, including ambient air, foodstuff (e.g. milk, fish, garden produce, large game, and farm animals), groundwater, Ottawa River water and other surface water on and off-site. The purpose of the monitoring program is to verify that past and current radiological and non-radiological emissions derived from AECL operations and activities, such as process water effluent into the Ottawa River, are below regulatory limits and demonstrate that CRL operations do not negatively affect the quality of water on or leaving the site. In fact, ongoing program reports demonstrate that radiological emissions are well below regulatory limits and have been declining for the past five years, and that non-radiological contaminants do not negatively affect the quality of water on and off the site. Two updated Canadian Standards Association (CSA) standards for Effluent and Environmental monitoring have come into effect and have resulted in some changes to the AECL Program. This presentation will discuss effluent and surface water monitoring results, the observed trends, the changes triggered by the CSA standards, and a path forward for the future. (author)

  15. Towards a rational antimicrobial testing policy in the laboratory.

    Science.gov (United States)

    Banaji, N; Oommen, S

    2011-01-01

    Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital's antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  16. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 1999

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-12-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the three KAPL Sites [Knolls Site, Niskayuna, New York; Kesselring Site, West Milton, New York; S1C Site, Windsor, Connecticut] during calendar year 1999 resulted in no significant release of hazardous substances or radioactivity to the environment. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each Site and at off-site background locations.

  17. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 1999

    International Nuclear Information System (INIS)

    2000-01-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the three KAPL Sites [Knolls Site, Niskayuna, New York; Kesselring Site, West Milton, New York; S1C Site, Windsor, Connecticut] during calendar year 1999 resulted in no significant release of hazardous substances or radioactivity to the environment. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each Site and at off-site background locations

  18. Quality improvement project in cervical cancer screening: practical measures for monitoring laboratory performance.

    Science.gov (United States)

    Tarkkanen, Jussi; Geagea, Antoine; Nieminen, Pekka; Anttila, Ahti

    2003-01-01

    We conducted a quality improvement project in a cervical cancer screening programme in Helsinki in order to see if detection of precancerous lesions could be influenced by external (participation rate) and internal (laboratory praxis) quality measures. In order to increase the participation rate, a second personal invitation to Pap-test was mailed to nonparticipants of the first call. In order to improve the quality of screening, the cytotechnicians monitored their performance longitudinally by recording the number of slides reviewed per day, the pick-up rate of abnormal smears, the report of the consulting cytopathologist, and the number of histologically verified lesions detected from the cases that they had screened. Regular sessions were held to compare the histological findings with the cytological findings of all cases referred for colposcopy. No pressure was applied on the cytotechnicians to ensure that they felt comfortable with their daily workload. A total of 110 000 smears were screened for cervical cancer at the Helsinki City Hospital during 1996-99. Initially, the overall participation rate increased from 62% to 71%. The number of histologically confirmed precancerous lesions (CIN 1-3) more than doubled and their detection rate increased from 0.32% to 0.72%. Continuous education and feedback from daily work performance were important, yet rather inexpensive means in increasing laboratory performance. Additional measures are needed to further increase the participation rate. Impact of the quality measures on cancer incidence needs to be assessed later on.

  19. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 2000

    International Nuclear Information System (INIS)

    2001-01-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the Knolls Site, Niskayuna, New York and the Kesselring Site, West Milton, New York and site closure activities at the S1C Site, Windsor, Connecticut, continued to have no adverse effect on human health and the quality of the environment during calendar year 2000. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each Site and at off-site background locations. Monitoring programs at the S1C Site were reduced in scope during calendar year 2000 due to completion of site dismantlement activities during 1999

  20. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 2000

    Energy Technology Data Exchange (ETDEWEB)

    None

    2001-12-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the Knolls Site, Niskayuna, New York and the Kesselring Site, West Milton, New York and site closure activities at the S1C Site, Windsor, Connecticut, continued to have no adverse effect on human health and the quality of the environment during calendar year 2000. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each Site and at off-site background locations. Monitoring programs at the S1C Site were reduced in scope during calendar year 2000 due to completion of site dismantlement activities during 1999.

  1. The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.

    Science.gov (United States)

    Karara, Gustave; Verbeke, Frank; Nyssen, Marc

    2015-01-01

    In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.

  2. Clinical impact of laboratory error on therapeutic drug monitoring of once-daily tobramycin in cystic fibrosis: Case series

    Directory of Open Access Journals (Sweden)

    William A Prescott

    2014-01-01

    Full Text Available Once-daily dosing intravenous tobramycin is commonly used to treat cystic fibrosis pulmonary exacerbations. Clinicians often utilize historical therapeutic drug monitoring data to individualize the dose among patients who have been treated with tobramycin previously. This case series involves three patients with cystic fibrosis who had supra-therapeutic tobramycin levels despite use of a once-daily dosing that produced therapeutic drug levels during a previous hospital admission, raising questions about the validity of these levels. Investigation into several potential sources of error led to the discovery of an analyzer error in the laboratory. Once the laboratory’s tobramycin analyzer was recalibrated, the reported levels were comparable to historical levels. This case series emphasizes the clinical importance of critically analyzing reported levels, and specifically, the importance of utilizing past therapeutic drug monitoring data, if available, for all patients treated with intravenous tobramycin. If a patient was therapeutic on a similar dose of tobramycin during a previous admission, a dose adjustment may not be necessary, and clinicians should consider repeating levels while pursuing alternative explanations for the discrepant serum levels.

  3. Liquid Effluent Monitoring Program at the Pacific Northwest Laboratory

    International Nuclear Information System (INIS)

    Ballinger, M.Y.

    1995-05-01

    Pacific Northwest Laboratory (PNL) is conducting a program to monitor the waste water from PNL-operated research and development facilities on the Hanford Site. The purpose of the program is to collect data to assess administrative controls and to determine whether discharges to the process sewer meet sewer criteria. Samples have been collected on a regular basis from the major PNL facilities on the Hanford Site since March 1994. A broad range of analyses has been performed to determine the primary constituents in the liquid effluent. The sampling program is briefly summarized in the paper. Continuous monitoring of pH, conductivity, and flow also provides data on the liquid effluent streams. In addition to sampling and monitoring, the program is evaluating the dynamics of the waste stream with dye studies and is evaluating the use of newer technologies for potential deployment in future sampling/monitoring efforts. Information collected to date has been valuable in determining sources of constituents that may be higher than the Waste Acceptance Criteria (WAC) for the Treated Effluent Disposal Facility (TEDF). This facility treats the waste streams before discharge to the Columbia River

  4. Historical return on investment and improved quality resulting from development and mining of a hospital laboratory relational database.

    Science.gov (United States)

    Brimhall, Bradley B; Hall, Timothy E; Walczak, Steven

    2006-01-01

    A hospital laboratory relational database, developed over eight years, has demonstrated significant cost savings and a substantial financial return on investment (ROI). In addition, the database has been used to measurably improve laboratory operations and the quality of patient care.

  5. Use of ArcGIS in Environmental Monitoring at Idaho National Laboratory

    International Nuclear Information System (INIS)

    Oertel, Giles

    2007-01-01

    The Idaho National Laboratory is a U.S. Department of Energy site located in southeastern Idaho. The INL is required to perform environmental monitoring of anthropogenically introduced contaminants. One primary contaminant of interest is radioactive Cs-137 which is resident in INL soils due to past operational activities and atmospheric weapons testing. Collection of field data is performed using vehicle mounted and portable radiation detector units. All data is combined in ArcGIS and displayed over georeferenced satellite images and digital elevation models. The use of the ArcGIS geostatistical analysis package enhances the ability to look for areas of higher Cs-137 concentration. Combining current monitoring results with meteorological wind pattern maps allows for siting of new and improved monitoring locations. Use of the ArcGIS package provides an integrated analysis and mapping protocol for use in radioactive contaminant monitoring

  6. Automated Radioanalytical Chemistry: Applications For The Laboratory And Industrial Process Monitoring

    International Nuclear Information System (INIS)

    O'Hara, Matthew J.; Farawila, Anne F.; Grate, Jay W.

    2009-01-01

    The identification and quantification of targeted α- and β-emitting radionuclides via destructive analysis in complex radioactive liquid matrices is highly challenging. Analyses are typically accomplished at on- or off-site laboratories through laborious sample preparation steps and extensive chemical separations followed by analysis using a variety of detection methodologies (e.g., liquid scintillation, alpha energy spectroscopy, mass spectrometry). Analytical results may take days or weeks to report. When an industrial-scale plant requires periodic or continuous monitoring of radionuclides as an indication of the composition of its feed stream, diversion of safeguarded nuclides, or of plant operational conditions (for example), radiochemical measurements should be rapid, but not at the expense of precision and accuracy. Scientists at Pacific Northwest National Laboratory have developed and characterized a host of automated radioanalytical systems designed to perform reproducible and rapid radioanalytical processes. Platforms have been assembled for (1) automation and acceleration of sample analysis in the laboratory and (2) automated monitors for monitoring industrial scale nuclear processes on-line with near-real time results. These methods have been applied to the analysis of environmental-level actinides and fission products to high-level nuclear process fluids. Systems have been designed to integrate a number of discrete sample handling steps, including sample pretreatment (e.g., digestion and valence state adjustment) and chemical separations. The systems have either utilized on-line analyte detection or have collected the purified analyte fractions for off-line measurement applications. One PNNL system of particular note is a fully automated prototype on-line radioanalytical system designed for the Waste Treatment Plant at Hanford, WA, USA. This system demonstrated nearly continuous destructive analysis of the soft β-emitting radionuclide 99Tc in nuclear

  7. Annual environmental monitoring report of the Lawrence Berkeley Laboratory

    International Nuclear Information System (INIS)

    Schleimer, G.E.

    1983-04-01

    In order to establish whether LBL research activities produces any impact on the population surrounding the Laboratory, a program of environmental air and water sampling and continuous radiation monitoring was carried on throughout the year. For 1982, as in the previous several years, doses attributable to LBL radiological operations were a small fraction of the relevant radiation protection guidelines (RPG). The maximum perimeter dose equivalent was less than or equal to 24.0 mrem (the 1982 dose equivalent measured at the Building 88 monitoring station B-13A, about 5% of the RPG). The total population dose equivalent attributable to LBL operations during 1982 was less than or equal to 16 man-rem, about 0.002% of the RPG of 170 mrem/person to a suitable sample of the population

  8. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 2001

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-12-31

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the Knolls and Kesselring Sites and Site closure activities at the S1C Site (also known as the KAPL Windsor Site) continue to have no adverse effect on human health and the quality of the environment. The effluent and environmental monitoring programs conducted by KAPL at the Knolls and Kesselring Sites are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as environmental monitoring of air, water, sediment, and fish. Radiation measurements are also made around the perimeter of the Knolls and Kesselring Sites and at off-site background locations. The environmental monitoring program for the S1C Site continues to be reduced in scope from previous years due to the completion of Site dismantlement activities during 1999 and a return to green field conditions during 2000.

  9. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 2001

    International Nuclear Information System (INIS)

    2002-01-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) Sites are summarized and assessed in this report. Operations at the Knolls and Kesselring Sites and Site closure activities at the S1C Site (also known as the KAPL Windsor Site) continue to have no adverse effect on human health and the quality of the environment. The effluent and environmental monitoring programs conducted by KAPL at the Knolls and Kesselring Sites are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as environmental monitoring of air, water, sediment, and fish. Radiation measurements are also made around the perimeter of the Knolls and Kesselring Sites and at off-site background locations. The environmental monitoring program for the S1C Site continues to be reduced in scope from previous years due to the completion of Site dismantlement activities during 1999 and a return to green field conditions during 2000

  10. Assessment of leadership among clinical laboratories managers of teaching hospitals: Quantum leadership approach

    Directory of Open Access Journals (Sweden)

    H. Dargahi

    2017-10-01

    Full Text Available Background: Quantum leadership approach causes efficient and effective procedures among health care organizations, specially clinical laboratories. Objective: This research was aimed to determine the status of quantum leadership dimensions among all management levels of clinical laboratories of teaching hospitals of medical sciences universities in Tehran. Methods: This descriptive, analytical and cross-sectional study was induced among 180 managers of 35 clinical laboratories of Iran, Shahid Beheshti and Tehran Universities of Medical Sciences 2016. The research tool was researcher - constructed questionnaire of quantum skills, demographic details that its content and face validity and reliability were confirmed. For analysis of data, T-test and ANOVA techniques were used. Findings: Most of the studied clinical laboratories managers were male, married, with 15-20 years work experiences, 1-5 years managerial services, and minimally one training courses in clinical laboratory management. The managers had relatively desired and desired score of quantum skills and leadership respectively. Also, there was significant correlation between quantum leadership with age (P=0.01, and with management training courses (P=0.02. Conclusion: It is expected this paradigm may change the clinical laboratory management in the near future with regards to desirability of quantum leadership dimensions among clinical laboratories.

  11. Five-Year Data of Clinical Characteristics and Laboratory Findings of Hospitalized Hemophilic Patients in Dr. Hasan Sadikin General Hospital

    Directory of Open Access Journals (Sweden)

    Dina Marlina

    2016-12-01

    Full Text Available Background: Hemophilia A has the highest incidence, more than 80% of 172.323 cases worldwide in 2012. It is stated that clinical characteristics of hemophilia A is worse than others, so it is required to prove and to know further about the clinical characteristics and severity likelihood in all hemophilic patients in order to prevent re-bleeding and re-injury and also for a better medical response. Methods: A retrospective cross-sectional study was carried out to 43 medical records of hospitalized hemophilic patients from 2009 to 2013 in Dr Hasan Sadikin General Hospital. The inclusion criteria were a complete patient identity (name, age, sex, written chief complaint, complete physical examination (bleeding, edema, hematoma, hemarthrosis, anemic symptoms and laboratory test results (factor level, hemoglobin, hematocrit, platelet and Activated Partial Thromboplastin Time. The data was collected from August‒October 2014, analyzed and presented using frequency distribution. Results: Most of the patients were 5-10 years old, male and had hemophilia A. The most common complaint was external bleeding, followed by edema. From 43 patients, 38 (88% cases were classified as severe factor deficiency, had mild to severe anemia, however the platelet count in most of the cases was in normal value. About 91% cases had prolonged Activated Partial Thromboplastin Time in moderate to severe level. Conclusions: Similar with other studies worldwide, most of the hospitalized hemophilic patients have hemophilia A. Most of the patents has moderate to severe bleeding with laboratory test result between moderate to severe level as well.

  12. 1996 LMITCO environmental monitoring program report for the Idaho National Engineering and Environmental Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    This report describes the calendar year 1996 environmental surveillance and compliance monitoring activities of the Lockheed Martin Idaho Technologies Company Environmental Monitoring Program performed at the Idaho National Engineering and Environmental Laboratory (INEEL). Results of sampling performed by the Radiological Environmental Surveillance, Site Environmental Surveillance, Drinking Water, Effluent Monitoring, Storm Water Monitoring, Groundwater Monitoring, and Special Request Monitoring Programs are included in this report. The primary purposes of the surveillance and monitoring activities are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standards, and to ensure protection of human health and the environment. This report compares 1996 data with program-specific regulatory guidelines and past data to evaluate trends.

  13. 1996 LMITCO environmental monitoring program report for the Idaho National Engineering and Environmental Laboratory

    International Nuclear Information System (INIS)

    1997-09-01

    This report describes the calendar year 1996 environmental surveillance and compliance monitoring activities of the Lockheed Martin Idaho Technologies Company Environmental Monitoring Program performed at the Idaho National Engineering and Environmental Laboratory (INEEL). Results of sampling performed by the Radiological Environmental Surveillance, Site Environmental Surveillance, Drinking Water, Effluent Monitoring, Storm Water Monitoring, Groundwater Monitoring, and Special Request Monitoring Programs are included in this report. The primary purposes of the surveillance and monitoring activities are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standards, and to ensure protection of human health and the environment. This report compares 1996 data with program-specific regulatory guidelines and past data to evaluate trends

  14. Personal dose monitoring in hospitals: Global assessment, critical applications and future needs

    International Nuclear Information System (INIS)

    Covens, P.; Berus, D.; Buls, N.; Clerinx, P.; Vanhavere, F.

    2007-01-01

    It is known that medical applications using ionising radiation are wide spread and still increasing. Physicians, technicians, nurses and others constitute the largest group of workers occupationally exposed to man-made sources of radiation. Many hospital workers are consequently subjected to routine monitoring of professional radiation exposures. in the university hospital, UZ Brussel, 600 out of 4000 staff members are daily monitored for external radiation exposures. The most obvious applications of ionising radiation are diagnostic radiology, diagnostic or therapeutic use of radionuclides in nuclear medicine and external radiation therapy or brachytherapy in radiotherapy departments. Other important applications also include various procedures in interventional radiology (IR), in vitro biomedical research and radiopharmaceutical production around cyclotrons. Besides the fact that many of the staff members, involved in these applications, are not measurably exposed, detailed studies were carried out at workplaces where routine dose monitoring encounters difficulties and for some applications where relatively high occupational exposures can be found. most of the studies are concentrated around nuclear medicine applications and IR. They contain assessments of both effective dose and doses at different parts of the body. The results contribute to better characterisation of the different workplaces in a way that critical applications can be identified. Moreover, conclusions point out future needs for practical routine dose monitoring and optimisation of radiation protection. (authors)

  15. Factors Influencing Laboratory Information System Effectiveness Through Strategic Planning in Shiraz Teaching Hospitals.

    Science.gov (United States)

    Bahador, Fateme; Sharifian, Roxana; Farhadi, Payam; Jafari, Abdosaleh; Nematolahi, Mohtram; Shokrpour, Nasrin

    This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

  16. Quality assurance in the HIV/AIDS laboratory network of China.

    Science.gov (United States)

    Jiang, Yan; Qiu, Maofeng; Zhang, Guiyun; Xing, Wenge; Xiao, Yao; Pan, Pinliang; Yao, Jun; Ou, Chin-Yih; Su, Xueli

    2010-12-01

    In 2009, there were 8273 local screening laboratories, 254 confirmatory laboratories, 35 provincial confirmatory central laboratories and 1 National AIDS Reference Laboratory (NARL) in China. These laboratories were located in Center for Disease Control and Prevention (CDC) facilities, hospitals, blood donation clinics, maternal and child health (MCH) hospitals and border health quarantine health-care facilities. The NARL and provincial laboratories provide quality assurance through technical, bio-safety and managerial training; periodic proficiency testing; on-site supervisory inspections; and commercial serologic kit evaluations. From 2002 to 2009, more than 220 million HIV antibody tests were performed at screening laboratories, and all reactive and indeterminate samples were confirmed at confirmatory laboratories. The use of highly technically complex tests, including CD4 cell enumeration, viral load, dried blood spot (DBS)-based early infant diagnosis (EID), drug resistance (DR) genotyping, HIV-1 subtyping and incidence assays, have increased in recent years and their performance quality is closely monitored. China has made significant progress in establishing a well-coordinated HIV laboratory network and QA systems. However, the coverage and intensity of HIV testing and quality assurance programmes need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

  17. Rule Based Expert System for Monitoring Real Time Drug Supply in Hospital Using Radio Frequency Identification Technology

    Science.gov (United States)

    Driandanu, Galih; Surarso, Bayu; Suryono

    2018-02-01

    A radio frequency identification (RFID) has obtained increasing attention with the emergence of various applications. This study aims to examine the implementation of rule based expert system supported by RFID technology into a monitoring information system of drug supply in a hospital. This research facilitates in monitoring the real time drug supply by using data sample from the hospital pharmacy. This system able to identify and count the number of drug and provide warning and report in real time. the conclusion is the rule based expert system and RFID technology can facilitate the performance in monitoring the drug supply quickly and precisely.

  18. Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

    Science.gov (United States)

    Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

    2014-09-01

    To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

  19. Pending laboratory tests and the hospital discharge summary in patients discharged to sub-acute care.

    Science.gov (United States)

    Walz, Stacy E; Smith, Maureen; Cox, Elizabeth; Sattin, Justin; Kind, Amy J H

    2011-04-01

    Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown. To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations. Retrospective cohort study. Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003-2005 (N = 564) Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient's discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge. Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients' pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients' pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge. Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved

  20. Economic evaluation of laboratory testing strategies for hospital-associated Clostridium difficile infection.

    Science.gov (United States)

    Schroeder, Lee F; Robilotti, Elizabeth; Peterson, Lance R; Banaei, Niaz; Dowdy, David W

    2014-02-01

    Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and 93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI.

  1. 1992 Effluent and environmental monitoring report for the Bettis Atomic Power Laboratory Pittsburgh Site

    International Nuclear Information System (INIS)

    1992-01-01

    The results of the radiological and non-radiological environmental monitoring programs for 1992 at the Bettis-Pittsburgh Site are presented. The results obtained from the monitoring programs demonstrate that the existing procedures ensured that environmental releases during 1992 were in accordance with applicable Federal and State regulations. Evaluation of the environmental data indicates that operation of the Laboratory continues to have no adverse effect on the quality of the environment. A conservative assessment of radiation exposure to the general public as a result of Laboratory operations demonstrated that the dose received by any member of the public was well below the most restrictive dose limits established by the Environmental Protection Agency and the Department of Energy

  2. 1992 Effluent and environmental monitoring report for the Bettis Atomic Power Laboratory Pittsburgh Site

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    The results of the radiological and non-radiological environmental monitoring programs for 1992 at the Bettis-Pittsburgh Site are presented. The results obtained from the monitoring programs demonstrate that the existing procedures ensured that environmental releases during 1992 were in accordance with applicable Federal and State regulations. Evaluation of the environmental data indicates that operation of the Laboratory continues to have no adverse effect on the quality of the environment. A conservative assessment of radiation exposure to the general public as a result of Laboratory operations demonstrated that the dose received by any member of the public was well below the most restrictive dose limits established by the Environmental Protection Agency and the Department of Energy.

  3. Monitoring, Verification, and Treatment of Infectious Wastes and Their Optimal Management in the Hospitals of Qom City, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Fahiminia

    2016-08-01

    Full Text Available Background and Objectives: Given that no comprehensive studies have yet been conducted on treatment of infectious wastes in hospitals of Qom City, this research was performed with the purpose of investigating the treatment methods used in these hospitals and monitoring the performance of waste elimination devices. Methods: Required information was obtained through in-person visit and observing the current situation, and the variables affecting waste treatment were extracted based on the type of treatment systems, and were collected, and accordingly, biological monitoring tests were designed for the studied hospitals. The data were analyzed using Fisher's exact test. Results: In this study, from 9 active hospitals in Qom Province, only 3 hospitals were equipped with waste treatment system. In hospital A, growth of Bacillus stearothermophilus spore were observed in 6.25% of the samples, while no microbial growth was recorded in hospital B. The initial investment to buy the machine in hospital A was about four times than that of hospital B. Conclusion: The findings of this study showed that treatment device of hospital B is more appropriate compared to the devices of hospital A due to complete destruction of spores, lower cost (for purchase, and maintenance. .

  4. Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya

    Directory of Open Access Journals (Sweden)

    Phidelis M. Maruti

    2014-09-01

    Objectives: To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. Methods: SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders – including upper management, clinicians, laboratory staff and maintenance staff – to the mission of sustainable quality practices at BDHL. Results: After 16 months in the SLMTA programme, BDHL improved from zero stars (38% to four stars (89%. Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81% in an external surveillance audit conducted by Kenya Accreditation Service (KENAS. Conclusion: Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.

  5. The need for strengthening the influenza virus detection ability of hospital clinical laboratories: an investigation of the 2009 pandemic

    Science.gov (United States)

    Yang, Shigui; Zhou, Yuqing; Cui, Yuanxia; Ding, Cheng; Wu, Jie; Deng, Min; Wang, Chencheng; Lu, Xiaoqing; Chen, Xiaoxiao; Li, Yiping; Shi, Dongyan; Mi, Fenfang; Li, Lanjuan

    2017-03-01

    Most hospital clinical laboratories (HCLs) in China are unable to perform influenza virus detection. It remains unclear whether the influenza detection ability of HCLs influences the early identification and mortality rate of influenza. A total of 739 hospitalized patients with 2009 influenza A (H1N1) virus treated at 65 hospitals between May and December, 2009, in Zhejiang, China, were included based on identifications by HCLs and by public health laboratories (PHLs) of the Centers for Disease Control and Prevention. Of the patients, 407 (55.1%) were male, 17 died, resulting in an in-hospital mortality rate of 2.3%, and 297 patients were identified by HCLs and 442 by PHLs. The results indicated that a 24-hour delay in identification led to a 13% increase in the odds of death (OR = 1.13, P hospital mortality rate of the HCL group was significantly lower than that of the PHL group (1.0% vs. 3.2%, P hospital mortality rate by 68.8%. HCL-based influenza virus detection facilitated early identification and reduced influenza mortality, and influenza detection ability of HCLs should be strengthened.

  6. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

    I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

  7. Maternal health, antenatal and at 8 weeks after delivery, in home versus in-hospital fetal monitoring in high-risk pregnancies

    NARCIS (Netherlands)

    Monincx, W. M.; Birnie, E.; Zondervan, H. A.; Bleker, O. P.; Bonsel, G. J.

    2001-01-01

    To assess maternal health outcome, comparing high-risk pregnant women to either domiciliary monitoring or in-hospital monitoring, and a low risk pregnant group. Paper and pencil questionnaire, distributed antenatal and 8 weeks after the delivery. A university hospital. Three groups: 130 high-risk

  8. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 1996

    International Nuclear Information System (INIS)

    1996-01-01

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) sites are summarized and assessed in this report. The principal function at KAPL sites (Knolls, Kesselring, and Windsor) is research and development in the design and operation of Naval nuclear propulsion plants. The Kesselring Site is also used for the training of personnel in the operation of these plants. The Naval nuclear propulsion plant at the Windsor Site is currently being dismantled. Operations at the three KAPL sites resulted in no significant release of hazardous substances or radioactivity to the environment. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each site and at off-site background locations

  9. Knolls Atomic Power Laboratory environmental monitoring report, calendar year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    The results of the effluent and environmental monitoring programs at the three Knolls Atomic Power Laboratory (KAPL) sites are summarized and assessed in this report. The principal function at KAPL sites (Knolls, Kesselring, and Windsor) is research and development in the design and operation of Naval nuclear propulsion plants. The Kesselring Site is also used for the training of personnel in the operation of these plants. The Naval nuclear propulsion plant at the Windsor Site is currently being dismantled. Operations at the three KAPL sites resulted in no significant release of hazardous substances or radioactivity to the environment. The effluent and environmental monitoring programs conducted by KAPL are designed to determine the effectiveness of treatment and control methods, to provide measurement of the concentrations in effluents for comparison with applicable standards, and to assess resultant concentrations in the environment. The monitoring programs include analyses of samples of liquid and gaseous effluents for chemical constituents and radioactivity as well as monitoring of environmental air, water, sediment, and fish. Radiation measurements are also made around the perimeter of each site and at off-site background locations.

  10. A New Meteo-oceanographic and Environmental Monitoring Laboratory in Brazil

    Science.gov (United States)

    Fontes, Roberto F. C.; Dottori, Marcelo; Silveira, Ilson C. A.; Castro, Belmiro M.

    2013-04-01

    The newer oil provinces in the pre-salt regions off the Brazilian Coast have raised the necessity of the creation of monitoring and observational centers, regarding the best comprehension on the ocean and atmosphere dynamics. The relation between industry and university is a concept based on collaboration, and it is an innovative social experiment in Brazil. The sustainability of that collaboration depends on the balance of mutual interests on private business and public academic institutions. The entrepreneur needs continuous accesses to the new academic researches, and the greatest benefit, for the academy, are funding complementation and personnel qualification. We need to establish a thread of new challenges, some of them based on disruption of paradigms in the Brazilian academic culture, and removal of obstructive clauses from the entrepreneur. Questioning and methods revalidation, in the oceanic environment areas, also requires a collaborative and interdisciplinary effort, congregating the physical aspects along with others compartments of the environmental monitoring. We proposed the creation of a Meteo-oceanographic and Environmental Monitoring Laboratory - LAMMOA (Portuguese acronym), which will be installed in a new facility funded by PETROBRAS (the Brazilian leading oil company) and ruled by USP, UNESP and UNICAMP, the state public universities in Santos (São Paulo State, Brazil). The new facility will be a research center in oil and gas activities, named CENPEG-BS (Portuguese acronym for Research Center of Oil and Gas in the Bay of Santos). Several laboratories and groups will work together, in a highly collaborative environment and so, capable of quickly respond to sudden demands on offshore activities and logistic operations, as well as in contingency situations. LAMMOA will continuous monitor oceanic regions where the pre-salt activities of oil exploitation occur. It will monitor meteo-oceanographic parameters like winds, waves and currents

  11. RADIOLOGICAL EMISSIONS AND ENVIRONMENTAL MONITORING FOR BROOKHAV EN NATIONAL LABORATORY, 1947 - 1961.

    Energy Technology Data Exchange (ETDEWEB)

    MEINHOLD,C.B.; MEINHOLD,A.F.(EDITED BY BOND,P.D.)

    2001-05-30

    Brookhaven National Laboratory (BNL) has monitored its releases to the environment since its inception in 1947. From 1962 to 1966 and from 1971 to the present, annual reports,were published that recorded the emissions and releases to the environment from Laboratory operations. In 1998, a report was written to summarize the environmental data for the years 1967 to 1970. One of the purposes of the current report is to complete BNL's environmental history by covering the period from 1948 through 1961. The activities in 1947 were primarily organizational and there is no information on the use of radiation at the Laboratory before 1948. An additional objective of this report is to provide environmental data to the Agency for Toxic Substances and Disease Registry (ATSDR). The report does not provide an estimate of the doses associated with BNL operations. The report is comprised of two parts. The first part is a summary of emissions, releases, and environmental monitoring information including a discussion of the uncertainties in these data. Part two contains the detailed information on the approach taken to estimate the releases from the fuel cartridge failures at the Brookhaven Graphite Research Reactor (BGRR). A series of appendices present more detailed information on these events in tabular form. The approach in this report is to be reasonable, conservative, (pessimistic), and transparent in estimating releases from fuel cartridge ruptures. Clearly, reactor stack monitoring records and more extensive records would have greatly improved this effort, but in accordance with Atomic Energy Commission (AEC) Appendix 0230 Annex C-9, many of the detailed records from this time were not retained.

  12. Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure.

    Science.gov (United States)

    Aurora, R Nisha; Patil, Susheel P; Punjabi, Naresh M

    2018-04-21

    Sleep apnea is an underdiagnosed condition in patients with heart failure. Efficient identification of sleep apnea is needed, as treatment may improve heart failure-related outcomes. Currently, use of portable sleep monitoring in hospitalized patients and those at risk for central sleep apnea is discouraged. This study examined whether portable sleep monitoring with respiratory polygraphy can accurately diagnose sleep apnea in patients hospitalized with decompensated heart failure. Hospitalized patients with decompensated heart failure underwent concurrent respiratory polygraphy and polysomnography. Both recordings were scored for obstructive and central disordered breathing events in a blinded fashion, using standard criteria, and the apnea-hypopnea index (AHI) was determined. Pearson's correlation coefficients and Bland-Altman plots were used to examine the concordance among the overall, obstructive, and central AHI values derived by respiratory polygraphy and polysomnography. The sample consisted of 53 patients (47% women) with a mean age of 59.0 years. The correlation coefficient for the overall AHI from the two diagnostic methods was 0.94 (95% CI, 0.89-0.96). The average difference in AHI between the two methods was 3.6 events/h. Analyses of the central and obstructive AHI values showed strong concordance between the two methods, with correlation coefficients of 0.98 (95% CI, 0.96-0.99) and 0.91 (95% CI, 0.84-0.95), respectively. Complete agreement in the classification of sleep apnea severity between the two methods was seen in 89% of the sample. Portable sleep monitoring can accurately diagnose sleep apnea in hospitalized patients with heart failure and may promote early initiation of treatment. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  13. A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

    Science.gov (United States)

    Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

    2015-08-01

    management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

  14. Isotope laboratories

    International Nuclear Information System (INIS)

    1978-01-01

    This report from the Dutch Ministry of Health is an advisory document concerned with isotope laboratories in hospitals, in connection with the Dutch laws for hospitals. It discusses which hospitals should have isotope laboratories and concludes that as many hospitals as possible should have small laboratories so that emergency cases can be dealt with. It divides the Netherlands into regions and suggests which hospitals should have these facilities. The questions of how big each lab. is to be, what equipment each has, how each lab. is organised, what therapeutic and diagnostic work should be carried out by each, etc. are discussed. The answers are provided by reports from working groups for in vivo diagnostics, in vitro diagnostics, therapy, and safety and their results form the criteria for the licences of isotope labs. The results of a questionnaire for isotope labs. already in the Netherlands are presented, and their activities outlined. (C.F.)

  15. Development of a laboratory prototype water quality monitoring system suitable for use in zero gravity

    Science.gov (United States)

    Misselhorn, J. E.; Witz, S.; Hartung, W. H.

    1973-01-01

    The development of a laboratory prototype water quality monitoring system for use in the evaluation of candidate water recovery systems and for study of techniques for measuring potability parameters is reported. Sensing techniques for monitoring of the most desirable parameters are reviewed in terms of their sensitivities and complexities, and their recommendations for sensing techniques are presented. Rationale for selection of those parameters to be monitored (pH, specific conductivity, Cr(+6), I2, total carbon, and bacteria) in a next generation water monitor is presented along with an estimate of flight system specifications. A master water monitor development schedule is included.

  16. From grass to grace: How SLMTA revolutionised the Bamenda Regional Hospital Laboratory in Cameroon

    Directory of Open Access Journals (Sweden)

    Siyem C. Nkwawir

    2014-11-01

    Objectives: To evaluate the results of SLMTA implementation at BRHL and discuss lessons learned. Method: In 2010, the SLMTA programme was rolled out in Cameroon to improve laboratory quality management systems in five laboratories, including BRHL. Three workshops were conducted (the first centralised, the remaining two on-site at each laboratory and improvement projects were implemented after each workshop with the assistance of mentors. Audits were used in order to evaluate performance and to identify areas for further improvement. Results: BRHL had the lowest score (18% amongst the cohort at the baseline audit and the highest (81% at the official Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA audit conducted in August 2013 by the African Society for Laboratory Medicine. Improvements were observed in each of the 12 Quality System Essentials; improvement was especially noteworthy in the areas of facilities and safety, and purchasing and inventory. Staff investment and pride in the quality of laboratory services increased. Conclusion: BRHL’s remarkable improvement was achieved with a combination of SLMTA training activities, intensive on-site mentorship and the collective focus of all laboratory staff. The experience at Bamenda Hospital illustrates what can be achieved when a laboratory successfully harnesses the energy of its staff and implements changes to improve the quality of services in a transformation taking them from grass to grace.

  17. Report on a Workshop on mobile laboratories for monitoring environmental radiation

    International Nuclear Information System (INIS)

    Andrasi, A,; Nemeth, I.; Zombori, P.; Urban, J.

    1992-01-01

    The international Workshop organized by the Health Physics Department of the Central Research Institute for Physics and by the Radiation Protection Department of the Paks Nuclear Power Plant was presented in this paper. The aims of the Workshop were the introduction of the mobile laboratories and the demonstration of the applied methods for monitoring environmental radiation in accidental situation. The intercomparison measurements showed that the results given by different participating laboratories (9 institutions from the middle and east European region) agreed well within an acceptable error margin. The demonstration, measurements and discussions were very useful for the participants and this could be a good basis for further developments and cooperations among the participating institutions. (author) 7 figs.; 2 tabs

  18. Economic Evaluation of Laboratory Testing Strategies for Hospital-Associated Clostridium difficile Infection

    Science.gov (United States)

    Robilotti, Elizabeth; Peterson, Lance R.; Banaei, Niaz; Dowdy, David W.

    2014-01-01

    Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and 93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI. PMID:24478478

  19. Cost effectiveness of adopted quality requirements in hospital laboratories.

    Science.gov (United States)

    Hamza, Alneil; Ahmed-Abakur, Eltayib; Abugroun, Elsir; Bakhit, Siham; Holi, Mohamed

    2013-01-01

    The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189. The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase. In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase. The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.

  20. Rotavirus Infection in the Auckland Region After the Implementation of Universal Infant Rotavirus Vaccination: Impact on Hospitalizations and Laboratory Implications.

    Science.gov (United States)

    McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J

    2018-01-01

    In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.

  1. [Blood volume for biochemistry determinations--laboratory needs and everyday practice].

    Science.gov (United States)

    Sztefko, Krystyna; Mamica, Katarzyna; Bugajska, Jolanta; Maziarz, Barbara; Tomasik, Przemysław

    2014-01-01

    Blood loss due to diagnostic phlebotomy jest a very serious problem, especially for newborn, infants and critically ill patients on intensive care units. Although single blood loss can be easily tolerated in adults, in small babies and in patients who are frequently monitored based on laboratory tests iatrogenic anaemia can occur. To evaluate the blood volume drawn for routine biochemistry tests in relation to patient age and the number of parameters requested. Blood volume drawn for routine biochemistry measurements from patients hospitalized in University Children's Hospital (N = 2980, children age from one day to 18 years) and in University Hospital (N = 859, adults, aged > 1.8 years) in Cracow has been analyzed. Blood volume was calculated based on regular tube diameter and blood heights in the tube. In case of microvettes the blood volume was 0.2 ml. Statistical analysis has been performed by using PRISM 5.0. The statistical significance was set at p nurses and doctors should include the information about current laboratory automation and methods miniaturization; 2) The amount of blood volume needed by laboratory for the requested number of tests should always be taken into account when diagnostic phlebotomy is necessary.

  2. [Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

    Science.gov (United States)

    Kino, Shuichi; Suwabe, Akira

    2014-12-01

    In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

  3. From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

    Science.gov (United States)

    Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

    2006-12-01

    To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

  4. Elaboration of a program for monitoring the ionizing radiations in a large hospital; Elaboracao de um programa de monitoracao das radiacoes ionizantes num hospital de grande porte

    Energy Technology Data Exchange (ETDEWEB)

    Carreira, Mauricio Costa

    1996-11-01

    Personnel monitoring data collected in the Radiotherapy, Diagnostic Radiology and Hemodynamics Departments of the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP during the interval from 1986 to 1995 were analyzed. The data were classified according to the profession of the workers and compared to those collected in a previous period (1973-1982). Internationally established criteria, published published in the ICRP 35 and 60 were used together with additional Brazilian criteria (CNEN NE 3.01) to optimize personnel monitoring such that the required radioprotection is provided. The results show that 80% of the workers need not be monitored because their doses will not exceed 3/10 the annual limits. An economy of about US$10,200 in monitoring cost per year could be realized as well as reduction in the hospital clerical costs expended to maintain the records. The improvements gaining by reducing the number of monitored persons will not compromise the safety standard required for radiation protection. (author)

  5. Monitoring and reporting of preanalytical errors in laboratory medicine: the UK situation.

    Science.gov (United States)

    Cornes, Michael P; Atherton, Jennifer; Pourmahram, Ghazaleh; Borthwick, Hazel; Kyle, Betty; West, Jamie; Costelloe, Seán J

    2016-03-01

    Most errors in the clinical laboratory occur in the preanalytical phase. This study aimed to comprehensively describe the prevalence and nature of preanalytical quality monitoring practices in UK clinical laboratories. A survey was sent on behalf of the Association for Clinical Biochemistry and Laboratory Medicine Preanalytical Working Group (ACB-WG-PA) to all heads of department of clinical laboratories in the UK. The survey captured data on the analytical platform and Laboratory Information Management System in use; which preanalytical errors were recorded and how they were classified and gauged interest in an external quality assurance scheme for preanalytical errors. Of the 157 laboratories asked to participate, responses were received from 104 (66.2%). Laboratory error rates were recorded per number of specimens, rather than per number of requests in 51% of respondents. Aside from serum indices for haemolysis, icterus and lipaemia, which were measured in 80% of laboratories, the most common errors recorded were booking-in errors (70.1%) and sample mislabelling (56.9%) in laboratories who record preanalytical errors. Of the laboratories surveyed, 95.9% expressed an interest in guidance on recording preanalytical error and 91.8% expressed interest in an external quality assurance scheme. This survey observes a wide variation in the definition, repertoire and collection methods for preanalytical errors in the UK. Data indicate there is a lot of interest in improving preanalytical data collection. The ACB-WG-PA aims to produce guidance and support for laboratories to standardize preanalytical data collection and to help establish and validate an external quality assurance scheme for interlaboratory comparison. © The Author(s) 2015.

  6. [DIFFERENT APPROACHES FOR CHEMICAL RISK ASSESSMENT IN LABORATORIES].

    Science.gov (United States)

    Caporossi, Lidia; Papaleo, Bruno; Capanna, Silvia; Calicchia, Sara; Marcellini, Laura; De Rosa, Mariangela; Castellano, Paola

    2015-01-01

    The aim of this study was to compare the different approaches used for chemical risk assessment, in relation to the perception of riskfor operators, in some research laboratories of a hospital in Rome. All information regarding the chemicals used for the application of three algorithmic models for chemical risk assessment ("Movarisch", "Inforisk", "Archimede") were collected. An environmental and biological monitoring and a study on the combined exposure to multiple chemicals using the World Health Organization proposed steps were carried out. A questionnaire was prepared for the identification of risk perception. An estimation of chemical risk with algorithms was compared with data from monitoring: findings showed that estimated risk was higher than those identified with airborne or urine concentrations, always under their limit values. The study of multiple exposure showed a possible cumulative risk, in some cases, but the conditions of use (volume and time) often bring to a reduced one. The perception of risk attributed to the monitored hazardous substances showed a correct perception in all laboratories and for all workers, with regard to the substances manipulated.

  7. Reduction of operative mortality after implementation of Surgical Outcomes Monitoring and Improvement Programme by Hong Kong Hospital Authority.

    Science.gov (United States)

    Yuen, W C; Wong, K; Cheung, Y S; Lai, P Bs

    2018-04-01

    Since 2008, the Hong Kong Hospital Authority has implemented a Surgical Outcomes Monitoring and Improvement Programme (SOMIP) at 17 public hospitals with surgical departments. This study aimed to assess the change in operative mortality rate after implementation of SOMIP. The SOMIP included all Hospital Authority patients undergoing major/ultra-major procedures in general surgery, urology, plastic surgery, and paediatric surgery. Patients undergoing liver or renal transplantation or who had multiple trauma or massive bowel ischaemia were excluded. In SOMIP, data retrieval from the Hospital Authority patient database was performed by six full-time nurse reviewers following a set of precise data definitions. A total of 230 variables were collected for each patient, on demographics, preoperative and operative variables, laboratory test results, and postoperative complications up to 30 days after surgery. In this study, we used SOMIP cumulative 5-year data to generate risk-adjusted 30-day mortality models by hierarchical logistic regression for both emergency and elective operations. The models expressed overall performance as an annual observed-to-expected mortality ratio. From 2009/2010 to 2015/2016, the overall crude mortality rate decreased from 10.8% to 5.6% for emergency procedures and from 0.9% to 0.4% for elective procedures. From 2011/2012 to 2015/2016, the risk-adjusted observed-to-expected mortality ratios showed a significant downward trend for both emergency and elective operations: from 1.126 to 0.796 and from 1.150 to 0.859, respectively (Mann- Kendall statistic = -0.8; PAuthority's overall crude mortality rates and risk-adjusted observed-to-expected mortality ratios for emergency and elective operations significantly declined after SOMIP was implemented.

  8. Capacitive Sensing for Non-Invasive Breathing and Heart Monitoring in Non-Restrained, Non-Sedated Laboratory Mice.

    Science.gov (United States)

    González-Sánchez, Carlos; Fraile, Juan-Carlos; Pérez-Turiel, Javier; Damm, Ellen; Schneider, Jochen G; Zimmermann, Heiko; Schmitt, Daniel; Ihmig, Frank R

    2016-07-07

    Animal testing plays a vital role in biomedical research. Stress reduction is important for improving research results and increasing the welfare and the quality of life of laboratory animals. To estimate stress we believe it is of great importance to develop non-invasive techniques for monitoring physiological signals during the transport of laboratory animals, thereby allowing the gathering of information on the transport conditions, and, eventually, the improvement of these conditions. Here, we study the suitability of commercially available electric potential integrated circuit (EPIC) sensors, using both contact and contactless techniques, for monitoring the heart rate and breathing rate of non-restrained, non-sedated laboratory mice. The design has been tested under different scenarios with the aim of checking the plausibility of performing contactless capture of mouse heart activity (ideally with an electrocardiogram). First experimental results are shown.

  9. Capacitive Sensing for Non-Invasive Breathing and Heart Monitoring in Non-Restrained, Non-Sedated Laboratory Mice

    Directory of Open Access Journals (Sweden)

    Carlos González-Sánchez

    2016-07-01

    Full Text Available Animal testing plays a vital role in biomedical research. Stress reduction is important for improving research results and increasing the welfare and the quality of life of laboratory animals. To estimate stress we believe it is of great importance to develop non-invasive techniques for monitoring physiological signals during the transport of laboratory animals, thereby allowing the gathering of information on the transport conditions, and, eventually, the improvement of these conditions. Here, we study the suitability of commercially available electric potential integrated circuit (EPIC sensors, using both contact and contactless techniques, for monitoring the heart rate and breathing rate of non-restrained, non-sedated laboratory mice. The design has been tested under different scenarios with the aim of checking the plausibility of performing contactless capture of mouse heart activity (ideally with an electrocardiogram. First experimental results are shown.

  10. Experiences in the monitoring of radiation workers in industry and hospitals in the Philippines

    International Nuclear Information System (INIS)

    Mateo, A.J.

    1976-08-01

    The task of monitoring of radiation doses among radiation workers employed either in industry and hospitals in the Philippines is presently being undertaken by the Philippine Atomic Energy Commission. These radiation monitoring devices cover not only radioactive materials or sources but also x-ray machines. The most common dosimetry used is the film badge. This paper presents some of the experiences gained in the use of the film badge and other dosimeters

  11. Laboratory cost and utilization containment.

    Science.gov (United States)

    Steiner, J W; Root, J M; White, D C

    1991-01-01

    The authors analyzed laboratory costs and utilization in 3,771 cases of Medicare inpatients admitted to a New England academic medical center ("the Hospital") from October 1, 1989 to September 30, 1990. The data were derived from the Hospital's Decision Resource System comprehensive data base. The authors established a historical reference point for laboratory costs as a percentage of total inpatient costs using 1981-82 Medicare claims data and cost report information. Inpatient laboratory costs were estimated at 9.5% of total inpatient costs for pre-Diagnostic Related Groups (DRGs) Medicare discharges. Using this reference point and adjusting for the Hospital's 1990 case mix, the "expected" laboratory cost was 9.3% of total cost. In fact, the cost averaged 11.5% (i.e., 24% above the expected cost level), and costs represented an even greater percentage of DRG reimbursement at 12.9%. If we regard the reimbursement as a total cost target (to eliminate losses from Medicare), then that 12.9% is 39% above the "expected" laboratory proportion of 9.3%. The Hospital lost an average of $1,091 on each DRG inpatient. The laboratory contributed 29% to this loss per case. Compared to other large hospitals, the Hospital was slightly (3%) above the mean direct cost per on-site test and significantly (58%) above the mean number of inpatient tests per inpatient day compared to large teaching hospitals. The findings suggest that careful laboratory cost analyses will become increasingly important as the proportion of patients reimbursed in a fixed manner grows. The future may hold a prospective zero-based laboratory budgeting process based on predictable patterns of DRG admissions or other fixed-reimbursement admission and laboratory utilization patterns.

  12. Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

    International Nuclear Information System (INIS)

    Ballinger, M.Y.; Shields, K.D.

    1999-01-01

    The Pacific Northwest National Laboratory (PNNL) operates a number of research and development (R and D) facilities for the Department of Energy on the Hanford Site. According to DOE Order 5400.1, a Facility Effluent Monitoring Plan is required for each site, facility, or process that uses, generates, releases, or manages significant pollutants or hazardous materials. Three of the R and D facilities: the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling and thus individual Facility Effluent Monitoring Plans (FEMPs) have been developed for them. Because no definition of ''significant'' is provided in DOE Order 5400.1 or the accompanying regulatory guide DOE/EH-0173T, this FEMP was developed to describe monitoring requirements in the DOE-owned, PNNL-operated facilities that do not have individual FEMPs. The remainder of the DOE-owned, PNNL-operated facilities are referred to as Balance-of-Plant (BOP) facilities. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R and D. R and D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in the FEMP

  13. Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Ballinger, M.Y.; Shields, K.D.

