Errors in the total testing process in the clinical chemistry laboratory at the University of Gondar Hospital, northwest Ethiopia

Background: Laboratory services have been described as the major processes contributing to safe patient care in the modern healthcare sector. However, occurrences of errors in the overall testing processes impair the clinical decision-making process. Such errors are supposed to be high in resource-poor countries, like Ethiopia. The objective of this study was to assess errors in the total testing process in the Clinical Chemistry laboratory of the University of Gondar Hospital, Northwest EthiopiaMethods: A cross-sectional study was conducted at the University of Gondar Hospital from February to March 2016. All the required data were collected using established quality indicators. Data were analyzed using SPSS version 20. Frequencies and cross-tabulations were used to summarize descriptive statistics.Results: A total of 3259 samples and corresponding laboratory request forms were received for analysis. The analysis of the overall distribution of errors revealed that 89.6% were preanalytical errors, 2.6% were analytical, and 7.7% were postanalytical errors. Of the pre-analytical errors, incomplete request form filling was the most frequent error observed, followed by sample rejection rate (3.8%). Analytical errors related to internal and external quality control exceeding the target range, (14.4%) and (51.4%) respectively, were reported. Excessive turnaround time and unreported critical value cases were the major defects in the post-analytical phase of quality assurance.Conclusion: The present finding showed relatively high frequency of errors, which alarms the importance of quality indicators to assess errors in the total testing process. The University of Gondar Hospital laboratory should improve the quality of healthcare services based on these findings using laboratory standards.Keywords: Analytical errors; clinical laboratory; postanalytical errors; pre-analytical errors; qualit

How Does ISO 15189 Laboratory Accreditation Support the Delivery of Healthcare in Ethiopia? A Systematic Review

BACKGROUND: Assessing quality by considering input, process and output level quality variables is important to ensure improved quality services. Designing and execution of an effective quality management system are aimed for the purpose of quality improvement, error reduction and associated risks. Therefore, this review is designed to assess the value of accreditation on the performance of healthcare institutions in ensuring quality improvement interventions. Moreover, this review presents important concepts of accreditation and the aspects of quality.METHODS: Published articles were downloaded using EndNote® application software program from PubMed (NML) database, Web of Sciences (TS) and Google Scholar. From a total of 883 downloaded full-text published materials, only 28 journals and 1 report issued from 2010 to 2017 were used for the development of this review.RESULT: The overall quality of healthcare services in developing countries was error-prone and suffered from limitations. These could be associated with wrong interventions and increased risks. Accreditation schemes have been implemented to provide quality care and ensure safety.CONCLUSION: Evaluation feedback induces interventions aimed at quality improvement and ensures better management systems, good process design, wise resource utilization, meeting patients’ need and increased satisfaction. Hence, stakeholders must be engaged in the provision of improve quality patient care and reduce associated risks. Hence, giving special quality improvement attention helps to improve quality healthcare services

Conductive Coatings of Cotton Fabric Consisting of Carbonized Charcoal for E-Textile

Development of smart textiles is an emerging discipline in the last two decades where a conductive element is integrated into a textile material by some means. The purpose of this research was to develop a conductive textile fabric by coating with charcoal as a conductive element. The charcoal was produced by carbonizing the eucalyptus wood at a temperature of 928 °C for 37 min producing 59.17% w/w of fixed carbon yield and conductivity of 463.34 Sm−1 (Siemens per meter) compared to immeasurable conductivity of the wood. This was followed by characterization of physical and chemical properties of charcoal. Thereafter, a cotton fabric was pad-coated with a dispersion based on the charcoal. The paper herein reports the results of preparing different recipes using different quantities of charcoal particles with other components of the coating mixture, which was tested to obtain the best coating in terms of electrical conductivity. The optimal concentration of the conductive particles of the charcoal was studied. Performance evaluation of the coated fabric was assessed for the durability of fabric towards different fastness agents. The effect of charcoal loading on thermal and sensorial comfort of the fabric in addition to the air and water permeability was studied and a significant change was observed. Finally, a proof of concept was developed to demonstrate if the resulting pieces of information during the process were viable. As observed, the pad-coated cotton fabric using charcoal showed increased electrical conductivity from 1.58 × 10−12 Scm−1 (Siemens per centimeter) for the controlled sample to 124.49 Scm−1 for the coated sample designating that the resulting fabric is in a conductor category

Assessment of Knowledge, Attitude, and Practice about Biomedical Waste Management and Associated Factors among the Healthcare Professionals at Debre Markos Town Healthcare Facilities, Northwest Ethiopia

Background. Healthcare activities restore health and save lives at the same time; however, they can generate hazardous biomedical wastes to a human being or the environment. Generation and disposal of biomedical wastes have become an emerging problem worldwide. Objective. To assess knowledge, attitude, and practice about biomedical waste management and associated factors among healthcare professionals in Debre Markos town healthcare facilities, northwest Ethiopia. Methods. A cross-sectional study was employed, and data were collected through structured self-administered questionnaire and observational checklist. Data were entered into the Epi-data 3.1 software and exported into SPSS version 20 for analysis. Bivariate and multivariate logistic regression analyses were computed. Variables with a P value of <0.05 in the multivariate logistic regression analysis were considered to explain the presence of statistically significant associations. Result. Among 296 healthcare professionals studied, 168 (56.8%), 196 (66.2%), and 229 (77.4%) had adequate knowledge, favorable attitude, and adequate practice score, respectively. Regarding associated factors, MSc and MD+ (AOR: 4, 95% CI: (1.37, 149.52)), BSc holders (AOR: 2.53, 95% CI: (1.47, 4.38)), and availability of color-coded bins (AOR: 7.68, 95% CI: (3.30, 17.89)) were identified more likely to contribute for adequate knowledge, favorable attitude, and adequate practice scores, respectively. Conclusion. The level of knowledge, attitude, and practice scores were not satisfactory. Majority of the healthcare professionals did not access biomedical waste management training. Educational level, use of visual aid, and availability of color-coded bins in the department were identified as a factor for biomedical waste management. Regular training should be given to healthcare professionals

Incineration of Textile Sludge for Partial Replacement of Cement in Concrete Production: A Case of Ethiopian Textile Industries

The rapid growth of textile industries in Ethiopia plays an important role in economic development. However, the sludge from these wastewater treatment plants, which is not an integral part of the treatment process, is often considered hazardous as it is contaminated with heavy metals of dyestuffs and chemicals. The customary transfer routines such as landfilling and incineration may not be suitable because the leachate from the landfilling destinations and the buildups from the incinerators lead to optional contamination. Moreover, such transfer choices are not financially practical. Therefore, there is a growing need to look for various applications of sludge handling for sustainable development. This study attempts to find out an environmentally friendly solution for the management of the textile sludge by incinerating the sludge and using it for partial replacement of cement in concrete production. Concrete is a