    1999-04-02

    The Pacific Northwest National Laboratory (PNNL) operates a number of research and development (R and D) facilities for the Department of Energy on the Hanford Site. According to DOE Order 5400.1, a Facility Effluent Monitoring Plan is required for each site, facility, or process that uses, generates, releases, or manages significant pollutants or hazardous materials. Three of the R and D facilities: the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling and thus individual Facility Effluent Monitoring Plans (FEMPs) have been developed for them. Because no definition of ''significant'' is provided in DOE Order 5400.1 or the accompanying regulatory guide DOE/EH-0173T, this FEMP was developed to describe monitoring requirements in the DOE-owned, PNNL-operated facilities that do not have individual FEMPs. The remainder of the DOE-owned, PNNL-operated facilities are referred to as Balance-of-Plant (BOP) facilities. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R and D. R and D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in the FEMP.

  14. Requirements for the authorization of operation os a calibration laboratory of gamma-ray monitors

    International Nuclear Information System (INIS)

    Silva, Raimundo Dias da; Kibrit, Eduardo

    2011-01-01

    This paper describes the process for obtaining the authorization of operation of a laboratory designed to calibrate area and personal monitors with gamma radiation, by using a sealed Cs-137 source. The regulations of Comissao Nacional de Energia Nuclear (CNEN) are deeply analysed and discussed. The authorization for construction, the authorization for modification of items important to safety, the authorization for the acquisition and handling of radiation sources, the authorization for operating, and the authorization for withdrawal of operation of the laboratory are also discussed. The paper also describes the technical and managerial requirements necessary to operate a gamma radiation calibration laboratory in Brazil. . (author)

  15. Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt.

    Science.gov (United States)

    Elhoseeny, T A; Mohammad, E K

    2013-01-01

    Assessment and improvement of turnaround times (TAT) as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 (SD 31.8) min] was within the College of American Pathologists' benchmark, the 90th percentile was long (96.7 min); 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians (range 1-5) was 3.46 (SD 0.49). The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor (32.3%), followed by routine test TAT (18.5%). Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

  16. Measuring hospital-acquired pressure injuries: A surveillance programme for monitoring performance improvement and estimating annual prevalence.

    Science.gov (United States)

    Jull, Andrew; McCall, Elaine; Chappell, Matt; Tobin, Sam

    2016-06-01

    To describe a surveillance approach for monitoring the effect of improvement initiatives on hospital-acquired pressure injuries and findings arising from that surveillance. Random sampling of patients on the same day of each successive month from a campus of child and adult hospitals using a standard audit tool to identify presence of hospital-acquired pressure injury. Where multiple pressure injuries were present, the most severe grade injury contributed to prevalence. Statistical process control charts were used to monitor monthly performance and Maximum Likelihood Estimation to determine timing of step change. 8274 patients were assessed over 3 years from an eligible population of 32,259 hospitalised patients. 517 patients had hospital-acquired pressure injuries giving an overall prevalence of 6.2% (95% CI 5.7-6.8%). Annual prevalence was 8.4% (95% CI 7.4-9.5%) in the first year, falling to 5.6% (95% CI 4.7-6.4%) in the second year and 4.8% (95% CI 4.0-5.6%) in the third year. A step change was signalled with mean prevalence up to July 2013 being 7.9% (95% CI 7.1-8.8%) and mean prevalence thereafter 4.8% (95% CI 4.2-5.4%). Hospital-acquired pressure injuries were found in all age ranges, but were more frequent in children up to 14 years (17.4%) and those aged 75 years or older (38.7%). Monthly random sampling of patients within clinical units can be used to monitor performance improvement. This approach represents a rational alternative to cross-sectional prevalence surveys especially if the focus is on performance improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Analysis of bias in measurements of potassium, sodium and hemoglobin by an emergency department-based blood gas analyzer relative to hospital laboratory autoanalyzer results.

    Directory of Open Access Journals (Sweden)

    Jian Bo Zhang

    Full Text Available The emergency departments (EDs of Chinese hospitals are gradually being equipped with blood gas machines. These machines, along with the measurement of biochemical markers by the hospital laboratory, facilitate the care of patients with severe conditions who present to the ED. However, discrepancies have been noted between the Arterial Blood Gas (ABG analyzers in the ED and the hospital laboratory autoanalyzer in relation to electrolyte and hemoglobin measurements. The present study was performed to determine whether the ABG and laboratory measurements of potassium, sodium, and hemoglobin levels are equivalent, and whether ABG analyzer results can be used to guide clinical care before the laboratory results become available.Study power analyses revealed that 200 consecutive patients who presented to our ED would allow this prospective single-center cohort study to detect significant differences between ABG- and laboratory-measured potassium, sodium, and hemoglobin levels. Paired arterial and venous blood samples were collected within 30 minutes. Arterial blood samples were measured in the ED by an ABL 90 FLEX blood gas analyzer. The biochemistry and blood cell counts of the venous samples were measured in the hospital laboratory. The potassium, sodium, and hemoglobin concentrations obtained by both methods were compared by using paired Student's t-test, Spearman's correlation, Bland-Altman plots, and Deming regression.The mean ABG and laboratory potassium values were 3.77±0.44 and 4.2±0.55, respectively (P<0.0001. The mean ABG and laboratory sodium values were 137.89±5.44 and 140.93±5.50, respectively (P<0.0001. The mean ABG and laboratory Hemoglobin values were 12.28±2.62 and 12.35±2.60, respectively (P = 0.24.Although there are the statistical difference and acceptable biases between ABG- and laboratory-measured potassium and sodium, the biases do not exceed USCLIA-determined limits. In parallel, there are no statistical differences and

  18. The clinical practice of intraoperative neurophysiological monitoring in Shanghai Huashan Hospital

    Directory of Open Access Journals (Sweden)

    WU Jin-song

    2012-12-01

    Full Text Available Intraoperative neurophysiological monitoring (IONM is the gold standard of the intraoperative functional brain mapping. It employs various electrophysiological methods such as awake craniotomy, intraoperative somatosensory and motor evoked potentials monitoring, intraoperative cortical stimulation and sub-cortical stimulation to accurately map the cortical and sub-cortical nervous pathways so that the continuous assessment and real -time protection of the functional integrity of certain neural structures can be achieved during surgery. Based on decades of clinical practice, the Department of Neurosurgery of Shanghai Huashan Hospital has set up an "IONM clinical practice guideline" used in the institute. The clinical practice guideline covers technical and operation standards of IONM in all kinds of common neurosurgery diseases and does improve the clinical efficacy in neurosurgical procedures.

  19. Non-Invasive Optical Sensor Based Approaches for Monitoring Virus Culture to Minimize BSL3 Laboratory Entry

    Directory of Open Access Journals (Sweden)

    Viswanath Ragupathy

    2015-06-01

    Full Text Available High titers of infectious viruses for vaccine and diagnostic reference panel development are made by infecting susceptible mammalian cells. Laboratory procedures are strictly performed in a Bio-Safety Level-3 (BSL3 laboratory and each entry and exit involves the use of  disposable Personnel Protective Equipment (PPE to observe cell culture conditions. Routine PPE use involves significant recurring costs. Alternative non-invasive optical sensor based approaches to remotely monitor cell culture may provide a promising and cost effective approach to monitor infectious virus cultures resulting in lower disruption and costs. We report here the monitoring of high titer cultures of Human Immunodeficiency Virus-1 (HIV-1 and Herpes Simplex Virus-2 (HSV-2 remotely with the use of optical oxygen sensors aseptically placed inside the cell culture vessel. The replacement of culture media for cell and virus propagation and virus load monitoring was effectively performed using this fluorescent sensor and resulted in half the number of visits to the BSL3 lab (five versus ten.

  20. Heparin-induced thrombocytopenia: reducing misdiagnosis via collaboration between an inpatient anticoagulation pharmacy service and hospital reference laboratory.

    Science.gov (United States)

    Burnett, Allison E; Bowles, Harmony; Borrego, Matthew E; Montoya, Tiffany N; Garcia, David A; Mahan, Charles

    2016-11-01

    Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of lab results. Utilizing retrospective chart review and a database for all patients with a HIT Ab ordered during the study period, we compared the incidence of HIT Ab testing before and after implementation of the pharmacy-driven 4T score intervention. Our intervention significantly reduced the number of inappropriate HIT Ab tests processed (176 vs. 63, p reference laboratories can result in reduction of misdiagnosis of HIT and significant cost savings with similar safety.

  1. Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital.

    Science.gov (United States)

    Konger, Raymond L; Ndekwe, Paul; Jones, Genea; Schmidt, Ronald P; Trey, Marty; Baty, Eric J; Wilhite, Denise; Munshi, Imtiaz A; Sutter, Bradley M; Rao, Maddamsetti; Bashir, Chowdry M

    2016-03-01

    To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team. Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care. Published by Oxford University Press on behalf of the American Society for Clinical Pathology, 2016. This work is written by US Government employees and is in the public domain in the US.

  2. A systematic review of the cost of data collection for performance monitoring in hospitals.

    Science.gov (United States)

    Jones, Cheryl; Gannon, Brenda; Wakai, Abel; O'Sullivan, Ronan

    2015-04-01

    Key performance indicators (KPIs) are used to identify where organisational performance is meeting desired standards and where performance requires improvement. Valid and reliable KPIs depend on the availability of high-quality data, specifically the relevant minimum data set ((MDS) the core data identified as the minimum required to measure performance for a KPI) elements. However, the feasibility of collecting the relevant MDS elements is always a limitation of performance monitoring using KPIs. Preferably, data should be integrated into service delivery, and, where additional data are required that are not currently collected as part of routine service delivery, there should be an economic evaluation to determine the cost of data collection. The aim of this systematic review was to synthesise the evidence base concerning the costs of data collection in hospitals for performance monitoring using KPI, and to identify hospital data collection systems that have proven to be cost minimising. We searched MEDLINE (1946 to May week 4 2014), Embase (1974 to May week 2 2014), and CINAHL (1937 to date). The database searches were supplemented by searching for grey literature through the OpenGrey database. Data was extracted, tabulated, and summarised as part of a narrative synthesis. The searches yielded a total of 1,135 publications. After assessing each identified study against specific inclusion exclusion criteria only eight studies were deemed as relevant for this review. The studies attempt to evaluate different types of data collection interventions including the installation of information communication technology (ICT), improvements to current ICT systems, and how different analysis techniques may be used to monitor performance. The evaluation methods used to measure the costs and benefits of data collection interventions are inconsistent across the identified literature. Overall, the results weakly indicate that collection of hospital data and improvements in data

  3. The application of acoustic emission measurements on laboratory testpieces to large scale pressure vessel monitoring

    International Nuclear Information System (INIS)

    Ingham, T.; Dawson, D.G.

    1975-01-01

    A test pressure vessel containing 4 artificial defects was monitored for emission whilst pressure cycling to failure. Testpieces cut from both the failed vessel and from as-rolled plate material were tested in the laboratory. A marked difference in emission characteristics was observed between plate and vessel testpieces. Activity from vessel material was virtually constant after general yield and emission amplitudes were low. Plate testpieces showed maximum activity at general yield and more frequent high amplitude emissions. An attempt has been made to compare the system sensitivities between the pressure vessel test and laboratory tests. In the absence of an absolute calibration device, system sensitivities were estimated using dummy signals generated by the excitation of an emission sensor. The measurements have shown an overall difference in sensitivity between vessel and laboratory tests of approximately 25db. The reduced sensitivity in the vessel test is attributed to a combination of differences in sensors, acoustic couplant, attenuation, and dispersion relative to laboratory tests and the relative significance of these factors is discussed. Signal amplitude analysis of the emissions monitored from laboratory testpieces showed that, whith losses of the order of 25 to 30db, few emissions would be detected from the pressure vessel test. It is concluded that no reliable prediction of acoustic behaviour of a structure may be made from laboratory test unless testpieces of the actual structural material are used. A considerable improvement in detection sensitivity, is also required for reliable detection of defects in low strength ductile materials and an absolute method of system calibration is required between tests

  4. [Quality use of commercial laboratory for clinical testing services - considering laboratory's role].

    Science.gov (United States)

    Ogawa, Shinji

    2014-12-01

    The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review).

  5. Fifty-five years (1955-2010) of the Coagulation Section at Laboratory of Hematology, Sestre milosrdnice University Hospital, and its founder, hematologist Ljubomir Popović.

    Science.gov (United States)

    Stancić, Vladimir; Stancić, Nevenka; Vucelić, Vesna; Lang, Nada; Grbac, Ljiljana

    2011-09-01

    The Coagulation Section at Laboratory of Hematology, Sestre milosrdnice University Hospital, Zagreb, was founded in 1955 by Ljubomir Popović, hematologist and assistant at School of Medicine, University of Zagreb, in cooperation with hard-working laboratory technicians. Apart from papers on hematologic neoplasms, plasmacytoma and lymphoma, Ljubomir Popović published a number of papers in the field of anticoagulant therapy with heparin and oral anticoagulants, some of which are also in use today. After Ljubomir Popović left the Hospital in 1964, the Laboratory was run by Professor Nedjeljko Milić, head of the newly founded Division of Hematology. In 1968, the management of the Laboratory of Hematology was taken over by Biserka Raić, MS, medical biochemist, until her retirement in 2007. Great development in morphological and cytometric studies of blood and blood cells has been paralleled by continuous progress and almost dominating activities in the diagnosis of hemostasis disorders. In the 1970s, Marko Koprcina, hematologist, and Biserka Raić introduced the then latest tests in practice at all Hospital departments. In that golden age of the Coagulation Section, M. Koprcina, B. Raić and their associates transferred their knowledge to all colleagues in the Hospital. Through that collaboration, high standards in the diagnosis of hemostasis disorders were achieved, from which the currently high level of clinical knowledge about coagulation disorders and their treatment has derived, making Sestre milosrdnice University Hospital one of the leading hospitals in this field in the country. By describing development of the Coagulation Section and the life of its founder Ljubomir Popović, the authors tried to provide an answer to the following question: can today's clinicians still have a deciding role in laboratory development, considering that assessments of different phenomena are always initiated by an interested clinician who is trying to interpret and understand

  6. MONITORING ASPERGILLUS SPECIES BY QUANTITATIVE PCR DURING CONSTRUCTION OF A MULTI-STORY HOSPITAL BUILDING

    Science.gov (United States)

    Noscomial fungal infections represent a persistent threat in hospitals. One of the major issues in fungal control has been monitoring these fungi in a timely manner. Quantitative polymerase chain reaction (QPCR) allows for the rapid (2 to 4 h), sensitive (often down to a single...

  7. Association between air pollution and hospital admission: Case study at three monitoring stations in Malaysia

    Science.gov (United States)

    Zahari, Marina; Zin@Ibrahim, Wan Zawiah Wan; Ismail, Noriszura; Ni, Tan Hui

    2014-06-01

    The relationships between the exposure of pollutants towards hospitalized admission and mortality have been identified in several studies on Asian cities such as Taipei, Bangkok and Tokyo. In Malaysia, evidence on the health risks associated with exposure to pollutants is limited. In this study, daily time-series data were analysed to estimate risks of cardiovascular and respiratory hospitalized admissions associated with particulate matter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide, sulphur dioxide, and ozone concentrations in Klang Valley during 2004-2009. Daily counts of hospital admissions for cardiovascular and respiratory outcomes were obtained from eleven hospitals while pollutants data were taken from several air quality monitoring stations located nearest to the hospitals. These data were fitted with Generalised Additive Poisson regression models. Additionally, temperature, humidity, and time data were also included to allow for potential effect of weather and time-varying influences on hospital admissions. CO showed the most significant (P Malaysia.

  8. Monitoring Hospitalized Adult Patients for Opioid-Induced Sedation and Respiratory Depression.

    Science.gov (United States)

    Jungquist, Carla R; Smith, Kirsten; Nicely, Kelly L Wiltse; Polomano, Rosemary C

    2017-03-01

    : Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks. The authors review the literature on unintended advancing sedation and respiratory depression associated with opioid administration and present evidence-based recommendations for clinical decision making and patient monitoring, using both nursing assessments and electronic technologies.

  9. 1998 Environmental Monitoring Program Report for the Idaho National Engineering and Environmental Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    L. V. Street

    1999-09-01

    This report describes the calendar year 1998 compliance monitoring and environmental surveillance activities of the Lockheed Martin Idaho Technologies Company Environmental Monitoring Program performed at the Idaho National Engineering and Environmental Laboratory. This report includes results of sampling performed by the Drinking Water, Effluent, Storm Water, Groundwater Monitoring, and Environmental Surveillance Programs. This report compares the 1998 results to program-specific regulatory guidelines and past data to evaluate trends. The primary purposes of the monitoring and surveillance activities are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standards, and to ensure protection of public health and the environment. Surveillance of environmental media did not identify any previously unknown environmental problems or trends, which would indicate a loss of control or unplanned releases from facility operations. The INEEL complied with permits and applicable regulations, with the exception of nitrogen samples in a disposal pond effluent stream and iron and total coliform bacteria in groundwater downgradient from one disposal pond. Data collected by the Environmental Monitoring Program demonstrate that the public health and environment were protected.

  10. 1987 environmental monitoring report, Sandia National Laboratories, Livermore, California

    International Nuclear Information System (INIS)

    Devlin, T.K.

    1988-04-01

    Sandia National Labortories conduct various research activities related to Department of Energy interests which have the potential for release of hazardous materials or radionuclides to the environment. A strict environmental control program places maximum emphasis on limiting releases. The environmental monitoring program conducted by Lawrence Livermore National Laboratory and augmented by Sandia is designed to measure the performance of the environmental controls. The program includes analysis of air, water, soil, vegetation, sewer effluent, ground water, and foodstuffs for various toxic, hazardous, or radioactive materials. Based on these studies, the releases of materials of concern at Sandia during 1987 were well below applicable Department of Energy standards. 8 refs., 3 figs., 12 tabs

  11. TEMPERATURE MONITORING OPTIONS AVAILABLE AT THE IDAHO NATIONAL LABORATORY ADVANCED TEST REACTOR

    Energy Technology Data Exchange (ETDEWEB)

    J.E. Daw; J.L. Rempe; D.L. Knudson; T. Unruh; B.M. Chase; K.L Davis

    2012-03-01

    As part of the Advanced Test Reactor National Scientific User Facility (ATR NSUF) program, the Idaho National Laboratory (INL) has developed in-house capabilities to fabricate, test, and qualify new and enhanced sensors for irradiation testing. To meet recent customer requests, an array of temperature monitoring options is now available to ATR users. The method selected is determined by test requirements and budget. Melt wires are the simplest and least expensive option for monitoring temperature. INL has recently verified the melting temperature of a collection of materials with melt temperatures ranging from 100 to 1000 C with a differential scanning calorimeter installed at INL’s High Temperature Test Laboratory (HTTL). INL encapsulates these melt wires in quartz or metal tubes. In the case of quartz tubes, multiple wires can be encapsulated in a single 1.6 mm diameter tube. The second option available to ATR users is a silicon carbide temperature monitor. The benefit of this option is that a single small monitor (typically 1 mm x 1 mm x 10 mm or 1 mm diameter x 10 mm length) can be used to detect peak irradiation temperatures ranging from 200 to 800 C. Equipment has been installed at INL’s HTTL to complete post-irradiation resistivity measurements on SiC monitors, a technique that has been found to yield the most accurate temperatures from these monitors. For instrumented tests, thermocouples may be used. In addition to Type-K and Type-N thermocouples, a High Temperature Irradiation Resistant ThermoCouple (HTIR-TC) was developed at the HTTL that contains commercially-available doped molybdenum paired with a niobium alloy thermoelements. Long duration high temperature tests, in furnaces and in the ATR and other MTRs, demonstrate that the HTIR-TC is accurate up to 1800 C and insensitive to thermal neutron interactions. Thus, degradation observed at temperatures above 1100 C with Type K and N thermocouples and decalibration due to transmutation with tungsten

  12. Determination of contamination operational value by routine monitoring in research laboratories

    International Nuclear Information System (INIS)

    Salomao, Edeilson; Medeiros, Regina Bitelli; Mattos, Maria Fernanda S.S.; Daros, Kellen Adriana Curci

    2008-01-01

    The radioisotopes have a large spectrum of applicability in many areas of science, as in medicine, agriculture and industry in general. In the biological area, the radioisotopes have brought many benefits to study physiological processes in living organisms and in vitro. The most radioisotopes used in biological research are emitters of radiation of low energy, mainly β, and are used as unsealed sources. The manipulation of these radioisotopes generates radioactive wastes and eventually can cause contamination in the areas of handling or even occasionally in areas to which access is not controlled. According to CNEN-NE-3.02 standard is necessary and mandatory the exposure and contamination levels control in the areas of handling of unsealed sources. The goal of the work is to establish how often the monitoring should be done through the survey of the contamination and exposure levels, in areas designed to manipulate 32 P and how this monitoring can contribute to the improvement the conditions of radiological protection. From the twenty eight research laboratories registered by 'Nucleo de Protecao Radiologica' (NPR) were selected four where the activities are not restrict to 32 P biological assays. The levels of contamination and exposure were evaluated using monitors GM and the layout of laboratories containing the points to be tracker defined based on the researchers' routine. At each point three values were obtained to measure the rate of contamination on the surface and exposure rate. The measures were made twice a week before and after the radioisotope manipulation. Based on these data was possible to establish the range from 0,306 to 0,678 Bq.cm -2 as operational average level to the superficial contamination. The average exposure rate measured was 5.16 n C/Kg.h. The results were important to demonstrating to researchers how they can contribute to the improvement of radiological protection conditions. (author)

  13. 1997 LMITCO Environmental Monitoring Program Report for the Idaho National Engineering and Environmental Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, B.; Street, L.; Wilhelmsen, R.

    1998-09-01

    This report describes the calendar year 1997 environmental surveillance and compliance monitoring activities of the Lockheed Martin Idaho Technologies Company Environmental Monitoring Program performed at the Idaho National Engineering and Environmental Laboratory. This report includes results of sampling performed by the Radiological Environmental Surveillance, Site Environmental Surveillance, Drinking Water, Effluent Monitoring, Storm Water Monitoring, Groundwater Monitoring, and Special Request Monitoring Programs and compares 1997 data with program-specific regulatory guidelines and past data to evaluate trends. The primary purposes of the surveillance and monitoring activities are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standard, and to ensure protection of human health and the environment. Surveillance of environmental media did not identify any previously unknown environmental problems or trends indicating a loss of control or unplanned releases from facility operations. With the exception of one nitrogen sample in the disposal pond effluent stream and iron and total coliform bacteria in groundwater downgradient from one disposal pond, compliance with permits and applicable regulations was achieved. Data collected by the Environmental Monitoring Program demonstrate that public health and the environment were protected.

  14. Mass Spectrometry in Clinical Laboratory: Applications in Therapeutic Drug Monitoring and Toxicology.

    Science.gov (United States)

    Garg, Uttam; Zhang, Yan Victoria

    2016-01-01

    Mass spectrometry (MS) has been used in research and specialized clinical laboratories for decades as a very powerful technology to identify and quantify compounds. In recent years, application of MS in routine clinical laboratories has increased significantly. This is mainly due to the ability of MS to provide very specific identification, high sensitivity, and simultaneous analysis of multiple analytes (>100). The coupling of tandem mass spectrometry with gas chromatography (GC) or liquid chromatography (LC) has enabled the rapid expansion of this technology. While applications of MS are used in many clinical areas, therapeutic drug monitoring, drugs of abuse, and clinical toxicology are still the primary focuses of the field. It is not uncommon to see mass spectrometry being used in routine clinical practices for those applications.

  15. 1985 Environmental Monitoring Program report for the Idaho National Engineering Laboratory site

    International Nuclear Information System (INIS)

    Hoff, D.L.; Chew, E.W.; Rope, S.K.

    1986-05-01

    The results of the various monitoring programs for 1985 indicated that radioactivity from the Idaho National Engineering Laboratory (INEL) Site operations could not be distinguished from worldwide fallout and natural radioactivity in the region surrounding the Site. Although some radioactive materials were discharged during Site operations, concentrations and doses to the surrounding population were of no health consequence and were far less than State of Idaho and Federal health protection guidelines. This report describes the air, water, and foodstuff samples routinely collected at the INEL boundary locations and at locations distant from the INEL Site. It compares and evaluates the sample results, discussing implications, if any. Included for the first time this year are data from air and water samples routinely collected from onsite locations. The report also summarizes significant environmental activities at the INEL Site during 1985, nonradioactive and radioactive effluent monitoring at the Site, and the US Geological Survey (USGS) groundwater monitoring program

  16. Assessment of laboratory and daily energy expenditure estimates from consumer multi-sensor physical activity monitors.

    Science.gov (United States)

    Chowdhury, Enhad A; Western, Max J; Nightingale, Thomas E; Peacock, Oliver J; Thompson, Dylan

    2017-01-01

    Wearable physical activity monitors are growing in popularity and provide the opportunity for large numbers of the public to self-monitor physical activity behaviours. The latest generation of these devices feature multiple sensors, ostensibly similar or even superior to advanced research instruments. However, little is known about the accuracy of their energy expenditure estimates. Here, we assessed their performance against criterion measurements in both controlled laboratory conditions (simulated activities of daily living and structured exercise) and over a 24 hour period in free-living conditions. Thirty men (n = 15) and women (n = 15) wore three multi-sensor consumer monitors (Microsoft Band, Apple Watch and Fitbit Charge HR), an accelerometry-only device as a comparison (Jawbone UP24) and validated research-grade multi-sensor devices (BodyMedia Core and individually calibrated Actiheart™). During discrete laboratory activities when compared against indirect calorimetry, the Apple Watch performed similarly to criterion measures. The Fitbit Charge HR was less consistent at measurement of discrete activities, but produced similar free-living estimates to the Apple Watch. Both these devices underestimated free-living energy expenditure (-394 kcal/d and -405 kcal/d, respectively; P<0.01). The multi-sensor Microsoft Band and accelerometry-only Jawbone UP24 devices underestimated most laboratory activities and substantially underestimated free-living expenditure (-1128 kcal/d and -998 kcal/d, respectively; P<0.01). None of the consumer devices were deemed equivalent to the reference method for daily energy expenditure. For all devices, there was a tendency for negative bias with greater daily energy expenditure. No consumer monitors performed as well as the research-grade devices although in some (but not all) cases, estimates were close to criterion measurements. Thus, whilst industry-led innovation has improved the accuracy of consumer monitors, these devices

  17. Assessment of laboratory and daily energy expenditure estimates from consumer multi-sensor physical activity monitors.

    Directory of Open Access Journals (Sweden)

    Enhad A Chowdhury

    Full Text Available Wearable physical activity monitors are growing in popularity and provide the opportunity for large numbers of the public to self-monitor physical activity behaviours. The latest generation of these devices feature multiple sensors, ostensibly similar or even superior to advanced research instruments. However, little is known about the accuracy of their energy expenditure estimates. Here, we assessed their performance against criterion measurements in both controlled laboratory conditions (simulated activities of daily living and structured exercise and over a 24 hour period in free-living conditions. Thirty men (n = 15 and women (n = 15 wore three multi-sensor consumer monitors (Microsoft Band, Apple Watch and Fitbit Charge HR, an accelerometry-only device as a comparison (Jawbone UP24 and validated research-grade multi-sensor devices (BodyMedia Core and individually calibrated Actiheart™. During discrete laboratory activities when compared against indirect calorimetry, the Apple Watch performed similarly to criterion measures. The Fitbit Charge HR was less consistent at measurement of discrete activities, but produced similar free-living estimates to the Apple Watch. Both these devices underestimated free-living energy expenditure (-394 kcal/d and -405 kcal/d, respectively; P<0.01. The multi-sensor Microsoft Band and accelerometry-only Jawbone UP24 devices underestimated most laboratory activities and substantially underestimated free-living expenditure (-1128 kcal/d and -998 kcal/d, respectively; P<0.01. None of the consumer devices were deemed equivalent to the reference method for daily energy expenditure. For all devices, there was a tendency for negative bias with greater daily energy expenditure. No consumer monitors performed as well as the research-grade devices although in some (but not all cases, estimates were close to criterion measurements. Thus, whilst industry-led innovation has improved the accuracy of consumer monitors

  18. Measurement comparisons of radioactivity among European monitoring laboratories for the environment and food stuff

    International Nuclear Information System (INIS)

    Waetjen, U.; Spasova, Y.; Altzitzoglou, T.

    2008-01-01

    For more than 15 years, European Union (EU) laboratories monitoring environmental radioactivity have been obliged to participate in measurement comparisons organised by the European Commission. After a short review of comparisons conducted during the 1990s, the approach of IRMM organising these comparisons since 2003 is presented. It relies on the provision of comparison samples with reference values traceable to the International Reference System for radionuclides (SIR). The results of the most recent comparison, the determination of 40 K, 90 Sr and 137 Cs in milk powder, are presented. The influence of repetitive participation in measurement comparisons on laboratory performance is studied on the basis of data from more than 20 laboratories having participated in several exercises during the last 15 years

  19. Management and technical requirements for laboratories in charge of water monitoring

    International Nuclear Information System (INIS)

    Ottaviani, M.; Bonadonna, L.; Lucentini, L.; Pettine, P.

    2008-01-01

    This report completes the series of volumes focused on microbiological (Rapporti ISTISAN 07/5) and chemical methods (Rapporti ISTISAN 07/31) for the monitoring of water intended for human consumption according to the Italian Legislative Decree 31/2001 (transposition of European Directive 98/83/EC) and its integrations. The guidelines here presented concern management and technical requirements for laboratories in charge of testing parameters required by the Decree also taking into account the criteria stated by the standard UNI CEI EN ISO/IEC 17025 [it

  20. Surveillance of infection severity: a registry study of laboratory diagnosed Clostridium difficile.

    Directory of Open Access Journals (Sweden)

    Iryna Schlackow

    conditions can be established using routinely collected laboratory hospital data. In the settings studied here these systems have higher performance than those monitoring mortality, at least in C. difficile infection. Such systems could have wider applicability for monitoring infections presenting in hospital.

  1. The Cost-Effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing

    Directory of Open Access Journals (Sweden)

    Bogavac-Stanojevic Natasa

    2017-09-01

    Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with

  2. Virtual-Instrument-Based Online Monitoring System for Hands-on Laboratory Experiment of Partial Discharges

    Science.gov (United States)

    Karmakar, Subrata

    2017-01-01

    Online monitoring of high-voltage (HV) equipment is a vital tool for early detection of insulation failure. Most insulation failures are caused by partial discharges (PDs) inside the HV equipment. Because of the very high cost of establishing HV equipment facility and the limitations of electromagnetic interference-screened laboratories, only a…

  3. Groundwater level monitoring sampling and analysis plan for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    This Sampling and Analysis Plan addresses groundwater level monitoring activities that will be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory, a research facility owned by the US Department of Energy and managed by Martin Marietta Energy Systems, Inc. Groundwater level monitoring will be conducted at 129 sites within the WAG. All of the sites will be manually monitored on a semiannual basis. Forty-five of the 128 wells, plus one site in White Oak Lake, will also be equipped with automatic water level monitoring equipment. The 46 sites are divided into three groups. One group will be equipped for continuous monitoring of water level, conductivity, and temperature. The other two groups will be equipped for continuous monitoring of water level only. The equipment will be rotated between the two groups. The data collected from the water level monitoring will be used to support determination of the contaminant flux at WAG 6.

  4. Groundwater level monitoring sampling and analysis plan for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1994-04-01

    This Sampling and Analysis Plan addresses groundwater level monitoring activities that will be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory, a research facility owned by the US Department of Energy and managed by Martin Marietta Energy Systems, Inc. Groundwater level monitoring will be conducted at 129 sites within the WAG. All of the sites will be manually monitored on a semiannual basis. Forty-five of the 128 wells, plus one site in White Oak Lake, will also be equipped with automatic water level monitoring equipment. The 46 sites are divided into three groups. One group will be equipped for continuous monitoring of water level, conductivity, and temperature. The other two groups will be equipped for continuous monitoring of water level only. The equipment will be rotated between the two groups. The data collected from the water level monitoring will be used to support determination of the contaminant flux at WAG 6

  5. Calgary Laboratory Services

    Directory of Open Access Journals (Sweden)

    James R. Wright MD, PhD

    2015-12-01

    Full Text Available Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta’s debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an “unhappy shotgun marriage” by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context.

  6. Real-time alpha monitoring of a radioactive liquid waste stream at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J.D.; Whitley, C.R.; Rawool-Sullivan, M. [Los Alamos National Lab., NM (United States)

    1995-12-31

    This poster display concerns the development, installation, and testing of a real-time radioactive liquid waste monitor at Los Alamos National Laboratory (LANL). The detector system was designed for the LANL Radioactive Liquid Waste Treatment Facility so that influent to the plant could be monitored in real time. By knowing the activity of the influent, plant operators can better monitor treatment, better segregate waste (potentially), and monitor the regulatory compliance of users of the LANL Radioactive Liquid Waste Collection System. The detector system uses long-range alpha detection technology, which is a nonintrusive method of characterization that determines alpha activity on the liquid surface by measuring the ionization of ambient air. Extensive testing has been performed to ensure long-term use with a minimal amount of maintenance. The final design was a simple cost-effective alpha monitor that could be modified for monitoring influent waste streams at various points in the LANL Radioactive Liquid Waste Collection System.

  7. Radiation monitoring in a self-shielded cyclotron installation

    International Nuclear Information System (INIS)

    Capaccioli, L.; Gori, C.; Mazzocchi, S.; Spano, G.

    2002-01-01

    As nuclear medicine is approaching a new era with the spectacular growth of PET diagnosis, the number of medical cyclotrons installed within the major hospitals is increasing accordingly. Therefore modern medical cyclotron are highly engineered and highly reliable apparatus, characterised with reduced accelerating energies (as the major goal is the production of fluorine 18) and often self-shielded. However specific dedicated monitors are still necessary in order to assure the proper radioprotection. At the Careggi University Hospital in Florence a Mini trace 10 MeV self-shielded cyclotron produced by General Electric has been installed in 2000. In a contiguous radiochemistry laboratory, the preparation and quality control of 1 8F DG and other radiopharmaceuticals takes place. Aim of this work is the characterisation and the proper calibration of the above mentioned monitors and control devices

  8. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories.

    Science.gov (United States)

    Niesters, H G; Rossen, J W; van der Avoort, H; Baas, D; Benschop, K; Claas, E C; Kroneman, A; van Maarseveen, N; Pas, S; van Pelt, W; Rahamat-Langendoen, J C; Schuurman, R; Vennema, H; Verhoef, L; Wolthers, K; Koopmans, M

    2013-01-24

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for characterisation and typing. However, with the introduction of molecular diagnostic methods and sequencing in most of the larger diagnostic and university hospital centres in high-income countries, the distinction between diagnostic and reference/public health laboratory functions has become less clear-cut. Given these developments, new ways of networking and data sharing are needed. Assuming that clinical and public health laboratories may be able to use the same data for their own purposes when sequence-based testing and typing are used, we explored ways to develop a collaborative approach and a jointly owned database (TYPENED) in the Netherlands. The rationale was that sequence data - whether produced to support clinical care or for surveillance -can be aggregated to meet both needs. Here we describe the development of the TYPENED approach and supporting infrastructure, and the implementation of a pilot laboratory network sharing enterovirus sequences and metadata.

  9. Advancing internal erosion monitoring using seismic methods in field and laboratory studies

    Science.gov (United States)

    Parekh, Minal L.

    This dissertation presents research involving laboratory and field investigation of passive and active methods for monitoring and assessing earthen embankment infrastructure such as dams and levees. Internal erosion occurs as soil particles in an earthen structure migrate to an exit point under seepage forces. This process is a primary failure mode for dams and levees. Current dam and levee monitoring practices are not able to identify early stages of internal erosion, and often the result is loss of structure utility and costly repairs. This research contributes to innovations for detection and monitoring by studying internal erosion and monitoring through field experiments, laboratory experiments, and social and political framing. The field research in this dissertation included two studies (2009 and 2012) of a full-scale earthen embankment at the IJkdijk in the Netherlands. In both of these tests, internal erosion occurred as evidenced by seepage followed by sand traces and boils, and in 2009, eventual failure. With the benefit of arrays of closely spaced piezometers, pore pressure trends indicated internal erosion near the initiation time. Temporally and spatially dense pore water pressure measurements detected two pore water pressure transitions characteristic to the development of internal erosion, even in piezometers located away from the backward erosion activity. At the first transition, the backward erosion caused anomalous pressure decrease in piezometers, even under constant or increasing upstream water level. At the second transition, measurements stabilized as backward erosion extended further upstream of the piezometers, as shown in the 2009 test. The transitions provide an indication of the temporal development and the spatial extent of backward erosion. The 2012 IJkdijk test also included passive acoustic emissions (AE) monitoring. This study analyzed AE activity over the course of the 7-day test using a grid of geophones installed on the

  10. Comparative evaluations of individual radiation doses at hospital environment in two decades 73-82 and 86-95

    International Nuclear Information System (INIS)

    Carreira, Mauricio Costa; Almeida, Adelaide de; Santos, Maria Concepta P.S.

    1996-01-01

    Individual radiation doses in two decades of Hospital das Clinicas, Ribeirao Preto, Sao Paulo State, Brazil, are analysed. The annual values are studied according to the hospital service and specific worker categories. The workers are classified in categories A or B as recommended by ICRP 35. Three types of individual monitors (film badges, Ca So 4 and Li F + Ca So 4 ) supplied by three distinct laboratories are compared

  11. Annual environmental monitoring report of the Lawrence Berkeley Laboratory, 1977

    International Nuclear Information System (INIS)

    Stephens, L.D.

    1978-03-01

    The data obtained from the Environmental Monitoring Program of the Lawrence Berkeley Laboratory for the Calendar year 1977 are described and general trends are discussed. The general trend of decreasing radiation levels at our site boundary due to accelerator operation during past years has leveled off during 1977 and in some areas shows a slight but not statistically significant increase as predicted in last year's summary. There were changes in both ion beams as well as current which have resulted in shifts in maxima at the monitoring stations. The gamma levels are once again reported as zero. There is only one period of detectable gamma radiation due to accelerator operation. The annual dose equivalent are reported from the environmental monitoring stations since they have been established. Radiation levels at the Olympus Gate Station have shown a steady decline since 1959 when estimates were first made. The Olympus Gate Station is in direct view of the Bevatron and most directly influenced by that accelerator. Over the past several years the atmospheric sampling program has, with the exception of occasional known releases, yielded data which are within the range of normal background. The surface water program always yields results within the range of normal background. As no substantial changes in the quantities of radionuclides used are anticipated, no changes are expected in these observations

  12. Los Alamos National Laboratory Meteorology Monitoring Program: 2016 Data Completeness/ Quality Report

    Energy Technology Data Exchange (ETDEWEB)

    Bruggeman, David Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-15

    This report summarizes data completeness by tower and by instrument for 2016 and compares that data with the Los Alamos National Laboratory (LANL) and American National Standards Institute (ANSI) 2015 standards. This report is designed to make data users aware of data completeness and any data quality issues. LANL meteorology monitoring goals include 95% completeness for all measurements. The ANSI 2015 standard requires 90% completeness for all measurements. This report documents instrument/tower issues as they impact data completeness.

  13. Health centres' view of the services provided by a university hospital laboratory: Use of satisfaction surveys

    Science.gov (United States)

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-01-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  14. Quality Indicators in Laboratory Medicine: from theory to practice. Preliminary data from the IFCC Working Group Project "Laboratory Errors and Patient Safety".

    Science.gov (United States)

    Sciacovelli, Laura; O'Kane, Maurice; Skaik, Younis Abdelwahab; Caciagli, Patrizio; Pellegrini, Cristina; Da Rin, Giorgio; Ivanov, Agnes; Ghys, Timothy; Plebani, Mario

    2011-05-01

    The adoption of Quality Indicators (QIs) has prompted the development of tools to measure and evaluate the quality and effectiveness of laboratory testing, first in the hospital setting and subsequently in ambulatory and other care settings. While Laboratory Medicine has an important role in the delivery of high-quality care, no consensus exists as yet on the use of QIs focussing on all steps of the laboratory total testing process (TTP), and further research in this area is required. In order to reduce errors in laboratory testing, the IFCC Working Group on "Laboratory Errors and Patient Safety" (WG-LEPS) developed a series of Quality Indicators, specifically designed for clinical laboratories. In the first phase of the project, specific QIs for key processes of the TTP were identified, including all the pre-, intra- and post-analytic steps. The overall aim of the project is to create a common reporting system for clinical laboratories based on standardized data collection, and to define state-of-the-art and Quality Specifications (QSs) for each QI independent of: a) the size of organization and type of activities; b) the complexity of processes undertaken; and c) different degree of knowledge and ability of the staff. The aim of the present paper is to report the results collected from participating laboratories from February 2008 to December 2009 and to identify preliminary QSs. The results demonstrate that a Model of Quality Indicators managed as an External Quality Assurance Program can serve as a tool to monitor and control the pre-, intra- and post-analytical activities. It might also allow clinical laboratories to identify risks that lead to errors resulting in patient harm: identification and design of practices that eliminate medical errors; the sharing of information and education of clinical and laboratory teams on practices that reduce or prevent errors; the monitoring and evaluation of improvement activities.

  15. A fuzzy model for processing and monitoring vital signs in ICU patients

    Directory of Open Access Journals (Sweden)

    Valentim Ricardo AM

    2011-08-01

    Full Text Available Abstract Background The area of the hospital automation has been the subject of much research, addressing relevant issues which can be automated, such as: management and control (electronic medical records, scheduling appointments, hospitalization, among others; communication (tracking patients, staff and materials, development of medical, hospital and laboratory equipment; monitoring (patients, staff and materials; and aid to medical diagnosis (according to each speciality. Methods In this context, this paper presents a Fuzzy model for helping medical diagnosis of Intensive Care Unit (ICU patients and their vital signs monitored through a multiparameter heart screen. Intelligent systems techniques were used in the data acquisition and processing (sorting, transforming, among others it into useful information, conducting pre-diagnosis and providing, when necessary, alert signs to the medical staff. Conclusions The use of fuzzy logic turned to the medical area can be very useful if seen as a tool to assist specialists in this area. This paper presented a fuzzy model able to monitor and classify the condition of the vital signs of hospitalized patients, sending alerts according to the pre-diagnosis done helping the medical diagnosis.

  16. Meteorological Monitoring Sampling and Analysis Plan for Environmental Monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-12-01

    This Sampling and Analysis Plan addresses meteorological monitoring activities that will be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory (ORNL). Meterological monitoring of various climatological parameters (eg., temperature, wind speed, humidity) will be collected by instruments installed at WAG 6. Data will be recorded electronically at frequencies varying from 5-min intervals to 1-h intervals, dependent upon parameter. The data will be downloaded every 2 weeks, evaluated, compressed, and uploaded into a WAG 6 data base for subsequent use. The meteorological data will be used in water balance calculations in support of the WAG 6 hydrogeological model

  17. Applicability of a generic monitoring program for radioactive waste burial grounds at Oak Ridge National Laboratory and Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    1978-07-01

    Six burial grounds were evaluated at Oak Ridge to determine which would be most suitable for testing the generic monitoring approach, and two were selected. Burial Ground 4 was chosen because it is known to be leaking radioactivity and a monitoring program is desirable to determine the source, pattern and extent of the leakage. Burial Ground 6 was chosen because the most complete radiologic and geologic data is available and modern burial practices have been utilized at this site. At the Idaho National Engineering Laboratory (INEL) only one burial ground exists, the Radioactive Waste Management Complex (RWMC). The data available on the burial grounds are insufficient for an adequate understanding of radionuclide migration patterns and accordingly, inadequate for the design of reliable monitoring programs. It was decided, therefore, that preliminary monitoring programs should be designed in order to obtain additional data for a later implementation of reliable monitoring programs. The monitoring programs designed for ORNL consist primarily of the installation of surface water monitoring stations, the surveillance of trench sump wells, a test boring program to study subsurface geologic conditions, a ground water sampling program and the installation of instrumentation, specifically infiltrometers and evaporation pans, to develop data on site water balances. The program designed for the INEL burial ground includes installation of trench sumps, a ground water monitoring program, test borings to further define subsurface geohydrologic conditions and the installation of instrumentation to develop data on the site water balance. The estimated costs of implementing the recommended programs are about $420,820 for monitoring Burial Grounds 4 and 6 at Oak Ridge and $382,060 for monitoring the RWMC at INEL. 12 figures

  18. [Surface Cleaning and Disinfection in the Hospital. Improvement by Objective Monitoring and Intervention].

    Science.gov (United States)

    Woltering, R; Hoffmann, G; Isermann, J; Heudorf, U

    2016-11-01

    Background and Objective: An assessment of cleaning and disinfection in hospitals by the use of objective surveillance and review of mandatory corrective measures was undertaken. Methods: A prospective examination of the cleaning and disinfection of surfaces scheduled for daily cleaning in 5 general care hospitals by use of an ultraviolet fluorescence targeting method (UVM) was performed, followed by structured educational and procedural interventions. The survey was conducted in hospital wards, operating theatres and intensive care units. Cleaning performance was measured by complete removal of UVM. Training courses and reinforced self-monitoring were implemented after the first evaluation. 6 months later, we repeated the assessment for confirmation of success. Results: The average cleaning performance was 34% (31/90) at base-line with significant differences between the 5 hospitals (11-67%). The best results were achieved in intensive care units (61%) and operating theatres (58%), the worst results in hospital wards (22%). The intervention significantly improved cleaning performance up to an average of 69% (65/94; +34.7%; 95% confidence interval (CI): 21.2-48.3; pcleaning and disinfection of surfaces by fluorescence targeting is appropriate for evaluating hygiene regulations. An intervention can lead to a significant improvement of cleaning performance. As part of a strategy to improve infection control in hospitals, fluorescence targeting enables a simple inexpensive and effective surveillance of the cleaning performance and corrective measures. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Study of variables affecting critical value notification in a laboratory catering to tertiary care hospital.

    Science.gov (United States)

    Agarwal, Rachna; Chhillar, Neelam; Tripathi, Chandra B

    2015-01-01

    During post-analytical phase, critical value notification to responsible caregiver in a timely manner has potential to improve patient safety which requires cooperative efforts between laboratory personnel and caregivers. It is widely accepted by hospital accreditors that ineffective notification can lead to diagnostic errors that potentially harm patients and are preventable. The objective of the study was to assess the variables affecting critical value notification, their role in affecting it's quality and approaches to improve it. In the present study 1,187 critical values were analysed in the Clinical Chemistry Laboratory catering to tertiary care hospital for neuropsychiatric diseases. During 25 months of study period, we evaluated critical value notification with respect to clinical care area, caregiver to whom it was notified and timeliness of notification. During the study period (25 months), the laboratory obtained 1,279 critical values in clinical chemistry. The analytes most commonly notified were sodium and potassium (20.97 & 20.8 % of total critical results). Analysis of critical value notification versus area of care showed that critical value notification was high in ICU and emergency area followed by inpatients and 64.61 % critical values were notified between 30 and 120 min after receiving the samples. It was found that failure to notify the responsible caregiver in timely manner represent an important patient safety issue and may lead to diagnostic errors. The major area of concern are notification of critical value for outpatient samples, incompleteness of test requisition forms regarding illegible writing, lack of information of treating physician and location of test ordering and difficulty in contacting the responsible caregiver.

  20. Diagnostic trends in Clostridium difficile detection in Finnish microbiology laboratories.

    Science.gov (United States)

    Könönen, Eija; Rasinperä, Marja; Virolainen, Anni; Mentula, Silja; Lyytikäinen, Outi

    2009-12-01

    Due to increased interest directed to Clostridium difficile-associated infections, a questionnaire survey of laboratory diagnostics of toxin-producing C. difficile was conducted in Finland in June 2006. Different aspects pertaining to C. difficile diagnosis, such as requests and criteria used for testing, methods used for its detection, yearly changes in diagnostics since 1996, and the total number of investigations positive for C. difficile in 2005, were asked in the questionnaire, which was sent to 32 clinical microbiology laboratories, including all hospital-affiliated and the relevant private clinical microbiology laboratories in Finland. The situation was updated by phone and email correspondence in September 2008. In June 2006, 28 (88%) laboratories responded to the questionnaire survey; 24 of them reported routinely testing requested stool specimens for C. difficile. Main laboratory methods included toxin detection (21/24; 88%) and/or anaerobic culture (19/24; 79%). In June 2006, 18 (86%) of the 21 laboratories detecting toxins directly from feces, from the isolate, or both used methods for both toxin A (TcdA) and B (TcdB), whereas only one laboratory did so in 1996. By September 2008, all of the 23 laboratories performing diagnostics for C. difficile used methods for both TcdA and TcdB. In 2006, the number of specimens processed per 100,000 population varied remarkably between different hospital districts. In conclusion, culturing C. difficile is common and there has been a favorable shift in toxin detection practice in Finnish clinical microbiology laboratories. However, the variability in diagnostic activity reported in 2006 creates a challenge for national monitoring of the epidemiology of C. difficile and related diseases.

  1. Towards a rational antimicrobial testing policy in the laboratory

    Directory of Open Access Journals (Sweden)

    N Banaji

    2011-01-01

    Full Text Available Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital′s antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  2. Wireless physiological monitoring system for psychiatric patients.

    Science.gov (United States)

    Rademeyer, A J; Blanckenberg, M M; Scheffer, C

    2009-01-01

    Patients in psychiatric hospitals that are sedated or secluded are at risk of death or injury if they are not continuously monitored. Some psychiatric patients are restless and aggressive, and hence the monitoring device should be robust and must transmit the data wirelessly. Two devices, a glove that measures oxygen saturation and a dorsally-mounted device that measures heart rate, skin temperature and respiratory rate were designed and tested. Both devices connect to one central monitoring station using two separate Bluetooth connections, ensuring a completely wireless setup. A Matlab graphical user interface (GUI) was developed for signal processing and monitoring of the vital signs of the psychiatric patient. Detection algorithms were implemented to detect ECG arrhythmias such as premature ventricular contraction and atrial fibrillation. The prototypes were manufactured and tested in a laboratory setting on healthy volunteers.

  3. Intercomparison of in vivo monitoring systems in Europe. Results from Risoe National Laboratory

    International Nuclear Information System (INIS)

    Lauridsen, B.; Soegaard-Hansen, J.

    1996-12-01

    This report contains the contribution from Risoe National Laboratory to the European project: 'Intercomparison of in Vivo Monitoring Systems in Europe'. The whole-body counter at Risoe and the measurement on a phantom used as an intercalibration object in the project is described. In four case studies, prepared by the project coordinator, intakes of radionuclides and resulting doses are calculated. These calculations are based on informations on the radioactive materials taken into the body, routes of intake and on body contents of radionuclides from simulated single or multiple whole-body measurement. The answer from Risoe National Laboratory to two questionnaires - one on the whole-body counting facility and calibration methods and one on the legal requirements is the country - is listed. (au)

  4. Mining of hospital laboratory information systems: a model study defining age- and gender-specific reference intervals and trajectories for plasma creatinine in a pediatric population.

    Science.gov (United States)

    Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas; Sørensen, Steen

    2015-09-01

    The knowledge of physiological fluctuation and variation of even commonly used biochemical quantities in extreme age groups and during development is sparse. This challenges the clinical interpretation and utility of laboratory tests in these age groups. To explore the utility of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high-resolution gender- and age-groups. Normal probability plots were used to deduce parameters of the normal distributions from healthy creatinine values in the mixed hospital datasets. Furthermore, temporal trajectories were generated from repeated measurements to examine developmental patterns in periods of changing creatinine levels. Creatinine shows great age dependence from birth throughout childhood. We computed and replicated 95% reference intervals in narrow gender and age bins and showed them to be comparable to those determined in healthy population studies. We identified pronounced transitions in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods with pronounced heterogeneity and valid reference intervals. Furthermore, part of the heterogeneity in creatinine distribution is likely due to differences in biological and chronological age of children and should be considered when using age-specific reference intervals.

  5. Assessment of readiness for clinical decision support to aid laboratory monitoring of immunosuppressive care at U.S. liver transplant centers.

    Science.gov (United States)

    Jacobs, J; Weir, C; Evans, R S; Staes, C

    2014-01-01

    Following liver transplantation, patients require lifelong immunosuppressive care and monitoring. Computerized clinical decision support (CDS) has been shown to improve post-transplant immunosuppressive care processes and outcomes. The readiness of transplant information systems to implement computerized CDS to support post-transplant care is unknown. a) Describe the current clinical information system functionality and manual and automated processes for laboratory monitoring of immunosuppressive care, b) describe the use of guidelines that may be used to produce computable logic and the use of computerized alerts to support guideline adherence, and c) explore barriers to implementation of CDS in U.S. liver transplant centers. We developed a web-based survey using cognitive interviewing techniques. We surveyed 119 U.S. transplant programs that performed at least five liver transplantations per year during 2010-2012. Responses were summarized using descriptive analyses; barriers were identified using qualitative methods. Respondents from 80 programs (67% response rate) completed the survey. While 98% of programs reported having an electronic health record (EHR), all programs used paper-based manual processes to receive or track immunosuppressive laboratory results. Most programs (85%) reported that 30% or more of their patients used external laboratories for routine testing. Few programs (19%) received most external laboratory results as discrete data via electronic interfaces while most (80%) manually entered laboratory results into the EHR; less than half (42%) could integrate internal and external laboratory results. Nearly all programs had guidelines regarding pre-specified target ranges (92%) or testing schedules (97%) for managing immunosuppressive care. Few programs used computerized alerting to notify transplant coordinators of out-of-range (27%) or overdue laboratory results (20%). Use of EHRs is common, yet all liver transplant programs were largely

  6. 1991 Environmental monitoring report Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Culp, T.; Cox, W.; Hwang, S.; Jones, A.; Longley, S.; Parsons, A.; Wolff, T.; Fish, J.; Ward, S.

    1992-11-01

    This 1991 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress such as National Environmental Policy Act (NEPA) documentation, environmental permits, envirorunental restoration (ER), and various waste management programs for Sandia National Laboratories in Albuquerque (SNL, Albuquerque) are included. The maximum offsite dose impact was calculated to be 1.3 x 10 -3 mrem. The total population within a 50-mile radius of SNL, Albuquerque, received a collective dose of 0.53 person-rem during 1991 from SNL, Albuquerque, operations. As in the previous year, the 1991 operations at SNL, Albuquerque, had no discernible impact on the general public or on the environment

  7. 1983 Environmental monitoring program report for Idaho National Engineering Laboratory Site

    International Nuclear Information System (INIS)

    Hoff, D.L.; Chew, E.W.; Dickson, R.L.

    1984-05-01

    The results of the various monitoring programs for 1983 indicated that radioactivity from the Idaho National Engineering Laboratory (INEL) Site operations could not be distinguished from worldwide fallout and natural radioactivity in the region surrounding the Site. Although some radioactive materials were discharged during Site operations, concentrations and doses to the surrounding population were of no health consequence and were far less than State of Idaho and Federal health protection guidelines. This report describes the air, water, and foodstuff samples routinely collected at the INEL boundary locations and at locations distant from the INEL Site. 11 figures, 14 tables

  8. Accuracy of a Wrist-Worn Wearable Device for Monitoring Heart Rates in Hospital Inpatients: A Prospective Observational Study.

    Science.gov (United States)

    Kroll, Ryan R; Boyd, J Gordon; Maslove, David M

    2016-09-20

    As the sensing capabilities of wearable devices improve, there is increasing interest in their application in medical settings. Capabilities such as heart rate monitoring may be useful in hospitalized patients as a means of enhancing routine monitoring or as part of an early warning system to detect clinical deterioration. To evaluate the accuracy of heart rate monitoring by a personal fitness tracker (PFT) among hospital inpatients. We conducted a prospective observational study of 50 stable patients in the intensive care unit who each completed 24 hours of heart rate monitoring using a wrist-worn PFT. Accuracy of heart rate recordings was compared with gold standard measurements derived from continuous electrocardiographic (cECG) monitoring. The accuracy of heart rates measured by pulse oximetry (Spo2.R) was also measured as a positive control. On a per-patient basis, PFT-derived heart rate values were slightly lower than those derived from cECG monitoring (average bias of -1.14 beats per minute [bpm], with limits of agreement of 24 bpm). By comparison, Spo2.R recordings produced more accurate values (average bias of +0.15 bpm, limits of agreement of 13 bpm, P<.001 as compared with PFT). Personal fitness tracker device performance was significantly better in patients in sinus rhythm than in those who were not (average bias -0.99 bpm vs -5.02 bpm, P=.02). Personal fitness tracker-derived heart rates were slightly lower than those derived from cECG monitoring in real-world testing and not as accurate as Spo2.R-derived heart rates. Performance was worse among patients who were not in sinus rhythm. Further clinical evaluation is indicated to see if PFTs can augment early warning systems in hospitals. ClinicalTrials.gov NCT02527408; https://clinicaltrials.gov/ct2/show/NCT02527408 (Archived by WebCite at  http://www.webcitation.org/6kOFez3on).

  9. Hydrogeological characterization, modelling and monitoring of the site of Canada's Underground Research Laboratory

    International Nuclear Information System (INIS)

    Davison, C.C.; Guvanasen, V.

    1985-01-01

    Atomic Energy of Canada Limited (AECL) is constructing an Underground Research Laboratory (URL) to a depth of 250 m in a previously undisturbed granitic pluton located near Lac du Bonnet, Manitoba, as one of the major research projects within the Canadian Nuclear Fuel Waste Management Program. This paper discusses the hydrogeological characterization of the URL site, the modelling approach used to represent this information, the hydrogeological monitoring system installed to monitor the actual drawdown conditions that develop in response to the excavation, and the procedures employed to calibrate the numerical model. Comparisons between the drawdown predictions made by the model prior to any excavation and the actual drawdowns that have been measured since shaft excavation began in May 1984 are also discussed

  10. Improvement in QA protocol for TLD based personnel monitoring laboratory in last five year

    International Nuclear Information System (INIS)

    Rakesh, R.B.

    2018-01-01

    The Quality Assurance (QA) in Personnel monitoring (PM) is a tool to assess the performance of PM laboratories and reliability of dose estimation with respect to standards laid down by international agencies such as IAEA (ISO trumpet curve), IEC, ANSI etc. Reliable personal dose estimation is a basic requirement for radiation protection planning as well as decision making continuous improvement in radiation protection is inherent in radiation protection practices which is highly dependent on accuracy and reliability of the monitoring data. Experience based evolution of Quality control (QC) measures as well as Quality assurance (QA) protocol are two important aspects towards continuous improvement in accuracy and reliability of personnel monitoring results. The paper describes improvement in QC measures and QA protocols initiated during the last five years which led to improvement in the quality of PM services

  11. Laboratory tools for diagnosis and monitoring response in patients with chronic myeloid leukemia.

    Science.gov (United States)

    Tohami, Tali; Nagler, Arnon; Amariglio, Ninette

    2012-08-01

    Chronic myeloid leukemia (CML) is a clonal hematological disease that represents 15-20% of all adult leukemia cases. The study and treatment of CML has contributed pivotal advances to translational medicine and cancer therapy. The discovery that a single chromosomal abnormality, the Philadelphia (Ph) chromosome, is responsible for the etiology of this disease was a milestone for treating and understanding CML. Subsequently, CML became the first disease for which allogeneic bone marrow transplantation is the treatment of choice. Currently, CML is one of the few diseases where treatment targeted against the chromosomal abnormality is the sole frontline therapy for newly diagnosed patients. The use of directed therapy for CML challenged disease monitoring during treatment and led to the development of definitions that document response and predict relapse sooner than the former routine methods. These methods relied on classical cytogenetics through molecular cytogenetics (FISH) and, finally, on molecular monitoring assays. This review discusses the laboratory tools used for diagnosing CML, for monitoring during treatment, and for assessing remission or relapse. The advantages and disadvantages of each test, the common definition of response levels, and the efforts to standardize molecular monitoring for CML patient management are discussed.

  12. HA Cells monitoring at the Underground Research Laboratory (URL) in the CMHM (Andra)

    International Nuclear Information System (INIS)

    Gay, Olivier; Allagnat, Dominique; Morel, Jacques; Armand, Gilles

    2010-01-01

    The experimental monitoring program of the HA (High Activity) cells was carried out at the Underground Research Laboratory (URL) in the Meuse Haute Marne department in France (CMHM Andra). Inspections made by video and photographs, section measurements and geo-referenced trajectories, in addition to measurements of convergence, temperature and hygrometry over time, allowed a better analysis of the behaviour of the HA cells after excavation, and subsequently over the long term. (authors)

  13. Monitoring of airborne bacteria and aerosols in different wards of hospitals - Particle counting usefulness in investigation of airborne bacteria.

    Science.gov (United States)

    Mirhoseini, Seyed Hamed; Nikaeen, Mahnaz; Khanahmd, Hossein; Hatamzadeh, Maryam; Hassanzadeh, Akbar

    2015-01-01

    The presence of airborne bacteria in hospital environments is of great concern because of their potential role as a source of hospital-acquired infections (HAI). The aim of this study was the determination and comparison of the concentration of airborne bacteria in different wards of four educational hospitals, and evaluation of whether particle counting could be predictive of airborne bacterial concentration in different wards of a hospital. The study was performed in an operating theatre (OT), intensive care unit (ICU), surgery ward (SW) and internal medicine (IM) ward of four educational hospitals in Isfahan, Iran. A total of 80 samples were analyzed for the presence of airborne bacteria and particle levels. The average level of bacteria ranged from 75-1194 CFU/m (3) . Mean particle levels were higher than class 100,000 cleanrooms in all wards. A significant correlation was observed between the numbers of 1-5 µm particles and levels of airborne bacteria in operating theatres and ICUs. The results showed that factors which may influence the airborne bacterial level in hospital environments should be properly managed to minimize the risk of HAIs especially in operating theaters. Microbial air contamination of hospital settings should be performed by the monitoring of airborne bacteria, but particle counting could be considered as a good operative method for the continuous monitoring of air quality in operating theaters and ICUs where higher risks of infection are suspected.

  14. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol

    Science.gov (United States)

    Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S.; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

    2014-01-01

    Aims: With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. Background: DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. Methods/Design: A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting

  15. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol.

    Science.gov (United States)

    Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

    2014-01-01

    With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting quantitative and qualitative findings

  16. Calibration of radioprotection equipment gamma radiation at the Laboratory of Ionizing Radiation Metrology - DEN/UFPE

    International Nuclear Information System (INIS)

    Nazario, Macilene; Khoury, Helen; Hazin, Clovis

    2003-01-01

    This work presents aspects of the radioprotection equipment calibration service of the Laboratory for Metrology of Ionizing Radiations (LMRI) of the DEN/UFPE related to the calibration procedures, characteristics of the radiation beam and the evaluation of equipment calibrated in the period of 2001-2002. The LMRI-DEN/UFPE is one of the four laboratories in Brazil licensed by the Brazilian Nuclear Energy Commission for the execution of calibration services on area, surface contamination and personal monitors used by industries, hospitals, universities and research institutes using radioactive sources

  17. Idaho National Laboratory Cultural Resource Monitoring Report for Fiscal Year 2016

    International Nuclear Information System (INIS)

    Gilbert, Hollie Kae; Holmer, Marie Pilkington; Olson, Christina Liegh; Pace, Brenda Ringe

    2016-01-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory's (INL) Cultural Resource Management (CRM) Office during fiscal year (FY) 2016. Overall monitoring included surveillance of the following 23 individual cultural resource localities: two locations with human remains, one of which is also a cave; seven additional caves; six prehistoric archaeological sites; four historic archaeological sites; one historic trail; Experimental Breeder Reactor I (EBR-I), a National Historic Landmark; Aircraft Nuclear Propulsion (ANP) objects located at EBR-I; and one Arco Naval Proving Ground (NPG) property, CF-633 and related objects and structures. Several INL work processes and projects were also monitored to confirm compliance with original INL CRM recommendations and assess the effects of ongoing work. On one occasion, ground disturbing activities within the boundaries of the Critical Infrastructure Test Range Complex (CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. Additionally, the CRM office was notified during two Trespass Investigations conducted by INL Security. Most of the cultural resources monitored in FY 2016 exhibited no adverse impacts, resulting in Type 1 impact assessments. However, Type 2 impacts were noted five times. Three previously reported Type 2 impacts were once again documented at the EBR-I National Historic Landmark, including spalling and deterioration of bricks due to inadequate drainage, minimal maintenance, and rodent infestation. The ANP engines and locomotive on display at the EBR-I Visitors Center also exhibited impacts related to long term exposure. Finally, most of the Arco NPG properties monitored at Central Facilities Area exhibited problems with lack of timely and appropriate maintenance as well as inadequate drainage. No new Type 3 or Type 4 impacts that adversely affected significant cultural resources and threatened National

  18. Design of a instrumentation module for monitoring ingestive behavior in laboratory studies.

    Science.gov (United States)

    Fontana, Juan M; Lopez-Meyer, Paulo; Sazonov, Edward S

    2011-01-01

    The development of accurate and objective tools for monitoring of ingestive behavior (MIB) is one of the most important needs facing studies of obesity and eating disorders. This paper presents the design of an instrumentation module for non-invasive monitoring of food ingestion in laboratory studies. The system can capture signals from a variety of sensors that characterize ingestion process (such as acoustical and other swallowing sensors, strain sensor for chewing detection and self-report buttons). In addition to the sensors, the data collection system integrates time-synchronous video footage that can be used for annotation of subject's activity. Both data and video are simultaneously and synchronously acquired and stored by a LabVIEW-based interface specifically developed for this application. This instrumentation module improves a previously developed system by eliminating the post-processing stage of data synchronization and by reducing the risks of operator's error.

  19. Environmental and effluent monitoring at Lucas Heights Research Laboratories, 1994

    International Nuclear Information System (INIS)

    Hoffmann, E.L.; Camilleri, A.; Loosz, T.; Farrar, Y.

    1995-12-01

    Results are presented of environmental and effluent monitoring conducted in the vicinity of the Lucas Heights Research Laboratories (LHRL) during 1994. All low level liquid and gaseous effluent discharges complied with existing discharge authorisations and relevant environmental regulations. Potential effective doses to the general public from controlled airborne discharges during this period, were estimated to be less than 0.015 mSv/year for receptor locations on the 1.6 km buffer zone boundary around HIFAR. This value represents 1.5 % of the 1 mSv/year dose limit for long term exposure that is recommended by the National Health and Medical Research Council, and 5 % of the site dose constraint of 0.3 mSv/year adopted by ANSTO. 27 refs., 22 tabs., 6 figs

  20. Environmental and effluent monitoring at Lucas Heights Research Laboratories, 1994

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, E L; Camilleri, A; Loosz, T; Farrar, Y

    1995-12-01

    Results are presented of environmental and effluent monitoring conducted in the vicinity of the Lucas Heights Research Laboratories (LHRL) during 1994. All low level liquid and gaseous effluent discharges complied with existing discharge authorisations and relevant environmental regulations. Potential effective doses to the general public from controlled airborne discharges during this period, were estimated to be less than 0.015 mSv/year for receptor locations on the 1.6 km buffer zone boundary around HIFAR. This value represents 1.5 % of the 1 mSv/year dose limit for long term exposure that is recommended by the National Health and Medical Research Council, and 5 % of the site dose constraint of 0.3 mSv/year adopted by ANSTO. 27 refs., 22 tabs., 6 figs.

  1. Metallurgical Laboratory Hazardous Waste Management Facility groundwater monitoring report: Third quarter 1993

    International Nuclear Information System (INIS)

    1993-12-01

    During third quarter 1993, samples from AMB groundwater monitoring wells at the Metallurgical Laboratory Hazardous Waste Management Facility were analyzed for certain heavy metals, indicator parameters, radionuclides, volatile organic compounds, and other constituents. Eight parameters exceeded standards during the quarter. As in previous quarters, tetrachloroethylene and trichloroethylene exceeded final Primary Drinking Water Standards; and aluminum, iron, lead, manganese, pH, and total organic halogens exceeded the Savannah River Site Flag 2 criteria in one or more of the wells. Groundwater flow direction and rate in the water-table unit were similar to previous quarters

  2. Prioritizing factors affecting the hospital employees' productivity from the hospital managers' viewpoint using integrated decision-making trial and evaluation laboratory and analytic network process

    Directory of Open Access Journals (Sweden)

    Ardalan Feili

    2018-01-01

    Full Text Available Objectives: This study aimed to identify and prioritize factors affecting the hospital employees' productivity from the viewpoint of hospital managers working in the teaching hospitals affiliated to Iran, Shiraz University of Medical Sciences, in 2017. Materials and Methods: This was an applied, cross-sectional, and descriptive-analytical study conducted in 2017 in all teaching hospitals affiliated to Iran, Shiraz University of Medical Sciences. After identifying factors affecting hospital employees' productivity using the results of previous studies, all hospital managers (56 managers were selected as the study population using census method to prioritize the factors. The decision-making trial and evaluation laboratory (DEMATEL and analytic network process (ANP techniques were used for analyzing the collected data through Excel 2010 and Super Decision 2.8. Results: Fifteen factors affecting employees' productivity were determined using the results of previous studies which were classified into four clusters. The results of DEMATEL technique showed that “employees' attitude toward the organization” was the most affecting factor (r = 11.928 and also the most affected factor (c = 12.120, as well as the most important factor affecting the employees' productivity (r + c = 24.048. In addition, the results of ANP showed that the cluster of “leadership and management styles” (relative weight [RW] = 0.274 and its factors, especially “involving employees in the decision-making processes” (L1 (RW = 0.102 and “delegation of authority to the employees” (L2 (RW = 0.100 were the most important factors affecting the employees' productivity. Conclusion: According to the results, adopting an appropriate leadership style and providing participatory management, involving the employees in the hospital decision-making processes, etc., had significant effects on the increases in the employees' motivation and productivity.

  3. An easy, rapid and inexpensive method to monitor tributyltin (TBT) toxicity in the laboratory.

    Science.gov (United States)

    Cruz, Andreia; Moreira, Rafael; Mendo, Sónia

    2014-05-01

    Tributyltin (TBT) contamination remains a major problem worldwide. Many laboratories are committed to the development of remediation methodologies that could help reduce the negative impact of this compound in the environment. Furthermore, it is important to have at hand simple methodologies for evaluating TBT toxicity in the laboratory, besides the use of complex and costly analytical instrumentation. With that purpose, a method was adapted that is based on the inhibition of growth of an indicator strain, Micrococcus luteus ATCC 9341, under TBT. Different types of matrices, of TBT concentrations and sample treatments were tested. The results herein reported show that the bioassay method can be applied for both aqueous and soil samples and also for a high range of TBT concentrations (at least up to 500 μmol/L). Besides being cheap and easy to perform, it can be performed in any laboratory. Additionally, one possible application of the method to monitor TBT degradation is presented as an example.

  4. Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

    Science.gov (United States)

    Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

    2014-01-01

    Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. First annual report on the Biological Monitoring and Abatement Program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Loar, J.M.; Amano, H.; Jimenez, B.D.; Kitchings, J.T.; Meyers-Schoene, L.; Mohrbacher, D.A.; Olsen, C.R.

    1992-08-01

    As a condition of the National Pollutant Discharge Elimination System (NPDES) permit issued to Oak Ridge National Laboratory (ORNL) on April 1, 1986, a Biological Monitoring and Abatement Program (BMAP) was developed for White Oak Creek (WOC); selected tributaries of WOC, including Fifth Creek, First Creek, Melton Branch, and Northwest Tributary; and the Clinch River. BMAP consists of seven major tasks that address both radiological and nonradiological contaminants in the aquatic and terrestrial environs on-site and the aquatic environs off-site. These tasks are (1) toxicity monitoring; (2) bioaccumulation monitoring of nonradiological contaminants in aquatic biota; (3) biological indicator studies; (4) instream ecological monitoring; (5) assessment of contaminants in the terrestrial environment; (6) radioecology of WOC and White Oak Lake (WOL); and (7) contaminant transport, distribution, and fate in the WOC embayment-Clinch River-Watts Bar Reservoir system. This document, the first of a series of annual reports presenting the results of BMAP, describes studies that were conducted from March through December 1986

  6. First annual report on the Biological Monitoring and Abatement Program at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Loar, J. M. [ed.; Adams, S. M.; Blaylock, B. G.; Boston, H. L.; Frank, M. L.; Garten, C. T.; Houston, M. A.; Kimmel, B. L.; Ryon, M. G.; Smith, J. G.; Southworth, G. R.; Stewart, A. J.; Walton, B. T.; Berry, J. B.; Talmage, S. S. [Oak Ridge National Lab., TN (United States); Amano, H. [JAERI, Tokai Res., Establishment, Ibari-Ken (Japan); Jimenez, B. D. [School of Pharmacy, Univ. of Puerto Rico (San Juan); Kitchings, J. T. [ERCE, Denver, CO (United States); Meyers-Schoene, L. [Advanced Sciences, Inc., Fernald, OH (United States); Mohrbacher, D. A. [Univ. of Tennessee, Knoxville, TN (United States); Olsen, C. R. [USDOE Office of Energy Research, Washington, DC (United States). Office of Health and Environmental Research

    1992-08-01

    As a condition of the National Pollutant Discharge Elimination System (NPDES) permit issued to Oak Ridge National Laboratory (ORNL) on April 1, 1986, a Biological Monitoring and Abatement Program (BMAP) was developed for White Oak Creek (WOC); selected tributaries of WOC, including Fifth Creek, First Creek, Melton Branch, and Northwest Tributary; and the Clinch River. BMAP consists of seven major tasks that address both radiological and nonradiological contaminants in the aquatic and terrestrial environs on-site and the aquatic environs off-site. These tasks are (1) toxicity monitoring; (2) bioaccumulation monitoring of nonradiological contaminants in aquatic biota; (3) biological indicator studies; (4) instream ecological monitoring; (5) assessment of contaminants in the terrestrial environment; (6) radioecology of WOC and White Oak Lake (WOL); and (7) contaminant transport, distribution, and fate in the WOC embayment-Clinch River-Watts Bar Reservoir system. This document, the first of a series of annual reports presenting the results of BMAP, describes studies that were conducted from March through December 1986.

  7. Revolutionizing clinical microbiology laboratory organization in hospitals with in situ point-of-care.

    Science.gov (United States)

    Cohen-Bacrie, Stéphan; Ninove, Laetitia; Nougairède, Antoine; Charrel, Rémi; Richet, Hervé; Minodier, Philippe; Badiaga, Sékéné; Noël, Guilhem; La Scola, Bernard; de Lamballerie, Xavier; Drancourt, Michel; Raoult, Didier

    2011-01-01

    Clinical microbiology may direct decisions regarding hospitalization, isolation and anti-infective therapy, but it is not effective at the time of early care. Point-of-care (POC) tests have been developed for this purpose. One pilot POC-lab was located close to the core laboratory and emergency ward to test the proof of concept. A second POC-lab was located inside the emergency ward of a distant hospital without a microbiology laboratory. Twenty-three molecular and immuno-detection tests, which were technically undemanding, were progressively implemented, with results obtained in less than four hours. From 2008 to 2010, 51,179 tests yielded 6,244 diagnoses. The second POC-lab detected contagious pathogens in 982 patients who benefited from targeted isolation measures, including those undertaken during the influenza outbreak. POC tests prevented unnecessary treatment of patients with non-streptococcal tonsillitis (n = 1,844) and pregnant women negative for Streptococcus agalactiae carriage (n = 763). The cerebrospinal fluid culture remained sterile in 50% of the 49 patients with bacterial meningitis, therefore antibiotic treatment was guided by the molecular tests performed in the POC-labs. With regard to enterovirus meningitis, the mean length-of-stay of infected patients over 15 years old significantly decreased from 2008 to 2010 compared with 2005 when the POC was not in place (1.43±1.09 versus 2.91±2.31 days; p = 0.0009). Altogether, patients who received POC tests were immediately discharged nearly thrice as often as patients who underwent a conventional diagnostic procedure. The on-site POC-lab met physicians' needs and influenced the management of 8% of the patients that presented to emergency wards. This strategy might represent a major evolution of decision-making regarding the management of infectious diseases and patient care.

  8. Revolutionizing clinical microbiology laboratory organization in hospitals with in situ point-of-care.

    Directory of Open Access Journals (Sweden)

    Stéphan Cohen-Bacrie

    Full Text Available BACKGROUND: Clinical microbiology may direct decisions regarding hospitalization, isolation and anti-infective therapy, but it is not effective at the time of early care. Point-of-care (POC tests have been developed for this purpose. METHODS AND FINDINGS: One pilot POC-lab was located close to the core laboratory and emergency ward to test the proof of concept. A second POC-lab was located inside the emergency ward of a distant hospital without a microbiology laboratory. Twenty-three molecular and immuno-detection tests, which were technically undemanding, were progressively implemented, with results obtained in less than four hours. From 2008 to 2010, 51,179 tests yielded 6,244 diagnoses. The second POC-lab detected contagious pathogens in 982 patients who benefited from targeted isolation measures, including those undertaken during the influenza outbreak. POC tests prevented unnecessary treatment of patients with non-streptococcal tonsillitis (n = 1,844 and pregnant women negative for Streptococcus agalactiae carriage (n = 763. The cerebrospinal fluid culture remained sterile in 50% of the 49 patients with bacterial meningitis, therefore antibiotic treatment was guided by the molecular tests performed in the POC-labs. With regard to enterovirus meningitis, the mean length-of-stay of infected patients over 15 years old significantly decreased from 2008 to 2010 compared with 2005 when the POC was not in place (1.43±1.09 versus 2.91±2.31 days; p = 0.0009. Altogether, patients who received POC tests were immediately discharged nearly thrice as often as patients who underwent a conventional diagnostic procedure. CONCLUSIONS: The on-site POC-lab met physicians' needs and influenced the management of 8% of the patients that presented to emergency wards. This strategy might represent a major evolution of decision-making regarding the management of infectious diseases and patient care.

  9. Environmental monitoring at Argonne National Laboratory. Annual report, 1981

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1982-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1981 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, soil, grass, bottom sediment, and milk; for a variety of chemical constituents in air, surface water, and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements were made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with applicable environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  10. The makeover of the Lakeshore General Hospital laboratories.

    Science.gov (United States)

    Estioko-Taimuri, Teresa

    2006-01-31

    This article describes the expansion and reorganization of a moderate-sized Canadian laboratory from Day One to "Live Day." The key factors to the success of this project were organized planning by the laboratory staff and the introduction of core lab theories, team building, and organized training sessions. The successful makeover resulted in improved turnaround time for STAT tests, especially those coming from the Emergency Unit. The efforts of the laboratory personnel toward the improvement of laboratory services, in spite of budget, human resources constraints, and resistance to change, are addressed.

  11. [The characteristics of medical technologies in emergency medical care hospital].

    Science.gov (United States)

    Murakhovskiĭ, A G; Babenko, A I; Bravve, Iu I; Tataurova, E A

    2013-01-01

    The article analyzes the implementation of major 12 diagnostic and 17 treatment technologies applied during medical care of patients with 12 key nosology forms of diseases in departments of the emergency medical care hospital No 2 of Omsk. It is established that key groups of technologies in the implementation of diagnostic process are the laboratory clinical diagnostic analyses and common diagnostic activities at reception into hospital and corresponding departments. The percentage of this kind of activities is about 78.3% of all diagnostic technologies. During the realization of treatment process the priority technologies are common curative and rehabilitation activities, intensive therapy activities and clinical diagnostic monitoring activities. All of them consist 80.1% of all curative technologies.

  12. State-wide hospital clinical laboratory plan for measuring cholinesterase activity for individuals suspected of exposure to nerve agent chemical weapons.

    Science.gov (United States)

    Wu, Alan H B; Smith, Andrew; McComb, Robert; Bowers, George N; Makowski, Gregory S; McKay, Charles A; Vena, Jason; McDonagh, John; Hopfer, Sidney; Sena, Salvatore F; Malkus, Herbert; Forte, Elaine; Kelly, Katherine

    2008-02-01

    Hospital laboratories currently lack the capacity to provide emergency determination of cholinesterase activity. We have developed a hospital-based 3-tiered system to test plasma for butyrylcholinesterase (BChE) activity and whole blood for red cell acetylcholinesterase (AChE) activity using available technology and personnel. Interagency communications, toxidrome definition, and patient triage will be coordinated by the Connecticut Department of Public Health and the Poison Control Center. Initial BChE data documents good precision between institutions (coefficient of variation chemical terrorism or large scale HazMat events.

  13. Molecular diagnostics for lassa fever at Irrua specialist teaching hospital, Nigeria: lessons learnt from two years of laboratory operation.

    Directory of Open Access Journals (Sweden)

    Danny A Asogun

    Full Text Available BACKGROUND: Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH in the central senatorial district of Edo State struggled with this challenge for many years. METHODOLOGY/PRINCIPAL FINDINGS: A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12% tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization--often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p = 0.005, had lower body temperature (p<0.0001, and had higher creatinine (p<0.0001 and blood urea levels (p<0.0001 than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed--within lineage II--a separate clade that could be further subdivided into three clusters. CONCLUSIONS/SIGNIFICANCE: Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients.

  14. Active waste disposal monitoring at the Radioactive Waste Management Complex, Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Hubbell, J.M.

    1990-10-01

    This report describes an active waste disposal monitoring system proposed to be installed beneath the low-level radioactive disposal site at the Radioactive Waste Management Complex (RWMC), Idaho National Engineering Laboratory, Idaho. The monitoring instruments will be installed while the waste is being disposed. Instruments will be located adjacent to and immediately beneath the disposal area within the unsaturated zone to provide early warning of contaminant movement before contaminants reach the Snake River Plain Aquifer. This study determined the optimum sampling techniques using existing monitoring equipment. Monitoring devices were chosen that provide long-term data for moisture content, movement of gamma-emitting nuclides, and gas concentrations in the waste. The devices will allow leachate collection, pore-water collection, collection of gasses, and access for drilling through and beneath the waste at a later time. The optimum monitoring design includes gas sampling devices above, within, and below the waste. Samples will be collected for methane, tritium, carbon dioxide, oxygen, and volatile organic compounds. Access tubes will be utilized to define the redistribution of radionuclides within, above, and below the waste over time and to define moisture content changes within the waste using spectral and neutron logging, respectively. Tracers will be placed within the cover material and within waste containers to estimate transport times by conservative chemical tracers. Monitoring the vadose zone below, within, and adjacent to waste while it is being buried is a viable monitoring option. 12 refs., 16 figs., 1 tab

  15. SHynergie: Development of a virtual project laboratory for monitoring hydraulic stimulations

    Science.gov (United States)

    Renner, Jörg; Friederich, Wolfgang; Meschke, Günther; Müller, Thomas; Steeb, Holger

    2016-04-01

    Hydraulic stimulations are the primary means of developing subsurface reservoirs regarding the extent of fluid transport in them. The associated creation or conditioning of a system of hydraulic conduits involves a range of hydraulic and mechanical processes but also chemical reactions, such as dissolution and precipitation, may affect the stimulation result on time scales as short as hours. In the light of the extent and complexity of these processes, the steering potential for the operator of a stimulation critically depends on the ability to integrate the maximum amount of site-specific information with profound process understanding and a large spectrum of experience. We report on the development of a virtual project laboratory for monitoring hydraulic stimulations within the project SHynergie (http://www.ruhr-uni-bochum.de/shynergie/). The concept of the laboratory envisioned product that constitutes a preparing and accompanying rather than post-processing instrument ultimately accessible to persons responsible for a project over a web-repository. The virtual laboratory consists of a data base, a toolbox, and a model-building environment. Entries in the data base are of two categories. On the one hand, selected mineral and rock properties are provided from the literature. On the other hand, project-specific entries of any format can be made that are assigned attributes regarding their use in a stimulation problem at hand. The toolbox is interactive and allows the user to perform calculations of effective properties and simulations of different types (e.g., wave propagation in a reservoir, hydraulic test). The model component is also hybrid. The laboratory provides a library of models reflecting a range of scenarios but also allows the user to develop a site-specific model constituting the basis for simulations. The laboratory offers the option to use its components following the typical workflow of a stimulation project. The toolbox incorporates simulation

  16. Novel Monitoring Techniques for Characterizing Frictional Interfaces in the Laboratory

    Directory of Open Access Journals (Sweden)

    Paul A. Selvadurai

    2015-04-01

    Full Text Available A pressure-sensitive film was used to characterize the asperity contacts along a polymethyl methacrylate (PMMA interface in the laboratory. The film has structural health monitoring (SHM applications for flanges and other precision fittings and train rail condition monitoring. To calibrate the film, simple spherical indentation tests were performed and validated against a finite element model (FEM to compare normal stress profiles. Experimental measurements of the normal stress profiles were within −7.7% to 6.6% of the numerical calculations between 12 and 50 MPa asperity normal stress. The film also possessed the capability of quantifying surface roughness, an important parameter when examining wear and attrition in SHM applications. A high definition video camera supplied data for photometric analysis (i.e., the measure of visible light of asperities along the PMMA-PMMA interface in a direct shear configuration, taking advantage of the transparent nature of the sample material. Normal stress over individual asperities, calculated with the pressure-sensitive film, was compared to the light intensity transmitted through the interface. We found that the luminous intensity transmitted through individual asperities linearly increased 0.05643 ± 0.0012 candelas for an increase of 1 MPa in normal stress between normal stresses ranging from 23 to 33 MPa.

  17. Aespoe Hard Rock Laboratory. Hydro Monitoring Program. Report for 2008

    Energy Technology Data Exchange (ETDEWEB)

    Wass, Eva; Nyberg, Goeran (GEOSIGMA, Uppsala (Sweden))

    2009-08-15

    The Aespoe island is situated close to the nuclear power plant of Simpevarp in southeastern Sweden. As part of the pre-investigations preceding excavation of the Aespoe Hard Rock Laboratory, registrations of the groundwater levels and electrical conductivity in packed-off borehole sections and levels in open boreholes started in 1987. The investigations are still ongoing and are planned to continue for a long period of time. As the tunnel excavation went on from the autumn 1990 and onwards, new boreholes were drilled in the tunnel and instrumented to enable groundwater pressure monitoring in packed-off sections. In addition, other hydro-related measurements such as water flow in the tunnel, electrical conductivity of tunnel water and inflow and outflow of water through tunnel pipes have been performed. This report is a summary of the monitoring during 2008. In order to allow for comparison with factors that may influence the groundwater level/pressure and flow, meteorological data are also presented in the report. From the end of 1991, the disturbance from the tunnel is the dominating factor influencing groundwater levels in the area. In one chapter, activities that may have an influence on the ground water situation are listed and briefly discussed.

  18. Aespoe Hard Rock Laboratory. Hydro Monitoring Program. Report for 2009

    Energy Technology Data Exchange (ETDEWEB)

    Wass, Eva; Nyberg, Goeran (GEOSIGMA, Uppsala (Sweden))

    2010-05-15

    The Aespoe island is situated close to the nuclear power plant of Simpevarp in southeastern Sweden. As part of the pre-investigations preceding excavation of the Aespoe Hard Rock Laboratory, registrations of the groundwater levels and electrical conductivity in packed-off borehole sections and levels in open boreholes started in 1987. The investigations are still ongoing and are planned to continue for a long period of time. As the tunnel excavation went on from the autumn 1990 and onwards, new boreholes were drilled in the tunnel and instrumented to enable groundwater pressure monitoring in packed-off sections. In addition, other hydro-related measurements such as water flow in the tunnel, electrical conductivity of tunnel water and inflow and outflow of water through tunnel pipes have been performed. This report is a summary of the monitoring during 2009. In order to allow for comparison with factors that may influence the groundwater level/pressure and flow, meteorological data are also presented in the report. From the end of 1991, the disturbance from the tunnel is the dominating factor influencing groundwater levels in the area. In one chapter, activities that may have an influence on the ground water situation are listed and briefly discussed

  19. Aespoe Hard Rock Laboratory. Hydro Monitoring Program. Report for 2008

    International Nuclear Information System (INIS)

    Wass, Eva; Nyberg, Goeran

    2009-08-01

    The Aespoe island is situated close to the nuclear power plant of Simpevarp in southeastern Sweden. As part of the pre-investigations preceding excavation of the Aespoe Hard Rock Laboratory, registrations of the groundwater levels and electrical conductivity in packed-off borehole sections and levels in open boreholes started in 1987. The investigations are still ongoing and are planned to continue for a long period of time. As the tunnel excavation went on from the autumn 1990 and onwards, new boreholes were drilled in the tunnel and instrumented to enable groundwater pressure monitoring in packed-off sections. In addition, other hydro-related measurements such as water flow in the tunnel, electrical conductivity of tunnel water and inflow and outflow of water through tunnel pipes have been performed. This report is a summary of the monitoring during 2008. In order to allow for comparison with factors that may influence the groundwater level/pressure and flow, meteorological data are also presented in the report. From the end of 1991, the disturbance from the tunnel is the dominating factor influencing groundwater levels in the area. In one chapter, activities that may have an influence on the ground water situation are listed and briefly discussed

  20. Aespoe Hard Rock Laboratory. Hydro Monitoring Program. Report for 2009

    International Nuclear Information System (INIS)

    Wass, Eva; Nyberg, Goeran

    2010-05-01

    The Aespoe island is situated close to the nuclear power plant of Simpevarp in southeastern Sweden. As part of the pre-investigations preceding excavation of the Aespoe Hard Rock Laboratory, registrations of the groundwater levels and electrical conductivity in packed-off borehole sections and levels in open boreholes started in 1987. The investigations are still ongoing and are planned to continue for a long period of time. As the tunnel excavation went on from the autumn 1990 and onwards, new boreholes were drilled in the tunnel and instrumented to enable groundwater pressure monitoring in packed-off sections. In addition, other hydro-related measurements such as water flow in the tunnel, electrical conductivity of tunnel water and inflow and outflow of water through tunnel pipes have been performed. This report is a summary of the monitoring during 2009. In order to allow for comparison with factors that may influence the groundwater level/pressure and flow, meteorological data are also presented in the report. From the end of 1991, the disturbance from the tunnel is the dominating factor influencing groundwater levels in the area. In one chapter, activities that may have an influence on the ground water situation are listed and briefly discussed

  1. Evaluation of clinical, laboratory, and electrophoretic profiles for diagnosis of malnutrition in hospitalized dogs

    Directory of Open Access Journals (Sweden)

    Andrei Kelliton Fabretti

    2015-02-01

    Full Text Available Malnutrition is a major factor associated with increased rates of mortality and readmission, longer hospital stays, and greater health care spending. Recognizing malnourished or at-risk animals allows for nutritional intervention and improved prognosis. This study evaluated the association between clinical, laboratory, and electrophoretic variables and the nutritional status (NS of hospitalized dogs in order to generate a profile of the sick dog and to facilitate the diagnosis of malnutrition. We divided 215 dogs into groups according to the severity of the underlying disease and we determined the clinical NS based on the assessment of the body condition score and the muscle mass score. The NS was classified as clinically well nourished, clinical moderate malnutrition, or clinical severe malnutrition. Statistical analyses were conducted by using the chi-square test or Fisher’s exact test; the Kruskal-Wallis test was used for continuous variables. A strong association was found between malnutrition and the severity of the underlying disease. In hospitalized dogs, low body mass index values, anemia, low hemoglobin concentrations, high fibrinogen concentrations, decreased albumin fraction, and increased gamma-globulin fraction (in electrophoresis were associated with malnutrition, reinforcing the classification of poor NS. However, the skin and coat characteristics, the total number of lymphocytes, blood glucose, cholesterol, and total protein concentration were not found to be good predictors of NS.

  2. 1990 Environmental Monitoring Report, Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Hwang, S.; Yeager, G.; Wolff, T.; Parsons, A.; Dionne, D.; Massey, C.; Schwartz, B.; Fish, J.; Thompson, D.; Goodrich, M.

    1991-05-01

    This 1990 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress such as National Environmental Policy Act (NEPA) documentation, environmental permits, environmental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque (SNL, Albuquerque) are included. The maximum offsite dose impact was calculated to be 2.0 x 10 -3 mrem. The total 50-mile population received a collective dose of 0.82 person-rem during 1990 from SNL, Albuquerque, operations. As in the previous year, the 1990 SNL operations had no adverse impact on the general public or on the environment. This report is prepared for the US Department of Energy in compliance with DOE Order 5400.1. 97 refs., 30 figs., 137 tabs

  3. Using statistical process control for monitoring the prevalence of hospital-acquired pressure ulcers.

    Science.gov (United States)

    Kottner, Jan; Halfens, Ruud

    2010-05-01

    Institutionally acquired pressure ulcers are used as outcome indicators to assess the quality of pressure ulcer prevention programs. Determining whether quality improvement projects that aim to decrease the proportions of institutionally acquired pressure ulcers lead to real changes in clinical practice depends on the measurement method and statistical analysis used. To examine whether nosocomial pressure ulcer prevalence rates in hospitals in the Netherlands changed, a secondary data analysis using different statistical approaches was conducted of annual (1998-2008) nationwide nursing-sensitive health problem prevalence studies in the Netherlands. Institutions that participated regularly in all survey years were identified. Risk-adjusted nosocomial pressure ulcers prevalence rates, grade 2 to 4 (European Pressure Ulcer Advisory Panel system) were calculated per year and hospital. Descriptive statistics, chi-square trend tests, and P charts based on statistical process control (SPC) were applied and compared. Six of the 905 healthcare institutions participated in every survey year and 11,444 patients in these six hospitals were identified as being at risk for pressure ulcers. Prevalence rates per year ranged from 0.05 to 0.22. Chi-square trend tests revealed statistically significant downward trends in four hospitals but based on SPC methods, prevalence rates of five hospitals varied by chance only. Results of chi-square trend tests and SPC methods were not comparable, making it impossible to decide which approach is more appropriate. P charts provide more valuable information than single P values and are more helpful for monitoring institutional performance. Empirical evidence about the decrease of nosocomial pressure ulcer prevalence rates in the Netherlands is contradictory and limited.

  4. Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture

    Science.gov (United States)

    Norgaard, Astrid; de Lichtenberg, Trine Honnens; Nielsen, Jens; Johansson, Pär I.

    2014-01-01

    Background The practice of transfusing red blood cells is still liberal in some centres suggesting a lack of compliance with guidelines recommending transfusion of red blood cells at haemoglobin levels of 6–8 g/dL in the non-bleeding patient. Few databases provide ongoing feedback of data on pre-transfusion haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels. Materials and methods Hospital data on admissions, diagnoses and surgical procedures were used to define the populations of patients. Data on haemoglobin measurements and red blood cell transfusions were used to calculate pre-transfusion haemoglobin, percentage of transfused patients and transfusion volumes. Results The model dataset include 33,587 admissions, of which 10% had received at least one unit of red blood cells. Haemoglobin measurements preceded 96.7% of the units transfused. The median pre-transfusion haemoglobin was 8.9 g/dL (interquartile range 8.2–9.7) at the hospital level. In only 6.5% of the cases, transfusion was initiated at 7.3 g/dL or lower as recommended by the Danish national transfusion guideline. In 27% of the cases, transfusion was initiated when the haemoglobin level was 9.3 g/dL or higher, which is not recommended. A median of two units was transfused per transfusion episode and per hospital admission. Transfusion practice was more liberal in surgical and intensive care units than in medical departments. Discussion We described pre-transfusion haemoglobin levels, transfusion rates and volumes at hospital and departmental levels, and in surgical subpopulations. Initial data revealed an extensive liberal practice and low compliance with national transfusion guidelines, and identified wards in need of intervention. PMID

  5. Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

    Science.gov (United States)

    Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

    2015-07-01

    Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

  6. A monitor for the laboratory evaluation of control integrity in digital control systems operating in harsh electromagnetic environments

    Science.gov (United States)

    Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

    1992-01-01

    This paper presents a strategy for dynamically monitoring digital controllers in the laboratory for susceptibility to electromagnetic disturbances that compromise control integrity. The integrity of digital control systems operating in harsh electromagnetic environments can be compromised by upsets caused by induced transient electrical signals. Digital system upset is a functional error mode that involves no component damage, can occur simultaneously in all channels of a redundant control computer, and is software dependent. The motivation for this work is the need to develop tools and techniques that can be used in the laboratory to validate and/or certify critical aircraft controllers operating in electromagnetically adverse environments that result from lightning, high-intensity radiated fields (HIRF), and nuclear electromagnetic pulses (NEMP). The detection strategy presented in this paper provides dynamic monitoring of a given control computer for degraded functional integrity resulting from redundancy management errors, control calculation errors, and control correctness/effectiveness errors. In particular, this paper discusses the use of Kalman filtering, data fusion, and statistical decision theory in monitoring a given digital controller for control calculation errors.

  7. U.S. Geological Survey geohydrologic studies and monitoring at the Idaho National Laboratory, southeastern Idaho

    Science.gov (United States)

    Bartholomay, Roy C.

    2017-09-14

    BackgroundThe U.S. Geological Survey (USGS) geohydrologic studies and monitoring at the Idaho National Laboratory (INL) is an ongoing, long-term program. This program, which began in 1949, includes hydrologic monitoring networks and investigative studies that describe the effects of waste disposal on water contained in the eastern Snake River Plain (ESRP) aquifer and the availability of water for long-term consumptive and industrial use. Interpretive reports documenting study findings are available to the U.S. Department of Energy (DOE) and its contractors; other Federal, State, and local agencies; private firms; and the public at https://id.water.usgs.gov/INL/Pubs/index.html. Information contained within these reports is crucial to the management and use of the aquifer by the INL and the State of Idaho. USGS geohydrologic studies and monitoring are done in cooperation with the DOE Idaho Operations Office.

  8. Results and discussion of laboratory experiences with different automated TLD readers for personnel monitoring

    International Nuclear Information System (INIS)

    Regulla, D.F.; Drexeler, G.

    Although the film seems to continue serving as the main personnel dosemeter in Germany for the time in sight, the evolution of particularly solid state techniques and their properties are thoroughly considered with respect to a possible generalized application in personnel monitoring. For this reason different automated TLD systems that are commercially available have been investigated in the laboratory in order to find out their usefulness for a largescale or also decentralized service. Along with studying the dosimetrical and apparative parameters, the question has been discussed to which monitoring philosophy these TLD systems seem to fit. It is reported both on experimental experiences achieved as well as on the results of basic discussions that in return influence the discussion about the necessary outfit of personnel TL dosemeters

  9. [Monitoring of hematogenous occupational exposure in medical staff in infectious disease hospital].

    Science.gov (United States)

    Xie, Manxia; Zhou, Jin; Wang, Yimei

    2015-10-01

    To investigate the status and risk factors for hematogenous occupational exposure in medical staff in an infectious disease hospital, and to provide a scientific basis for targeted preventive and control measures. The occupational exposure of 395 medical workers in our hospital was monitored from January 2012 to December 2014, among whom 79 individuals with occupational exposure were subjected to intervention and the risk factors for occupational exposure were analyzed. The high-risk group was mainly the nursing staff (69.6%). The incidence of hematogenous occupational exposure was high in medical personnel with a working age under 3 years, aged under 25 years, and at the infection ward, accounting for 63.3%, 72.1%, and 72.2%, respectively. Hepatitis B virus, hepatitis C virus, Treponema pallidum, and human immunodeficiency virus were the primary exposure sources. Sharp injury was the major way of injury (91.1%), with needle stick injury accounting for the highest proportion (86.1%). Injury occurred on the hand most frequently (91.1%). The high-risk links were improper disposal during or after pulling the needle, re-capturing the needle, and processing waste, accounting for 46.8%, 17.7%, and 12.7%, respectively. Seventy-nine professionals with occupational exposure were not infected. The main risk factor for hematogenous occupational exposure in medical staff in the infectious disease hospital is needle stick injury. Strengthening the occupational protection education in medical staff in infectious disease hospital, implementing protective measures, standardizing operating procedures in high-risk links, and enhancing the supervision mechanism can reduce the incidence of occupational exposure and infection after exposure.

  10. Audit of high energy therapy beams in hospital oncology departments by the National Radiation Laboratory

    International Nuclear Information System (INIS)

    Smyth, V.G.

    1994-02-01

    In 1993 the output of every high energy radiotherapy beam used clinically in New Zealand was measured by National Radiation Laboratory (NRL) staff using independent dosimetry equipment. The purpose of this was to audit the dosimetry that is used by hospital physicists for the basis of patient treatments, and to uncover any errors that may be clinically significant. This report analyses the uncertainties involved in comparing the NRL and hospital measurements, and presents the results of the 1993 audit. The overall uncertainty turns out to be about 1.5%. The results for linear accelerator photon beams are consistent with a purely random variation within this uncertainty. Electron beams show some small errors beyond the expected uncertainty. Gamma beams have the potential to be the most accurately measured, but in practice are less accurately measured than linear accelerator beams. None of the disagreements indicated an error of clinical significance. 8 refs., 3 figs., 2 tabs

  11. General aspects of radiological protection to consider for the licensing a hospital cyclotron

    International Nuclear Information System (INIS)

    Andrada Contardi, F.A.; Fruttero, N.H.; Bozzo, R.H.; Moschella, E.G.

    2010-01-01

    The use of PET/PET-CT studies for a variety of diagnoses has increased significantly on a global scale. Modern medical cyclotrons must be placed in or near hospitals on account of the short radioactive half-life of the pharmaceuticals used in such studies. Many countries in Latin America are now licensing cyclotrons and laboratories for the production of radio-pharmaceuticals for the first time, and most are expected to have installations within the near future. This report outlines the general aspects of radiological protection important to consideration during the licensing of these facilities, and includes the following: general operation of the cyclotron and laboratory for the production of radiopharmaceuticals, safety systems (shielding, interlocks, ventilation, manual safety systems, alarms and monitors), and general aspects for licensing an installation (monitoring, accidental and incidental events, activation of components, etc.) and personnel. (authors) [es

  12. Surveillance Plan for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-12-01

    This Surveillance Plan has been developed as part of the Environmental Monitoring Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental monitoring will be conducted in two phases: the baseline monitoring phase and the routine annual monitoring phase. The baseline monitoring phase will be conducted to establish the baseline contaminant release conditions at the Waste Area Grouping (WAG), to confirm the site-related chemicals of concern (COC), and to gather data to confirm the site hydrologic model The baseline monitoring phase is expected to begin in 1994 and continue for 12--18 months. The routine annual monitoring phase will consist of continued sampling and analyses of COC to determine off-WAG contaminant flux, to identify trends in releases, and to confirm the COC The routine annual monitoring phase will continue for ∼4 years after completion of the baseline monitoring phase. This Surveillance Plan presents the technical and quality assurance surveillance activities for the various WAG 6 environmental monitoring and data evaluation plans and implementing procedures

  13. Meteorological monitoring sampling and analysis plan for the environmental monitoring plan at Waste Area Grouping 6, Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1995-09-01

    This Sampling and Analysis Plan addresses meteorological monitoring activities that wall be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory, a research facility owned by the US Department of Energy and managed by Lockheed Martin Energy Systems, Inc. Meteorological monitoring of various climatological parameters (e.g., temperature, wind speed, humidity) will be collected by instruments installed at WAG 6. Data will be recorded electronically at frequencies varying from 5-min intervals to 1-h intervals, dependent upon parameter. The data will be downloaded every 2 weeks, evaluated, compressed, and uploaded into a WAG 6 data base for subsequent use. The meteorological data will be used in water balance calculations in support of the WAG 6 hydrogeological model

  14. [Outsourcing of clinical laboratory department].

    Science.gov (United States)

    Murai, T

    2000-03-01

    Recently, to improve financial difficulties at various hospitals, outsourcing of the laboratory department is be coming more wide spread. At the department of clinical pathology of St. Luke's International Hospital, the system, so called, "Branch labo" which is one of the outsourcing laboratory conditions, was adopted in March 1999. In this reports. We described the decision procedure for accepting the situation and the circumstances of operation.

  15. A national survey on pediatric critical values used in clinical laboratories across Canada.

    Science.gov (United States)

    Gong, Yanping; Adeli, Khosrow

    2009-11-01

    Notification of critical values to clinical staff is an important post-analytical process in all acute care clinical laboratories. No data are available however on how laboratories obtain or establish critical values, particularly in pediatric settings. This study was designed to examine and compare critical values used for pediatric patients in biochemistry laboratories in Canada and assess potential interlaboratory variability. Fourteen clinical laboratories, including two in pediatric hospitals and twelve in hospitals caring for both children and adults, participated in a survey that included 14 pre-selected STAT chemistry tests and 19 pre-selected therapeutic drug monitoring (TDM) tests. Among fourteen chemistry tests, good agreement was observed for critical values used for sodium and pH at both low and high levels within 14 participant laboratories. Significant interlaboratory variability existed for glucose critical values at the high end, magnesium at high end, and PO2 at the low end. For 19 TDM tests, the majority of laboratories did not have alert values to report values over the therapeutic level but not toxic. For critical values greater than the toxic range, significant variability existed at both trough and peak levels among laboratories surveyed. When asked to provide the source for critical values established at each site, only a limited number of laboratories identified their sources as either internal decision or published references. Although all laboratories have established and routinely use critical values to alert clinical staff, considerable variability exists in both the critical limits reported as well as the source of such values. There is a clear need for new national efforts to standardize pediatric critical value reporting and establish evidence-based critical limits for all medical laboratories across Canada.

  16. An audit of the laboratory diagnosis of cryptosporidiosis in England and Wales.

    Science.gov (United States)

    Chalmers, Rachel M; Atchison, Christina; Barlow, Katrina; Young, Yvonne; Roche, Anita; Manuel, Rohini

    2015-07-01

    To assess the level of practice consistent with UK national standards for Cryptosporidium testing, an audit was performed of 156 publicly funded clinical microbiology laboratories in England and Wales between August 2013 and April 2014. Responses were received from 85 (54 %) laboratories. First line diagnostic methods used were mainly microscopy with modified Ziehl-Neelsen (mZN) or auramine phenol (AP) staining (68/85, 80 %), enzyme immunoassays (EIAs) (16/85, 19 %) or in-house PCR (1/85, 1 %). The use of EIAs was more widespread than reported previously. Various methods were used for confirmation of positive EIA reactions and laboratories frequently resorted to sending samples to the national reference laboratory for this purpose, indicating that guidance is required for performance monitoring and confirmation of positive reactions. Laboratory positivity rates were related to the diagnostic test used, with highest median rates reported by those using PCR, EIAs or AP microscopy, and the lowest by those using mZN microscopy. One-third of responding laboratories (28/85, 33 %) routinely tested all stools for Cryptosporidium. However, 16 (19 %) laboratories used stool consistency to decide whether to test for this parasite. Other selection criteria included patient age (n = 18; 21 % laboratories), history or clinical details (n = 40; 47 %), duration of hospitalization (n = 18; 21 %) or clinician requests (n = 25; 29 %). To encourage laboratories to test all stools submitted for the investigation of diarrhoeal illness for Cryptosporidium, revision of the guidance in the national standards is under way. This will enable improved assessment of the burden of illness and ability to monitor outbreaks, and measure changes in reported cases.

  17. Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism.

    Science.gov (United States)

    Vulpio, Carlo; Bossola, Maurizio; Di Stasio, Enrico; Pepe, Gilda; Nure, Eda; Magalini, Sabina; Agnes, Salvatore

    2016-05-01

    The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG). The ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT. The concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT. The monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. [Development of a microbiology data warehouse (Akita-ReNICS) for networking hospitals in a medical region].

    Science.gov (United States)

    Ueki, Shigeharu; Kayaba, Hiroyuki; Tomita, Noriko; Kobayashi, Noriko; Takahashi, Tomoe; Obara, Toshikage; Takeda, Masahide; Moritoki, Yuki; Itoga, Masamichi; Ito, Wataru; Ohsaga, Atsushi; Kondoh, Katsuyuki; Chihara, Junichi

    2011-04-01

    The active involvement of hospital laboratory in surveillance is crucial to the success of nosocomial infection control. The recent dramatic increase of antimicrobial-resistant organisms and their spread into the community suggest that the infection control strategy of independent medical institutions is insufficient. To share the clinical data and surveillance in our local medical region, we developed a microbiology data warehouse for networking hospital laboratories in Akita prefecture. This system, named Akita-ReNICS, is an easy-to-use information management system designed to compare, track, and report the occurrence of antimicrobial-resistant organisms. Participating laboratories routinely transfer their coded and formatted microbiology data to ReNICS server located at Akita University Hospital from their health care system's clinical computer applications over the internet. We established the system to automate the statistical processes, so that the participants can access the server to monitor graphical data in the manner they prefer, using their own computer's browser. Furthermore, our system also provides the documents server, microbiology and antimicrobiotic database, and space for long-term storage of microbiological samples. Akita-ReNICS could be a next generation network for quality improvement of infection control.

  19. Prevalência de dislipidemias em adultos da demanda laboratorial de Salvador, Brasil Prevalence of dyslipidemias in non-hospital laboratory tests of adults from Salvador, Brazil

    Directory of Open Access Journals (Sweden)

    Ines Lessa

    1997-12-01

    Full Text Available OBJETIVO: Determinar a prevalência das dislipidemias em adultos da demanda laboratorial não-hospitalar da cidade de Salvador (BA. MÉTODOS: Casuística procedente de amostra probabilística de 25% dos laboratórios não-hospitalares da cidade que usavam o método enzimático para dosagem dos lípides séricos e controle de qualidade da Sociedade Brasileira de Patologia Clínica (93% do total; LDL estimado pela fórmula de Friedewald. Sorteados os meses ímpares de 1995 para o estudo. Critérios para dislipidemias, em mg/dl: colesterol ³240; LDL ³160; HDL ³200. Análise: prevalências, seus intervalos de confiança (IC a 95% e qui-quadrado (chi². RESULTADOS: Excluídos uma recusa e um laboratório que arquivava laudos só por 3 meses, foram analisados dados de 24 dos 26 laboratórios amostrados. Dos 7392 adultos, 65,5% eram mulheres. Prevalências estimadas e valores dos IC a 95% para homens, foram: hipercolesterolemia =24,0% (20,5; 27,5; LDL elevado =26,1 (22,4; 29,3; HDL baixo =15,9 (14,2; 17,8 e hipertrigliceridemia =27,6 (25,7; 29,5. Para mulheres: hipercolesterolemia =30,0 (27,8; 32,2, LDL elevado =33,1 (30,8; 35,4; HDL baixo =8,0 (7,1; 8,9 e hipertrigliceridemia =30,4 (29,0; 31,4. Todas as prevalências diferiram significantemente inter-gênero (p, 0,05 a pPURPOSE: To determine the prevalence of dyslipidemia in non-hospital laboratory tests of adults from Salvador, Brazil. METHODS: The study was carried out in subjects from a probabilistic sample of 25% of a total of 104 local laboratories that used the same enzymatic method for lipid analysis with the quality control as recommended by the Brazilian Society of Clinical Analyses. These represented 93% of all non-hospital laboratories of Salvador in 1995. The odd months of 1995 were selected for sampling in the present study. Criteria for dyslipidemias were: total cholesterol ³240; LDL ³160; HDL ³200mg/dl. Prevalence rates and their 95% confidence intervals (CI and chi² test were

  20. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Sasa Nie

    2017-10-01

    Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

  1. Monitoring of Frequency and Antimicrobial Susceptibility of Pathogens on the Hands of Healthcare Workers in a Tertiary Hospital

    Directory of Open Access Journals (Sweden)

    Tselebonis Athanasios

    2016-09-01

    Full Text Available Objective: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward and explore differences between departments, professions and genders.

  2. Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Antonieta Medina Lara

    Full Text Available Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART have rarely been evaluated.Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779. Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM or laboratory and clinical monitoring (LCM; individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial.3316 (1660LCM;1656CDM symptomatic, immunosuppressed ART-naive adults (median (IQR age 37 (32,42; CD4 86 (31,139 cells/mm(3 were followed for median 4.9 years. LCM had a mean 0.112 year (41 days survival benefit at an additional mean cost of $765 [95%CI:685,845], translating into an adjusted incremental cost of $7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below $3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks. CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term.There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low-income African countries. CD4 monitoring

  3. Status of contamination monitoring in Bangladesh

    Energy Technology Data Exchange (ETDEWEB)

    Begum, Aleya [Institute of Nuclear Science and Technology, Savar, Dacca (Bangladesh)

    1997-06-01

    The applications of radioisotopes and radiation sources to the research and development in medicine, food agriculture, industries and others are rapidly increasing in Bangladesh. The existing major nuclear facilites and allied laboratories of the country include 3 MW TRIGA Mark-2 research reactor for training, research and radioisotope production, 14 MeV neutron generator for nuclear data measurement and elemental analysis via neutron activation, 3 MeV Van de Graaff accelerator for the research and application of nuclear physics, and 50,000 Ci and 5,000 Ci Co-60 irradiators. About 10 Co-60 and Cs-137 teletherapy units are in operation in hospitals. The radioactive contamination of working areas, equipment, protective clothing and skin may result from normal operation and accidents, and contamination monitoring and decontamination are the essential part of radiation protection program. Surface contamination is monitored with Berthold survey meters. Hand and foot monitors have been used. Routine systematic search, continuous air monitoring, the examination of silt movement in Chittagong harbor using Sc-46 tracer and the measurement of tritium contamination for the neutron generator are reported. (K.I.)

  4. Financial performance monitoring of the technical efficiency of critical access hospitals: a data envelopment analysis and logistic regression modeling approach.

    Science.gov (United States)

    Wilson, Asa B; Kerr, Bernard J; Bastian, Nathaniel D; Fulton, Lawrence V

    2012-01-01

    From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital--the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).

  5. Contaminant monitoring programmes using marine organisms: Quality assurance and good laboratory practice

    International Nuclear Information System (INIS)

    1990-01-01

    This publication provides guidelines for obtaining reliable and relevant data during monitoring programmes in which contaminants are measured in marine organisms. It describes the precautions to be taken in each of the procedural steps from planning and sampling to the publication of data reports. The purpose of this document is to provide general guidance on quality assurance and to outline the approach that could be taken by laboratories to achieve the specific aims(s) for each marine pollution monitoring programme. Since most laboratories are currently focussing on programmes involving marine organisms, this document will be confined to this aspect. Four main aims can be identified for programmes involving the collection and analysis of marine organisms for the three main groups of contaminants (metals, organochlorine compounds and petroleum hydrocarbons), these are: (i) The measurement of contaminant levels in edible marine organisms in relation to public health; (ii) The identification of heavily contaminated areas of the sea (''hot spots'') where levels of contaminants are at least an order of magnitude higher than levels in clean or uncontaminated areas; (iii) The establishment of present levels of contaminants in marine organisms (i.e., a ''baseline''); (iv) The assessment of changes in concentrations of contaminants in organisms over a period of time (trends). The selection of organisms will be dictated by the eating patterns of the population. These can be identified by a survey of the species sold at the market, by obtaining information from colleagues in government departments who deal with such matters or in the absence of such information, by distributing a questionnaire to a representative section of the general public. 9 refs, 4 figs

  6. Study for correction of neutron scattering in the calibration of the albedo individual monitor from the Neutron Laboratory (LN), IRD/CNEN-RJ, Brazil

    International Nuclear Information System (INIS)

    Freitas, B.M.; Silva, A.X. da

    2014-01-01

    The Instituto de Radioprotecao e Dosimetria (IRD) runs a neutron individual monitoring service with albedo type monitor and thermoluminescent detectors (TLD). Moreover the largest number of workers exposed to neutrons in Brazil is exposed to 241 Am-Be fields. Therefore a study of the response of albedo dosemeter due to neutron scattering from 241 Am-Be source is important for a proper calibration. In this work, it has been evaluated the influence of the scattering correction in two distances at the Low Scattering Laboratory of the Neutron Laboratory of the Brazilian National Laboratory (Lab. Nacional de Metrologia Brasileira de Radiacoes Ionizantes) in the calibration of that albedo dosemeter for a 241 Am-Be source. (author)

  7. The laboratory-type data input and processing subsystem of the country-wide environmental radiation monitoring system in Hungary

    International Nuclear Information System (INIS)

    Kanyar, B.; Fulop, N.; Glavatszkih, N.; Nemeth, A.

    1996-01-01

    The countrywide radiation monitoring activity in Hungary is shared among the national networks as agriculture, environmental protection and public health ones. They are mostly involved in the environmental sampling and laboratory type determinations of the radioactive pollution, meanwhile the organisations mainly from the Army and Civil Defence are responsible to the early warning system. A moderately effective collaboration is established only around the Nuclear Power Plant Paks. Based on more than 10 years experience in collaboration around the NPP the Hungarian Atomic Energy Commission initiated some centralism in the countrywide monitoring activity as well. As the first step the National Research Institute for Radiobiology and Radiohygiene has been charged to establish an Information Center for laboratory-type data collection, processing, analysis and informing regularly the proper organizations on the results. The Information Centre is equipped with a computer type of SUN SPARCserver-20 and the laboratories are planned to be linked on line by PC stations. The main user programs for data collection, control and restricted processing are written in INGRES data manager software. The semiprocessed results can be transformed in a readable form for general statistical etc. packages

  8. Laboratory indicators of the diagnosis and course of imported malaria

    DEFF Research Database (Denmark)

    Gjørup, Ida E; Vestergaard, Lasse S; Møller, Kirsten

    2007-01-01

    When travellers return from malaria-endemic areas and present to hospital with fever, microscopy of blood smears remains the leading method to verify a suspected diagnosis of malaria. Additional laboratory abnormalities may, however, also be indicative of acute malaria infection. We monitored....... For comparison, admission values of a group of febrile patients with suspected malaria, but with negative blood slides, were also assessed (n=66). The thrombocyte, leucocyte counts and coagulation factor II-VII-X were significantly lower in the malaria group compared to the non-malaria group, whereas the C......-reactive protein, lactate dehydrogenase and bilirubin were significantly higher in the malaria group. The differences were particularly strong with falciparum malaria. By contrast, haemoglobin levels were not affected. In conclusion, our study emphasizes the role of a few commonly analysed laboratory parameters...

  9. Environmental monitoring at the Lawrence Livermore National Laboratory: 1986 annual report

    International Nuclear Information System (INIS)

    Holland, R.C.; Buddemeier, R.W.; Brekke, D.D.

    1987-04-01

    This report documents the results of the environmental monitoring program at the Lawrence Livermore National Laboratory (LLNL) for 1986. To evaluate the effect of LLNL operations on the local environment, measurements of direct radiation and a variety of radionuclides and chemical pollutants in ambient air, soil, surface water, groundwater, vegetation, milk, foodstuff, and sewage effluents were made at both the Livermore site and nearby Site 300. This report was prepared to meet the requirements of DOE Order 5484.1. Evaluations are made of LLNL's compliance with all applicable guides, standards, and limits for radiological and nonradiological releases to the environment. The data indicate that no releases in excess of the applicable standards were made during 1986, and that LLNL operations had no adverse environmental impact

  10. Environmental monitoring at the Lawrence Livermore National Laboratory: Annual report, 1987

    International Nuclear Information System (INIS)

    Holland, R.C.; Brekke, D.D.

    1988-04-01

    This report documents the results of the Environmental Monitoring Program at the Lawrence Livermore Laboratory (LLNL) for 1987. To evaluate the effect of LLNL operations on the local environment, measurements were made of direct radiation and a variety of radionuclides and chemical pollutants in ambient air, soil, sewage effluents, surface water, groundwater, vegetation, foodstuff, and milk at both the Livermore site and nearby Site 300. Evaluations were made of LLNL's compliance with the applicable guides, standards, and limits for radiological and nonradiological releases to the environment. The data indicates that the only releases in excess of applicable standards were four releases to the sanitary sewer. LLNL operations had no adverse impact on the environment during 1987. 65 refs., 24 figs

  11. Safety in laboratories: Indian scenario.

    Science.gov (United States)

    Mustafa, Ajaz; Farooq, A Jan; Qadri, Gj; S A, Tabish

    2008-07-01

    Health and safety in clinical laboratories is becoming an increasingly important subject as a result of emergence of highly infectious diseases such as Hepatitis and HIV. A cross sectional study was carried out to study the safety measures being adopted in clinical laboratories of India. Heads of laboratories of teaching hospitals of India were subjected to a standardized, pretested questionnaire. Response rate was 44.8%. only 60% of laboratories had person in-charge of safety in laboratory. Seventy three percent of laboratories had safety education program regarding hazards. In 91% of laboratories staff is using protective clothing while working in laboratories. Hazardous material regulations are followed in 78% of laboratories. Regular health check ups are carried among laboratory staff in 43.4% of laboratories.Safety manual is available in 56.5% of laboratories. 73.9% of laboratories are equipped with fire extinguishers. Fume cupboards are provided in 34.7% of laboratories and they are regularly checked in 87.5% of these laboratories. In 78.26% of laboratories suitable measures are taken to minimize formation of aerosols.In 95.6% of laboratories waste is disposed off as per bio-medical waste management handling rules. Laboratory of one private medical college was accredited with NABL and safety parameters were better in that laboratory. Installing safety engineered devices apparently contributes to significant decrease in injuries in laboratories; laboratory safety has to be a part of overall quality assurance programme in hospitals. Accreditation has to be made necessary for all laboratories.

  12. 1996 environmental monitoring report for the Bettis Atomic Power Laboratory, Pittsburgh Site

    International Nuclear Information System (INIS)

    1996-01-01

    The 1996 results for the Bettis-Pittsburgh radiological and non-radiological environmental monitoring programs are presented. The primary mission of the Bettis Laboratory has been directed toward the design, development, testing, and operation of nuclear reactor propulsion plants for naval surface and submarine vessels. The results obtained from the monitoring programs demonstrate that the existing procedures ensured that releases to the environment during 1996 were in accordance with applicable federal, state, county, and local regulations. Evaluation of the environmental data indicated that the current operations at the Site continue to have no adverse effect on the quality of the environment. A conservative assessment of radiation exposure to the general public as a result of Site operations demonstrated that the dose received by any member of the public was well below the most restrictive dose limits established by the Environmental Protection Agency, the Nuclear Regulatory Commission and the US Department of Energy. A risk assessment of potentially exposed populations to chemical residues in the environment at the Site demonstrated that these residues do not pose any significant health risk

  13. 1996 environmental monitoring report for the Bettis Atomic Power Laboratory, Pittsburgh Site

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    The 1996 results for the Bettis-Pittsburgh radiological and non-radiological environmental monitoring programs are presented. The primary mission of the Bettis Laboratory has been directed toward the design, development, testing, and operation of nuclear reactor propulsion plants for naval surface and submarine vessels. The results obtained from the monitoring programs demonstrate that the existing procedures ensured that releases to the environment during 1996 were in accordance with applicable federal, state, county, and local regulations. Evaluation of the environmental data indicated that the current operations at the Site continue to have no adverse effect on the quality of the environment. A conservative assessment of radiation exposure to the general public as a result of Site operations demonstrated that the dose received by any member of the public was well below the most restrictive dose limits established by the Environmental Protection Agency, the Nuclear Regulatory Commission and the US Department of Energy. A risk assessment of potentially exposed populations to chemical residues in the environment at the Site demonstrated that these residues do not pose any significant health risk.

  14. The development of a national surveillance system for monitoring blood use and inventory levels at sentinel hospitals in South Korea.

    Science.gov (United States)

    Lim, Y A; Kim, H H; Joung, U S; Kim, C Y; Shin, Y H; Lee, S W; Kim, H J

    2010-04-01

    We developed a web-based program for a national surveillance system to determine baseline data regarding the supply and demand of blood products at sentinel hospitals in South Korea. Sentinel hospitals were invited to participate in a 1-month pilot-test. The data for receipts and exports of blood from each hospital information system were converted into comma-separated value files according to a specific conversion rule. The daily data from the sites could be transferred to the web-based program server using a semi-automated submission procedure: pressing a key allowed the program to automatically compute the blood inventory level as well as other indices including the minimal inventory ratio (MIR), ideal inventory ratio (IIR), supply index (SI) and utilisation index (UI). The national surveillance system was referred to as the Korean Blood Inventory Monitoring System (KBIMS) and the web-based program for KBIMS was referred to as the Blood Inventory Monitoring System (BMS). A total of 30 256 red blood cell (RBC) units were submitted as receipt data, however, only 83% of the receipt data were submitted to the BMS server as export data (25 093 RBC units). Median values were 2.67 for MIR, 1.08 for IIR, 1.00 for SI, 0.88 for UI and 5.33 for the ideal inventory day. The BMS program was easy to use and is expected to provide a useful tool for monitoring hospital inventory levels. This information will provide baseline data regarding the supply and demand of blood products in South Korea.

  15. [Validation of a questionnaire to evaluate patient safety in clinical laboratories].

    Science.gov (United States)

    Giménez Marín, Ángeles; Rivas-Ruiz, Francisco

    2012-01-01

    The aim of this study was to prepare, pilot and validate a questionnaire to evaluate patient safety in the specific context of clinical laboratories. A specific questionnaire on patient safety in the laboratory, with 62 items grouped into six areas, was developed, taking into consideration the diverse human and laboratory contextual factors which may contribute to producing errors. A pilot study of 30 interviews was carried out, including validity and reliability analyses using principal components factor analysis and Cronbach's alpha. Subsequently, 240 questionnaires were sent to 21 hospitals, followed by a test-retest of 41 questionnaires with the definitive version. The sample analyzed was composed of 225 questionnaires (an overall response rate of 80%). Of the 62 items initially assessed, 17 were eliminated due to non-compliance with the criteria established before the principal components factor analysis was performed. For the 45 remaining items, 12 components were identified, with an cumulative variance of 69.5%. In seven of the 10 components with two or more items, Cronbach's alpha was higher than 0.7. The questionnaire items assessed in the test-retest were found to be stable. We present the first questionnaire with sufficiently proven validity and reliability for evaluating patient safety in the specific context of clinical laboratories. This questionnaire provides a useful instrument to perform a subsequent macrostudy of hospital clinical laboratories in Spain. The questionnaire can also be used to monitor and promote commitment to patient safety within the search for continuous quality improvement. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Environmental Monitoring Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-09-01

    This document presents the Environmental Monitoring Plan (EMP) for Waste Area Grouping (WAG) 6 at the Oak Ridge National Laboratory (ORNL). Based on the results of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) and on subsequent discussions with regulators, a decision was made to defer implementing source control remedial measures at the WAG. The alternative selected to address the risks associated with WAG 6 involves maintenance of site access controls prevent public exposure to on-site contaminants, continued monitoring of contaminant releases determine if source control measures are required, and development of technologies that could support the final remediation of WAG 6. Although active source control measures are not being implemented at WAG 6, environmental monitoring is necessary to ensure that any potential changes in contaminant release from the WAG are identified early enough to take appropriate action. Two types of environmental monitoring will be conducted: baseline monitoring and annual routine monitoring. The baseline monitoring will be conducted to establish the baseline contaminant release conditions at the WAG, confirm the site-related chemicals of concern (COCs), and gather data to confirm the site hydrologic model. The baseline monitoring is expected to begin in 1994 and last for 12--18 months. The annual routine monitoring will consist of continued sampling and analyses of COCs to determine off-WAG contaminant flux and risk, identify mills in releases, and confirm the primary contributors to risk. The annual routine monitoring will continue for ∼ 4 years after completion of the baseline monitoring

  17. Environmental Monitoring Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    This document presents the Environmental Monitoring Plan (EMP) for Waste Area Grouping (WAG) 6 at the Oak Ridge National Laboratory (ORNL). Based on the results of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) and on subsequent discussions with regulators, a decision was made to defer implementing source control remedial measures at the WAG. The alternative selected to address the risks associated with WAG 6 involves maintenance of site access controls prevent public exposure to on-site contaminants, continued monitoring of contaminant releases determine if source control measures are required, and development of technologies that could support the final remediation of WAG 6. Although active source control measures are not being implemented at WAG 6, environmental monitoring is necessary to ensure that any potential changes in contaminant release from the WAG are identified early enough to take appropriate action. Two types of environmental monitoring will be conducted: baseline monitoring and annual routine monitoring. The baseline monitoring will be conducted to establish the baseline contaminant release conditions at the WAG, confirm the site-related chemicals of concern (COCs), and gather data to confirm the site hydrologic model. The baseline monitoring is expected to begin in 1994 and last for 12--18 months. The annual routine monitoring will consist of continued sampling and analyses of COCs to determine off-WAG contaminant flux and risk, identify mills in releases, and confirm the primary contributors to risk. The annual routine monitoring will continue for {approximately} 4 years after completion of the baseline monitoring.

  18. Area monitoring dosimeter program for the Pacific Northwest National Laboratory: Results for CY 1997

    International Nuclear Information System (INIS)

    Bivins, S.R.; Stoetzel, G.A.

    1998-07-01

    In January 1993, Pacific Northwest National Laboratory (PNNL) established an area monitoring dosimeter program in accordance with Article 514 of the US Department of Energy (DOE) Radiological Control Manual (RCM). The purpose of the program was to minimize the number of areas requiring issuance of personnel dosimeters and to demonstrate that doses outside Radiological Buffer Areas are negligible. In accordance with 10 CFR Part 835.402 (a) (1)--(3) and Article 511.1 of the RCM, personnel dosimetry shall be provided to (1) radiological workers who are likely to receive at least 100 mrem annually, and (2) declared pregnant workers, minors, and members of the public who are likely to receive at least 50 mrem annually. Program results for calendar years (CY) 1993--1996 confirmed that personnel dosimetry was not needed for individuals located in areas monitored by the program. A total of 93 area thermoluminescent dosimeters (TLDs) were placed in PNNL facilities during CY 1997. The TLDs were exchanged and analyzed quarterly. All routine area monitoring TLD results were less than 50 mrem annually after correcting for worker occupancy. The results support the conclusions that personnel dosimeters are not necessary for staff, declared pregnant workers, minors, or members of the public in these monitored areas

  19. Area Monitoring Dosimeter Program for the Pacific Northwest National Laboratory: Results for CY 1998

    International Nuclear Information System (INIS)

    GA Stoetzel; SR Bivins

    1999-01-01

    In January 1993, Pacific Northwest National Laboratory (PNNL) established an area monitoring dosimeter program in accordance with Article 514 of the Department of Energy (DOE) Radiological Control Manual (RCM). The purpose of the program was to minimize the number of areas requiring issuance of personnel dosimeters and to demonstrate that doses outside Radiological Buffer Areas are negligible. In accordance with 10 CFR Part 835.402 (a)(1)-(4) and Article 511.1 of the RCM, personnel dosimetry shall be provided to (1) radiological workers who are likely to receive at least 100 mrem annually and (2) declared pregnant workers, minors, and members of the public who are likely to receive at least 50 mrem annually. Program results for calendar years 1993-1997 confirmed that personnel dosimetry was not needed for individuals located in areas monitored by the program. A total of 97 area thermoluminescent dosimeters (TLDs) were placed in PNNL facilities during calendar year 1998. The TLDs were exchanged and analyzed quarterly. All routine area monitoring TLD results were less than 50 mrem annually after correcting for worker occupancy. The results support the conclusion that personnel dosimeters are not necessary for staff, declared pregnant workers, minors, or members of the public in these monitored areas

  20. Annual report of the Environmental Restoration Monitoring and Assessment Program at Oak Ridge National Laboratory for FY 1992

    International Nuclear Information System (INIS)

    Clapp, R.B.

    1992-09-01

    This report summarizes the salient features of the annual efforts of the investigations and monitoring, conducted to support the Environmental Restoration (ER) Program at Oak Ridge National Laboratory (ORNL). The results presented can be used to develop a conceptual understanding of the key contaminants and the sources, fluxes, and processes affecting their distribution and movement. This information forms a basis for prioritizing sites and for selecting, implementing, and evaluating remedial actions. Groundwater, soils, sediments, and surface water monitoring results are described

  1. Ambient air monitoring for organic compounds, acids, and metals at Los Alamos National Laboratory, January 1991

    International Nuclear Information System (INIS)

    Williams, C.H.; Eberhart, C.F.

    1992-01-01

    Los Alamos National Laboratory (LANL) contracted Radian Corporation (Radian) to conduct a short-term, intensive air monitoring program whose goal was to estimate the impact of chemical emissions from LANL on the ambient air environment. A comprehensive emission inventory had identified more than 600 potential air contaminants in LANL's emissions. A subset of specific target chemicals was selected for monitoring: 20 organic vapors, 6 metals and 5 inorganic acid vapors. These were measured at 5 ground level sampling sites around LANL over seven consecutive days in January 1991. The sampling and analytical strategy used a combination of EPA and NIOSH methods modified for ambient air applications

  2. Dig-face monitoring during excavation of a radioactive plume at Mound Laboratory, Ohio

    International Nuclear Information System (INIS)

    Josten, N.E.; Gehrke, R.J.; Carpenter, M.V.

    1995-12-01

    A dig-face monitoring system consists of onsite hardware for collecting information on changing chemical, radiological, and physical conditions in the subsurface soil during the hazardous site excavation. A prototype dig-face system was take to Mount Laboratory for a first trial. Mound Area 7 was the site of historical disposals of 232 Th, 227 Ac, and assorted debris. The system was used to monitor a deep excavation aimed at removing 227 Ac-contaminated soils. Radiological, geophysical, and topographic sensors were used to scan across the excavation dig-face at four successive depths as soil was removed. A 3-D image of the contamination plumes was developed; the radiation sensor data indicated that only a small portion of the excavated soil volume was contaminated. The spatial information produced by the dig-face system was used to direct the excavation activities into the area containing the 227 Ac and to evaluate options for handling the separate 232 Th plume

  3. Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

    Directory of Open Access Journals (Sweden)

    Feyisayo Jegede

    2016-05-01

    Objective: We assessed routinely-submitted LRFs to determine the degree of correctness, completeness and consistency. Methods: LRFs submitted to the Department of Haematology (DH and Blood Transfusion Services (BTS of Aminu Kano Teaching Hospital in Kano, Nigeria, between October 2014 and December 2014, were evaluated for completion of all items on the forms. Performance in four quality indicator domains, including patient identifiers, test request details, laboratory details and physician details, was derived as a composite percentage. Results: Of the 2084 LRFs evaluated, 999 were from DH and 1085 from BTS. Overall, LRF completeness was 89.5% for DH and 81.2% for BTS. Information on patient name, patient location and laboratory number were 100% complete for DH, whereas only patient name was 100% complete for BTS. Incomplete information was mostly encountered on BTS forms for physician’s signature (60.8% and signature of laboratory receiver (63.5%. None of the DH and only 9.4% of BTS LRFs met all quality indicator indices. Conclusion: The level of completion of LRFs from these two departments was suboptimal. This underscores the need to review and redesign the LRF, improve on training and communication between laboratory and clinical staff and review specimen rejection practices.

  4. Radiobioassay economics and laboratory management

    International Nuclear Information System (INIS)

    Gilchrist, J.

    1983-01-01

    The economic situation faced by laboratories in the US is less than ideal. Inflation/interest rates are in the area of 10 to 20% per year, reimbursement policies are putting pressures on the laboratories, hospitals are in a cost-containment mode in the best of cases, and in the worst, are closing for a lack of funds. In the past six years, there has been a national net loss of 186 hospitals, according to American Hospital Association figures. The pressure is acute on community hospitals; 135 have failed. Many hospitals (160) have applied for federal grants as financially distressed hospitals. Since the community hospitals account for 85% of all admissions in the US, it is obvious that the pressure has been greatest on the hospitals that account for the greatest number of admissions. To put the general economic scene in perspective, according to 1977 Medicare data, 24% of all community hospitals had total expenses that exceeded their total revenues. Many social and economic factors contribute to this picture, but the rapidly rising operating expenses due to inflation, new high cost medical technology, surplus of hospital beds, and inadequate planning, purchasing, accounting, and hiring practices play a noticeable part in contributing to this problem

  5. Project management: importance for diagnostic laboratories.

    Science.gov (United States)

    Croxatto, A; Greub, G

    2017-07-01

    The need for diagnostic laboratories to improve both quality and productivity alongside personnel shortages incite laboratory managers to constantly optimize laboratory workflows, organization, and technology. These continuous modifications of the laboratories should be conducted using efficient project and change management approaches to maximize the opportunities for successful completion of the project. This review aims at presenting a general overview of project management with an emphasis on selected critical aspects. Conventional project management tools and models, such as HERMES, described in the literature, associated personal experience, and educational courses on management have been used to illustrate this review. This review presents general guidelines of project management and highlights their importance for microbiology diagnostic laboratories. As an example, some critical aspects of project management will be illustrated with a project of automation, as experienced at the laboratories of bacteriology and hygiene of the University Hospital of Lausanne. It is important to define clearly beforehand the objective of a project, its perimeter, its costs, and its time frame including precise duration estimates of each step. Then, a project management plan including explanations and descriptions on how to manage, execute, and control the project is necessary to continuously monitor the progression of a project to achieve its defined goals. Moreover, a thorough risk analysis with contingency and mitigation measures should be performed at each phase of a project to minimize the impact of project failures. The increasing complexities of modern laboratories mean clinical microbiologists must use several management tools including project and change management to improve the outcome of major projects and activities. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. Variation in interoperability across clinical laboratories nationwide.

    Science.gov (United States)

    Patel, Vaishali; McNamara, Lauren; Dullabh, Prashila; Sawchuk, Megan E; Swain, Matthew

    2017-12-01

    To characterize nationwide variation and factors associated with clinical laboratories': (1) capabilities to send structured test results electronically to ordering practitioners' EHR systems; and (2) their levels of exchange activity, as measured by whether they sent more than three-quarters of their test results as structured data to ordering practitioners' EHR systems. A national survey of all independent and hospital laboratories was conducted in 2013. Using an analytic weighted sample of 9382 clinical laboratories, a series of logistic regression analyses were conducted to identify organizational and area characteristics associated with clinical laboratories' exchange capability and activity. Hospital-based clinical laboratories (71%) and larger clinical laboratories (80%) had significantly higher levels of capability compared to independent (58%) and smaller laboratories (48%), respectively; though all had similar levels of exchange activity, with 30% of clinical laboratories sending 75% or more of their test results electronically. In multivariate analyses, hospital and the largest laboratories had 1.87 and 4.40 higher odds, respectively, of possessing the capability to send results electronically compared to independent laboratories (pLaboratories located in areas with a higher share of potential exchange partners had a small but significantly greater capability to send results electronically and higher levels of exchange activity(pClinical laboratories' capability to exchange varied by size and type; however, all clinical laboratories had relatively low levels of exchange activity. The role of exchange partners potentially played a small but significant role in driving exchange capability and activity. Published by Elsevier B.V.

  7. Environmental monitoring at Argonne National Laboratory. Annual report for 1982

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1983-03-01

    The results of the environmental monitoring program at Argonne Ntaional Laboratory for 1982 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, soil, grass, bottom sediment, and milk; for a variety of chemical constituents in air, surface water, ground water, and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and masurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements were made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with applicable environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  8. Environmental monitoring at Argonne National Laboratory. Annual report for 1980

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1981-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1980 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, soil, grass, bottom sediment, and foodstuffs; for a variety of chemical constituents in air, surface water, and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements were made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with applicable environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  9. Environmental monitoring at Argonne National Laboratory. Annual report for 1978

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1979-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1978 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, Argonne effluent water, soil, grass, bottom sediment, and foodstuffs; for a variety of chemical constituents in air, surface water, and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements wee made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with applicable environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  10. Environmental monitoring at Argonne National Laboratory. Annual report for 1976

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1977-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1976 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, Argonne effluent water, soil, grass, bottom sediment, and foodstuffs; for a variety of chemical constituents in surface and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements were made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with accepted environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  11. Environmental monitoring at Argonne National Laboratory. Annual report for 1979

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1980-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1979 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, Argonne effluent water, soil, grass, bottom sediment, and foodstuffs; for a variety of chemical constituents in air, surface water, and Argonne effluent water; and of the environemetal penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measuremenets were made to aid in the interpretation of the boundary and off-site data. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances and are compared with applicable environmental quality standards. The potential radiation dose to off-site population groups is also estimated

  12. Area Monitoring Dosimeter Program for the Pacific Northwest National Laboratory: Results for CY 2000

    International Nuclear Information System (INIS)

    Bivins, Steven R; Stoetzel, Gregory A

    2001-01-01

    Pacific Northwest National Laboratory (PNNL) established an area monitoring dosimeter program in accordance with Article 514 of the Department of Energy (DOE) Radiological Control Manual (RCM) in January 1993. This program is to minimize the number of areas requiring issuance of personnel dosimeters and to demonstrate that doses outside Radiological Buffer Areas are negligible. In accordance with 10 CFR Part 835.402 (a) (1)-(4) and Article 511.1 of the DOE Standard Radiological Control, personnel dosimetry shall be provided to (1) radiological workers who are likely to receive at least 100 mrem annually, and (2) declared pregnant workers, minors, and members of the public who are likely to receive at least 50 mrem annually. Program results for calendar years 1993-2000 confirm that personnel dosimetry is not needed for individuals located in areas monitored by the program

  13. Idaho National Laboratory Cultural Resource Monitoring Report for Fiscal Year 2007

    International Nuclear Information System (INIS)

    Brenda R. Pace

    2007-01-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory's (INL) Cultural Resource Management (CRM) Office during fiscal year 2007 (FY 2007). In FY 2007, 40 localities were revisited: two locations of heightened Shoshone-Bannock tribal sensitivity, four caves, three butte/craters, twelve prehistoric archaeological sites, two historic stage stations, nine historic homesteads, a portion of Goodale's Cutoff of the Oregon Trail, a portion of historic trail T-16, one World War II dump, four buildings from the World War II period, and Experimental Breeder Reactor-I, a modern scientific facility and National Historic Landmark. Several INL project areas were also monitored in FY 2007. This included direct observation of ground disturbing activities within the Power Burst Facility (PBF, now designated as the Critical Infrastructure Test Range Complex-CITRC), backfilling operations associated with backhoe trenches along the Big Lost River, and geophysical surveys designed to pinpoint subsurface unexploded ordnance in the vicinity of the Naval Ordnance Disposal Area. Surprise checks were also made to three ongoing INL projects to ensure compliance with INL CRM Office recommendations to avoid impacts to cultural resources. Although some impacts were documented, no significant adverse effects that would threaten the National Register eligibility of any resource were observed at any location

  14. Hospital-acquired malnutrition in children at a tertiary care hospital

    African Journals Online (AJOL)

    Del-Rossi Sean Quadros

    As such, there is a need for hospitals to monitor its occurrence using cost- effective but accurate tools. Table 1: General .... Malades Hospital, France.2. Our study ... daily weight loss, which is the critical threshold for an adverse clinical outcome ...

  15. Risk Factors for Transmission of HIV in a Hospital Environment of Yaoundé, Cameroon

    Directory of Open Access Journals (Sweden)

    Dora Mbanya

    2010-05-01

    Full Text Available Risk factors for HIV transmission within a hospital setting were assessed using pre-structured questionnaires and observations. Of 409 respondents, 66.3% corresponded to the nursing staff, 14.4% doctors and 8.3% laboratory staff. The irregular use of gloves and other protective clothing for risky tasks, and recapping of needles after use were some of the risk factors identified, especially amongst nurses. Preventive measures were not always implemented by health personnel. More emphasis should be placed not only on diffusing universal precautions and recommendations for hospital staff safety, but accompanying measures for monitoring and evaluation of implementation of these standards are also indispensable.

  16. [Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital].

    Science.gov (United States)

    López-Picazo Ferrer, J J; Tomás García, N; Cubillana Herrero, J D; Gómez Company, J A; de Dios Cánovas García, J

    2014-01-01

    To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level («A» to «D») increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. There were 22.4±6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. AEP is useful to assess the admission appropriateness and may be included in the «Emergencies» process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  17. The Design Fabrication Installation & Evaluation of the Balance Probe Monitor for Large Centrifuges at a National Laboratory Facility.

    Energy Technology Data Exchange (ETDEWEB)

    Gallegos, Jonathan Michael [Univ. of Texas, Austin, TX (United States)

    2016-11-01

    Balance Probe Monitors were designed, fabricated, installed, and evaluated at Sandia National Laboratories (SNL) for the 22,600 g kg (50,000 g lb) direct drive electromotor driven large centrifuges. These centrifuges provide a high onset/decay rate g environment. The Balance Probe Monitor is physically located near a centrifuge’s Capacitance Probe, a crucial sensor for the centrifuge’s sustainability. The Balance Probe Monitor will validate operability of the centrifuge. Most importantly, it is used for triggering a kill switch under the condition that the centrifuge displacement value exceeds allowed tolerances. During operational conditions, the Capacitance Probe continuously detects the structural displacement of the centrifuge and an adjoining AccuMeasure 9000 translates this displacement into an output voltage.

  18. Monitoring plan for long-term environmental measurements at the proposed Douglas Point Ecological Laboratory, Nanjemoy, Maryland

    International Nuclear Information System (INIS)

    Jensen, B.L.; Miles, K.J.; Strass, P.K.; McDonald, B.S.; Nugent, A.

    1979-01-01

    The Douglas Point Ecological Laboratory has been set up at the site of a proposed power plant, which is to be powered by either nuclear, coal, or an alternate form of fuel. A plan for long-range monitoring of terrestrial ecosystems and atmospheric chemistry is presented. A site characterization study will be made initially. Chemical and physical soil profiles will be established with continuous measurement of soil moisture and nutrient content, as well as other parameters. Data sets will be established, reflecting changes in rainfall pH and rate of deposition through precipitation and dryfall sedimentation of Ca 2+ , Mg 2+ , K + , Na + , SO 4 3- , Cl - , NH 4 + , and NO 3 - . Among other objectives are the development of new monitoring techniques that can be used to trace energy flow, nutrient transport, and radionuclide transport through all trophic levels to selected carnivores. The atmospheric monitoring plan is outlined as to system design and specifications; system installation, operation, and maintenance, data processing and reports; quality assurance program; and project organization. A discussion of administrative and operational monitoring costs is included

  19. Clinical and Laboratory Findings in Patients with Tramadol Intoxication Referred to Razi Hospital During 2005-06

    Directory of Open Access Journals (Sweden)

    Morteza Rahbar Taromsari

    2012-03-01

    Full Text Available Introduction: Frequency of Tramadol intoxication is increasing as a result of its useas a drug for suppression of withdrawal symptoms by opioids abusers and its wideaccessibility of this drug. Tramadol intoxication can lead to death and, therefore, earlyidentification of its clinical manifestations is crucial since early detection of theintoxication and its treatment could improve patients' survival This study investigatedthe frequency of clinical and laboratory findings in Tramadol intoxication.Methods: In this cross-sectional study, patients with Tramadol intoxication whoreferred to Razi Hospital in Rasht, Iran, during 2005-06 were examined. Theirmedical records were surveyed for demographic data, past medical history,neurological examination, and routine laboratory tests. All data were statisticallyanalyzed by SPSS software version 14.Result: The majority of the 306 patients (83.3% male were in the age range of 20-40 years and 68.6% of them had been educated up to high school. The mean dose ofingested Tramadol was 746± 453mg (mean± SD. Agitation (25.2% and seizure(20.3% were the most frequent reported symptoms. Among laboratory abnormalities,the most common findings were prolonged PT (18.3% and increased ALT (5.6%.Conclusion: The most common clinical presentation was agitation and the mostcommon laboratory finding was prolonged PT. Of all the patients, 3 cases wereadmitted to ICU. Although Tramadol poisoning might lead to death, there was onlyone death after Tramadol poisoning in the current study.

  20. Neonatal hypoglycemia: prevalence and clinical manifestations in tehran children's hospital

    International Nuclear Information System (INIS)

    Dashti, N.; Einollahi, N.; Abbasi, S.

    2007-01-01

    To measure the prevalence of hypoglycemia among newborn infants in Children Hospital using a standard laboratory glucose method and to evaluate the evidence of clinical manifestations of hypoglycemia, designing appropriate strategies for prevention and treatment. The study population consisted of 673 neonates in Tehran Children's Hospital and was conducted between June 2004 and March 2005. The incidence of neonatal hypoglycemia in the present study group was 15.15% live births. The clinical features which remained significantly associated with the hypoglycemic neonates were refusal of feeding (45%), hyporeflexia (36.2%), irritability (30%), cyanosis (28.4%), tackypnea (24.5%), seizure (16.6%), weak cry (15.8%), apneic spels (9.8%), pallor (1.9%), cardiac arrest (9.1%) and sweating (1%). Hypoglycemia does occur frequently in newborn infants and requires careful monitoring and therapy of serum glucose. (author)

  1. Chromatography related performance of the Monitor for Aerosols and Gases in Ambient Air (MARGA): laboratory and field based evaluation

    Science.gov (United States)

    Evaluation of the semi-continuous Monitor for Aerosols and Gases in Ambient Air (MARGA, Metrohm Applikon B.V.) was conducted with an emphasis on examination of accuracy and precision associated with processing of chromatograms. Using laboratory standards and atmospheric measureme...

  2. A review of the probabilistic safety assessment of the Radiation Monitor Calibration Laboratory of the Almirante Alvaro Alberto Power Plant

    International Nuclear Information System (INIS)

    Gomes, Erica Cupertino

    2005-03-01

    The main purpose of this work is to update the PSA study of the Radiation Monitor Calibration Laboratory of the Almirante Alvaro Alberto Power Station taking into account new information. It is considered in this study an evaluation of the human reliability analysis in the calibration procedure of the radiation monitors, and for such the THERP modeling is used, as well as the use of the Bayesian approach for the calculation of the equipment failure probabilities used by the operators. Some accident scenarios of external origin were incorporated for evaluating their importance for an accident that might expose a worker to gamma radiation. A catastrophic failure is analyzed in the diesel generators 3 and 4, whose building is nearby the laboratory, as well as the route of change and the transportation of the steam generator of the nuclear power plant since the laboratory is located in the plant controlled area. Although more accidents scenarios are considered in this work, a conservative approach was not used and thus a smaller radiological risk was obtained. (author)

  3. A Laboratory Experimental Study: An FBG-PVC Tube Integrated Device for Monitoring the Slip Surface of Landslides

    Science.gov (United States)

    Zhang, Shaojie; Chen, Jiang; Teng, Pengxiao; Wei, Fangqiang; Chen, Qiao

    2017-01-01

    A new detection device was designed by integrating fiber Bragg grating (FBG) and polyvinyl chloride (PVC) tube in order to monitor the slip surface of a landslide. Using this new FBG-based device, a corresponding slope model with a pre-set slip surface was designed, and seven tests with different soil properties were carried out in laboratory conditions. The FBG sensing fibers were fixed on the PVC tube to measure strain distributions of PVC tube at different elevation. Test results indicated that the PVC tube could keep deformation compatible with soil mass. The new device was able to monitor slip surface location before sliding occurrence, and the location of monitored slip surface was about 1–2 cm above the pre-set slip surface, which basically agreed with presupposition results. The monitoring results are expected to be used to pre-estimate landslide volume and provide a beneficial option for evaluating the potential impact of landslides on shipping safety in the Three Gorges area. PMID:29084157

  4. Environmental monitoring at Argonne National Laboratory. Annual report for 1983

    International Nuclear Information System (INIS)

    Golchert, N.W.; Duffy, T.L.; Sedlet, J.

    1984-03-01

    The results of the environmental monitoring program at Argonne National Laboratory for 1983 are presented and discussed. To evaluate the effect of Argonne operations on the environment, measurements were made for a variety of radionuclides in air, surface water, soil, grass, bottom sediment, and milk; for a variety of chemical constituents in air, surface water, ground water, and Argonne effluent water; and of the environmental penetrating radiation dose. Sample collections and measurements were made at the site boundary and off the Argonne site for comparison purposes. Some on-site measurements were made to aid in the interpretation of the boundary and off-site data. The potential radiation dose to off-site population groups is also estimated. The results of the program are interpreted in terms of the sources and origin of the radioactive and chemical substances (natural, fallout, Argonne, and other) and are compared with applicable environmental quality standards. 19 references, 8 figures, 49 tables

  5. The challenges in monitoring and preventing patient safety incidents for people with intellectual disabilities in NHS acute hospitals: evidence from a mixed-methods study.

    Science.gov (United States)

    Tuffrey-Wijne, Irene; Goulding, Lucy; Gordon, Vanessa; Abraham, Elisabeth; Giatras, Nikoletta; Edwards, Christine; Gillard, Steve; Hollins, Sheila

    2014-09-24

    There has been evidence in recent years that people with intellectual disabilities in acute hospitals are at risk of preventable deterioration due to failures of the healthcare services to implement the reasonable adjustments they need. The aim of this paper is to explore the challenges in monitoring and preventing patient safety incidents involving people with intellectual disabilities, to describe patient safety issues faced by patients with intellectual disabilities in NHS acute hospitals, and investigate underlying contributory factors. This was a 21-month mixed-method study involving interviews, questionnaires, observation and monitoring of incident reports to assess the implementation of recommendations designed to improve care provided for patients with intellectual disabilities and explore the factors that compromise or promote patient safety. Six acute NHS Trusts in England took part. Data collection included: questionnaires to clinical hospital staff (n = 990); questionnaires to carers (n = 88); interviews with: hospital staff including senior managers, nurses and doctors (n = 68) and carers (n = 37); observation of in-patients with intellectual disabilities (n = 8); monitoring of incident reports (n = 272) and complaints involving people with intellectual disabilities. Staff did not always readily identify patient safety issues or report them. Incident reports focused mostly around events causing immediate or potential physical harm, such as falls. Hospitals lacked effective systems for identifying patients with intellectual disabilities within their service, making monitoring safety incidents for this group difficult.The safety issues described by the participants were mostly related to delays and omissions of care, in particular: inadequate provision of basic nursing care, misdiagnosis, delayed investigations and treatment, and non-treatment decisions and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders. The events leading to avoidable harm

  6. National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

    Science.gov (United States)

    Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo

    2018-02-01

    This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.

  7. Environmental monitoring of subsurface low-level waste disposal facilities at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Ashwood, T.L.; Hicks, D.S.

    1992-01-01

    Oak Ridge National Laboratory (ORNL) generates low-level waste (LLW) as part of its research and isotope production activities. This waste is managed in accordance with US Department of Energy (DOE) Order 5820.2A. Solid LLW management includes disposal in above-ground, tumulus-type facilities as well as in various types of subsurface facilities. Since 1986, subsurface disposal has been conducted using various designs employing greater-confinement-disposal (GCD) techniques. The purpose of this paper is to present monitoring results that document the short-term performance of these GCD facilities

  8. Laboratory monitoring of patients treated with antihypertensive drugs and newly exposed to non steroidal anti-inflammatory drugs: a cohort study.

    Directory of Open Access Journals (Sweden)

    Jean-Pascal Fournier

    Full Text Available BACKGROUND: Drug-Drug Interactions between Non Steroidal Anti-Inflammatory Drugs (NSAIDs and Angiotensin Converting Enzyme Inhibitors (ACEIs, Angiotensin Receptor Blocker (ARBs or diuretics can lead to renal failure and hyperkalemia. Thus, monitoring of serum creatinine and potassium is recommended when a first dispensing of NSAID occur in patients treated with these drugs. METHODS: We conducted a pharmacoepidemiological retrospective cohort study using data from the French Health Insurance Reimbursement Database to evaluate the proportion of serum creatinine and potassium laboratory monitoring in patients treated with ACEI, ARB or diuretic and receiving a first dispensing of NSAID. We described the first dispensing of NSAID among 3,500 patients of a 4-year cohort (6,633 patients treated with antihypertensive drugs and analyzed serum creatinine and potassium laboratory monitoring within the 3 weeks after the first NSAID dispensing. RESULTS: General Practitioners were the most frequent prescribers of NSAIDs (85.5%, 95% CI: 84.3-86.6. The more commonly prescribed NSAIDs were ibuprofen (20%, ketoprofen (15%, diclofenac (15% and piroxicam (12%. Serum creatinine and potassium monitoring was 10.7% (95% CI: 9.5-11.8 in patients treated by ACEIs, ARBs or diuretics. Overall, monitoring was more frequently performed to women aged over 60, treated with digoxin or glucose lowering drugs, but not to patients treated with ACEIs, ARBs or diuretics. Monitoring was more frequent when NSAIDs' prescribers were cardiologists or anesthesiologists. CONCLUSION: Monitoring of serum creatinine and potassium of patients treated with ACEIs, ARBs or diuretics and receiving a first NSAID dispensing is insufficiently performed and needs to be reinforced through specific interventions.

  9. System of Monitoring Potential Deceased Organ Donations in Over 200 Hospitals in Poland Using a Web Tool: Implementation and Structure.

    Science.gov (United States)

    Danek, T; Protasiuk, R; Mańkowski, M; Brutkiewicz, A; Trześniewski, R; Podlińska, I; Milecka, A; Jonas, M; Danielewicz, R; Czerwiński, J

    2016-06-01

    In 2010 the formation of the Polish Hospitals Network of Organ Donation Coordinators, originated by Poltransplant, began. One of the goals of this project is to report all deaths in hospital ICUs in which a coordinator is posted. The aim of this strategy is to monitor donation potential, following the recruitment process of potential donors and indicating stages of that process that may be improved to increase effective recruitment. Until the end of 2014 all data were forwarded to Poltransplant as Excel files, but since January 1, 2015, reporting and data collection have been are performed using web tool www.koordynator.net. The aim of the paper is to present the essentials in functioning principles, structure, and usage of the www.koordynator.net system, its technical construction, and to display good practices (know-how) tested by 1 country, for countries such as Poland, that contend with organ insufficiency. The application www.koordynator.net allows for remote addition of individual records with information about deceased patients in hospital ICUs, the forwarding of data about potential and actual organ donors, the generation of complete reports about deceased patients in each hospital monthly, and the introduction of historical data. Introduction of a potential donation monitoring system in 209 hospitals with transplant coordinators increases the number of identified potential and effective actual donors due to self-assessment analysis. Eventually, the www.koordynator.net reporting system allowed for external evaluation by coordinators from other hospitals, regional coordinators, and Poltransplant. The system is a modern tool that improves and increases the quality system in the organ donation field (quality assurance program). Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Establishment of Next-Generation Neurosurgery Research and Training Laboratory with Integrated Human Performance Monitoring.

    Science.gov (United States)

    Bernardo, Antonio

    2017-10-01

    Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. Until recently, few means have allowed surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory designed to recreate the setting of a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Performance indicators and decision making for outsourcing public health laboratory services.

    Science.gov (United States)

    Santos, Maria Angelica Borges dos; Moraes, Ricardo Montes de; Passos, Sonia Regina Lambert

    2012-06-01

    To develop performance indicators for outsourcing clinical laboratory services, based on information systems and public administrative records. In the municipality of Rio de Janeiro, Southern Brazil, the public health laboratory network comprised 33 laboratories with automated equipment (but no integrated information system), 90 primary care units (where sample collection was performed) and 983 employees. Information records were obtained from the administrative records of the Budget Information System for Public Health and the Outpatient and Hospital Information System of the Unified Health System. Performance indicators (production, productivity, usage and costs) were generated from data collected routinely from 2006 to 2008. The variations in production, costs and unit prices for tests were analyzed by Laspeyres and Paasche indices, which specifically measure laboratory activity, and by the Consumer Price Index from the Brazilian Institute of Geography and Statistics. A total of 10,359,111 tests were performed in 2008 (10.6% increase over 2006), and the test/employee ratio grew by 8.6%. The costs of supplies, wages and providers increased by 2.3%, 45.4% and 18.3%, respectively. The laboratory tests per visit and hospitalizations increased by 10% and 20%, respectively. The direct costs totaled R$ 63.2 million in 2008, representing an increase of 22.2% in current values during the period analyzed. The direct costs deflated by the Brazilian National Consumer Price Index (9.5% for the period) showed an 11.6% increase in production volumes. The activity-specific volume index, which considers changes in the mix of tests, showed increases of 18.5% in the test price and 3.1% in the production volume. The performance indicators, particularly the specific indices for volume and price of activity, constitute a baseline of performance potential for monitoring private laboratories and contractors. The economic performance indicators demonstrated the need for network

  12. Use of sulfur hexafluoride airflow studies to determine the appropriate number and placement of air monitors in an alpha inhalation exposure laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Newton, G.J.; Hoover, M.D.

    1995-12-01

    Determination of the appropriate number and placement of air monitors in the workplace is quite subjective and is generally one of the more difficult tasks in radiation protection. General guidance for determining the number and placement of air sampling and monitoring instruments has been provided by technical reports such as Mishima, J. These two documents and other published guidelines suggest that some insight into sampler placement can be obtained by conducting airflow studies involving the dilution and clearance of the relatively inert tracer gas sulfur hexafluoride (SF{sub 6}) in sampler placement studies and describes the results of a study done within the ITRI alpha inhalation exposure laboratories. The objectives of the study were to document an appropriate method for conducting SF{sub 6} dispersion studies, and to confirm the appropriate number and placement of air monitors and air samplers within a typical ITRI inhalation exposure laboratory. The results of this study have become part of the technical bases for air sampling and monitoring in the test room.

  13. MONITORING OF THE CEPHALOSPORINS CONSUMPTION IN THE TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radmila Veličković-Radovanović

    2015-06-01

    Full Text Available Irrational antibiotic consumption, especially in the case when there is no appropriate indication for its usage, may be one of the most crucial global issues for public health care, leading to bacterial resistance and the increase of indirect medical expenses. According to the report of the European program for the monitoring of the antibiotic consumption, Serbia is on the fifth place among the countries which are not members of EU. The goal of this work is the evaluation of antibiotic consumption in the Clinical Centre Niš, from 2007 to 2013, with the focus on the monitoring of the cephalosporins utilization, as they are one of the most prescribed groups of antibiotics in the tertiary health care. The utilization of antibiotics in the Clinical Center Niš in the observed period was obtained from the computerized database of the Department of Pharmacotherapy and expressed as defined daily dose (DDD per 100 bed/days (DBD. Our results showed that there was an increase in antibiotic use of the whole group of cephalosporins and penicillin as well as a reduction of quinolones consumption within the observed period. Our analysis showed that ceftriaxone was the most frequently prescribed cephalosporin, followed by cefuroxime. Although antibiotic therapy and prophylaxis in our hospital are in keeping with the recommended guidelines, the obtained results may suggest that cephalosporin consumption, and especially ceftriaxone consumption is higher than in other European countries.

  14. Monitoring laboratory data across manufacturers and laboratories--A prerequisite to make "Big Data" work.

    Science.gov (United States)

    Goossens, Kenneth; Van Uytfanghe, Katleen; Twomey, Patrick J; Thienpont, Linda M

    2015-05-20

    "The Percentiler" project provides quasi real-time access to patient medians across laboratories and manufacturers. This data can serve as "clearinghouse" for electronic health record applications, e.g., use of laboratory data for global health-care research. Participants send their daily outpatient medians to the Percentiler application. After 6 to 8weeks, the laboratory receives its login information, which gives access to the user interface. Data is assessed by peer group, i.e., 10 or more laboratories using the same test system. Participation is free of charge. Participation is global with, to date, >120 laboratories and >250 instruments. Up to now, several reports have been produced that address i) the general features of the project, ii) peer group observations; iii) synergisms between "The Percentiler" and dedicated external quality assessment surveys. Reasons for long-term instability and bias (calibration- or lot-effects) have been observed for the individual laboratory and manufacturers. "The Percentiler" project has the potential to build a continuous, global evidence base on in vitro diagnostic test comparability and stability. As such, it may be beneficial for all stakeholders and, in particular, the patient. The medical laboratory is empowered for contributing to the development, implementation, and management of global health-care policies. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Environmental monitoring plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1995-09-01

    This document presents an Environmental Monitoring Plan (EMP) for Waste Area Grouping (WAG 6) at Oak Ridge National Laboratory (ORNL). This document updates a draft monitoring plan developed in 1993. The draft plan was never finalized awaiting resolution of the mechanisms for addressing RCRA concerns at a site where the CERCLA process resulted in a decision to defer action, i.e., postpone closure indefinitely. Over the past two years the Tennessee Department of Environment and Conservation (TDEC), US Department of Energy (DOE), and US Environmental Protection Agency (EPA) Region IV, have agreed that RCRA authority at the site will be maintained through a post- closure permit; ''closure'' in this case referring to deferred action. Both a Revised Closure Plan (DOE 1995a) and a Post-Closure Permit Application (DOE 1995b) have been developed to document this agreement; relevant portions of the EMP will be included in the RCRA Post-Closure Permit Application. As the RCRA issues were being negotiated, DOE initiated monitoring at WAG 6. The purpose of the monitoring activities was to (1) continue to comply with RCRA groundwater quality assessment requirements, (2) install new monitoring equipment, and (3) establish the baseline conditions at WAG 6 against which changes in contaminant releases could be measured. Baseline monitoring is scheduled to end September 30, 1995. Activities that have taken place over the past two years are summarized in this document

  16. [Onsite microbiology services and outsourcing microbiology and offsite laboratories--advantage and disadvantage, thinking of effective utilization].

    Science.gov (United States)

    Hosokawa, Naoto

    2011-10-01

    In recent years, budget restrictions have prompted hospital managers to consider outsourcing microbiology service. But there are many advantages onsite microbiology services. Onsite microbiology services have some advantages. 1) High recovery rate of microorganism. 2) Shorter turn around time. 3) Easy to communicate between physician and laboratory technician. 4) Effective utilization of blood culture. 5) Getting early information about microorganism. 6) Making antibiogram (microbiological local factor). 7) Getting information for infection control. The disadvantages are operating costs and labor cost. The important point of maximal utilization of onsite microbiology service is close communication between physicians to microbiology laboratory. It will be able to provide prompt and efficient report to physicians through discussion about Gram stain findings, agar plate media findings and epidemiological information. The rapid and accurate identification of pathogen affords directed therapy, thereby decreasing the use of broad-spectrum antibiotics and shortening the length of hospital stay and unnecessary ancillary procedures. When the physician use outsourcing microbiology services, should discuss with offsite laboratories about provided services. Infection control person has to arrange data of susceptibility about every isolate and monitoring multi-drug resistant organism. Not only onsite microbiology services but also outsourcing microbiology services, to communicate bedside and laboratory is most important point of effective utilization.

  17. The value of point-of-care CD4+ and laboratory viral load in tailoring antiretroviral therapy monitoring strategies to resource limitations.

    Science.gov (United States)

    Hyle, Emily P; Jani, Ilesh V; Rosettie, Katherine L; Wood, Robin; Osher, Benjamin; Resch, Stephen; Pei, Pamela P; Maggiore, Paolo; Freedberg, Kenneth A; Peter, Trevor; Parker, Robert A; Walensky, Rochelle P

    2017-09-24

    To examine the clinical and economic value of point-of-care CD4 (POC-CD4) or viral load monitoring compared with current practices in Mozambique, a country representative of the diverse resource limitations encountered by HIV treatment programs in sub-Saharan Africa. We use the Cost-Effectiveness of Preventing AIDS Complications-International model to examine the clinical impact, cost (2014 US$), and incremental cost-effectiveness ratio [$/year of life saved (YLS)] of ART monitoring strategies in Mozambique. We compare: monitoring for clinical disease progression [clinical ART monitoring strategy (CLIN)] vs. annual POC-CD4 in rural settings without laboratory services and biannual laboratory CD4 (LAB-CD4), biannual POC-CD4, and annual viral load in urban settings with laboratory services. We examine the impact of a range of values in sensitivity analyses, using Mozambique's 2014 per capita gross domestic product ($620) as a benchmark cost-effectiveness threshold. In rural settings, annual POC-CD4 compared to CLIN improves life expectancy by 2.8 years, reduces time on failed ART by 0.6 years, and yields an incremental cost-effectiveness ratio of $480/YLS. In urban settings, biannual POC-CD4 is more expensive and less effective than viral load. Compared to biannual LAB-CD4, viral load improves life expectancy by 0.6 years, reduces time on failed ART by 1.0 year, and is cost-effective ($440/YLS). In rural settings, annual POC-CD4 improves clinical outcomes and is cost-effective compared to CLIN. In urban settings, viral load has the greatest clinical benefit and is cost-effective compared to biannual POC-CD4 or LAB-CD4. Tailoring ART monitoring strategies to specific settings with different available resources can improve clinical outcomes while remaining economically efficient.

  18. [Why medical consultation is needed in the clinical laboratory].

    Science.gov (United States)

    Kawai, T

    1998-10-01

    During the 20th century, at least until the 1980s, clinical laboratory practice had been rapidly expanded, mainly because of a significant advancement in medicine as a whole and also in laboratory technology. However, recent economic changes in health care environment worldwide have been influencing greatly future trends in clinical laboratory practice. Four major macroeconomic forces drive change in clinical laboratory practice as follows; (1) Increasing cost of health care, (2) Implications of an aging population, (3) Social change in the patient population, and (4) Explosion of new technologies. Obviously, the increasing cost of health care is the primary driver. Considering a rapid change in the health care environment, clearly there are two separate pathways to be considered with regard to future modes of delivering patient care services through the clinical laboratory: commercial independent laboratories and hospital laboratories. In most hospital laboratories, in addition to high-quality, accurate and precise laboratory data being delivered through automated informatics in a timely fashion, laboratory physicians and other laboratorians should be available 24 hours a day and 7 days a week. The primary purpose of this approach is to develop a system in which the physician can order the most efficient number of tests, which will provide the maximum amount of clinically relevant informations most rapidly and most accurately at the least cost to the patient. Laboratory physicians must play a key role particularly in hospital laboratories. Their most important roles include those of a professional supplier of laboratory results being useful for health care and clinically relevant, and that of a consultative role for primary care physicians and other co-medical staffs to make important medical decision, based on laboratory results obtained. Therefore, the Japan Society of Clinical Pathology started in 1990 in publishing a series of proposed guidelines for adequate

  19. Is point of care testing in Irish hospitals ready for the laboratory modernisation process? An audit against the current national Irish guidelines.

    LENUS (Irish Health Repository)

    O'Kelly, R A

    2013-04-11

    BACKGROUND: The Laboratory modernisation process in Ireland will include point of care testing (POCT) as one of its central tenets. However, a previous baseline survey showed that POCT was under-resourced particularly with respect to information technology (IT) and staffing. AIMS: An audit was undertaken to see if POCT services had improved since the publication of National Guidelines and if such services were ready for the major changes in laboratory medicine as envisaged by the Health Service Executive. METHODS: The 15 recommendations of the 2007 Guidelines were used as a template for a questionnaire, which was distributed by the Irish External Quality Assessment Scheme. RESULTS: Thirty-nine of a possible 45 acute hospitals replied. Only a quarter of respondent hospitals had POCT committees, however, allocation of staff to POCT had doubled since the first baseline survey. Poor IT infrastructure, the use of unapproved devices, and low levels of adverse incident reporting were still major issues. CONCLUSIONS: Point of care testing remains under-resourced, despite the roll out of such devices throughout the health service including primary care. The present high standards of laboratory medicine may not be maintained if the quality and cost-effectiveness of POCT is not controlled. Adherence to national Guidelines and adequate resourcing is essential to ensure patient safety.

  20. Self-Potential Monitoring of Landslides on Field and Laboratory Scale

    Science.gov (United States)

    Heinze, T.; Limbrock, J. K.; Weigand, M.; Wagner, F. M.; Kemna, A.

    2017-12-01

    Among several other geophysical methods used to observe water movement in the ground, the electrical self-potential method has been applied to a broad range of monitoring studies, especially focusing on volcanism and dam leakage but also during hydraulic fracturing. Electrical self-potential signals may be caused by various mechanisms. Though, the most relevant source of the self-potential field in the given context of landslides is the streaming potential, caused by a flowing electrolyte through porous media with electrically charged internal surfaces. So far, existing models focus on monitoring water flow in non-deformable porous media. However, as the self-potential is sensitive to hydraulic parameters of the soil, any change in these parameters will cause an alteration of the electric signal. Mass movement will significantly influence the hydraulic parameters of the solid as well as the pressure field, assuming that fluid movement is faster than pressure diffusion. We present self-potential measurements from over a year of continuous monitoring at an old landslide site. Using a three-dimensional electric-resistivity underground model, the self-potential signal is analyzed with respect to precipitation and the resulting flow in the ground. Additional data from electrical measurements and conventional sensors are included to assess saturation. The field observations are supplemented by laboratory experiments in which we study the behavior of the self-potential during failure of a piled land slope. For the undrained scenarios, we observe a clear correlation between the mass movements and signals in the electric potential, which clearly differ from the underlying potential variations due to increased saturation and fluid flow. In the drained experiments, we do not observe any measurable change in the electric potential. We therefore assume that change in fluid properties and release of the load causes disturbances in flow and streaming potential. Our results

  1. Parameters of a simple whole body counter and thyroid monitor established at the Dresden Felsenkeller underground laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sahre, P [Rossendorf Nuclear Engineering and Analytics, Inc., Dresden (Germany); Schoenmuth, T [Rossendorf Nuclear Engineering and Analytics, Inc., Dresden (Germany)

    1997-03-01

    At the Rossendorf Nuclear Engineering and Analytics Inc. a simple whole body counter and an iodine-thyroid monitor are used for measuring the internal contamination of workers. There is no shielding chamber in both cases. By using the chamber at the Dresden Felsenkeller underground laboratory the lower limit of detection could be improved by a factor of about 3 for whole body counting and by a factor of 2,5 for thyroid monitoring (I 131, I 125). Concerning the lower limit of detection the applicability of the German standard DIN 25 482 implemented in the Gamma-Vision software packadge is discussed in the paper. (orig.)

  2. Metallurgical Laboratory Hazardous Waste Management Facility groundwater monitoring report

    International Nuclear Information System (INIS)

    Thompson, C.Y.

    1993-03-01

    During fourth quarter 1992, samples from 18 groundwater monitoring wells of the AMB series at the Metallurgical Laboratory Hazardous Waste Management Facility were analyzed for certain heavy metals, indicator parameters, radionuclides, volatile organic compounds, and other constituents. Six parameters exceeded final Primary Drinking Water Standards (PDWS) and the Savannah River Site Flag 2 criteria during the quarter. The results for fourth quarter 1992 are fairly consistent with the rest of the year's data. Tetrachloroethylene exceeded the final PDWS in well AMB 4D only two of the four quarters; in the other three wells in which it was elevated, it was present at similar levels throughout the year. Trichloroethylene consistently exceeded its PDWS in wells AMB 4A, 4B, 4D, 5, and 7A during the year. Trichloroethylene was elevated in well AMB 6 only during third and fourth quarters and in well AMB 7 only during fourth quarter. Total alpha-emitting radium was above the final PDWS for total radium in well AMB 5 at similar levels throughout the year and exceeded the PDWS during one of the three quarters it was analyzed for (third quarter 1992) in well AMB 10B

  3. Environmental monitoring plan - environmental monitoring section. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Wilt, G.C. [ed.; Tate, P.J.; Brigdon, S.L. [and others

    1994-11-01

    This report presents the environmental monitoring plan for the Lawrence Livermore National Laboratory. A site characterization is provided along with monitoring and measurement techniques and quality assurance measures.

  4. Environmental monitoring plan - environmental monitoring section. Revision 1

    International Nuclear Information System (INIS)

    Wilt, G.C.; Tate, P.J.; Brigdon, S.L.

    1994-11-01

    This report presents the environmental monitoring plan for the Lawrence Livermore National Laboratory. A site characterization is provided along with monitoring and measurement techniques and quality assurance measures

  5. Cyber Defense Research and Monitoring Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — This facility acts as a fusion point for bridging ARL's research in tactical and operational Information Assurance (IA) areas and the development and assessment of...

  6. Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

    Science.gov (United States)

    Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

    2013-01-01

    Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

  7. Groundwater level monitoring sampling and analysis plan for the environmental monitoring plan at waste area grouping 6, Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This document is the Groundwater Level Monitoring Sampling and Analysis Plan (SAP) for Waste Area Grouping (WAG) 6 at Oak Ridge National Laboratory (ORNL). Note that this document is referred to as a SAP even though no sampling and analysis will be conducted. The term SAP is used for consistency. The procedures described herein are part of the Environmental Monitoring Plan (EMP) for WAG 6, which also includes monitoring tasks for seeps and springs, groundwater quality, surface water, and meteorological parameters. Separate SAPs are being issued concurrently to describe each of these monitoring programs. This SAP has been written for the use of the field personnel responsible for implementation of the EMP, with the intent that the field personnel will be able to take these documents to the field and quickly find the appropriate steps required to complete a specific task. In many cases, Field Operations Procedures (FOPs) will define the steps required for an activity. The FOPs for the EMP are referenced and briefly described in the relevant sections of the SAPs, and are contained within the FOP Manual. Both these documents (the SAP and the FOP Manual) will be available to personnel in the field.

  8. Groundwater level monitoring sampling and analysis plan for the environmental monitoring plan at waste area grouping 6, Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1995-09-01

    This document is the Groundwater Level Monitoring Sampling and Analysis Plan (SAP) for Waste Area Grouping (WAG) 6 at Oak Ridge National Laboratory (ORNL). Note that this document is referred to as a SAP even though no sampling and analysis will be conducted. The term SAP is used for consistency. The procedures described herein are part of the Environmental Monitoring Plan (EMP) for WAG 6, which also includes monitoring tasks for seeps and springs, groundwater quality, surface water, and meteorological parameters. Separate SAPs are being issued concurrently to describe each of these monitoring programs. This SAP has been written for the use of the field personnel responsible for implementation of the EMP, with the intent that the field personnel will be able to take these documents to the field and quickly find the appropriate steps required to complete a specific task. In many cases, Field Operations Procedures (FOPs) will define the steps required for an activity. The FOPs for the EMP are referenced and briefly described in the relevant sections of the SAPs, and are contained within the FOP Manual. Both these documents (the SAP and the FOP Manual) will be available to personnel in the field

  9. Problem-based learning in laboratory medicine resident education: a satisfaction survey.

    Science.gov (United States)

    Lepiller, Quentin; Solis, Morgane; Velay, Aurélie; Gantner, Pierre; Sueur, Charlotte; Stoll-Keller, Françoise; Barth, Heidi; Fafi-Kremer, Samira

    2017-04-01

    Theoretical knowledge in biology and medicine plays a substantial role in laboratory medicine resident education. In this study, we assessed the contribution of problem-based learning (PBL) to improve the training of laboratory medicine residents during their internship in the department of virology, Strasbourg University Hospital, France. We compared the residents' satisfaction regarding an educational program based on PBL and a program based on lectures and presentations. PBL induced a high level of satisfaction (100%) among residents compared to lectures and presentations (53%). The main advantages of this technique were to create a situational interest regarding virological problems, to boost the residents' motivation and to help them identify the most relevant learning objectives in virology. However, it appears pertinent to educate the residents in appropriate bibliographic research techniques prior to PBL use and to monitor their learning by regular formative assessment sessions.

  10. Frost damage of bricks composing a railway tunnel monument in Central Japan: field monitoring and laboratory simulation

    Science.gov (United States)

    Thomachot, C.; Matsuoka, N.; Kuchitsu, N.; Morii, M.

    2005-07-01

    Bricks of tunnels and bridges of Usui Pass railway (Japan) exposed to north are subject to frost damage. Average depth of erosion due to detachment of angular blocks is around 1-1.5 cm. In order to assess this weathering and to understand its mechanism, an experimental study was carried out in the field and laboratory. Field monitoring showed the combination of seasonal and diurnal freezing with a maximum of heave when the freezing front reached 5 cm depth. Bricks taken from the site were submitted to unidirectional freezing at capillary and vacuum saturation in the laboratory. Results showed that frost damage of bricks was favoured by high saturation level and repetition of freeze-thaw cycles.

  11. Frost damage of bricks composing a railway tunnel monument in Central Japan: field monitoring and laboratory simulation

    Directory of Open Access Journals (Sweden)

    C. Thomachot

    2005-01-01

    Full Text Available Bricks of tunnels and bridges of Usui Pass railway (Japan exposed to north are subject to frost damage. Average depth of erosion due to detachment of angular blocks is around 1-1.5 cm. In order to assess this weathering and to understand its mechanism, an experimental study was carried out in the field and laboratory. Field monitoring showed the combination of seasonal and diurnal freezing with a maximum of heave when the freezing front reached 5 cm depth. Bricks taken from the site were submitted to unidirectional freezing at capillary and vacuum saturation in the laboratory. Results showed that frost damage of bricks was favoured by high saturation level and repetition of freeze-thaw cycles.

  12. The Implementation of a Hospital-wide Practice for the Selective Use of Carbapenems Based on the Monitoring of Susceptibility of Pseudomonas aeruginosa Isolates.

    Science.gov (United States)

    Ohshima, Toshio; Asai, Satomi; Miyazawa, Miki; Yamamoto, Yukari; Hisada, Akifumi; Kumazawa, Chie; Hashimoto, Masayoshi; Fukawa, Katsuji; Iwashita, Hideo; Umezawa, Kazuo; Yamada, Sanetoshi; Yamamoto, Yoshiro; Miyachi, Hayato

    2017-12-20

    To control carbapenem-resistant Pseudomonas aeruginosa, we implemented a hospital-wide policy concerning the selective use of carbapenems based on the monitoring of P. aeruginosa isolates for susceptibility to five carbapenems using a customized dry plate method. In this study, we retrospectively investigated the outcome of our measures to control carbapenem-resistant P. aeruginosa. To select effective carbapenems, 100 clinical isolates were collected, and the minimum inhibitory concentration (MIC) to 5 carbapenems (IPM/CS, MEPM, DRPM, BIPM and PAPM/BP) was monitored using a customized dry plate method from 2006 to 2013. Carbapenems, which were associated with a high rate of drug resistance in P. aeruginosa, were restricted from use during our intervention study. The antimicrobial use density per 100 bed-days (AUD 100 ) of carbapenems and the detection rates of carbapenem (IPM/CS and MEPM)-resistant P. aeruginosa were determined during the period of the intervention. The isolates consistently showed higher rates of drug-resistant P. aeruginosa in IPM/CS and PAPM/BP. Thus, DRPM, MEPM and BIPM were adopted for hospital-wide use. The detection rates of all IPM/Cs and MEPM-resistant P. aeruginosa significantly decreased. Meanwhile, the consumption of carbapenems showed an increasing trend. The outcome of the hospital-wide implementation of the selective use of carbapenems based on periodic monitoring of the susceptibility of P. aeruginosa isolates was retrospectively studied. Implementation of this measure might have contributed in part to the control of carbapenem-resistant P. aeruginosa in our hospital.

  13. Performance of risk-adjusted control charts to monitor in-hospital mortality of intensive care unit patients: A simulation study

    NARCIS (Netherlands)

    Koetsier, Antonie; de Keizer, Nicolette F.; de Jonge, Evert; Cook, David A.; Peek, Niels

    2012-01-01

    Objectives: Increases in case-mix adjusted mortality may be indications of decreasing quality of care. Risk-adjusted control charts can be used for in-hospital mortality monitoring in intensive care units by issuing a warning signal when there are more deaths than expected. The aim of this study was

  14. [Role of medium-sized independent laboratories in control of healthcare-associated infection].

    Science.gov (United States)

    Anzai, Eiko; Fukui, Toru

    2009-05-01

    In 2006, the Ministry of Health and Welfare revised the regulations regarding the Medical Service Law. The amendments stipulate that all healthcare institutions are required to implement infection control programs. However, small hospitals and clinics have no clinical microbiology laboratories, whereas medium-sized hospitals have few medical technologists and the outsourcing of microbiology tests to independent laboratories is common. The decreasing number of laboratories and recent outsourcing tendency reflect the increasing commercialization, and, with it, the escalating number of commercially operating chains. Each independent laboratory is responsible for supporting activities related to the surveillance, control, and prevention of healthcare-associated infections in the associated small and medium-sized hospitals. The people responsible for infection control in these hospitals usually do not have a background in microbiology. The evaluation of communication between independent laboratory staff and hospital personnel, and rapid turnaround time of microbiology laboratory test reports are important elements ensuring the quality of independent laboratory work. With the pressures of financial constraints in the Japanese medical insurance system, the development of a cost-effective and practical protocol for quality assurance is a real dilemma.

  15. Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study.

    Science.gov (United States)

    Loeffert, Sophie Tiphaine; Melloul, Elise; Dananché, Cédric; Hénaff, Laetitia; Bénet, Thomas; Cassier, Pierre; Dupont, Damien; Guillot, Jacques; Botterel, Françoise; Wallon, Martine; Gustin, Marie-Paule; Vanhems, Philippe

    2017-11-25

    Monitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk. A daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min -1 . Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel. Aspergillus fumigatus strains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines. This study was approved by the clinical research and ethics committees of EHH. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Monitoring of Recommended Metabolic Laboratory Parameters Among Medicaid Recipients on Second-Generation Antipsychotics in Federally Qualified Health Centers.

    Science.gov (United States)

    Uzal, Natalia E; Chavez, Benjamin; Kosirog, Emily R; Billups, Sarah J; Saseen, Joseph J

    2018-02-01

    In 2004, a consensus statement outlining recommended metabolic monitoring for patients prescribed second-generation antipsychotics (SGAs) was published. More than a decade later, suboptimal adherence rates to these recommendations continue to be reported, which could lead to long-term and costly complications. To define the prevalence of appropriately monitored Medicaid patients receiving care at federally qualified health centers (FQHCs) prescribed SGAs. This was a retrospective study examining electronic health record and Medicaid claims data to assess the rates of glucose and lipid monitoring for patients prescribed SGAs from January 2014 to August 2016 in a FQHC. Prescription and laboratory claims for patients receiving care at 4 FQHCs were reviewed. Descriptive statistics were used to evaluate the primary outcome. A total of 235 patients were included in the analysis. Patients initiated on SGA therapy (n = 92) had baseline glucose and lipid monitoring rates of 50% and 23%, respectively. The 3-month monitoring rates were 37% for glucose and 26% for lipids, whereas annual rates were 71% and 40%, respectively. Patients continuing SGA therapy (n = 143) had annual glucose and lipid monitoring rates of 67% and 44%. Medicaid patients at FQHCs initially prescribed SGAs have low baseline and 3-month metabolic monitoring, whereas annual monitoring was comparable to previously published studies. Adults receiving chronic care at a FQHC were more likely to receive glucose monitoring. Those with type 2 diabetes mellitus and/or hyperlipidemia were more likely to receive glucose and lipid monitoring.

  17. Vadose zone monitoring at the radioactive waste management complex, Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    McElroy, D.L.; Hubbell, J.M.

    1989-01-01

    A network of vadose zone instruments was installed in surficial sediments and sedimentary interbeds beneath the Radioactive Waste Management Complex (RWMC) of the Idaho National Engineering Laboratory. The network of instruments monitor moisture movement in a heterogeneous geologic system comprised of sediments which overlie and are intercalated with basalt flows. The general range of matric potentials in the surficial sediments (0 to 9.1 m) was from saturation to -3 bars. The basalt layer beneath the surficial sediments impedes downward water movement. The general range of matric potentials in the 9-, 34- and 73-m interbeds was from -0.3 to 1.7 bars. Preliminary results indicated downward moisture movement through the interbeds. 8 refs., 9 figs., 1 tab

  18. A laser profilometry technique for monitoring fluvial dike breaching in laboratory experiments

    Science.gov (United States)

    Dewals, Benjamin; Rifai, Ismail; Erpicum, Sébastien; Archambeau, Pierre; Violeau, Damien; Pirotton, Michel; El kadi Abderrezzak, Kamal

    2017-04-01

    A challenging aspect for experimental modelling of fluvial dike breaching is the continuous monitoring of the transient breach geometry. In dam breaching cases induced by flow overtopping over the whole breach crest (plane erosion), a side view through a glass wall is sufficient to monitor the breach formation. This approach can be extended for 3D dam breach tests (spatial erosion) if the glass wall is located along the breach centreline. In contrast, using a side view does not apply for monitoring fluvial dike breaching, because the breach is not symmetric in this case. We present a non-intrusive, high resolution technique to record the breach development in experimental models of fluvial dikes by means of a laser profilometry (Rifai et al. 2016). Most methods used for monitoring dam and dike breaching involve the projection of a pattern (fringes, grid) on the dam or dike body and the analysis of its deformation on images recorded during the breaching (e.g., Pickert et al. 2011, Frank and Hager 2014). A major limitation of these methods stems from reflection on the water surface, particularly in the vicinity of the breach where the free surface is irregular and rippled. This issue was addressed by Spinewine et al. (2004), who used a single laser sheet so that reflections on the water surface were strongly limited and did not hamper the accurate processing of each image. We have developed a similar laser profilometry technique tailored for laboratory experiments on fluvial dike breaching. The setup is simple and relatively low cost. It consists of a digital video camera (resolution of 1920 × 1080 pixels at 60 frames per second) and a swiping red diode 30 mW laser that enables the projection of a laser sheet over the dike body. The 2D image coordinates of each deformed laser profile incident on the dike are transformed into 3D object coordinates using the Direct Linear Transformation (DLT) algorithm. All 3D object coordinates computed over a swiping cycle of the

  19. Quality management system and accreditation of the in vivo monitoring laboratory at Karslruhe Institute of Technology.

    Science.gov (United States)

    Breustedt, B; Mohr, U; Biegard, N; Cordes, G

    2011-03-01

    The in vivo monitoring laboratory (IVM) at Karlsruhe Institute of Technology (KIT), with one whole body counter and three partial-body counters, is an approved lab for individual monitoring according to German regulation. These approved labs are required to prove their competencies by accreditation to ISO/IEC 17025:2005. In 2007 a quality management system (QMS), which was successfully audited and granted accreditation, was set up at the IVM. The system is based on the ISO 9001 certified QMS of the central safety department of the Research Centre Karlsruhe the IVM belonged to at that time. The system itself was set up to be flexible and could be adapted to the recent organisational changes (e.g. founding of KIT and an institute for radiation research) with only minor effort.

  20. Clinical presentation of terbinafine-induced severe liver injury and the value of laboratory monitoring: a Critically Appraised Topic.

    Science.gov (United States)

    Kramer, O N; Albrecht, J

    2017-11-01

    Many physicians monitor liver function tests during terbinafine therapy. To evaluate the symptoms of published cases of terbinafine-associated severe drug-induced liver injury (DILI) to assess the utility of laboratory monitoring. We based our search on the LiverTox database of the National Institutes of Health, but we also searched both PubMed and Embase. In addition, we hand searched the references of the papers we found. All reports of patients with DILI on terbinafine and with reported clinical symptoms, or absence thereof, were evaluated. Two independent reviewers (J.A. and O.N.K.) assessed articles for eligibility of inclusion, and collected and evaluated the data. Thirty-eight papers fulfilled the inclusion criteria, with reports of 69 symptomatic patients. The mean duration of terbinafine treatment until onset of symptoms was 30·2 days (range 5-84). Symptoms in order of frequency were jaundice, flu-like symptoms, dark urine and pruritus. Patients experienced symptoms for a mean and median of 14·8 and 16 days, respectively (range 0-42) until seeking medical attention. Patients who had DILI were symptomatic, usually with jaundice, abdominal pain and general malaise, but also with severe pruritus. No asymptomatic patient was identified through laboratory screening. The timeline of DILI onset varies significantly, but most cases occur between 4 and 6 weeks. There was no time point at which monitoring was meaningful, and we do not recommend monitoring of liver function tests on terbinafine; however, patients should be advised to discontinue treatment and look for medical care when symptoms of DILI occur. © 2017 British Association of Dermatologists.

  1. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    Science.gov (United States)

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Continuous air monitor correlation to fixed air sample data at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Whicker, J.J.

    1993-01-01

    Continuous air monitoring instruments (CAMS) deployed in laboratories in the TA-55 plutonium facility at Los Alamos National Laboratory (LANL) alarmed less than 33 percent of the time when fixed air sample measurements in the same laboratory showed integrated concentrations exceeding 500 DAC-hrs. The purpose of this study was to explore effects of non-instrument variables on alarm sensitivities for properly working CAMS. Non-instrument variables include air flow patterns, particle size of released material, and the energy of the release. Dilution Factors (DFs) for 21 airborne releases in various rooms and of different magnitudes were calculated and compared. The median DF for releases where the CAM alarmed was 13.1 while the median DF for releases where the CAM did not alarm was 179. Particle sizes ranged considerably with many particles larger than 10 μm. The cause of the release was found to be important in predicting if a CAM would alarm with releases from bagouts resulting in the greatest percentage of CAM alarms. The results of this study suggest that a two-component strategy for CAM placement at LANL be utilized. The first component would require CAMs at exhaust points in the rooms to provide for reliable detection for random release locations. The second component would require placing CAMs at locations where releases have historically been seen. Finally, improvements in CAM instrumentation is needed

  3. Association of Implementation of Practice Standards for Electrocardiographic Monitoring with Nurses’ Knowledge, Quality of Care, and Patient Outcomes: Findings from the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial

    Science.gov (United States)

    Funk, Marjorie; Fennie, Kristopher P.; Stephens, Kimberly E.; May, Jeanine L.; Winkler, Catherine G.; Drew, Barbara J.

    2017-01-01

    Background Although continuous electrocardiographic (ECG) monitoring is ubiquitous in hospitals, monitoring practices are inconsistent. We evaluated implementation of American Heart Association practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. Methods and Results The PULSE Trial was a 6-year multi-site randomized clinical trial with crossover that took place in 65 cardiac units in 17 hospitals. We measured outcomes at baseline, Time 2 after Group 1 hospitals received the intervention, and Time 3 after Group 2 hospitals received the intervention. Measurement periods were 15 months apart. The 2-part intervention consisted of an online ECG monitoring education program and strategies to implement and sustain change in practice. Nurses’ knowledge (N=3,013 nurses) was measured by a validated 20-item online test, quality of care related to ECG monitoring (N=4,587 patients) by on-site observation, and patient outcomes (mortality, in-hospital myocardial infarction, and not surviving a cardiac arrest) (N=95,884 hospital admissions) by review of administrative, laboratory, and medical record data. Nurses’ knowledge improved significantly immediately following the intervention in both groups, but was not sustained 15 months later. For most measures of quality of care (accurate electrode placement, accurate rhythm interpretation, appropriate monitoring, and ST-segment monitoring when indicated), the intervention was associated with significant improvement, which was sustained 15 months later. Of the 3 patient outcomes, only in-hospital myocardial infarction declined significantly after the intervention, and was sustained. Conclusions Online ECG monitoring education and strategies to change practice can lead to improved nurses’ knowledge, quality of care, and patient outcomes. PMID:28174175

  4. Quality Assurance Project Plan for the Environmental Monitoring Program in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-12-01

    Waste Area Grouping (WAG) 6 is a hazardous and low-level radioactive waste disposal site at Oak Ridge National Laboratory (ORNL). Extensive site investigations have revealed contaminated surface water, sediments, groundwater, and soils. Based on the results of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) conducted from 1989--1991 and on recent interactions with the US Environmental Protection Agency (EPA) and the Tennessee Department of Environment and Conservation (TDEC), a decision was made to defer implementing source control remedial measures at the WAG. The information shows WAG 6 contributes < 2% of the total off-site contaminant risk released over White Oak Dam (WOD). The alternative selected to address hazards at WAG 6 involves maintenance of site access controls to prevent public exposure to on-site contaminants, continued monitoring of contaminant releases to determine if source control measures will be required in the future, and development of technologies to support final remediation of WAG 6. This Quality Assurance Project Plan (QAPjP) has been developed as part of the Environmental Monitoring Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee (DOE/OR/01-1192 ampersand D1). Environmental monitoring will be conducted in two phases: the baseline monitoring phase and the routine annual monitoring phase. The baseline monitoring phase will be conducted to establish the baseline contaminant release conditions at the Waste Area Grouping (WAG), to confirm the site-related chemicals of concern (COC), and to gather data to confirm the site hydrologic model. The baseline monitoring phase is expected to begin in 1994 and continue for 12-18 months. The routine annual monitoring phase will consist of continued sampling and analyses of COC to determine off-WAG contaminant flux, to identify trends in releases, and to confirm the COC. The routine annual monitoring phase will continue for ∼4 years

  5. On-line monitoring of toxic materials in sewage at the Lawrence Livermore Laboratory

    International Nuclear Information System (INIS)

    Auyong, M.; Cate, J.L. Jr.; Rueppel, D.W.

    1980-01-01

    It is becoming increasingly important for industry to prevent releases of potentially toxic material to the environment. The Lawrence Livermore Laboratory has developed a system to monitor its sewage effluent on a continuous basis. A representative fraction of the total waste stream leaving the Plant is passed through a detection assembly consisting of an x-ray fluorescence unit which detects high levels of metals, sodium iodide crystal detectors that scan the sewage for the presence of elevated levels of radiation, and an industrial probe for pH monitoring. With the aid of a microprocessor, the data collected is reduced and analyzed to determine whether levels are approaching established environmental limits. Currently, if preset pH or radiation levels are exceeded, a sample of the suspect sewage is automatically collected for further analysis, and an alarm is sent to a station where personnel can be alerted to respond on a 24-hour basis. In the same manner, spectral data from the x-ray fluorescence unit will be routed through the 24-hour alarm system as soon as evaluation of the unit is complete. The design of the system and operational experience is discussed

  6. The management of clinical laboratories in Europe: a FESCC survey. Forum of the European Societies of Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    de Kieviet, Wim; Blaton, Victor; Kovacs, Gabor L; Palicka, Vladimir; Pulkki, Kari

    2002-03-01

    The professional duties of the specialists in clinical chemistry differ from country to country in Europe. One of the main goals of the Strategic Plan of the Forum of the European Societies of Clinical Chemistry and Laboratory Medicine (FESCC; IFCC-Europe) is to promote a high scientific and professional standard in the field of clinical chemistry and laboratory medicine in Europe. This can be stimulated by the knowledge of the local conditions in each country and by striving towards a strong and harmonised position in all the European countries. In order to enhance the knowledge of the managerial situation of the specialists in clinical chemistry in Europe, FESCC launched a survey in September 2000. This survey provides information about the position of the specialists in clinical chemistry in the various disciplines in the medical laboratories and in hospitals, and about the advisory tasks and the managerial education during the post-graduate training in clinical chemistry. Of the 35 FESCC member countries 33 have participated in the survey (94%). The results show a rather heterogeneous situation in Europe caused by the local historical developments, the differences in academic background and the relative numbers of private and physicians' office laboratories. Large differences exist between the European countries in the disciplines of laboratory medicine that are headed by a specialist in clinical chemistry. In the different countries the clinical chemistry laboratories are headed by specialists in clinical chemistry in between 20% and 100% of the laboratories. The haematology, immunology, microbiology, therapeutic drug monitoring, molecular biology and haemostasis laboratories and departments of blood banking are headed by specialists in clinical chemistry in between 0% and 100% of the laboratories. The responsibilities for the various managerial tasks of the specialists in clinical chemistry show no uniformity in Europe. In the majority of the countries the

  7. Study on the internal quality control of thyroid hormones assays in a hospital laboratory

    International Nuclear Information System (INIS)

    Hu Haiqiang; Chu Shaolin; Ye Peihong; Lei Qiufang; Chai Luhua; Xia Wei

    2004-01-01

    Objective: With the aim of providing more reliable information for clinical diagnosis, this study investigated the possible causes of the occasional instability of thyroid hormones (T 3 , T 4 , FT 3 , FT 4 TSH) assays in this laboratory and tried to seek plausible explanation for some seemingly contradictory (mismatching) readings of the laboratory reports. Methods: Regular monitoring and checks were enforced on laboratory equipment from sampling pipet to gamma-counters. Results of separation with PR reagent and solid - phase coated tube were compared for superiority (FT 3 ). Collected specimens were tested in monthly sets; this study consisted of 10 sets with total 964 specimens. Serum T 3 , T 4 , FT 3 , FT 4 levels were measured with RIA. For every hormone tested, values of parameters of the standard cure (B 0 , NSB, a, b, r, ED 20 , ED 50 , ED 80 , ABCV) were recorded in detail, from which the QC (quality control) table was derived. For complementary sake , mean level in patients' sera was noted along with the quality control sera. Shewart control chart was drawn for quick reference. Serum TSH levels were measured with IRMA; the parameters involved were: B 0 NSB, ED 80 , ED 50 , ED 20 , standard point deviation. Results: Among the 964 specimens tested, there were 154 specimens with seemingly contradictory (mismatching) results, of which, the majority (n=145) were not erroneous and were compatible with the clinical manifestations of thyroid dysfunction other than plain simple hyper-or hypothyroidism. Only 9 (5.8% of the 154) were due to technical errors (defective technic in removing the supernatant n=7, lipid blood separated with PR reagent n=2). Conclusion: Faulty technic in separation is the main source of random error. From the data of this laboratory, authors believe that solid-phase separation method is better than the conventional homogenous-phase separation method and is the preferred one. With meticulous adherence to standard laboratory procedures and

  8. Environmental Monitoring Plan

    International Nuclear Information System (INIS)

    Hunter, S.W.; Gallegos, G.M.; Surano, K.A.; Lamson, K.C.; Tate, P.J.; Balke, B.K.; Biermann, A.H.; Hoppes, W.G.; Fields, B.C.; Gouveia, F.J.; Berger, R.L.; Miller, F.S.; Rueppel, D.W.; Sims, J.M.

    1992-04-01

    The primary tasks of the environmental monitoring section (EMS) Livermore National Laboratory (LLNL) are: effluent monitoring of air, sewer, and NPDES water. Surveillance monitoring of soil, vegetation and foodstuff, water, air particulate, and air tritium. Radiation monitoring, dose assessment, emergency response, quality assurance, and reporting. This report describes LLNL and the monitoring plan

  9. Suspect/foil identification in actual crimes and in the laboratory: a reality monitoring analysis.

    Science.gov (United States)

    Behrman, Bruce W; Richards, Regina E

    2005-06-01

    Four reality monitoring variables were used to discriminate suspect from foil identifications in 183 actual criminal cases. Four hundred sixty-one identification attempts based on five and six-person lineups were analyzed. These identification attempts resulted in 238 suspect identifications and 68 foil identifications. Confidence, automatic processing, eliminative processing and feature use comprised the set of reality monitoring variables. Thirty-five verbal confidence phrases taken from police reports were assigned numerical values on a 10-point confidence scale. Automatic processing identifications were those that occurred "immediately" or "without hesitation." Eliminative processing identifications occurred when witnesses compared or eliminated persons in the lineups. Confidence, automatic processing and eliminative processing were significant predictors, but feature use was not. Confidence was the most effective discriminator. In cases that involved substantial evidence extrinsic to the identification 43% of the suspect identifications were made with high confidence, whereas only 10% of the foil identifications were made with high confidence. The results of a laboratory study using the same predictors generally paralleled the archival results. Forensic implications are discussed.

  10. Development of laboratory and process sensors to monitor particle size distribution of industrial slurries

    Energy Technology Data Exchange (ETDEWEB)

    Pendse, H.P.

    1992-10-01

    In this paper we present a novel measurement technique for monitoring particle size distributions of industrial colloidal slurries based on ultrasonic spectroscopy and mathematical deconvolution. An on-line sensor prototype has been developed and tested extensively in laboratory and production settings using mineral pigment slurries. Evaluation to date shows that the sensor is capable of providing particle size distributions, without any assumptions regarding their functional form, over diameters ranging from 0.1 to 100 micrometers in slurries with particle concentrations of 10 to 50 volume percents. The newly developed on-line sensor allows one to obtain particle size distributions of commonly encountered inorganic pigment slurries under industrial processing conditions without dilution.

  11. What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

    Science.gov (United States)

    Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

    2018-02-17

    For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal

  12. Monitoring exposure of personnel to volatile nitrosamines in the laboratory environment

    Energy Technology Data Exchange (ETDEWEB)

    Issenberg, P; Swanson, S E

    1980-01-01

    A convenient sampling method was developed for collection of volatile nitrosamines from large-volume air samples. Stainless steel tubes containing 0.3 g Tenax GC were employed to collect nitrosamines from 5-30 1 air samples. Nitrosamines were eluted from the sample tubes with diethylether to minimize formation of artifacts which were observed when thermal desorption was employed. Eluates were analysed directly by GC-TEA and nitrosamine identities were confirmed using high-resolution GC-MS with selected ion-monitoring. The detection limit was approximately 0.8 micrograms/m3 (0.3 ppb) for NDMA in 2 ml of diethylether extract. The laboratory operations studied included chemical synthesis, trace analysis, animal treatment, microbial mutagenesis tests and in vitro biochemical procedures. In most cases, nitrosamines were not detected in laboratory air, but levels of 200-800 micrograms/m3 (42 to 180 ppb) of N-nitrosomethyl-tert-butylamine were measured during animal treatment, 0.8-8.6 micrograms/m3 (0.3 to 2.8 ppb) of NDMA during mutagenesis assays, 12-22 micrograms/m3 (4-7 ppb) of NDMA during in vitro metabolism studies and 11 micrograms/m3 (3.6 ppb) of NDMA in a walk-in refrigerator. Appropriate corrective measures reduced all nitrosamine levels to below the detection limit. Hamsters and rats treated with NDAA (80 mg/kg, s.c.) excreted 4.4 and 12.9%, respectively, of the nitrosamine in expired air in 24 hr. This route of excretion may be metabolically significant and should be considered in the safe design of animal treatment and holding facilities.

  13. Bacteriological Evaluation of Kwale General Hospital Environment ...

    African Journals Online (AJOL)

    ... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.

  14. Application Anti Microbial Activity Test and Direct Inoculation of Urinary Specimen Test to Increase the Quality of Results and Decrease the Production Cost in Clinical Microbiology Laboratory, Sanglah General Hospital Hospital, Bali-Indonesia

    Directory of Open Access Journals (Sweden)

    Nyoman Sri-Budayanti

    2012-05-01

    Full Text Available Objective: Urinary tract infection (UTI is the most common bacterial infection in general practice and in hospitals. Fast and accurate urine culture and sensitivity test are needed for adequate therapy. Anti Microbial Activity test (AMA test that is used to detect the presence of antibiotics in urine specimens is not commonly used in clinical microbiology laboratories. Some laboratories are still using indirect inoculation technique using enriched media before inoculating onto the agar media. The aim of this research is to compare results of urinary examination of direct inoculation technique with AMA test with indirect inoculation technique without AMA test.Methods: A number of 210 urine specimens were collected in Clinical Microbiology Laboratory at Sanglah General Hospital within a time period between 16 June until 16 July 2009.Results: Antibiotics were detected in 40% of the urinary specimens; whereas 48.1% showed no evidence of UTI, that is negative AMA test and sterile urinary culture or colony growth < 105 CFU/ml. Only 11.9% of the specimens indicates urinary tract infections. The examination can be completed within 2-3 days which is shorter than indirect inoculation test which require 5-7 days. Direct inoculation technique can reduce the cost of production three-fold the costs require for an indirect inoculation test.Conclusions: Application of AMA test and direct inoculation technique can give results more rapidly, reliable and useful for clinicians. This also decrease the laboratory’s cost of production.

  15. Monitoring of Adverse Drug Reactions Associated with Antihypertensive Medicines at a University Teaching Hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    Fowad Khurshid

    2012-09-01

    Full Text Available Aim To monitor the adverse drug reactions (ADRs caused by antihypertensive medicines prescribed in a university teaching hospital.Methods:he present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO, Government of India.Results:A total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29 % than males, 7 (3.64 %. Combination therapy was associated with more number of adverse drug reactions (66.7 % as against monotherapy (33.3 %. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7, followed by diuretics (n = 5, and beta- blockers (n = 4. Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7, followed by torasemide (n = 3. Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8 % followed by musculo-skeletal complaints (23.8 % and gastro-intestinal disorders (14.3 %. Conclusions:The present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

  16. An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh

    Directory of Open Access Journals (Sweden)

    Hoque Dewan ME

    2012-12-01

    Full Text Available Abstract Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh. Methods Using adapted World Health Organization (WHO hospital assessment tools and standards, an assessment of 18 randomly selected district (n=6 and sub-district (n=12 hospitals was undertaken. Teams of trained assessors used direct case observation, record review, interviews, and Management Information System (MIS data to assess the quality of clinical case management and monitoring; infrastructure, processes and hospital administration; essential hospital and laboratory supports, drugs and equipment. Results Findings demonstrate that the overall quality of care provided in these hospitals was poor. No hospital had a functioning triage system to prioritise those children most in need of immediate care. Laboratory supports and essential equipment were deficient. Only one hospital had all of the essential drugs for paediatric care. Less than a third of hospitals had a back-up power supply, and just under half had functioning arrangements for safe-drinking water. Clinical case management was found to be sub-optimal for prevalent illnesses, as was the quality of neonatal care. Conclusion Action is needed to improve the quality of paediatric care in hospital settings in Bangladesh, with a particular need to invest in improving newborn care.

  17. Request of laboratory liver tests in primary care in Spain: potential savings if appropriateness indicator targets were achieved.

    Science.gov (United States)

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

    2015-10-01

    Liver laboratory tests are used to screen for liver disease, suggest the underlying cause, estimate the severity, assess prognosis, and monitor the efficacy of therapy. The aim of this study was to compare the liver laboratory tests requesting patterns by GPs in Spain, according to geographic and hospital characteristics, to investigate the degree of requesting appropriateness. One hundred and forty-one clinical laboratories were invited to participate from diverse regions across Spain. They filed out the number of laboratory liver tests requested by GPs for the year 2012. Two types of appropriateness indicators were calculated: every test request per 1000 inhabitants or ratios of related tests requests. The indicator results obtained were compared between the different hospitals, according to their setting, location, and management. The savings generated, if each area would have achieved indicator targets, were calculated. We recruited 76 laboratories covering a population of 17,679,195 inhabitants. GPs requested 20,916,780 laboratory liver tests in the year 2012. No differences were obtained according to their setting. Lactate dehydrogenase and direct bilirubin per 1000 inhabitants were significantly higher in institutions with private management. Largest differences were observed between communities. Nine, 31, 0, and 13 laboratories, respectively, achieved the aspartate aminotransferase, lactate dehydrogenase, γ-glutamyl transpeptidase, and total bilirubin-related alanine aminotransferase indicator targets. Reaching ratios would have resulted in savings of €1,028,468. There was a high variability in the request of liver tests. This emphasizes the need to implement interventions to improve appropriate use of liver tests.

  18. TH-E-209-01: Fluoroscopic Dose Monitoring and Patient Follow-Up Program at Massachusetts General Hospital

    International Nuclear Information System (INIS)

    Liu, B.

    2016-01-01

    Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilities over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.

  19. TH-E-209-01: Fluoroscopic Dose Monitoring and Patient Follow-Up Program at Massachusetts General Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B. [Massachusetts General Hospital (United States)

    2016-06-15

    Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilities over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.

  20. The assessment of stat laboratory test ordering practice and impact of targeted individual feedback in an urban teaching hospital.

    Science.gov (United States)

    Sorita, Atsushi; Steinberg, Daniel I; Leitman, Michael; Burger, Alfred; Husk, Gregg; Sivaprasad, Latha

    2014-01-01

    Overuse of inpatient stat laboratory orders ("stat" is an abbreviation of the Latin word "statim," meaning immediately, without delay) is a major problem in the modern healthcare system. To understand patterns of stat laboratory ordering practices at our institution and to assess the effectiveness of individual feedback in reducing these orders. Medicine and General Surgery residents were given a teaching session about appropriate stat ordering practice in January 2010. Individual feedback was given to providers who were the highest utilizers of stat laboratory orders by their direct supervisors from February through June of 2010. The proportion of stat orders out of total laboratory orders per provider was the main outcome measure. All inpatient laboratory orders from September 2009 to June 2010 were analyzed. The median proportion of stat orders out of total laboratory orders was 41.6% for nontrainee providers (N = 500), 38.7% for Medicine residents (N = 125), 80.2% for General Surgery residents (N = 32), and 24.2% for other trainee providers (N = 150). Among 27 providers who received feedback (7 nontrainees, 16 Medicine residents, and 4 General Surgery residents), the proportion of stat laboratory orders per provider decreased by 15.7% (95% confidence interval: 5.6%-25.9%, P = 0.004) after feedback, whereas the decrease among providers who were high utilizers but did not receive feedback (N = 39) was not significant (4.5%; 95% confidence interval: 2.1%-11.0%, P = 0.18). Monthly trends showed reduction in the proportion of stat orders among Medicine and General Surgery residents, but not among other trainee providers. The frequency of stat ordering was highly variable among providers. Individual feedback to the highest utilizers of stat orders was effective in decreasing these orders. © 2013 Society of Hospital Medicine.

  1. Laboratory and field based evaluation of chromatography related performance of the Monitor for AeRosols and Gases in ambient Air (MARGA)

    Science.gov (United States)

    The semi-continuous Monitor for AeRosols and Gases in Ambient air (MARGA) was evaluated using laboratory and field data with a focus on chromatography. The performance and accuracy assessment revealed various errors and uncertainties resulting from mis-identification and mis-int...

  2. An enhanced ionising radiation monitoring and detecting technique in radiotherapy units of hospitals using wireless sensor networks

    International Nuclear Information System (INIS)

    Ali, Peter

    2017-01-01

    In this paper, a solution of ionising radiation monitoring based on the concept of Wireless Sensor Network (WSN), is presented. Radiation dose rate measured by the sensor node is sent to the monitoring station through ZigBee wireless network operated on 2.4 GHz unlicensed Industrial Scientific Medical (ISM) band. The system is calibrated for use for ionizing radiation dose rate range of between amount of ionising radiation observed in radiotherapy unit of a hospital and 1.02 mSv/h. Power consumption of the sensor node is kept low by operating the node ZigBee radio with low duty cycle: i.e. by keeping the radio awake only during data transmission/reception. Two ATmega8 microcontrollers, one each for sensor node and the monitoring station, are programmed to perform interfacing, data processing, and control functions. The system range of coverage is 124m for outdoor (line of site) deployment and 56.8m for indoor application where 5 brick walls separated the sensor node and the monitoring station. Range of coverage of the system is extendable via the use of ZigBee router (s)

  3. Occupational radiation exposure monitoring among radiation workers in Nepal

    International Nuclear Information System (INIS)

    Bhatt, Chhavi Raj; Shrestha, Shanta Lall; Khanal, Tara; Ween, Borgny

    2008-01-01

    Nepal was accepted as a member of the IAEA in 2007. Nepal is one of the world's least developed countries and is defined in Health Level IV. The population counted 26.4 millions in 2007. The health care sector increases with new hospitals and clinics, however, Nepal has no radiation protection authority or radiation protection regulation in the country until now. The radiation producing equipment in the health sector includes conventional X-ray and dental X-ray equipment, fluoroscopes, mammography, CT, catheterization laboratory equipment, nuclear medicine facilities, a few linear accelerators, Co 60 teletherapy and High Dose Rate brachytherapy sources. The situation regarding dosimetry service for radiation workers is unclear. A survey has been carried out to give an overview of the situation. The data collection of the survey was performed by phone call interviews with responsible staff at the different hospitals and clinics. Data about different occupationally exposed staff, use of personal radiation monitoring and type of dosimetry system were collected. In addition, it was asked if dosimetry reports were compiled in files or databases for further follow-up of staff, if needed. The survey shows that less of 25% of the procedures performed on the surveyed hospitals and clinics are performed by staff with personnel radiation monitoring. Radiation monitoring service for exposed staff is not compulsory or standardized, since there is no radiation protection authority. Nepal has taken a step forward regarding radiation protection, with the IAEA membership, although there are still major problems that have to be solved. An evaluation of the existing practice of staff dosimetry can be the first helpful step for further work in building a national radiation protection authority. (author)

  4. Quality in the molecular microbiology laboratory.

    Science.gov (United States)

    Wallace, Paul S; MacKay, William G

    2013-01-01

    In the clinical microbiology laboratory advances in nucleic acid detection, quantification, and sequence analysis have led to considerable improvements in the diagnosis, management, and monitoring of infectious diseases. Molecular diagnostic methods are routinely used to make clinical decisions based on when and how to treat a patient as well as monitor the effectiveness of a therapeutic regime and identify any potential drug resistant strains that may impact on the long term patient treatment program. Therefore, confidence in the reliability of the result provided by the laboratory service to the clinician is essential for patient treatment. Hence, suitable quality assurance and quality control measures are important to ensure that the laboratory methods and service meet the necessary regulatory requirements both at the national and international level. In essence, the modern clinical microbiology laboratory ensures the appropriateness of its services through a quality management system that monitors all aspects of the laboratory service pre- and post-analytical-from patient sample receipt to reporting of results, from checking and upholding staff competency within the laboratory to identifying areas for quality improvements within the service offered. For most European based clinical microbiology laboratories this means following the common International Standard Organization (ISO9001) framework and ISO15189 which sets out the quality management requirements for the medical laboratory (BS EN ISO 15189 (2003) Medical laboratories-particular requirements for quality and competence. British Standards Institute, Bristol, UK). In the United States clinical laboratories performing human diagnostic tests are regulated by the Centers for Medicare and Medicaid Services (CMS) following the requirements within the Clinical Laboratory Improvement Amendments document 1988 (CLIA-88). This chapter focuses on the key quality assurance and quality control requirements within the

  5. Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital.

    Science.gov (United States)

    Dolscheid-Pommerich, Ramona C; Dolscheid, Sarah; Grigutsch, Daniel; Stoffel-Wagner, Birgit; Graeff, Ingo

    2016-01-01

    Fulfilling the requirements of point-of-care testing (POCT) training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb) determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb) were compared with Hb measurements performed at the central laboratory (Hb-ZL). Additionally, sub collectives (WHO anemia classification, patients with Hb 85y.) were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ phemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.

  6. Implementation of a rapid HIT immunoassay at a university hospital - Retrospective analysis of HIT laboratory orders in patients with thrombocytopenia.

    Science.gov (United States)

    Black, Anne; Heimerl, Susanne; Oertli, Linnéa; Wilczek, Wolf; Greinacher, Andreas; Spannagl, Michael; Herr, Wolfgang; Hart, Christina

    2017-10-01

    Heparin-induced thrombocytopenia (HIT) is a rare cause of thrombocytopenia and a potentially life-threatening adverse drug reaction. Clinical overdiagnosis of HIT results in costly laboratory tests and anticoagulation. Criteria and algorithms for diagnosis are established, but their translation into clinical practice is still challenging. In a retrospective approach we studied all HIT related laboratory test requests within four years and evaluated data before (1st period, 24month) and after (2nd period, 24month) replacing particle gel immunoassay (PaGIA) and enzyme-linked immunosorbent assay (ELISA) by a chemiluminescent immunoassay (CLIA). HIT was confirmed by heparin-induced platelet activation (HIPA) test. Clinical pretest probability for HIT using an implemented simplified 4Ts score and platelet count were evaluated. Costs for laboratory tests and alternative anticoagulation were calculated. In 1850 patients with suspected HIT, 2327 laboratory orders were performed. In 87.2% of these orders an intermediate/high simplified 4Ts score was found. Thrombocytopenia was present in 87.1%. After replacing PaGIA and ELISA by CLIA the number of immunological and functional laboratory tests was reduced by 38.2%. The number of positive HIT immunoassays declined from 22.6% to 6.0%, while the number of positive HIPA tests among positive immunological tests increased by 19%. Altogether, acute HIT was confirmed in 59 patients. A decline in the use of alternative anticoagulants was observed in the 2nd period. Our study shows that in a university hospital setting HIT is well-known, but diagnosis requires a precise laboratory confirmation. Replacing PaGIA and ELISA by CLIA did not influence laboratory order behavior but results in reduced overall costs for laboratory diagnostics and alternative anticoagulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Operation the laboratory for NBC protection and bio monitoring in the case of terrorist attack with NBC weapons

    International Nuclear Information System (INIS)

    Tusek, D.; Vucemilovic, A; Klobucar, J.

    2009-01-01

    The aim of this study was to develop efficacy of Operation the Laboratory for NBC protection and Bio monitoring in the case of terrorist attack with chemical weapons. When is necessary quickly, adeptly Operation and unambiguous confirmation about use chemical warfare agent, the Laboratory must be ready and qualified for reaction. The Laboratory had to develop capability for the timely sampling and unambiguous identification chemical warfare agents in a battlefield or in case of the terrorist attack. The need for quality sample collection and analyses is critical to verify use of chemical weapon (CW) by an enemy or terrorists. Collection, packaging, transport and analysis of samples must be carried out on proper way and quickly enough for military, medical or political purposes. Precise records must accompany each sample but these records must not contaminate samples anyway. All sampling team personnel have to be equipped with appropriate equipment and qualified in its handling. After arriving samples at our Laboratory, we will handle with them on standard procedures; carry out preparation such as Headspace, Liquid/liquid extraction, Solid phase extraction, Liquid/solid extraction, concentration and derivatization. After that we will analyze samples by gas-chromatography mass-spectrometry (GC/MS) method.(author)

  8. Improving Accuracy of Influenza-Associated Hospitalization Rate Estimates

    Science.gov (United States)

    Reed, Carrie; Kirley, Pam Daily; Aragon, Deborah; Meek, James; Farley, Monica M.; Ryan, Patricia; Collins, Jim; Lynfield, Ruth; Baumbach, Joan; Zansky, Shelley; Bennett, Nancy M.; Fowler, Brian; Thomas, Ann; Lindegren, Mary L.; Atkinson, Annette; Finelli, Lyn; Chaves, Sandra S.

    2015-01-01

    Diagnostic test sensitivity affects rate estimates for laboratory-confirmed influenza–associated hospitalizations. We used data from FluSurv-NET, a national population-based surveillance system for laboratory-confirmed influenza hospitalizations, to capture diagnostic test type by patient age and influenza season. We calculated observed rates by age group and adjusted rates by test sensitivity. Test sensitivity was lowest in adults >65 years of age. For all ages, reverse transcription PCR was the most sensitive test, and use increased from 65 years. After 2009, hospitalization rates adjusted by test sensitivity were ≈15% higher for children 65 years of age. Test sensitivity adjustments improve the accuracy of hospitalization rate estimates. PMID:26292017

  9. Hematologic, hepatic, renal, and lipid laboratory monitoring after initiation of combination antiretroviral therapy in the United States, 2000-2010.

    Science.gov (United States)

    Yanik, Elizabeth L; Napravnik, Sonia; Ryscavage, Patrick; Eron, Joseph J; Koletar, Susan L; Moore, Richard D; Zinski, Anne; Cole, Stephen R; Hunt, Peter; Crane, Heidi M; Kahn, James; Mathews, William C; Mayer, Kenneth H; Taiwo, Babafemi O

    2013-06-01

    We assessed laboratory monitoring after combination antiretroviral therapy initiation among 3678 patients in a large US multisite clinical cohort, censoring participants at last clinic visit, combination antiretroviral therapy change, or 3 years. Median days (interquartile range) to first hematologic, hepatic, renal, and lipid tests were 30 (18-53), 31 (19-56), 33 (20-59), and 350 (96-1106), respectively. At 1 year, approximately 80% received more than 2 hematologic, hepatic, and renal tests consistent with guidelines. However, only 40% received 1 or more lipid tests. Monitoring was more frequent in specific subgroups, likely reflecting better clinic attendance or clinician perception of higher susceptibility to toxicities.

  10. Dual vs. single computer monitor in a Canadian hospital Archiving Department: a study of efficiency and satisfaction.

    Science.gov (United States)

    Poder, Thomas G; Godbout, Sylvie T; Bellemare, Christian

    This paper describes a comparative study of clinical coding by Archivists (also known as Clinical Coders in some other countries) using single and dual computer monitors. In the present context, processing a record corresponds to checking the available information; searching for the missing physician information; and finally, performing clinical coding. We collected data for each Archivist during her use of the single monitor for 40 hours and during her use of the dual monitor for 20 hours. During the experimental periods, Archivists did not perform other related duties, so we were able to measure the real-time processing of records. To control for the type of records and their impact on the process time required, we categorised the cases as major or minor, based on whether acute care or day surgery was involved. Overall results show that 1,234 records were processed using a single monitor and 647 records using a dual monitor. The time required to process a record was significantly higher (p= .071) with a single monitor compared to a dual monitor (19.83 vs.18.73 minutes). However, the percentage of major cases was significantly higher (p= .000) in the single monitor group compared to the dual monitor group (78% vs. 69%). As a consequence, we adjusted our results, which reduced the difference in time required to process a record between the two systems from 1.1 to 0.61 minutes. Thus, the net real-time difference was only 37 seconds in favour of the dual monitor system. Extrapolated over a 5-year period, this would represent a time savings of 3.1% and generate a net cost savings of $7,729 CAD (Canadian dollars) for each workstation that devoted 35 hours per week to the processing of records. Finally, satisfaction questionnaire responses indicated a high level of satisfaction and support for the dual-monitor system. The implementation of a dual-monitor system in a hospital archiving department is an efficient option in the context of scarce human resources and has the

  11. A real-world cohort study on the quality of potassium and creatinine monitoring during initiation of mineralocorticoid receptor antagonists in patients with heart failure.

    Science.gov (United States)

    Nilsson, Erik; De Deco, Pietro; Trevisan, Marco; Bellocco, Rino; Lindholm, Bengt; Lund, Lars H; Coresh, Josef; Carrero, Juan J

    2018-05-02

    Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our healthcare. Observational study in 2007-2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods. Exclusion criteria considered death/hospitalization within 90 days, and lack of a second MRA dispense. Of 4,036 HF patients starting on MRA, 45% were initiated from a hospital, 24% from a primary care center and 30% from other private centers. Overall, 89% underwent pre-initiation testing, being more common among hospital (97%) than for primary care (74%) initiations. Only 24% were adequately monitored in all three recommended intervals, being again more frequent following hospital (33%) than private (21%) or primary care (17%) initiations. In multivariable analyses, adequate monitoring was more likely for hospital [odds ratio (OR), 95% confidence interval; 2.85, 2.34-3.56] initiations, and for patients with chronic kidney disease (OR 1.79, 1.30-2.43) and concomitant use of ACE (OR 1.27, 1.05-1.52), ARBs (OR 1.19, 1.01-1.40) or beta blockers (OR 1.65, 1.22-2.26). Age, sex and prescribing center explained a small portion of adequate monitoring (c-statistic, 0.63). Addition of comorbidities and medications improved prediction marginally (c-statistic, 0.65). Although serum potassium and creatinine monitoring before MRA initiation for HF is frequent, rates of post-initiation monitoring remain suboptimal, especially among primary care centers.

  12. M-Area and Metallurgical Laboratory Hazardous Waste Management Facilities Groundwater Monitoring and Corrective-Action Report, First and Second Quarters 1999, Volume III

    International Nuclear Information System (INIS)

    Chase, J.

    1999-01-01

    This report describes the groundwater monitoring and corrective-action program at the M-Area Hazardous Waste Management Facility (HWMF) and the Metallurgical Laboratory (Met Lab) HWMF at the Savannah River Site (SRS) during the first and second quarters 1999

  13. [Evaluation of clinical laboratories--assurance of their quality and competence].

    Science.gov (United States)

    Kawai, Tadashi

    2007-01-01

    Since ISO 15189:2003 was published, the accreditation program of clinical laboratories based on ISO 15189 has been introduced in many countries, except for those in USA where all clinical laboratories must be required to follow the federal law, CLIA'88. It will certainly help the accredited clinical laboratories improve their quality and competence. In relation to the activity of JCTLM, reference measurement laboratories will be accredited, based on ISO 15195 which is now under its review and amendment by ISO/TC212/WG2. In Japan, JCCLS (Japanese Committee for Clinical Laboratory Standards) and JAB (Japan Accreditation Board for Conformity Assessment) cojointly started the accreditation program for clinical laboratories, based on ISO 15189:2003, and a total of 15 laboratories including university hospitals, community hospitals and independent clinical laboratories have been accredited up until the end of 2006.

  14. Experience from long-term monitoring of RAKR ratios in 192Ir brachytherapy

    International Nuclear Information System (INIS)

    Carlsson Tedgren, Asa; Bengtsson, Emil; Hedtjaern, Hakan; Johansson, Asa; Karlsson, Leif; Lamm, Inger-Lena; Lundell, Marie; Mejaddem, Younes; Munck af Rosenschoeld, Per; Nilsson, Josef; Wieslander, Elinore; Wolke, Jeanette

    2008-01-01

    Background: Ratios of values of brachytherapy source strengths, as measured by hospitals and vendors, comprise constant differences as, e.g., systematic errors in ion chamber calibration factors and measurement setup. Such ratios therefore have the potential to reveal the systematic changes in routines or calibration services at either the hospital or the vendor laboratory, which could otherwise be hidden by the uncertainty in the source strength values. Methods: The RAKR of each new source in 13 afterloading units at five hospitals were measured by well-type ion chambers and compared to values for the same source stated on vendor certificates. Results: Differences from unity in the ratios of RAKR values determined by hospitals and vendors are most often small and stable around their mean values to within ±1.5%. Larger deviations are rare but occur. A decreasing ratio, seen at two hospitals for the same source, was useful in detecting an erroneous pressure gauge at the vendor's site. Conclusions: Establishing a mean ratio of RAKR values, as measured at the hospital and supplied on the vendor certificate, and monitoring this as a function of time are an easy way for the early detection of problems with equipment or routines at either the hospital or the vendor site

  15. Intercomparison Of Activity Measurements Of Co-58, Y-88, Ho-166m, Tc-99m, dan I-131 Between P3KRBiN and Laboratory Within BATAN And Hospitals

    International Nuclear Information System (INIS)

    Nazaroh; Ermi-Juita; Hermawan-Candra

    2003-01-01

    One way to maintain traceability and to keep consistency of the measurement result of radioactivity was intercomparison program. According with Surat Keputusan Kepala BATAN No.73/KA/IV/99, one of tasks and functions of standardization laboratory is to coordinate an intercomparison program of radioactivity measurement. In the year of 2000, intercomparison program of activity measurements between P3KRBiN and 10 laboratories within BATAN and 12 hospitals were carried out. For intercomparison of Co-58, Y-88, and Ho-166m, there were 3 laboratories within BATAN which have more than 50% difference compared with P3KRBiN measurements and for intercomparison of Tc-99m, dan I-131, there were 2 Dose-Calibrators belongs to hospitals which have more than 30% difference compared with P3KRBiN measurements. From that result it can be concluded that intercomparison of activity measurements are very important and needs continuously to maintain traceability and to keep consistency of measurement result. (author)

  16. Improvement in the performance of external quality assessment in Korean HIV clinical laboratories using unrecalcified human plasma.

    Science.gov (United States)

    Wang, Jin-Sook; Kee, Mee-Kyung; Choi, Byeong-Sun; Kim, Chan-Wha; Kim, Hyon-Suk; Kim, Sung Soon

    2012-01-01

    The external quality assessment schemes (EQAS) organizer provides a suitable program to monitor and improve the quality of human immunodeficiency virus (HIV) testing laboratories with EQAS panels prepared under various conditions. The aim of the current study was to investigate the effects of human plasma samples on the EQAS results of HIV obtained from hospital-based clinical laboratories. From 2007 to 2009, HIV EQAS panels consisted of four to six samples that consisted of undiluted positive and negative samples and were provided to laboratories twice per year. Up until the first half EQAS in 2008, EQAS panel materials were obtained by converting acid citrate dextrose treated plasma to serum via chemical treatment with CaCl2. Beginning with the second EQAS in 2008, all materials were prepared without the defibrination process. Approximately 300 HIV clinical laboratories participated in this program. The overall performance of clinical laboratories was shown to be improved when using unrecalcified plasma panels compared with recalcified panels. Significant differences were observed in EIA analyses of plasma for both positive (plaboratories.

  17. National survey on intra-laboratory turnaround time for some most common routine and stat laboratory analyses in 479 laboratories in China.

    Science.gov (United States)

    Fei, Yang; Zeng, Rong; Wang, Wei; He, Falin; Zhong, Kun; Wang, Zhiguo

    2015-01-01

    To investigate the state of the art of intra-laboratory turnaround time (intra-TAT), provide suggestions and find out whether laboratories accredited by International Organization for Standardization (ISO) 15189 or College of American Pathologists (CAP) will show better performance on intra-TAT than non-accredited ones. 479 Chinese clinical laboratories participating in the external quality assessment programs of chemistry, blood gas, and haematology tests organized by the National Centre for Clinical Laboratories in China were included in our study. General information and the median of intra-TAT of routine and stat tests in last one week were asked in the questionnaires. The response rate of clinical biochemistry, blood gas, and haematology testing were 36% (479/1307), 38% (228/598), and 36% (449/1250), respectively. More than 50% of laboratories indicated that they had set up intra-TAT median goals and almost 60% of laboratories declared they had monitored intra-TAT generally for every analyte they performed. Among all analytes we investigated, the intra-TAT of haematology analytes was shorter than biochemistry while the intra-TAT of blood gas analytes was the shortest. There were significant differences between median intra-TAT on different days of the week for routine tests. However, there were no significant differences in median intra-TAT reported by accredited laboratories and non-accredited laboratories. Many laboratories in China are aware of intra-TAT control and are making effort to reach the target. There is still space for improvement. Accredited laboratories have better status on intra-TAT monitoring and target setting than the non-accredited, but there are no significant differences in median intra-TAT reported by them.

  18. Kingsbury Laboratories

    International Nuclear Information System (INIS)

    Hughes, S.B.

    1986-01-01

    The paper concerns the work of the Kingsbury Laboratories of Fairey Engineering Company, for the nuclear industry. The services provided include: monitoring of nuclear graphite machining, specialist welding, non-destructive testing, and metallurgy testing; and all are briefly described. (U.K.)

  19. A cost benefit analysis of outsourced laboratory services.

    Science.gov (United States)

    Bowers, J A

    1995-11-01

    As healthcare moves toward increased capitation, hospital administrators must be aware of all costs associated with patient services. This article describes the cost benefit analysis process used by northern Indiana hospital consumers during 1994-1995 to evaluate a local laboratory service outsource provider, South Bend Medical Foundation (SBMF). In an effort to meet the best interests of the community at large, three competing hospitals, medical leadership, and the local outsource provider joined forces to ensure that cost effective quality services would be provided. Laboratory utilization patterns for common DRGs were also analyzed. The team created a reconfiguration analysis to help develop benchmark figures for consideration in future contract negotiations.

  20. Environmental Waste Management in a School Hospital and in a Laboratory of Human Anatomy of a University

    Directory of Open Access Journals (Sweden)

    Kira Lusa Manfredini

    2013-12-01

    Full Text Available The scientific and professional activities developed in a Hospital School and a Laboratory of Human Anatomy of a university can generate parallel, chemical residues from various degrees of angerousness, which may require physical treatment and / or suitable chemical, before being sent to final destination. The General Hospital (GH generates monthly 10 L of xylenes and 50 L of glutaraldehyde to provide ass instance to their patients. Already the Laboratory of Human Anatomy of University de Caxias do Sul (AL-UCS uses more than 10,000 liters for preserving corpses in tanks. The present study aims to analyze the chemical waste management of the GH and the AL-UCS and propose techniques for recovery and reuse of chemicals formaldehyde, glutaraldehyde and xylenes, minimizing the impacts generated by the use, often indispensable and sometimes questionable, of such waste. So far two sets of samples were collected (in March and April 2013 of xylene, glutaraldehyde and formaldehyde in the GH and also at the AL-UCS and it is intended to repeat the collections with monthly periodicity, in the next two semesters. Partial results show that, comparing the relationship of area and the medium areas of the chromatographic (in µV.s of patterns with compounds of interest, an increase in the percentage of formaldehyde relative to the samples in standard formalin (121.84% may be due to contamination with organic compounds with a retention time close to the compound of interest, the xylene was little degradation in the samples, indicating that this compound can be reused in the common procedures of healthcare institutions, with respect to glutaraldehyde significant degradation was observed for the compound in samples represents only 61.88% of the chromatographic peak area of the standard, therefore the reuse of these compounds may require the use of purification methods such as simple distillation and fractional distillation

  1. The role of the National Metrology laboratory for the improvement for the improvement of the individual monitoring in brazil

    International Nuclear Information System (INIS)

    Barbosa, R.A.; Baptista, L.A.M.M.; Silva, T.A. da

    1998-01-01

    Since 1980, the National Laboratory for ionising Radiation Metrology- LNMRI/IRD from Brazil has given support and performed quality control tests in the services that provide individual monitoring of external radiation in the country. Although the LNMRI/IRD has promoted intercomparisons and performance tests in all Brazilian individual monitoring systems, results showed that improvements in the their quality were too small, mainly due to a lack of a national policy and legal requirements for quality control them. In 1996, the Committee for Evaluation of External Individual Monitoring Services established a national policy for accreditation of individual monitoring services. In the new policy, the role of the LNMRI/IRD is mainly to verify the compliance of any individual monitoring system to the minimum accuracy requirements for the photon dose equivalent evaluation. Additionally, the LNMRI/IRD may verify any specific type-test to verify the results stated by the service itself. A new quality control program for all accredited services is also to be maintained by the LNMRI/IRD . This work shows and discusses the results of the role of the LNMRI/IRD under the old and the new accreditation policy for the systems used for the individual monitoring of photon beams

  2. Application of indices Cp and Cpk to improve quality control capability in clinical biochemistry laboratories.

    Science.gov (United States)

    Chen, Ming-Shu; Wu, Ming-Hsun; Lin, Chih-Ming

    2014-04-30

    The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  3. Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study

    DEFF Research Database (Denmark)

    Mosha, Dominic; Poulsen, Anja; Reyburn, Hugh

    2009-01-01

    respectively, prior to the BT decision. Pre-transfusion haemoglobin and body temperature were recorded in 2/3 of the patients, but respiratory rate and pulse rate were not routinely recorded. In 40% of BTs, the transfusion time exceeded the recommended 4 hours. The zonal blood bank (ZBB) and local donors......BACKGROUND: Blood transfusion (BT) can be lifesaving for children; however, monitoring the quality of BT is important. The current study describes the quality of paediatric BT delivered in two district hospitals in north-east Tanzania in order to identify areas for quality assurance and improvement...... in the administration of BT. METHODS: All 166 children admitted in the paediatric wards and receiving BT through April to June 2007 were prospectively observed. Medical records, request forms and registers in the laboratories were reviewed to identify blood source, blood screening and indications for BT. BT...

  4. Are laboratory tests always needed? Frequency and causes of laboratory overuse in a hospital setting.

    Science.gov (United States)

    Cadamuro, Janne; Gaksch, Martin; Wiedemann, Helmut; Lippi, Giuseppe; von Meyer, Alexander; Pertersmann, Astrid; Auer, Simon; Mrazek, Cornelia; Kipman, Ulrike; Felder, Thomas K; Oberkofler, Hannes; Haschke-Becher, Elisabeth

    2018-04-01

    Inappropriate utilization of laboratory resources is an increasing concern especially in high-throughput facilities. Until now, no reliable information has been published addressing to which extent laboratory results are actually used for clinical decision-making. Therefore, we aimed to close this gap using a novel retrospective approach including a survey of clinicians and nurses. We retrospectively evaluated the number of re-orders for potassium (K), lactate dehydrogenase (LD), aspartate-aminotransferase (AST), activated partial thromboplastin-time (APTT) and prothrombin-time/INR (PT/INR), after the initial order had to be cancelled due to preanalytical non-conformities. We analyzed subgroups regarding time to re-order, ward and sample priority (urgent vs. routine). Subsequently, we surveyed clinicians and nurses, asking for their estimate of the amount of failed re-orders as well as for possible reasons. From initially cancelled tests, only ~20% of K, LD, AST and ~30% of APTT and PT/INR tests were re-ordered within 24 h. 70% of the investigated clinical chemistry and 60% of coagulation tests were re-ordered one week after cancellation or not at all. Survey participants quite accurately estimated these numbers. Routine laboratory panels, short stay of out-patients, obsolete test results and avoiding additional phlebotomies were the main reasons for not re-ordering cancelled tests. Overall, 60-70% of test results in the investigated assays ordered in a high throughput laboratory are potentially inappropriate or of doubtful clinically importance. Although clinicians and nurses are aware of this situation, it is the duty of laboratory specialists to overcome overutilization in close collaboration with all involved healthcare workers. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  5. Draft environmental assessment of Argonne National Laboratory, East

    Energy Technology Data Exchange (ETDEWEB)

    1975-10-01

    This environmental assessment of the operation of the Argonne National Laboratory is related to continuation of research and development work being conducted at the Laboratory site at Argonne, Illinois. The Laboratory has been monitoring various environmental parameters both offsite and onsite since 1949. Meteorological data have been collected to support development of models for atmospheric dispersion of radioactive and other pollutants. Gaseous and liquid effluents, both radioactive and non-radioactive, have been measured by portable monitors and by continuous monitors at fixed sites. Monitoring of constituents of the terrestrial ecosystem provides a basis for identifying changes should they occur in this regime. The Laboratory has established a position of leadership in monitoring methodologies and their application. Offsite impacts of nonradiological accidents are primarily those associated with the release of chlorine and with sodium fires. Both result in releases that cause no health damage offsite. Radioactive materials released to the environment result in a cumulative dose to persons residing within 50 miles of the site of about 47 man-rem per year, compared to an annual total of about 950,000 man-rem delivered to the same population from natural background radiation. 100 refs., 17 figs., 33 tabs.

  6. Monitoring adverse events in hospitals: how safe are hospitals for patients?

    NARCIS (Netherlands)

    Baines, R.J.

    2018-01-01

    This thesis aims to assess trends in adverse event and preventable adverse event rates in hospitals in the Netherlands through the time period 2004 –2012. Furthermore patient safety for specific care processes and patient groups are assessed. Patient safety has been high on the international agenda

  7. Childhood liver diseases in Ga-Rankuwa Hospital, South Africa ...

    African Journals Online (AJOL)

    Rankuwa Hospital Histopathology Laboratory. Design: A retrospective study. Setting: Ga-Rankuwa Histopathology Laboratory. Subjects: Seventy two patients who underwent a liver biopsy during the study period. Methods: Laboratory records ...

  8. Monitoring Sensitive Bat Species at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Schoenberg, Kari M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-01-15

    Bats play a critical role in ecosystems and are vulnerable to disturbance and disruption by human activities. In recent decades, bat populations in the United States and elsewhere have decreased tremendously. There are 47 different species of bat in the United States and 28 of these occur in New Mexico with 15 different species documented at the Los Alamos National Laboratory (LANL) and surrounding areas. Euderma maculatum(the spotted bat) is listed as “threatened” by the state of New Mexico and is known to occur at LANL. Four other species of bats are listed as “sensitive” and also occur here. In 1995, a four year study was initiated at LANL to assess the status of bat species of concern, elucidate distribution and relative abundance, and obtain information on roosting sites. There have been no definitive studies since then. Biologists in the Environmental Protection Division at LANL initiated a multi-year monitoring program for bats in May 2013 to implement the Biological Resources Management Plan. The objective of this ongoing study is to monitor bat species diversity and seasonal activity over time at LANL. Bat species diversity and seasonal activity were measured using an acoustic bat detector, the Pettersson D500X. This ultrasound recording unit is intended for long-term, unattended recording of bat and other high frequency animal calls. During 2013, the detector was deployed at two locations around LANL. Study sites were selected based on proximity to water where bats may be foraging. Recorded bat calls were analyzed using Sonobat, software that can help determine specific species of bat through their calls. A list of bat species at the two sites was developed and compared to lists from previous studies. Species diversity and seasonal activity, measured as the number of call sequences recorded each month, were compared between sites and among months. A total of 17,923 bat calls were recorded representing 15 species. Results indicate that there is a

  9. TRANSFUSION OF BLOOD AND BLOOD COMPONENTS IN POLYTRAUMATISED PATIENTS AT CELJE HOSPITAL (1998–2001

    Directory of Open Access Journals (Sweden)

    Slavomir Milovanović

    2003-12-01

    Full Text Available Background. The replacement of fluids after severe injuries is always a complex issue, either in medical doctrine or in clinical practice. Regardless of the fact, daily work with patients requires the clearest possible guidelines and their regular monitoring.Methods. We made a chart showing the number of patients and the quantity of blood or blood components used in the Celje General Hospital in the past four years.Results. The analyses have shown that indications for the use of blood or blood components have narrowed. At the same time, it is quite evident that it is difficult and also risky to decide on a transfusion only on the given laboratory values. Only a careful analysis of the therapy has shown that the decision on a transfusion is based on both, the clinical picture and its development, the evaluation of visible and invisible loss of blood, and on regular and extensive laboratory monitoring.Conclusions. Despite improved surgical techniques and introduction of new transfusion strategies loss of blood and need for transfusion during and after polytrauma surgeries is still rather high. In the analysed four year period, the maintained level of haemoglobin in patients that had a major surgery has slightly declined. It is therefore essential to cooperate with the respective hospital transfusion committee and prepare as well as follow up some clear guidelines for the rationalisation, not only restriction of transfusion of blood and blood components.

  10. [Japanese sentinel project and contribution of laboratory medicine].

    Science.gov (United States)

    Nakashima, Naoki

    2013-06-01

    Ordinary passive surveillance (generally spontaneous reporting) of adverse effects of medical products is not enough to manage medical risks/safety. The Japanese government, following the "sentinel initiative" by the US government, started the "Japanese sentinel project" as an active surveillance of medical products with the Pharmaceuticals and Medical Devices Agency(PMDA). Using entire prescription data in the hospital information system, data on laboratory examinations, diagnosis, and therapy specific to an adverse effect are checked by detecting differences between before and after prescription of a specific medical product to extract adverse effects and calculate their correct frequency in the surveillance. The project uses standard masters and protocols to analyze data among medial institutes by installation of the SS-MIX standard storage system. Ten hospitals were selected in 2011 to join the project, and the entire system and network will be implemented in those hospitals and PMDA until 2013 fiscal year. JLAC10 is used in the project as the laboratory examination code of the Japanese Society of Laboratory Medicine. Many incorrect coding and ambiguous coding rules were found by voluntary surveillance of 6 of the 10 hospitals in the project. Thus, the Council on Standardized Master Operation of Clinical Laboratory Examinations will launch in 2013 to improve and maintain JLAC10, which is essential not only for the Japanese sentinel project but also for data utilization by many other projects.

  11. Idaho National Laboratory Cultural Resource Monitoring Report for 2013

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Julie B. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-10-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during 2013. Throughout the year, thirty-eight cultural resource localities were revisited including: two locations with Native American human remains, one of which is also a cave; fourteen additional caves; seven prehistoric archaeological sites ; four historic archaeological sites; one historic trail; one nuclear resource (Experimental Breeder Reactor-I, a designated National Historic Landmark); and nine historic structures located at the Central Facilities Area. Of the monitored resources, thirty-three were routinely monitored, and five were monitored to assess project compliance with cultural resource recommendations along with the effects of ongoing project activities. On six occasions, ground disturbing activities within the boundaries of the Power Burst Facility/Critical Infrastructure Test Range Complex (PBF/CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. In addition, two resources were visited more than once as part of the routine monitoring schedule or to monitor for additional damage. Throughout the year, most of the cultural resources monitored had no visual adverse changes resulting in Type 1determinations. However, Type 2 impacts were noted at eight sites, indicating that although impacts were noted or that a project was operating outside of culturally cleared limitations, cultural resources retained integrity and noted impacts did not threaten National Register eligibility. No new Type 3 or any Type 4 impacts that adversely impacted cultural resources and threatened National Register eligibility were observed at cultural resources monitored in 2013.

  12. Metallurgical Laboratory Hazardous Waste Management Facility groundwater monitoring report. First quarter 1995

    International Nuclear Information System (INIS)

    1995-06-01

    During first quarter 1995, samples from AMB groundwater monitoring wells at the Metallurgical Laboratory Hazardous Waste Management Facility (Met Lab HWMF) were analyzed for selected heavy metals, field measurements, radionuclides, volatile organic compounds, and other constituents. Six parameters exceeded standards during the quarter. As in previous quarters, tetrachloroethylene and trichloroethylene exceeded final Primary Drinking Water Standards (PDWS). Total organic halogens exceeded its Savannah River Site (SRS) Flag 2 criterion during first quarter 1995 as in fourth quarter 1994. Aluminum, iron, and manganese, which were not analyzed for during fourth quarter 1994, exceeded the Flag 2 criteria in at least two wells each during first quarter 1995. Groundwater flow direction and rate in the M-Area Aquifer Zone were similar to previous quarters. Conditions affecting the determination of groundwater flow directions and rates in the Upper Lost Lake Aquifer Zone, Lower Lost Lake Aquifer Zone, and the Middle Sand Aquifer Zone of the Crouch Branch Confining Unit were also similar to previous quarters

  13. [Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

    Science.gov (United States)

    Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

    2015-04-01

    It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (pCSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Leveraging the "living laboratory": on the emergence of the entrepreneurial hospital.

    Science.gov (United States)

    French, Martin; Miller, Fiona Alice

    2012-08-01

    For years, scholars have debated the "commercial ethos" in higher education, and the rise of the entrepreneurial university. But what of the "entrepreneurial hospital"? Largely unnoticed by scholars, this unique organisational form differs from the entrepreneurial university in some significant ways, not least in its capacity to use its innovations, and to count patients-and even patient populations-amongst its human capital. Accordingly, this article provides an initial conceptualisation of the entrepreneurial hospital, along with an exploration of its larger implications. Using twenty-six semi-structured interviews with key-informants (2008-2009), who work in two networked organisations within a single academic health science system in a Canadian province, our analysis identifies distinctive characteristics of an entrepreneurial hospital. Informed by grounded theory, especially situational analysis, we derive from our data an illustration of potentially incommensurate understandings of the entrepreneurial hospital's resources. On one hand, our study participants view patients and patient populations as a resource for research, linking its value to the contribution it can make to improved, more cost-effective care. On the other hand, some also see commercial potential in this resource. In both cases, exploitation is accompanied by perceived obligations to make proper use of patient populations, and to "give back" to the public-at-large, including through the entrepreneurial search for new ways of mobilising the resources of publicly-funded health care. Thus, a key task of the entrepreneurial hospital is to invent and mediate new uses for its care infrastructure and the unique resource constituted by patient populations. By drawing together care and research in new ways, the entrepreneurial hospital promises increased capacity for biomedical innovation. Yet, as it invents and mediates new uses for patient populations and health care infrastructure, the

  15. Situation analysis of occupational and environmental health laboratory accreditation in Thailand.

    Science.gov (United States)

    Sithisarankul, Pornchai; Santiyanont, Rachana; Wongpinairat, Chongdee; Silva, Panadda; Rojanajirapa, Pinnapa; Wangwongwatana, Supat; Srinetr, Vithet; Sriratanaban, Jiruth; Chuntutanon, Swanya

    2002-06-01

    The objective of this study was to analyze the current situation of laboratory accreditation (LA) in Thailand, especially on occupational and environmental health. The study integrated both quantitative and qualitative approaches. The response rate of the quantitative questionnaires was 54.5% (226/415). The majority of the responders was environmental laboratories located outside hospital and did not have proficiency testing. The majority used ISO 9000, ISO/IEC 17025 or ISO/ EEC Guide 25, and hospital accreditation (HA) as their quality system. However, only 30 laboratories were currently accredited by one of these systems. Qualitative research revealed that international standard for laboratory accreditation for both testing laboratory and calibration laboratory was ISO/IEC Guide 25, which has been currently revised to be ISO/IEC 17025. The National Accreditation Council (NAC) has authorized 2 organizations as Accreditation Bodies (ABs) for LA: Thai Industrial Standards Institute, Ministry of Industry, and Bureau of Laboratory Quality Standards, Department of Medical Sciences, Ministry of Public Health. Regarding LA in HA, HA considered clinical laboratory as only 1 of 31 items for accreditation. Obtaining HA might satisfy the hospital director and his management team, and hence might actually be one of the obstacles for the hospital to further improve their laboratory quality system and apply for ISO/IEC 17025 which was more technically oriented. On the other hand, HA may be viewed as a good start or even a pre-requisite for laboratories in the hospitals to further improve their quality towards ISO/IEC 17025. Interviewing the director of NAC and some key men in some large laboratories revealed several major problems of Thailand's LA. Both Thai Industrial Standards Institute and Bureau of Laboratory Quality Standards did not yet obtain Mutual Recognition Agreement (MRA) with other international ABs. Several governmental bodies had their own standards and

  16. Moisture Monitoring at Area G, Technical Area 54, Los Alamos National Laboratory, 2016 Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Levitt, Daniel Glenn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Birdsell, Kay Hanson [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Jennings, Terry L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); French, Sean B. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-01-17

    Hydrological characterization and moisture monitoring activities provide data required for evaluating the transport of subsurface contaminants in the unsaturated and saturated zones beneath Area G, and for the Area G Performance Assessment and Composite Analysis. These activities have been ongoing at Area G, Technical Area 54 of the Los Alamos National Laboratory since waste disposal operations began in 1957. This report summarizes the hydrological characterization and moisture monitoring activities conducted at Area G. It includes moisture monitoring data collected from 1986 through 2016 from numerous boreholes and access tubes with neutron moisture meters, as well as data collected by automated dataloggers for water content measurement sensors installed in a waste disposal pit cover, and buried beneath the floor of a waste disposal pit. This report is an update of a nearly identical report by Levitt et al., (2015) that summarized data collected through early 2015; this report includes additional moisture monitoring data collected at Pit 31 and the Pit 38 extension through December, 2016. It also includes information from the Jennings and French (2009) moisture monitoring report and includes all data from Jennings and French (2009) and the Draft 2010 Addendum moisture monitoring report (Jennings and French, 2010). For the 2015 version of this report, all neutron logging data, including neutron probe calibrations, were investigated for quality and pedigree. Some data were recalculated using more defensible calibration data. Therefore, some water content profiles are different from those in the Jennings and French (2009) report. All of that information is repeated in this report for completeness. Monitoring and characterization data generally indicate that some areas of the Area G vadose zone are consistent with undisturbed conditions, with water contents of less than five percent by volume in the top two layers of the Bandelier tuff at Area G. These data also

  17. Laboratory-based surveillance in the molecular era: The typened model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    H.G.M. Niesters (Bert); J.W. Rossen (John); H.G.A.M. van der Avoort (Harrie); D. Baas; K. Benschop (Kimberley); E.C.J. Claas (Eric); A. Kroneman; N.M. van Maarseveen (Noortje); S.D. Pas (Suzan); W. van Pelt (Wilfred); J. Rahamat-Langendoen (Janette); R. Schuurman (Rob); H. Vennema (Harry); L. Verhoef; K.C. Wolthers (Katja); M.P.G. Koopmans D.V.M. (Marion)

    2013-01-01

    textabstractLaboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories

  18. Laboratory-based surveillance in the molecular era : the TYPENED model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    Niesters, H G; Rossen, J W; van der Avoort, H; Baas, D; Benschop, K; Claas, E C; Kroneman, A; van Maarseveen, N; Pas, S; van Pelt, W; Rahamat-Langendoen, J C; Schuurman, R; Vennema, H; Verhoef, L; Wolthers, K; Koopmans, Marion

    2013-01-01

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for

  19. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    Niesters, H. G.; Rossen, J. W.; van der Avoort, H.; Baas, D.; Benschop, K.; Claas, E. C.; Kroneman, A.; van Maarseveen, N.; Pas, S.; van Pelt, W.; Rahamat-Langendoen, J. C.; Schuurman, R.; Vennema, H.; Verhoef, L.; Wolthers, K.; Koopmans, M.

    2013-01-01

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for

  20. Second annual report of the Environmental Restoration Monitoring and Assessment Program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Clapp, R.B.; Watts, J.A.

    1993-09-01

    This report summarizes the salient features of the annual efforts of environmental monitoring and field investigations conducted to support the Environmental Restoration (ER) Program at the Oak Ridge National Laboratory (ORNL). This report focuses on the watershed scale, striving to provide an ORNL site-wide perspective on types, distribution, and transport of contamination. Results are used to enhance the conceptual understanding of the key contaminants and the sources, fluxes, and processes affecting their distribution and movement. This report summarizes the efforts of the Waste Area Grouping (WAG) 2 and Site Investigations (SI) program. WAG 2 is the lower portion of the White Oak Creek (WOC) system which drains the major contaminated sites at ORNL and discharges to the Clinch River where public access is allowed. The remedial investigation for WAG 2 includes a long-term multimedia environmental monitoring effort that takes advantage of WAG 2's role as an integrator and conduit of contaminants from the ORNL site. This report also includes information from other site-specific remedial investigations and feasibility studies (RI/FS) for contaminated sites at ORNL and data from other ongoing monitoring programs conducted by other organizations [e.g., the National Pollutant Discharge Elimination System (NPDES) compliance monitoring conducted by the Environmental Surveillance and Protection Section]. This information is included to provide an integrated basis to support ER decision making. This report summarizes information gathered through early 1993. Annual data, such as annual discharges of contaminants, are reported for calendar year 1992

  1. Specimen rejection in laboratory medicine: Necessary for patient safety?

    Science.gov (United States)

    Dikmen, Zeliha Gunnur; Pinar, Asli; Akbiyik, Filiz

    2015-01-01

    The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.

  2. Implementation of the Gamma Monitor Calibration Laboratory (LABCAL) of the Institute of Chemical, Biological, Radiological and Nuclear Defense (IDQBRN) of the Technology Center of the Brazilian Army (CTEx)

    Energy Technology Data Exchange (ETDEWEB)

    Balthar, Mario Cesar V.; Amorim, Aneuri de; Santos, Avelino dos and others, E-mail: mariobalthar@gmail.com [Centro Tecnológico do Exército (IDQBRN/CTEx), Rio de Janeiro, RJ (Brazil). Instituto de Defesa Química, Biológica, Radiológica e Nuclear

    2017-07-01

    The objective of this work is to describe the implementation and adaptation stages of the Gamma Monitor Calibration Laboratory (Laboratório de Calibração de Monitores Gama - LABCAL) of the Institute of Chemical, Biological, Radiological and Nuclear Defense (Instituto de Defesa Química, Biológica, Radiológica e Nuclear - IDQBRN) of the Technology Center of the Brazilian Army (Centro Tecnológico do Exército - CTEx). Calibration of the radiation monitors used by the Brazilian Army will be performed by quantitatively measuring the ambient dose equivalent, in compliance with national legislation. LABCAL still seeks licensing from CNEN and INMETRO. The laboratory in intended to supply the total demand for calibration of ionizing radiation devices from the Brazilian Army. (author)

  3. Implementation of the Gamma Monitor Calibration Laboratory (LABCAL) of the Institute of Chemical, Biological, Radiological and Nuclear Defense (IDQBRN) of the Technology Center of the Brazilian Army (CTEx)

    International Nuclear Information System (INIS)

    Balthar, Mario Cesar V.; Amorim, Aneuri de; Santos, Avelino dos and others

    2017-01-01

    The objective of this work is to describe the implementation and adaptation stages of the Gamma Monitor Calibration Laboratory (Laboratório de Calibração de Monitores Gama - LABCAL) of the Institute of Chemical, Biological, Radiological and Nuclear Defense (Instituto de Defesa Química, Biológica, Radiológica e Nuclear - IDQBRN) of the Technology Center of the Brazilian Army (Centro Tecnológico do Exército - CTEx). Calibration of the radiation monitors used by the Brazilian Army will be performed by quantitatively measuring the ambient dose equivalent, in compliance with national legislation. LABCAL still seeks licensing from CNEN and INMETRO. The laboratory in intended to supply the total demand for calibration of ionizing radiation devices from the Brazilian Army. (author)

  4. Detection of Enterovirus D68 in Canadian Laboratories

    Science.gov (United States)

    Hatchette, Todd F.; Drews, Steven J.; Grudeski, Elsie; Booth, Tim; Martineau, Christine; Dust, Kerry; Garceau, Richard; Gubbay, Jonathan; Karnauchow, Tim; Krajden, Mel; Levett, Paul N.; Mazzulli, Tony; McDonald, Ryan R.; McNabb, Alan; Mubareka, Samira; Needle, Robert; Petrich, Astrid; Richardson, Susan; Rutherford, Candy; Smieja, Marek; Tellier, Raymond; Tipples, Graham

    2015-01-01

    The recent emergence of a severe respiratory disease caused by enterovirus D68 prompted investigation into whether Canadian hospital and provincial laboratories can detect this virus using commercial and laboratory-developed assays. This study demonstrated analytical sensitivity differences between commercial and laboratory-developed assays for the detection of enterovirus D68. PMID:25740765

  5. Characterisation of the ecotoxicity of hospital effluents: a review.

    Science.gov (United States)

    Orias, Frédéric; Perrodin, Yves

    2013-06-01

    The multiple activities that take place in hospitals (surgery, drug treatments, radiology, cleaning of premises and linen, chemical and biological analysis laboratories, etc.), are a major source of pollutant emissions into the environment (disinfectants, detergents, drug residues, etc.). Most of these pollutants can be found in hospital effluents (HWW), then in urban sewer networks and WWTP (weakly adapted for their treatment) and finally in aquatic environments. In view to evaluating the impact of these pollutants on aquatic ecosystems, it is necessary to characterise their ecotoxicity. Several reviews have focused on the quantitative and qualitative characterisation of pollutants present in HWW. However, none have focused specifically on the characterisation of their experimental ecotoxicity. We have evaluated this according to two complementary approaches: (i) a "substance" approach based on the identification of the experimental data in the literature for different substances found in hospital effluents, and on the calculation of their PNEC (Predicted Non Effect Concentration), (ii) a "matrix" approach for which we have synthesised ecotoxicity data obtained from the hospital effluents directly. This work first highlights the diversity of the substances present within hospital effluents, and the very high ecotoxicity of some of them (minimum PNEC observed close to 0,01 pg/L). We also observed that the consumption of drugs in hospitals was a predominant factor chosen by authors to prioritise the compounds to be sought. Other criteria such as biodegradability, excretion rate and the bioaccumulability of pollutants are considered, though more rarely. Studies of the ecotoxicity of the particulate phase of effluents must also be taken into account. It is also necessary to monitor the effluents of each of the specialised departments of the hospital studied. These steps is necessary to define realistic environmental management policies for hospitals (replacement of

  6. Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

    Directory of Open Access Journals (Sweden)

    Hikone M

    2015-07-01

    Full Text Available Mayu Hikone,1 Yusuke Ainoda,1,2 Sayaka Tago,2 Takahiro Fujita,2 Yuji Hirai,2 Kaori Takeuchi,2 Kyoichi Totsuka31Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 2Department of Infectious Diseases, Tokyo Women's Medical University, 3Department of Internal Medicine, Kitatama Hospital, Tokyo, JapanBackground: Clostridium difficile infection (CDI is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors.Methods: We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI.Results: Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4% were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03 and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049.Conclusion: Intensive care unit hospitalization and malignancy are risk factors for recurrent

  7. Monitoring of the general population with an installed whole body counter at West Cumberland Hospital, Whitehaven

    International Nuclear Information System (INIS)

    Boddy, K.; Francis, R.A.; Fenwick, J.D.; McKenzie, A.L.

    1989-03-01

    Body radioactivity in the general public has been measured in 395 volunteers in the Whitehaven area, using a whole-body monitor at West Cumberland Hospital. Between October 1986 and October 1987, estimates of total body radiocaesium in 240 volunteers ranged from below detection level to 1844 Bq with a mean of 415 Bq. From October 1987 until May 1988, a further 155 volunteers were monitored, and radiation levels ranged from 34 Bq to 685 Bq, with a mean of 257 Bq. In all volunteers, the ratio of body radiocaesium to body potassium, was well below unity. The average ratio of caesium-137 to caesium-134 from October 1987 to May 1988 was 3.28, corresponding to a ratio of 1.99 at the date of Chernobyl accident. This is consistent with a Chernobyl origin as the primary source for the radiocaesium. There were discernible, but not marked, trends of increasing body radiocaesium with milk and meat/fish consumption. (author)

  8. Oak Ridge National Laboratory Biological Monitoring and Abatement Program for White Oak Creek Watershed and the Clinch River

    International Nuclear Information System (INIS)

    Loar, J.M.; Adams, S.M.; Allison, L.J.; Blaylock, B.G.; Boston, H.L.; Huston, M.A.; Kimmel, B.L.; Smith, J.G.; Southworth, G.R.; Stewart, A.J.; Walton, B.T.; Kitchings, J.T.; Olsen, C.R.

    1991-09-01

    On April 1, 1986, a National Pollutant Discharge Elimination System (NPDES) permit was issued for the Oak Ridge National Laboratory (ORNL) (EPA 1986). As specified in Part 3: Special Conditions (Item H) of the permit, a plan for biological monitoring of the Clinch River, White Oak Creek (WOC), Northwest Tributary (NWT) of WOC, Melton Branch (MB), Fifth Creek, and First Creek shall be submitted for approval to the US Environmental Protection Agency (EPA) and the Tennessee Department of Health and Environment (TDHE) within 90 days of the effective date of the permit. The plan, which is referred to in Part 3 (H) of the permit as the Biological Monitoring Plan and Abatement Program (BMPAP), describes characterization monitoring studies to be conducted for the duration of the permit (5 years). In order to be consistent with the terminology used for the Biological Monitoring and Abatement Programs for the Oak Ridge Y-12 Plan and the Oak Ridge K-25 Plant, BMPAP will subsequently be referred to as the Biological Monitoring and Abatement Program (BMAP). The proposed BMAP outlined in this document is based on preliminary discussions held on December 9, 1985, between staff of Martin Marietta Energy Systems, Inc. (ORNL and Central Management), the US Department of Energy (DOE), EPA, and TDHE. 232 refs., 11 figs., 7 tabs

  9. Oak Ridge National Laboratory Biological Monitoring and Abatement Program for White Oak Creek Watershed and the Clinch River

    Energy Technology Data Exchange (ETDEWEB)

    Loar, J.M.; Adams, S.M.; Allison, L.J.; Blaylock, B.G.; Boston, H.L.; Huston, M.A.; Kimmel, B.L.; Smith, J.G.; Southworth, G.R.; Stewart, A.J.; Walton, B.T.; Kitchings, J.T.; Olsen, C.R.

    1991-09-01

    On April 1, 1986, a National Pollutant Discharge Elimination System (NPDES) permit was issued for the Oak Ridge National Laboratory (ORNL) (EPA 1986). As specified in Part 3: Special Conditions (Item H) of the permit, a plan for biological monitoring of the Clinch River, White Oak Creek (WOC), Northwest Tributary (NWT) of WOC, Melton Branch (MB), Fifth Creek, and First Creek shall be submitted for approval to the US Environmental Protection Agency (EPA) and the Tennessee Department of Health and Environment (TDHE) within 90 days of the effective date of the permit. The plan, which is referred to in Part 3 (H) of the permit as the Biological Monitoring Plan and Abatement Program (BMPAP), describes characterization monitoring studies to be conducted for the duration of the permit (5 years). In order to be consistent with the terminology used for the Biological Monitoring and Abatement Programs for the Oak Ridge Y-12 Plan and the Oak Ridge K-25 Plant, BMPAP will subsequently be referred to as the Biological Monitoring and Abatement Program (BMAP). The proposed BMAP outlined in this document is based on preliminary discussions held on December 9, 1985, between staff of Martin Marietta Energy Systems, Inc. (ORNL and Central Management), the US Department of Energy (DOE), EPA, and TDHE. 232 refs., 11 figs., 7 tabs.

  10. Laboratory hemostasis: milestones in Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J

    2013-01-01

    Hemostasis is a delicate, dynamic and intricate system, in which pro- and anti-coagulant forces cooperate for either maintaining blood fluidity under normal conditions, or else will prompt blood clot generation to limit the bleeding when the integrity of blood vessels is jeopardized. Excessive prevalence of anticoagulant forces leads to hemorrhage, whereas excessive activation of procoagulant forces triggers excessive coagulation and thrombosis. The hemostasis laboratory performs a variety of first, second and third line tests, and plays a pivotal role in diagnostic and monitoring of most hemostasis disturbances. Since the leading targets of Clinical Chemistry and Laboratory Medicine include promotion of progress in fundamental and applied research, along with publication of guidelines and recommendations in laboratory diagnostics, this journal is an ideal source of information on current developments in the laboratory technology of hemostasis, and this article is aimed to celebrate some of the most important and popular articles ever published by the journal in the filed of laboratory hemostasis.

  11. Monitoring as an information management task in hospitals

    Directory of Open Access Journals (Sweden)

    Wentz, Bernhard

    2008-08-01

    Full Text Available The increasing complexity of information systems requires a systematic monitoring of the information system’s architecture, components, and operation within the strategic, tactical, and operational information management. While there exists a broad methodical assistance for information system’s planning and directing, the monitoring aspect suffers from lacking awareness of the problem on the part of the information manager and missing knowledge about appropriate methods. The paper emphasizes the need for systematic monitoring and gives an overview of the most important methods and tools to support systematic monitoring of the HIS and its components. The overview is presented according to the levels of information management. Basis were best practice approaches like ITIL and COBIT, economic science’s approaches like the Balanced Scorecard as well as appropriate information management’s literature.

  12. The Quality Assurance_Quality Control of the Monitored Drift Tubes at the HEP Laboratory of the National Technical University of Athens

    CERN Document Server

    Alexopoulos, T; Dris, M; Filippas, A V; Fokitis, E; Gazis, E N; Katsoufis, E C; Maltezos, A; Maltezos, S; Papadopoulos, E; Papadopoulou, T D; Savva, Panagiota S; Stavropoulos, G D; Tsipolitis, G; Tzamariudaki, E

    2001-01-01

    The description of the Quality Assurance and Quality Control (QA_QC) procedures for the Monitored Drift Tubes (MDT's) followed at the HEP Laboratory of NTUA are presented and results of the tested tubes are given. The MDT's are the elements from which muon chambers for the ATLAS/LHC Muon Spectrometer are built..

  13. Using ATP-driven bioluminescence assay to monitor microbial safety in a contemporary human cadaver laboratory.

    Science.gov (United States)

    Benninger, Brion; Maier, Thomas

    2015-03-01

    The objective of this study was to utilize a cost-effective method for assessing the levels of bacterial, yeast, and mold activity during a human dissection laboratory course. Nowadays, compliance with safety regulations is policed by institutions at higher standards than ever before. Fear of acquiring an unknown infection is one of the top concerns of professional healthcare students, and it provokes anti-laboratory anxiety. Human cadavers are not routinely tested for bacteria and viruses prior to embalming. Human anatomy dissecting rooms that house embalmed cadavers are normally cleaned after the dissected cadavers have been removed. There is no evidence that investigators have ever assessed bacterial and fungal activities using adenosine triphosphate (ATP)-driven bioluminescence assays. A literature search was conducted on texts, journals, and websites regarding bacterial, yeast, and mold activities in an active cadaver laboratory. Midway into a clinical anatomy course, ATP bioluminescence assays were used to swab various sites within the dissection room, including entrance and exiting door handles, water taps, cadaver tables, counter tops, imaging material, X-ray box switches, and the cadaver surfaces. The results demonstrated very low activities on cadaver tables, washing up areas, and exiting door handles. There was low activity on counter tops and X-ray boxes. There was medium activity on the entrance door handles. These findings suggest an inexpensive and accurate method for monitoring safety compliance and microbial activity. Students can feel confident and safe in the environment in which they work. © 2014 Wiley Periodicals, Inc.

  14. Hospital boards and hospital strategic focus: the impact of board involvement in strategic decision making.

    Science.gov (United States)

    Ford-Eickhoff, Karen; Plowman, Donde Ashmos; McDaniel, Reuben R

    2011-01-01

    Despite pressures to change the role of hospital boards, hospitals have made few changes in board composition or director selection criteria. Hospital boards have often continued to operate in their traditional roles as either "monitors" or "advisors." More attention to the direct involvement of hospital boards in the strategic decision-making process of the organizations they serve, the timing and circumstances under which board involvement occurs, and the board composition that enhances their abilities to participate fully is needed. We investigated the relationship between broader expertise among hospital board members, board involvement in the stages of strategic decision making, and the hospital's strategic focus. We surveyed top management team members of 72 nonacademic hospitals to explore the participation of critical stakeholder groups such as the board of directors in the strategic decision-making process. We used hierarchical regression analysis to explore our hypotheses that there is a relationship between both the nature and involvement of the board and the hospital's strategic orientation. Hospitals with broader expertise on their boards reported an external focus. For some of their externally-oriented goals, hospitals also reported that their boards were involved earlier in the stages of decision making. In light of the complex and dynamic environment of hospitals today, those charged with developing hospital boards should match the variety in the external issues that the hospital faces with more variety in board makeup. By developing a board with greater breadth of expertise, the hospital responds to its complex environment by absorbing that complexity, enabling a greater potential for sensemaking and learning. Rather than acting only as monitors and advisors, boards impact their hospitals' strategic focus through their participation in the strategic decision-making process.

  15. Field Operations Procedures Manual for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-12-01

    This Sampling and Analysis Plan addresses meteorological monitoring activities that will be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory, a research facility owned by the US Department of Energy and managed by Martin Marietta Energy Systems, Inc. Meteorological monitoring of various climatological parameters (e.g., temperature, wind speed, humidity) will be collected by instruments installed at WAG 6. Data will be recorded electronically at frequencies varying from 5-min intervals to 1-h intervals, dependent upon parameter. The data will be downloaded every 2 weeks, evaluated, compressed, and uploaded into a WAG 6 data base for subsequent use. The meteorological data will be used in water balance calculations in support of the WAG 6 hydrogeological model

  16. Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

    Science.gov (United States)

    Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

    2016-01-01

    Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

  17. In Vitro Comparison of the New In-Line Monitor BMU 40 versus a Conventional Laboratory Analyzer

    Science.gov (United States)

    Grosse, F. Oliver; Holzhey, David; Falk, Volkmar; Schaarschmidt, Jan; Kraemer, Klaus; Mohr, Friedrich W.

    2010-01-01

    Abstract: Reliable information about different blood parameters is essential in maintaining hemodynamics, perfusion, and gas exchange during cardiopulmonary bypass (CPB). For this purpose, a precise and continuous monitoring is needed. The objective of this in vitro study was to compare a novel continuous in-line blood parameter monitoring system versus a reference laboratory analyzer. The study was conducted as an in vitro prospective experimental study during a CPB simulation. The reliability of BMU 40 was tested in monitoring the pO2, oxygen saturation (SO2), and hematocrit (Hct) under physiological and extreme conditions with regards to temperature, oxygenation, and blood concentration. Four different tests were performed and conducted with five sensors each. Correlation analyses and Bland-Altman analyses were performed. A total of 350 measurement points were compared. All monitored values of blood parameters correlated highly with laboratory values (all r values >.90). Test 1: Biases of pO2 (act) varied from −3.24 mmHg (±6.86 mmHg) up to 6.0 mmHg (±17.89 mmHg). The biases of pO2 (37°C) ranged from −3.52 mmHg (±6.01 mmHg) up to 68.8 mmHg (±67.82 mmHg). Test 2: The biases standard deviations (SD) for Hct ranged from −0.35% (±.79%) up to 2.35% (±.91%). The biases (SD) for SO2 varied from −.45% (±.86%) up to .85% (±1.01%). Test 3: The biases (SD) of Hct ranged from −1.00% (±1.84%) up to −.67% (±1.49%). Test 4: The biases (SD) for SO2 varied from −.36% (±1.60%) up to.48% (±.90%). The BMU 40 is a reliable device in measuring the partial oxygen pressure (pO2), SO2, and Hct under normal physiological and extreme conditions with regards to temperature, oxygenation, and blood concentration in simulation of CPB. The algorithm to calculate pO2 (37°C) under hypothermic conditions needs to be adjusted. (Before the official market launch a new software version of the BMU 40 has been developed. The algorithm to calculate pO2 (37°C) under

  18. Itinerant radiometric laboratory (IRL-76)

    International Nuclear Information System (INIS)

    Dolgirev, E.I.; Domaratskij, V.P.; Kostikov, Yu.I.

    1978-01-01

    A mobile radiometric laboratory for routine radiation monitoring of the environment, personnel, and population is described. As compared to the previous models, this one incorporates a number of new features and is more informative and versatile. The design and main technical and operating characteristics of the laboratory are detailed

  19. Computer-controlled radiation monitoring system

    International Nuclear Information System (INIS)

    Homann, S.G.

    1994-01-01

    A computer-controlled radiation monitoring system was designed and installed at the Lawrence Livermore National Laboratory's Multiuser Tandem Laboratory (10 MV tandem accelerator from High Voltage Engineering Corporation). The system continuously monitors the photon and neutron radiation environment associated with the facility and automatically suspends accelerator operation if preset radiation levels are exceeded. The system has proved reliable real-time radiation monitoring over the past five years, and has been a valuable tool for maintaining personnel exposure as low as reasonably achievable

  20. Molecular characterization of van genes found in vancomycin-resistant Enterococcus spp. isolated from Hospital das Clínicas, FMUSP, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    H.H. Caiaffa Filho

    Full Text Available Vancomycin-resistant enterococci strains (VRE is an important pathogen related with hospital infections in many countries, presenting limited or no therapeutic options for treating serious infections. VRE has presented some different genotypes been VanA and VanB considered to be the most important in hospital environments. In the present study the authors investigated the prevalence of van genes (A, B an C among clinical isolates of VRE in a five month period at a large tertiary hospital in Sao Paulo, Brazil. The results showed the presence of vanA, but not vanB or vanC in all 43 strains of E. faecalis and five E. faecium studied. The results bring an important issue, due to the possibility of resistance spread of vanA genes, to be monitored and solved by the hospital infection control team and the microbiology and molecular biology laboratories at tertiary Hospitals.

  1. Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

    Science.gov (United States)

    Fulga, Netta

    2013-06-01

    Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases. Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada. The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow. The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.

  2. The ability of clinical and laboratory findings to predict in-hospital death in patients with thrombotic thrombocytopenic purpura in an internal and emergency medicine department

    Directory of Open Access Journals (Sweden)

    Filippo Pieralli

    2012-01-01

    Full Text Available Introduction: Thrombotic thrombocytopenic purpura (TTP is a rare, life-threatening syndrome characterized by microangiopathic anemia, thrombocytopenia, diffuse microvascular thrombosis, and ischemia. It is associated with very low levels of ADAMTS-13. Measurement of ADAMTS-13 levels is used for diagnostic and prognostic purposes, but in every-day clinical practice, this type of analysis is not always readily available. In this retrospective study, we evaluated prognostic value of clinical and laboratory findings in patients with TTP. Materials and methods: We retrospectively investigated patients with clinically diagnosed TTP treated in a unit of Internal and Emergency Medicine (1996-2007. Clinical and laboratory findings were collected and analyzed in order to assess their ability to predict in-hospital death. Results: Twelve patients were identified (mean age 59 + 22 years; 58% were women. Five (42% died during the hospitalization, and the variables significantly associated with this outcome were: a delay between diagnosis and symptom onset (HR 1.36; 95% CI 1.04-1.78; p < 0.05; a higher severity score (HR 1.48; 95%CI 1,23-3.86; p < 0.05; hemodynamic instability with hypotension and/or shock (HR 3.35; 95%CI 3.02-9.26; p < 0.01; a higher schistocyte count on blood smear (HR 1.84; 95%CI 1.04-3.27; p < 0.05; and higher lactate values (HR 1.85; 95%CI 1.08- 3.16; p < 0.05. Conclusions: TTP is a rare and potentially fatal disease with protean manifestations. Delayed diagnosis after symptom onset is a major determinant of poor outcome. Hypotension and shock are also prognostically unfavourable. Laboratory evidence of cardiocirculatory compromise (i.e., elevated lactate levels and extension of the disease process (i.e., schistocyte count > 3 are predictive of in-hospital death, independently of the hemodynamic profile on admission.

  3. Clinical laboratory as an economic model for business performance analysis.

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovecki, Mladen

    2011-08-15

    To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal

  4. Extra-analytical quality indicators and laboratory performances.

    Science.gov (United States)

    Sciacovelli, Laura; Aita, Ada; Plebani, Mario

    2017-07-01

    In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

  5. Radiation exposure of non-monitored hospital personnel

    International Nuclear Information System (INIS)

    Renaud, L.; Blanchette, J.; Galand, C.

    1993-02-01

    This addendum to report INFO--0437-1 reports the raw results of phase 2 of the survey of medical personnel exposed to nuclear medicine patients. It also presents floor plans of the three hospitals surveyed. (L.L.) (42 tabs., 36 figs.)

  6. International remote monitoring project Argentina Nuclear Power Station Spent Fuel Transfer Remote Monitoring System

    International Nuclear Information System (INIS)

    Schneider, S.; Lucero, R.; Glidewell, D.

    1997-01-01

    The Autoridad Regulataria Nuclear (ARN) and the United States Department of Energy (DOE) are cooperating on the development of a Remote Monitoring System for nuclear nonproliferation efforts. A Remote Monitoring System for spent fuel transfer will be installed at the Argentina Nuclear Power Station in Embalse, Argentina. The system has been designed by Sandia National Laboratories (SNL), with Los Alamos National Laboratory (LANL) and Oak Ridge National Laboratory (ORNL) providing gamma and neutron sensors. This project will test and evaluate the fundamental design and implementation of the Remote Monitoring System in its application to regional and international safeguards efficiency. This paper provides a description of the monitoring system and its functions. The Remote Monitoring System consists of gamma and neutron radiation sensors, RF systems, and video systems integrated into a coherent functioning whole. All sensor data communicate over an Echelon LonWorks Network to a single data logger. The Neumann DCM 14 video module is integrated into the Remote Monitoring System. All sensor and image data are stored on a Data Acquisition System (DAS) and archived and reviewed on a Data and Image Review Station (DIRS). Conventional phone lines are used as the telecommunications link to transmit on-site collected data and images to remote locations. The data and images are authenticated before transmission. Data review stations will be installed at ARN in Buenos Aires, Argentina, ABACC in Rio De Janeiro, IAEA Headquarters in Vienna, and Sandia National Laboratories in Albuquerque, New Mexico. 2 refs., 2 figs

  7. Monitoring of atmospheric contamination by plutonium in laboratories

    International Nuclear Information System (INIS)

    Pomarola, J.; Risselin, A.; Feliers, P.

    1965-02-01

    Immediate detection of atmospheric contamination by plutonium is necessary for warning of operators. A precise estimate of the level of this contamination is also necessary in order to give the Medical Section proper information. Experiments have been carried out at CEN-FAR using atmospheric contamination by plutonium monitors. This paper deals successively with: important problems of monitoring, the carrying out of the experiments and the results yielded. (authors) [fr

  8. A professional development model for medical laboratory scientists working in the microbiology laboratory.

    Science.gov (United States)

    Amerson, Megan H; Pulido, Lila; Garza, Melinda N; Ali, Faheem A; Greenhill, Brandy; Einspahr, Christopher L; Yarsa, Joseph; Sood, Pramilla K; Hu, Peter C

    2012-01-01

    The University of Texas M.D. Anderson Cancer Center, Division of Pathology and Laboratory Medicine is committed to providing the best pathology and medicine through: state-of-the art techniques, progressive ground-breaking research, education and training for the clinical diagnosis and research of cancer and related diseases. After surveying the laboratory staff and other hospital professionals, the Department administrators and Human Resource generalists developed a professional development model for Microbiology to support laboratory skills, behavior, certification, and continual education within its staff. This model sets high standards for the laboratory professionals to allow the labs to work at their fullest potential; it provides organization to training technologists based on complete laboratory needs instead of training technologists in individual areas in which more training is required if the laboratory needs them to work in other areas. This model is a working example for all microbiology based laboratories who want to set high standards and want their staff to be acknowledged for demonstrated excellence and professional development in the laboratory. The PDM model is designed to focus on the needs of the laboratory as well as the laboratory professionals.

  9. [Trend survey of ocular infections with bacteria at Toyama University Hospital over the past six years--from the standpoint of laboratory examination].

    Science.gov (United States)

    Kubota, Tomomi; Hayashi, Shirou; Niimi, Hideki; Kitajima, Isao

    2012-07-01

    Specimens of bacterial ocular infections are frequently received in the clinical laboratory. However, a comprehensive trend survey of ocular infections with bacteria is very rare. Our objective is to understand the current tendency of ocular infections with bacteria in patients at Toyama University Hospital from the standpoint of laboratory examination. We studied 263 cases of ocular infection with bacteria diagnosed at Toyama University Hospital from January 2006 to December 2011. 123 were male and 140 were female, with a mean age of 61.2(0-98) years. Specimens were subjected to direct microscopy and culture. Cultures were positive in 174(66.2%) patients. The most common bacterial isolate was Staphylococcus (28.1%), followed by Corynebacterium (19.3%), Streptococcus (9.3%), and Propionibacterium (8.6%). MRSA accounted for 18.8% of all S. aureus isolates, and has increased in recent years. The number of bacteria detected was larger in March, June, July, August, and October. Age distribution indicated that around 70% of bacterial isolates were detected from patients over 60 years old. The most common specimen of ocular infections with bacteria was eye discharge (detection rate; 87.8%), followed by corneal scraping(41%), aqueous humor (19%), and vitreous body (27%). Nearly 80% of bacterial isolates were detected from patients with keratitis, endophthalmitis, dacryocystitis, and conjunctivitis. As for the disease specific detection rate, endophthalmitis was very low (38.3%). The detection rate by years indicated that the way doctors pick up the specimens greatly affects the detection rate. Based on this survey, we need close cooperation with medical doctors concerning laboratory examination in ocular infection with bacteria, and we must improve the detection sensitivity of specimens from patients with endophthalmitis.

  10. Monitoring of doses to patients in interventional cardiology: first results from three Serbian hospitals

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Arandjic, Danijela; Kosutic, Dushko

    2010-01-01

    The aim of this work is to assess level of radiation dose to patients in interventional cardiology procedures in three large Serbian hospitals and to investigate possibility for setting of trigger levels if dose quantities exceed certain levels. Three dedicated interventional cardiology laboratories were included in the survey. Information on annual workload was estimated based on number of coronary angiography (CA) procedures and percutaneous coronary interventions (PCI). Patients doses were assessed in terms of air kerma area product (PKA) and air kerma in international reference point (KIRP). Results were compared with internationally proposed Diagnostic Reference Levels (DRL) and similar surveys results. Average total annual number of procedures was 820, 1100 and 2500 in three hospitals, respectively, while total number of dose measurements was 337. All three centers reported PKA values higher than 100 Gy·cm 2 and even values above 200 Gy·cm 2 , corresponding to 42% and 16% of all measurements. Measured KIRP value higher than 5 Gy was reported in one center, indicating that skin doses associated possibility of skin injuries were observed. PKA mean hospital values for CA ranged from 33 to 78 Gy·cm 2 and for PCI from 73 to 113 Gy·cm 2 , while associated vales for KIRP were: 0.45-1.2 Gy and 1.1-1.8 Gy, respectively. Comparison of obtained results with international DRL indicated that significant number of procedures is not optimally performed as in some centers more than a half of patients receive doses above DRL. The presented results are valuable input for dose optimization strategies and increased awareness related to importance of dose management. With respect to high dose values, risk for stochastic effects and tissue reactions, dose management methods were proposed. (Author)

  11. Current use of equations for estimating glomerular filtration rate in Spanish laboratories.

    Science.gov (United States)

    Gràcia-Garcia, Sílvia; Montañés-Bermúdez, Rosario; Morales-García, Luis J; Díez-de Los Ríos, M José; Jiménez-García, Juan Á; Macías-Blanco, Carlos; Martínez-López, Rosalina; Ruiz-Altarejos, Joaquín; Ruiz-Martín, Guadalupe; Sanz-Hernández, Sonia; Ventura-Pedret, Salvador

    2012-07-17

    In 2006 the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) and the Spanish Society of Nephrology (S.E.N.) developed a consensus document in order to facilitate the diagnosis and monitoring of chronic kidney disease with the incorporation of equations for estimating glomerular filtration rate (eGFR) into laboratory reports. The current national prevalence of eGFR reporting and the degree of adherence to these recommendations among clinical laboratories is unknown. We administered a national survey in 2010-11 to Spanish clinical laboratories. The survey was through e-mail or telephone to laboratories that participated in the SEQC’s Programme for External Quality Assurance, included in the National Hospitals Catalogue 2010, including both primary care and private laboratories. A total of 281 laboratories answered to the survey. Of these, 88.2% reported on the eGFR, with 61.9% reporting on the MDRD equation and 31.6% using the MDRD-IDMS equation. A total of 42.5% of laboratories always reported serum creatinine values, and other variables only when specifically requested. Regarding the way results were presented, 46.2% of laboratories reported the exact numerical value only when the filtration rate was below 60mL/min/1.73m2, while 50.6% reported all values regardless. In 56.3% of the cases reporting eGFR, an interpretive commentary of it was enclosed. Although a high percentage of Spanish laboratories have added eGFR in their reports, this metric is not universally used. Moreover, some aspects, such as the equation used and the correct expression of eGFR results, should be improved.

  12. Towards Robot-Assisted Echocardiographic Monitoring in Catheterization Laboratories : Usability-Centered Manipulator for Transesophageal Echocardiography.

    Science.gov (United States)

    Pahl, Christina; Ebelt, Henning; Sayahkarajy, Mostafa; Supriyanto, Eko; Soesanto, Amiliana

    2017-08-15

    This paper proposes a robotic Transesophageal Echocardiography (TOE) system concept for Catheterization Laboratories. Cardiovascular disease causes one third of all global mortality. TOE is utilized to assess cardiovascular structures and monitor cardiac function during diagnostic procedures and catheter-based structural interventions. However, the operation of TOE underlies various conditions that may cause a negative impact on performance, the health of the cardiac sonographer and patient safety. These factors have been conflated and evince the potential of robot-assisted TOE. Hence, a careful integration of clinical experience and Systems Engineering methods was used to develop a concept and physical model for TOE manipulation. The motion of different actuators of the fabricated motorized system has been tested. It is concluded that the developed medical system, counteracting conflated disadvantages, represents a progressive approach for cardiac healthcare.

  13. Brookhaven National Laboratory environmental monitoring plan for Calendar Year 1996

    Energy Technology Data Exchange (ETDEWEB)

    Naidu, J.R.; Paquette, D.; Lee, R. [and others

    1996-10-01

    As required by DOE Order 5400.1, each U.S. Department of Energy (DOE) site, facility, or activity that uses, generates, releases, or manages significant quantities of hazardous materials shall provide a written Environmental Monitoring Plan (EMP) covering effluent monitoring and environmental surveillance. DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance, provides specific guidance regarding environmental monitoring activities.

  14. Brookhaven National Laboratory environmental monitoring plan for Calendar Year 1996

    International Nuclear Information System (INIS)

    Naidu, J.R.; Paquette, D.; Lee, R.

    1996-01-01

    As required by DOE Order 5400.1, each U.S. Department of Energy (DOE) site, facility, or activity that uses, generates, releases, or manages significant quantities of hazardous materials shall provide a written Environmental Monitoring Plan (EMP) covering effluent monitoring and environmental surveillance. DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance, provides specific guidance regarding environmental monitoring activities

  15. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    Adequately equipped clinical laboratories should provide early warning signals of health risks. The Assessment categorized the laboratories at three levels relating to the type of facility, these being hospital, health center and health post. This study used results from the SARA to determine the ability to make timely diagnosis ...

  16. U.S. Ebola Treatment Center Clinical Laboratory Support.

    Science.gov (United States)

    Jelden, Katelyn C; Iwen, Peter C; Herstein, Jocelyn J; Biddinger, Paul D; Kraft, Colleen S; Saiman, Lisa; Smith, Philip W; Hewlett, Angela L; Gibbs, Shawn G; Lowe, John J

    2016-04-01

    Fifty-five hospitals in the United States have been designated Ebola treatment centers (ETCs) by their state and local health authorities. Designated ETCs must have appropriate plans to manage a patient with confirmed Ebola virus disease (EVD) for the full duration of illness and must have these plans assessed through a CDC site visit conducted by an interdisciplinary team of subject matter experts. This study determined the clinical laboratory capabilities of these ETCs. ETCs were electronically surveyed on clinical laboratory characteristics. Survey responses were returned from 47 ETCs (85%). Forty-one (87%) of the ETCs planned to provide some laboratory support (e.g., point-of-care [POC] testing) within the room of the isolated patient. Forty-four (94%) ETCs indicated that their hospital would also provide clinical laboratory support for patient care. Twenty-two (50%) of these ETC clinical laboratories had biosafety level 3 (BSL-3) containment. Of all respondents, 34 (72%) were supported by their jurisdictional public health laboratory (PHL), all of which had available BSL-3 laboratories. Overall, 40 of 44 (91%) ETCs reported BSL-3 laboratory support via their clinical laboratory and/or PHL. This survey provided a snapshot of the laboratory support for designated U.S. ETCs. ETCs have approached high-level isolation critical care with laboratory support in close proximity to the patient room and by distributing laboratory support among laboratory resources. Experts might review safety considerations for these laboratory testing/diagnostic activities that are novel in the context of biocontainment care. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  17. Performance Indicators For Quality In Surgical And Laboratory ...

    African Journals Online (AJOL)

    Methodology: Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. Results: In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 ...

  18. Facility effluent monitoring plan for the 327 Facility

    International Nuclear Information System (INIS)

    1994-11-01

    The 327 Facility [Post-Irradiation Testing Laboratory] provides office and laboratory space for Pacific Northwest Laboratory (PNL) scientific and engineering staff conducting multidisciplinary research in the areas of post-irradiated fuels and structural materials. The facility is designed to accommodate the use of radioactive and hazardous materials in the conduct of these activities. This report summarizes the airborne emissions and liquid effluents and the results of the Facility Effluent Monitoring Plan (FEMP) determination for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements

  19. Radiation protection calibration facilities at the National Radiation Laboratory, New Zealand

    International Nuclear Information System (INIS)

    Foote, B.J.

    1995-01-01

    The National Radiation Laboratory (NRL), serving under the Ministry of Health, provides radiation protection services to the whole of New Zealand. Consequently it performs many functions that are otherwise spread amongst several organizations in larger countries. It is the national regulatory body for radiation protection. It writes and enforces codes of safe practice, and conducts safety inspections of all workplaces using radiation. It provides a personal monitoring service for radiation workers. It also maintains the national primary standards for x-ray exposure and 60 Co air kerma. These standards are transferred to hospitals through a calibration service. The purpose of this report is to outline the primary standards facilities at NRL, and to discuss the calibration of dosemeters using these facilities. (J.P.N.)

  20. Development and Monitoring the Key Performance Indicators of the Quality of Care for Patients with Cleft Lips/Palates at Srinagarind Hospital.

    Science.gov (United States)

    Mongkhonthawornchai, Siriporn; Pradubwong, Suteera; Augsornwan, Darawan; Pathumwiwatana, Pornpen; Sroyhin, Waranya; Pongpagatip, Sumalee; Wongkham, Jamras; Wachirapakorn, Jantira; Lao-unka, Kesorn; Mucnamporn, Tippawan; Chowchuen, Bowornsilp

    2015-08-01

    Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incidences in the Northeast of Thailand. These birth defects can affect patient's quality of life. CLP patients need crucial and long-term treatments by a multidisciplinary team starting from prenatal stage to late adulthood. Patients and their families should involve in their own care, and their care objectives should correspond with healthcare providers. Besides the clinical outcome of interdisciplinary team, key performance indicators (KPIs) need to be developed in the hospital service unit in order to improve quality of care and treatment outcomes. 1) to establish KPIs in hospital service units, and 2) to develop the information system to collect, analysis and improve the quality of CLP care. A nurse coordinator was appointed in the Tawanchai Center to coordinate care. The three periods were conducted for the nurse coordinator to work with nine service units in Srinagarind Hospital for consensus on both qualitative and quantitative data to be used as service unit quality measurement. Thirty one KPIs from nine service units were established, collected and analyzed during a four-month period in 2014. The 20 KPIs achieved the unit targets. Two PKIs of the rates of complication with anesthesia during/after surgery in the first 24 hours and the rates of patient/caregiver's satisfaction in acquiring information from the officer were improving. There were 11 KPIs that did not achieve the targets. The coordinator nurse of the Tawanchai Center discussed with the service unit for the cause and how to improve the outcome. The monitoring KPIs will lead to improvement of outcome for better patient quality as well as benchmarking with other hospitals of Cleft Center. The KPIs from hospital service units with the monitoring and analysis of information by the nurse coordinator will enhance and lead to improvement of the quality of the patients and family centered care process.

  1. Total laboratory automation: Do stat tests still matter?

    Science.gov (United States)

    Dolci, Alberto; Giavarina, Davide; Pasqualetti, Sara; Szőke, Dominika; Panteghini, Mauro

    2017-07-01

    During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions. In this laboratory department model, the short TAT for all first-line tests performed by TLA in the core laboratory represents the key paradigm, where no more stat testing is required because all samples are handled in real-time and (auto)validated results dispatched in a time that fulfills clinical needs. To optimally reach this goal, laboratories should be actively involved in managing all the steps covering the total examination process, speeding up also extra-laboratory phases, such sample delivery. Furthermore, to warrant effectiveness and not only efficiency, all the processes, e.g. specimen integrity check, should be managed by middleware through a predefined set of rules defined in light of the clinical governance. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  2. Quality in laboratory medicine: 50years on.

    Science.gov (United States)

    Plebani, Mario

    2017-02-01

    The last 50years have seen substantial changes in the landscape of laboratory medicine: its role in modern medicine is in evolution and the quality of laboratory services is changing. The need to control and improve quality in clinical laboratories has grown hand in hand with the growth in technological developments leading to an impressive reduction of analytical errors over time. An essential cause of this impressive improvement has been the introduction and monitoring of quality indicators (QIs) such as the analytical performance specifications (in particular bias and imprecision) based on well-established goals. The evolving landscape of quality and errors in clinical laboratories moved first from analytical errors to all errors performed within the laboratory walls, subsequently to errors in laboratory medicine (including errors in test requesting and result interpretation), and finally, to a focus on errors more frequently associated with adverse events (laboratory-associated errors). After decades in which clinical laboratories have focused on monitoring and improving internal indicators of analytical quality, efficiency and productivity, it is time to shift toward indicators of total quality, clinical effectiveness and patient outcomes. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Electromedical devices test laboratories accreditation

    International Nuclear Information System (INIS)

    Murad, C; Rubio, D; Ponce, S; Alvarez Abri, A; Terron, A; Vicencio, D; Fascioli, E

    2007-01-01

    In the last years, the technology and equipment at hospitals have been increase in a great way as the risks of their implementation. Safety in medical equipment must be considered an important issue to protect patients and their users. For this reason, test and calibrations laboratories must verify the correct performance of this kind of devices under national and international standards. Is an essential mission for laboratories to develop their measurement activities taking into account a quality management system. In this article, we intend to transmit our experience working to achieve an accredited Test Laboratories for medical devices in National technological University

  4. Data Report for Monitoring at Six West Virginia Marcellus Shale Development Sites using NETL’s Mobile Air Monitoring Laboratory (July–November 2012)

    Energy Technology Data Exchange (ETDEWEB)

    Pekney, Natalie J. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Reeder, Matthew [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Indiana Univ., Bloomington, IN (United Stat; Veloski, Garret A. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Diehl, J. Rodney [Indiana Univ., Bloomington, IN (United States)

    2016-06-16

    The West Virginia Department of Environmental Protection’s Office of Oil and Gas was directed according to the Natural Gas Horizontal Well Control Act of December 14, 2011 (West Virginia Code §22-6A) to conduct studies of horizontal well drilling activities related to air quality. The planned study, “Noise, Light, Dust, Volatile Organic Compounds Related to Well Location Restrictions,” required determination of the effectiveness of a 625 ft minimum set-back from the center of the pad of a horizontal well drilling site to the nearest occupied dwelling. An investigation was conducted at seven drilling sites by West Virginia University (WVU) and the National Energy Technology Laboratory (NETL) to collect data on dust, hydrocarbon compounds and on noise, radiation, and light levels. NETL’s role in this study was to collect measurements of ambient pollutant concentrations at six of the seven selected sites using NETL’s Mobile Air Monitoring Laboratory. The trailer-based laboratory was situated a distance of 492–1,312 ft from each well pad, on which activities included well pad construction, vertical drilling, horizontal drilling, hydraulic fracturing, and flaring, with the objective of evaluating the air quality impact of each activity for 1–4 weeks per site. Measured pollutants included volatile organic compounds (VOCs), coarse and fine particulate matter (PM10 and PM2.5, respectively), ozone, methane (CH4), carbon dioxide (CO2), carbon isotopes of CH4 and CO2, organic carbon (OC), elemental carbon (EC), oxides of nitrogen (NOx), and sulfur dioxide (SO2).

  5. Autoclaving practice in microbiology laboratories: report of a survey. The Public Health Laboratory Service Subcommittee on laboratory autoclaves.

    Science.gov (United States)

    1978-01-01

    The performance of autoclaves in 27 laboratories, operated in accordance with the normal routine of local practice, has been monitored using thermometric equipment. Sterilising performance was unsatisfactory on 10 of 62 occasions, and cooling was inadequate on 52 of 60 occasions. PMID:649767

  6. The LLNL Multiuser Tandem Laboratory computer-controlled radiation monitoring system

    International Nuclear Information System (INIS)

    Homann, S.G.

    1992-01-01

    The Physics Department of the Lawrence Livermore National Laboratory (LLNL) recently constructed a Multiuser Tandem Laboratory (MTL) to perform a variety of basic and applied measurement programs. The laboratory and its research equipment were constructed with support from a consortium of LLNL Divisions, Sandia National Laboratories Livermore, and the University of California. Primary design goals for the facility were inexpensive construction and operation, high beam quality at a large number of experimental stations, and versatility in adapting to new experimental needs. To accomplish these goals, our main design decisions were to place the accelerator in an unshielded structure, to make use of reconfigured cyclotrons as effective switching magnets, and to rely on computer control systems for both radiological protection and highly reproducible and well-characterized accelerator operation. This paper addresses the radiological control computer system

  7. Evaluation of Cases Consulted to Forensic Toxicology Laboratory between 2008 and 2012

    Directory of Open Access Journals (Sweden)

    Ismail Ethem Goren

    2013-08-01

    Full Text Available Purpose: In this study, we aimed to determine annual and seasonal distribution of cases and affecting factors of the distribution in Cukurova University Hospital, Forensic Toxicology Laboratory. Method: Five-year (up to 2012 from 2008 archives of cases consulted to our forensic toxicology laboratory was investigated and classified according to gender, situation of case, type of poisoning, seasonal distribution, findings were statistically evaluated by SPSS v20.0 software Results: After screening five-year archives using laboratory registration book, we determined that of 608 cases 49.5 % were from emergency medicine, 19.6 % from pediatric, 7.4 % from psychiatry, 4.4 % 4.4 from neurology, 2.3 % from other units of the hospital, 7.9 % from judicial authorities, 4.8 % from special requests and 6.1 % from circumjacent hospitals. 57.9 % of the cases are male and 42.1 % are female. 87.3 % of 608 cases were clinical cases, 7.9 % were forensic cases, 4.8 % special requests. 95.8 % of judicial cases were male and 85.4 % were drugs of abuse cases. 28.1 % of clinical cases were the carbon monoxide poisoning and 64.3 % of the carbon monoxide poisoning cases were female. Conclusion: When five-year data were evaluated, we determine that numbers of case are increasing every year. Males are more than in females. Forensic cases which were mostly drugs of abuse were most commonly have seen in male. When our data were investigated together with TUBIM’s data belong to 2009, 2010, 2011 and 2012 (Turkey Monitoring Centre for Drugs and Drugs Addiction, the use of drug abuse were seen most commonly in male. Also carbon monoxide poisoning in clinical cases were evaluated and we see that Carbon monoxide intoxication in winter was more than in summer due to heating. Women who exposed to carbon monoxide were more than men to be much more at home according to men. [Cukurova Med J 2013; 38(4.000: 675-680

  8. Phlebotomy skills expected of career entry CLS/CLT graduates: a Missouri hospital perspective.

    Science.gov (United States)

    Millstead, C

    2000-01-01

    To determine how much, what type, and what proficiency of phlebotomy experience CLS/CLT students should have during the training program to be prepared to meet the needs of the majority of Missouri hospital employers. Survey to determine the role healthcare professionals, inside and outside the laboratory, play in today's blood collection patterns and phlebotomy management. The Missouri Organization of Clinical Laboratory Science mailed 204 surveys to the Missouri Hospital Association member laboratories. MAIN OUTCOMES/CONCLUSIONS: This research examined the need for modifying phlebotomy skills of clinical laboratory science students. Data gathered from employers support the premise that entry-level competencies of CLS/CLT graduates will vary according to clinical facility size. CLS/CLT programs may use data from this study to plan phlebotomy practicums. It can be extrapolated that Missouri employers who are most likely to employ career entry graduates expect them to draw blood from 9.3 patients within one hour. Fifty-three percent of 40 to 400 bed hospitals expect graduates to perform difficult draws in at least eight types of hospital units. Laboratories are the major managers of hospital wide phlebotomy services; thus, CLS/CLT curricula should include phlebotomy management methods.

  9. GAAT dry well conductivity monitoring report, July 1997 through January 1998, Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1998-01-01

    A waste removal program is being implemented for the Gunite and Associated Tanks (GAAT) Operable Unit at Oak Ridge National Laboratory (ORNL), Oak Ridge, Tennessee. The waste is being removed by means of remotely operated, in-tank, confined sluicing equipment. The waste removal operations in Tanks W-3 and W-4 in the North Tank Farm (NTF) have been completed and the equipment is being moved to the South Tank Farm (STF), where it will be used to remove the sludges from the six STF tanks (W-5, W-6, W-7, W-8, W-9, and W-10) beginning later this year. During sluicing operations the dry wells adjacent to each of the tanks are instrumented so that potential releases can be detected by means external to the tank. The method of detection is by monitoring the electrical conductivity of the water in the dry well associated with each tank. This report documents the dry well conductivity monitoring data for the period from July 1997 through January 1998. The dry wells monitored during this period include DW-3, DW-4, DW-8, DW-9, and DW-10. The conductivity of the water passing through Pump Station 1 (PS 1) was also monitored. The principal activities that occurred during this period were the sluicing of Tanks W-3 and W-4 in the NTF, transfer of tank liquids from the NTF to the STF, and the installation of new risers, tank dome leveling, and emplacement of stabilized base backfill in the STF. Presented in this report are the dry well conductivity, rainfall, tank level, and STF construction information that is relevant to the analysis and interpretation of the monitoring data for the reporting period. A thorough analysis of the monitoring results for the period indicates that no releases have occurred from the gunite tanks being monitored

  10. Clinical Laboratory Data Management: A Distributed Data Processing Solution

    OpenAIRE

    Levin, Martin; Morgner, Raymond; Packer, Bernice

    1980-01-01

    Two turn-key systems, one for patient registration and the other for the clinical laboratory have been installed and linked together at the Hospital of the University of Pennsylvania, forming the nucleus of an evolving distributed Hospital Information System.

  11. The Effect of Interactive Web-Based Monitoring on Breastfeeding Exclusivity, Intensity, and Duration in Healthy, Term Infants After Hospital Discharge.

    Science.gov (United States)

    Ahmed, Azza H; Roumani, Ali M; Szucs, Kinga; Zhang, Lingsong; King, Demetra

    2016-01-01

    To determine whether a Web-based interactive breastfeeding monitoring system increased breastfeeding duration, exclusivity, and intensity as primary outcomes and decreased symptoms of postpartum depression as a secondary outcome. Two-arm, randomized controlled trial. Three hospitals in the Midwestern United States. One hundred forty one (141) mother-newborn dyads were recruited before discharge. Postpartum women were randomly assigned to the control or intervention groups. Women in the control group (n = 57) followed the standard hospital protocol, whereas women in the intervention group (n = 49) were given access to an online interactive breastfeeding monitoring system and were prompted to record breastfeeding and infant output data for 30 days. A follow-up online survey was sent to both groups at 1, 2, and 3 months to assess breastfeeding outcomes and postpartum depression. For mothers and infants, there were no significant differences in demographics between groups. No significant differences in breastfeeding outcomes were found between groups at discharge (p = .707). A significant difference in breastfeeding outcomes was found between groups at 1, 2, and 3 months (p = .027, p 3.0 ± 3.4, and 2.8 ± 3.6, respectively). However, there was no significant difference between groups at 1, 2, and 3 months (p = .389, .170, and .920, respectively) for depression. The Web-based interactive breastfeeding monitoring system may be a promising intervention to improve breastfeeding duration, exclusivity, and intensity. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  12. Clinical and laboratory characteristics and associated risk factors of infants hospitalized in neonatal unit due to indirect hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Sami Hatipoğlu

    2012-03-01

    Full Text Available Objectives: The aim of this study was to investigate characteristicsof neonates hospitalized to Neonatal Unit dueto indirect hyperbilirubinemia and to determine risk factorsfor indirect hyperbilirubinemia.Materials and methods: Totally 222 newborns, aged≥35 weeks of gestational age and hospitalized in neonatalunit with indirect hyperbilirubinemia, were investigated.Physical examination and laboratory studies of childrenwere performed. Decision of phototherapy and exchangetransfusion was done according to total serum bilirubin(TSB level that notified in the Guidelines of AmericanAcademy of Pediatrics.Results: Study group consisted of 131 (60% male and91 (30% female newborns. No significant difference wasfound in TSB values between male and female neonates.There was 71.2% term and 19.8% late preterm newbornbabies. Babies born with spontaneous vaginal deliveryhad borderline higher TSB values compared with cesareansection deliveries (p=0.051. ABO blood group incompatibilitywas found in 30.1% and Rh incompatibilityin 6.7%. Insufficient nutrition and inadequate caloric intakewere found in 49 (22.7% of neonates, urinary tractinfection in 19 (8.5%, hypernatremic dehydration in 9(4.5% and hypothyroidism in 4 (2.0%. Exchange transfusionwas performed in 10 newborns and kernicterus occurredin two. A significant negative correlation was foundbetween TSB values at hospitalization and baby’s birth(p<0.05 and a positive correlation between initial TSBvalue and percent of patient weight loss (p<0.05.Conclusions: According to our results, the most frequentetiological causes of jaundice in newborns were ABOblood group incompatibility, insufficient nutrition and beinglate preterm. J Clin Exp Invest 2012; 3(1: 38-43

  13. Increased patient delays in care after the closure of Martin Luther King Hospital: implications for monitoring health system changes.

    Science.gov (United States)

    Walker, Kara Odom; Leng, Mei; Liang, Li-Jung; Forge, Nell; Morales, Leo; Jones, Loretta; Brown, Arleen

    2011-01-01

    The safety net system remains an important part of the health care system for uninsured and minority populations, however, the closure of safety net hospitals changes the availability of care. Using community-based participatory research methods, we explored the impact of hospital closure among late middle aged and elderly racial/ethnic minorities in South Los Angeles. Telephone survey of participants in both 2008, after hospital closure, and 2003, before hospital closure, who self-identified as African American or Latino, were over the age of 50 and lived in zip codes of South Los Angeles. We developed multiple logistic regression models on imputed data sets weighted for non-response and adjusted for self-reported measures of demographic and clinical characteristics to examine the odds of reporting delays in care. After adjusting for covariates known to influence access to care and distributed differently in the two survey samples, we found significantly greater delays in care. Following the closure of the Martin Luther King, Jr. safety net hospital, the adjusted odds ratios were 1.70 (95% CI 1.01, 2.87) for delays in care, 1.88 (95% Cl 1.06, 3.13) for problems receiving needed medical care, and 2.62 (95% CI 1.46, 4.67) for seeing a specialist. Our survey of older minority adults in South Los Angeles found increased delays in access to care for needed medical services after the closure of Martin Luther King, Jr. Hospital. As health care reform unfolds, monitoring for changes in access to care that may result from new policies will be important to address future disparities, particularly for vulnerable populations.

  14. Laboratory studies and Pompe disease: from suspicion to therapy monitoring

    Directory of Open Access Journals (Sweden)

    K. V. Savost’yanov

    2016-01-01

    Full Text Available Pompe disease (PD is a rare, progressive, commonly fatal inherited autosomal recessive disease that is difficult to diagnose due to its obvious clinical heterogeneity and low awareness among physicians. Access to the laboratory diagnosis of rare diseases increases every year. In the past several years, Russian and foreign laboratories have achieved considerable success in accelerating and improving the diagnostic accuracy of PD. Unfortunately, the Russian-language literature contains scarce relevant information on the laboratory diagnosis of PD. This review is to fill up this gap. 

  15. A novel system to tackle hospital acquired pressure ulcers.

    Science.gov (United States)

    Renganathan, B S; Preejith, S P; Nagaiyan, Sridhar; Joseph, Jayaraj; Sivaprakasam, Mohanasankar

    2016-08-01

    Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols. Difficulty in monitoring patient position continuously, lack of turn reminders/alerts and suboptimal caregiver staffing ratio increases the occurrence of HAPUs. A novel method to address the need for improved pressure ulcer prevention is presented. The proposed method consists of a wearable device which continuously monitors the patient's position and communicates wirelessly with a tablet which enables alerts to be sent to the caregiver when a patient turn is due in accordance with the protocol adopted by the hospital. The patient's position is continuously monitored and the turning procedure carried out is logged and updated on the hospital's cloud system, thereby enabling centralized monitoring. Under a controlled setting, system was able to continuously monitor patient's position and can accurately detect standard patient positions.

  16. Multilevel groundwater monitoring of hydraulic head and temperature in the eastern Snake River Plain aquifer, Idaho National Laboratory, Idaho, 2009–10

    Science.gov (United States)

    Twining, Brian V.; Fisher, Jason C.

    2012-01-01

    During 2009 and 2010, the U.S. Geological Survey’s Idaho National Laboratory Project Office, in cooperation with the U.S. Department of Energy, collected quarterly, depth-discrete measurements of fluid pressure and temperature in nine boreholes located in the eastern Snake River Plain aquifer. Each borehole was instrumented with a multilevel monitoring system consisting of a series of valved measurement ports, packer bladders, casing segments, and couplers. Multilevel monitoring at the Idaho National Laboratory has been ongoing since 2006. This report summarizes data collected from three multilevel monitoring wells installed during 2009 and 2010 and presents updates to six multilevel monitoring wells. Hydraulic heads (heads) and groundwater temperatures were monitored from 9 multilevel monitoring wells, including 120 hydraulically isolated depth intervals from 448.0 to 1,377.6 feet below land surface. Quarterly head and temperature profiles reveal unique patterns for vertical examination of the aquifer’s complex basalt and sediment stratigraphy, proximity to aquifer recharge and discharge, and groundwater flow. These features contribute to some of the localized variability even though the general profile shape remained consistent over the period of record. Major inflections in the head profiles almost always coincided with low-permeability sediment layers and occasionally thick sequences of dense basalt. However, the presence of a sediment layer or dense basalt layer was insufficient for identifying the location of a major head change within a borehole without knowing the true areal extent and relative transmissivity of the lithologic unit. Temperature profiles for boreholes completed within the Big Lost Trough indicate linear conductive trends; whereas, temperature profiles for boreholes completed within the axial volcanic high indicate mostly convective heat transfer resulting from the vertical movement of groundwater. Additionally, temperature profiles

  17. [Nutritional status recording in hospitalized patient notes].

    Science.gov (United States)

    Matos, L; Teixeira, M A; Henriques, A; Tavares, M M; Alvares, L; Antunes, A; Amaral, Teresa F

    2007-01-01

    The prevalence of disease-related malnutrition (DRM) is described to be of 30-60% on admission to hospital, and of 10% in the community. It has been associated with worse clinical outcomes, namely higher morbidity and mortality as well as higher frequency of health care and its associated costs. The lack of screening and monitoring of nutritional status have been said to be risk factors for the increased prevalence of DRM during hospital stay. The aims of this study were to evaluate the importance given by health care professionals to certain aspects related with nutritional status (weight, food intake) of hospital patients and to see if there were any differences between the under and non undernourished ones. A systematic sample of patients from six hospitals was collected. Pregnancy, paediatric age and critical illness were exclusion criteria as well as incapacity to fulfil nutritional risk screening protocol and length-of-stay less than 24h. Socio-demographic, anthropometric data and clinical notes (e.g. weight, food/nutrient intake) from medical records were collected and Nutritional Risk Screening 2002 protocol was applied. A total of 1152 patients were included in this study. The prevalence of nutritional risk varied between 28.5% and 47.3% while undernutrition classified by anthropometrical parameters was considerably lower (6.3% to 14.9%). Two thirds of the patients had their food intake monitored and registered in medical records but only one third were weighted. Undernourished patients had their food intake more frequently monitored but their weight was less frequently measured, than the well-nourished ones. DRM prevalence amongst hospital patients on admission is significantly high. Clinical notes regarding nutritional status is rather infrequent on medical records. This study showed that urges the need to empower health care providers of the importance of the screening and monitoring of weight and food intake, on admission and during hospital stay.

  18. Hospital Adoption of Health Information Technology to Support Public Health Infrastructure.

    Science.gov (United States)

    Walker, Daniel M; Diana, Mark L

    2016-01-01

    Health information technology (IT) has the potential to improve the nation's public health infrastructure. In support of this belief, meaningful use incentives include criteria for hospitals to electronically report to immunization registries, as well as to public health agencies for reportable laboratory results and syndromic surveillance. Electronic reporting can facilitate faster and more appropriate public health response. However, it remains unclear the extent that hospitals have adopted IT for public health efforts. To examine hospital adoption of IT for public health and to compare hospitals capable of using and not using public health IT. Cross-sectional design with data from the 2012 American Hospital Association annual survey matched with data from the 2013 American Hospital Association Information Technology Supplement. Multivariate logistic regression was used to compare hospital characteristics. Inverse probability weights were applied to adjust for selection bias because of survey nonresponse. All acute care general hospitals in the United States that matched across the surveys and had complete data available were included in the analytic sample. Three separate outcome measures were used: whether the hospital could electronically report to immunization registries, whether the hospital could send electronic laboratory results, and whether the hospital can participate in syndromic surveillance. A total of 2841 hospitals met the inclusion criteria. Weighted results show that of these hospitals, 62.7% can electronically submit to immunization registries, 56.6% can electronically report laboratory results, and 54.4% can electronically report syndromic surveillance. Adjusted and weighted results from the multivariate analyses show that small, rural hospitals and hospitals without electronic health record systems lag in the adoption of public health IT capabilities. While a majority of hospitals are using public health IT, the infrastructure still has

  19. Laboratories new to the ICRM.

    Science.gov (United States)

    Karam, Lisa; Anagnostakis, Marios J; Gudelis, Arunas; Marsoem, Pujadi; Mauring, Alexander; Wurdiyanto, Gatot; Yücel, Ülkü

    2012-09-01

    The Scientific Committee of the ICRM decided, for the 2011 Conference, to present laboratories that are at a key developmental stage in establishing, expanding or applying radionuclide metrology capabilities. The expansion of radionuclide metrology capabilities is crucial to meet evolving and emerging needs in health care, environmental monitoring, and nuclear energy. Five laboratories (from Greece, Lithuania, Indonesia, Norway and Turkey) agreed to participate. Each laboratory is briefly introduced, and examples of their capabilities and standardization activities are discussed. Published by Elsevier Ltd.

  20. Intercomparison Measurements Exercises of Mobile Radiological Laboratories (invited paper)

    International Nuclear Information System (INIS)

    Martincic, R.

    2000-01-01

    After the reactor accident in Chernobyl, the importance of mobile radiological laboratories became evident and in situ gamma spectrometry became a common method for the rapid detection of gamma emitters in the environment. Since then different institutions in European countries have organised periodic intercomparison exercises of mobile radiological laboratories to improve the measurement methods and the preparedness of emergency monitoring teams. The general objectives of these workshops are to promote the knowledge and to exchange the experiences of emergency monitoring teams that use mobile radiological laboratories, as well as to foster the international harmonisation of emergency monitoring procedures and cooperation among teams. Finally, the results of intercomparison measurements have shown that such exercises are mandatory for rapid, efficient and correct environmental monitoring in nuclear or radiological emergencies. An overview of these intercomparison measurements is given, results from the 1999 intercomparison workshop are presented and lessons learned are discussed. (author)

  1. Laboratory testing in hyperthyroidism.

    Science.gov (United States)

    Grebe, Stefan K G; Kahaly, George J

    2012-09-01

    The clinical diagnosis of hypo- or hyperthyroidism is difficult (full text available online: http://education.amjmed.com/pp1/272). Clinical symptoms and signs are often non-specific, and there is incomplete correlation between structural and functional thyroid gland changes. Laboratory testing is therefore indispensible in establishing the diagnosis of thyrotoxicosis. Similar considerations apply to treatment monitoring. Laboratory testing also plays a crucial role in establishing the most likely cause for a patient's hyperthyroidism. Finally, during pregnancy, when isotopic scanning is relatively contraindicated and ultrasound is more difficult to interpret, laboratory testing becomes even more important. Copyright © 2012. Published by Elsevier Inc.

  2. Fourth report on the Oak Ridge National Laboratory Biological Monitoring and Abatement Program for White Oak Creek Watershed and the Clinch River

    Energy Technology Data Exchange (ETDEWEB)

    Loar, J.M. [ed.

    1994-04-01

    In response to a condition of the National Pollutant Discharge Elimination System (NPDES) permit issued to Oak Ridge National Laboratory (ORNL) on April 1, 1986, a Biological Monitoring and Abatement Program (BMAP) was developed for White Oak Creek (WOC) and selected tributaries. BMAP currently consists of six major tasks that address both radiological and nonradiological contaminants in the aquatic and terrestrial environs on-site and the aquatic environs off-site. These tasks are (1) toxicity monitoring, (2) bioaccumulation monitoring of nonradiological contaminants in aquatic biota, (3) biological indicator studies, (4) instream ecological monitoring, (5) assessment of contaminants in the terrestrial environment, and (6) radioecology of WOC and White Oak Lake. The ecological characterization of the WOC watershed will provide baseline data that can be used to document the ecological effects of the water pollution control program and the remedial action program. The long-term nature of BMAP ensures that the effectiveness of remedial measures will be properly evaluated.

  3. Second report on the Oak Ridge National Laboratory Biological Monitoring and Abatement Program for White Oak Creek Watershed and the Clinch River

    International Nuclear Information System (INIS)

    Loar, J.M.; Appellanis, S.M.; Jimenez, B.D.; Huq, M.V.; Meyers-Schone, L.J.; Mohrbacher, D.A.; Olsen, C.R.

    1992-12-01

    As a condition of the National Pollutant Discharge Elimination System (NPDES) permit issued to Oak Ridge National Laboratory (ORNL) on April 1, 1986, a Biological Monitoring and Abatement Program (BMAP) was developed for White Oak Creek (WOC); selected tributaries of WOC, including Fifth Creek, First Creek, Melton Branch, and Northwest Tributary; and the Clinch River. BMAP consists of seven major tasks that address both radiological and nonradiological contaminants in the aquatic and terrestrial environs on-site and the aquatic environs off-site. These tasks are (1) toxicity monitoring; (2) bioaccumulation monitoring of nonradiological contaminants in aquatic biota; (3) biological indicator studies; (4) instream ecological monitoring; (5) assessment of contaminants in the terrestrial environment; (6) radioecology of WOC and White Oak Lake (WOL); and (7) contaminant transport, distribution, and fate in the WOC embayment-Clinch River-Watts Bar Reservoir system. This document, the second of a series of annual reports, described the results of BMAP studies conducted in 1987

  4. Second report on the Oak Ridge National Laboratory Biological Monitoring and Abatement Program for White Oak Creek Watershed and the Clinch River

    Energy Technology Data Exchange (ETDEWEB)

    Loar, J.M. [ed.; Adams, S.M.; Bailey, R.D.; Blaylock, B.G.; Boston, H.L.; Cox, D.K.; Huston, M.A.; Kimmel, B.L.; Loar, J.M.; Olsen, C.R.; Ryon, M.G.; Shugart, L.R.; Smith, J.G.; Southworth, G.R.; Stewart, A.J.; Walton, B.T.; Talmage, S.S.; Murphy, J.B.; Valentine, C.K. [Oak Ridge National Lab., TN (United States); Appellanis, S.M.; Jimenez, B.D. [Puerto Rico Univ., San Juan (Puerto Rico); Huq, M.V. [Connecticut Dept. of Environmental Protection, Hamden, CT (United States); Meyers-Schone, L.J. [Frankfurter, Gross-Gerau (Germany); Mohrbacher, D.A. [Automated Sciences Group, Inc., Oak Ridge, TN (United States); Olsen, C.R. [USDOE Office of Energy Research, Washington, DC (United States). Environmental Sciences Div.; Stout, J.G. [Cincinnati Univ., OH (United States)

    1992-12-01

    As a condition of the National Pollutant Discharge Elimination System (NPDES) permit issued to Oak Ridge National Laboratory (ORNL) on April 1, 1986, a Biological Monitoring and Abatement Program (BMAP) was developed for White Oak Creek (WOC); selected tributaries of WOC, including Fifth Creek, First Creek, Melton Branch, and Northwest Tributary; and the Clinch River. BMAP consists of seven major tasks that address both radiological and nonradiological contaminants in the aquatic and terrestrial environs on-site and the aquatic environs off-site. These tasks are (1) toxicity monitoring; (2) bioaccumulation monitoring of nonradiological contaminants in aquatic biota; (3) biological indicator studies; (4) instream ecological monitoring; (5) assessment of contaminants in the terrestrial environment; (6) radioecology of WOC and White Oak Lake (WOL); and (7) contaminant transport, distribution, and fate in the WOC embayment-Clinch River-Watts Bar Reservoir system. This document, the second of a series of annual reports, described the results of BMAP studies conducted in 1987.

  5. Selection of liquid-level monitoring method for the Oak Ridge National Laboratory inactive liquid low-level waste tanks, remedial investigation/feasibility study

    International Nuclear Information System (INIS)

    1994-11-01

    Several of the inactive liquid low-level waste (LLLW) tanks at Oak Ridge National Laboratory contain residual wastes in liquid or solid (sludge) form or both. A plan of action has been developed to ensure that potential environmental impacts from the waste remaining in the inactive LLLW tank systems are minimized. This document describes the evaluation and selection of a methodology for monitoring the level of the liquid in inactive LLLW tanks. Criteria are established for comparison of existing level monitoring and leak testing methods; a preferred method is selected and a decision methodology for monitoring the level of the liquid in the tanks is presented for implementation. The methodology selected can be used to continuously monitor the tanks pending disposition of the wastes for treatment and disposal. Tanks that are empty, are scheduled to be emptied in the near future, or have liquid contents that are very low risk to the environment were not considered to be candidates for installing level monitoring. Tanks requiring new monitoring equipment were provided with conductivity probes; tanks with existing level monitoring instrumentation were not modified. The resulting data will be analyzed to determine inactive LLLW tank liquid level trends as a function of time

  6. Fluid status monitoring with a wireless network to reduce cardiovascular-related hospitalizations and mortality in heart failure: rationale and design of the OptiLink HF Study (Optimization of Heart Failure Management using OptiVol Fluid Status Monitoring and CareLink)

    Science.gov (United States)

    Brachmann, Johannes; Böhm, Michael; Rybak, Karin; Klein, Gunnar; Butter, Christian; Klemm, Hanno; Schomburg, Rolf; Siebermair, Johannes; Israel, Carsten; Sinha, Anil-Martin; Drexler, Helmut

    2011-01-01

    Aims The Optimization of Heart Failure Management using OptiVol Fluid Status Monitoring and CareLink (OptiLink HF) study is designed to investigate whether OptiVol fluid status monitoring with an automatically generated wireless CareAlert notification via the CareLink Network can reduce all-cause death and cardiovascular hospitalizations in an HF population, compared with standard clinical assessment. Methods Patients with newly implanted or replacement cardioverter-defibrillator devices with or without cardiac resynchronization therapy, who have chronic HF in New York Heart Association class II or III and a left ventricular ejection fraction ≤35% will be eligible to participate. Following device implantation, patients are randomized to either OptiVol fluid status monitoring through CareAlert notification or regular care (OptiLink ‘on' vs. ‘off'). The primary endpoint is a composite of all-cause death or cardiovascular hospitalization. It is estimated that 1000 patients will be required to demonstrate superiority of the intervention group to reduce the primary outcome by 30% with 80% power. Conclusion The OptiLink HF study is designed to investigate whether early detection of congestion reduces mortality and cardiovascular hospitalization in patients with chronic HF. The study is expected to close recruitment in September 2012 and to report first results in May 2014. ClinicalTrials.gov Identifier: NCT00769457 PMID:21555324

  7. Electric conductivity for laboratory and field monitoring of induced partial saturation (IPS) in sands

    Science.gov (United States)

    Kazemiroodsari, Hadi

    Liquefaction is loss of shear strength in fully saturated loose sands caused by build-up of excess pore water pressure, during moderate to large earthquakes, leading to catastrophic failures of structures. Currently used liquefaction mitigation measures are often costly and cannot be applied at sites with existing structures. An innovative, practical, and cost effective liquefaction mitigation technique titled "Induced Partial Saturation" (IPS) was developed by researchers at Northeastern University. The IPS technique is based on injection of sodium percarbonate solution into fully saturated liquefaction susceptible sand. Sodium percarbonate dissolves in water and breaks down into sodium and carbonate ions and hydrogen peroxide which generates oxygen gas bubbles. Oxygen gas bubbles become trapped in sand pores and therefore decrease the degree of saturation of the sand, increase the compressibility of the soil, thus reduce its potential for liquefaction. The implementation of IPS required the development and validation of a monitoring and evaluation technique that would help ensure that the sands are indeed partially saturated. This dissertation focuses on this aspect of the IPS research. The monitoring system developed was based on using electric conductivity fundamentals and probes to detect the transport of chemical solution, calculate degree of saturation of sand, and determine the final zone of partial saturation created by IPS. To understand the fundamentals of electric conductivity, laboratory bench-top tests were conducted using electric conductivity probes and small specimens of Ottawa sand. Bench-top tests were used to study rate of generation of gas bubbles due to reaction of sodium percarbonate solution in sand, and to confirm a theory based on which degree of saturation were calculated. In addition to bench-top tests, electric conductivity probes were used in a relatively large sand specimen prepared in a specially manufactured glass tank. IPS was

  8. US remote monitoring operational experience

    International Nuclear Information System (INIS)

    Dupree, S.A.; Sonnier, C.S.

    1997-01-01

    Under international partnerships and bilateral agreements with the U.S. Department of Energy, Sandia National Laboratories, other national laboratories, and international partner organizations have emplaced remote monitoring systems in nuclear facilities and laboratories in various parts of the world for the purpose of conducting field trials of remote monitoring. The purpose of the present report is to review the results from these field trials and draw general conclusions regarding the trials. Many thousands of hours of sensor and system operation have been logged, and data have been retrieved from many locations. In virtually all cases the system components have functioned as intended and data have been successfully collected and transmitted for review. Comparisons between front-end-triggered video and time-lapse video have shown that the triggered record has captured all relevant monitored operations at the various nuclear facilities included in the field trials. We believe the utility and functional reliability of remote monitoring for international safeguards has been shown. However, it should be kept in mind that openness and transparency, including some form of short-notice inspections, are likely to be prerequisites to the safeguards implementation of remote monitoring in any State

  9. 3Q/4Q98 Annual M-Area and Metallurgical Laboratory Hazardous Waste Management Facility Groundwater Monitoring and Correction-Action Report, Volumes I, II, and III

    International Nuclear Information System (INIS)

    Chase, J.

    1999-01-01

    This report describes the groundwater monitoring and corrective-action program at the M-Area Hazardous Waste Management Facility (HWMF) and the Metallurgical Laboratory (Met Lab) HWMF at the Savannah River Site (SRS) during 1998

  10. Ambient environmental radiation monitoring at the Lawrence Livermore Laboratory

    International Nuclear Information System (INIS)

    Lindeken, C.L.; White, J.H.; Toy, A.J.; Sundbeck, C.W.

    1975-01-01

    Thermoluminescence dosimetry is the principal means of measuring ambient γ radiation at the Lawrence Livermore Laboratory. These dosimeters are used at 12 perimeter locations and 41 locations in the off-site vicinity of the Laboratory, and are exchanged quarterly. Control dosimeters are stored in a 75-mm-thick lead shield located out-of-doors to duplicate temperature cycling of field dosimeters. Effect of dosimeter response to radiation in the shield is determined each quarter. Calibration irradiations are made midway through the exposure cycle to compensate for signal fading. Terrestrial exposure rates calculated from the activities of naturally occurring uranium, thorium, and potassium in Livermore Valley soils vary from 3 to 7 μR/hr. Local inferred exposure rates from cosmic radiation are approximately 4 μR/hr. TLD measurements are in good agreement with these data. Off-site and site perimeter data are compared, and differences related to Laboratory operations are discussed

  11. The Impact of Medicaid Disproportionate Share Hospital Payment on Provision of Hospital Uncompensated Care

    Science.gov (United States)

    Hsieh, Hui-Min; Bazzoli, Gloria J.

    2012-01-01

    This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response was inelastic in value. Policy makers need to continue to monitor how UC changes as sources of support for indigent care change with the Patient Protection and Affordable Care Act (PPACA). PMID:23230705

  12. Environmental monitoring plan

    International Nuclear Information System (INIS)

    Holland, R.C.

    1997-02-01

    This Environmental Monitoring Plan was written to fulfill the requirements of Department of Energy (DOE) Order 5400.1 and DOE Environmental Regulatory Guide DOE/EH 0173T. This Plan documents the background, organizational structure, and methods used for effluent monitoring and environmental surveillance at Sandia National Laboratories/California. The design, rationale, and historical results of the environmental monitoring system are discussed in detail. Throughout the Plan, recommendations for improvements to the monitoring system are made. 52 refs., 10 figs., 12 tabs

  13. [Risk management of hospital infections as a supporting tool for the improvement of hospital quality - some European examples].

    Science.gov (United States)

    Sitek, Mateusz; Witczak, Izabela; Kiedik, Dorota

    Prevention and control of nosocomial infections is one of the main pillars of security in each medical facility. This affects the quality of services and helps to minimize the economic losses incurred as a result of such infections. (Prolonged hospitalization, expensive antibiotic therapies, court costs of damages). Nosocomial infections occur in every medical facility in the hospitals in terms of risk of infection compared to other medicinal entities are at greater risk of environmental (number of hospitalizations for one bed, the amount of disinfectants, etc.). The number and diverse category of employment of medical and auxiliary, which should meet certain standards for the prevention of hospital infections, has an impact on the incidence of infection. It is impossible to eliminate hospital-acquired infections, but can be limited by appropriate measures, ranging from monitoring through the use of risk management methods, which are one of the elements supporting the improvement of the quality of medical entities. Hospital infection is a threat not only for patients but also for workers exposed to the risk of so-called occupational exposure. A comprehensive approach including elements of active surveillance and effective monitoring can help to minimize the risk of nosocomial infections.

  14. 2016 Results for Avian Monitoring at the TA-36 Minie Site, TA-39 Point 6, and TA-16 Burn Ground at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Hathcock, Charles Dean [Los Alamos National Laboratory; Thompson, Brent E. [Los Alamos National Laboratory; Berryhill, Jesse Tobias [Los Alamos National Laboratory

    2017-01-23

    Los Alamos National Security, LLC (LANS) biologists in the Environmental Compliance and Protection Division at Los Alamos National Laboratory (LANL) initiated a multi-year program in 2013 to monitor avifauna at two open detonation sites and one open burn site on LANL property. Monitoring results from these efforts are compared among years and with avifauna monitoring conducted at other areas across LANL. The objectives of this study are to determine whether LANL firing site operations impact bird abundance or diversity. LANS biologists completed the fourth year of this effort in 2016. The overall results from 2016 continue to indicate that operations are not negatively affecting bird populations. Data suggest that community structure may be changing at some sites and this trend will continue to be monitored.

  15. External quality assurance performance of clinical research laboratories in sub-saharan Africa.

    Science.gov (United States)

    Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

    2012-11-01

    Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

  16. Laboratory surveillance of influenza-like illness in seven teaching hospitals, South Korea: 2011-2012 season.

    Directory of Open Access Journals (Sweden)

    Ji Yun Noh

    Full Text Available BACKGROUND: A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI through the first teaching hospital-based surveillance scheme for ILI in South Korea. METHODS: Respiratory specimens were obtained from adult patients (≥18 years who visited the emergency department (ED with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus. RESULTS: Among 1,983 patients who visited the ED with ILI, 811 (40.9% were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983 during the 2011-2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983 and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5% in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6% cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes. CONCLUSION: This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.

  17. SAMJ Monitoring of rotavirus infection in a paediatric hospital by ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  18. Monitoring of rotavirus infection in a paediatric hospital by RNA ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  19. Gunite and associated tanks dry well conductivity monitoring report, Oak Ridge National Laboratory, Oak Ridge, Tennessee, February 1998 - December 1998

    International Nuclear Information System (INIS)

    1999-04-01

    A waste removal program is being implemented for the Gunite and Associated Tanks Operable Unit at Oak Ridge National Laboratory, Oak Ridge, Tennessee. The waste is being removed by means of remotely operated, in-tank, confined sluicing equipment. During sluicing operations the dry wells adjacent to each of the tanks are instrumented so that potential releases can be detected by means external to the tank. The method of detection is by monitoring the electrical conductivity of the water in the dry well associated with each tank. This report documents the dry well conductivity monitoring data for the period from February 1998 through December 1998. The dry wells monitored during this period include DW-5, DW-6, DW-7, DW-8, DW-9 and DW-10. The conductivity of the water passing through Pump Station 1 (PS1) was also monitored. During this period the sluicing activities at Tank W-6 were initiated and successfully completed. In addition, flight mixers were used to remove wastes from Tank W-5, and sluicing operations were initiated on Tank W-7. Presented in this report are the dry well conductivity, rainfall, tank level, and other appropriate information relevant to the analysis and interpretation of the monitoring data for the reporting period. A thorough analysis of the monitoring results from the six dry wells in the STF and PS1 for the period between February 1998 and December 1998 indicates that no releases have occurred from the gunite tanks being monitored. Overall, the dry well conductivity monitoring continues to provide a robust and sensitive method for detecting potential releases from the gunite tanks and for monitoring seasonal and construction-related changes in the dry well and drain system

  20. [Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues].

    Science.gov (United States)

    Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji

    2014-11-01

    We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.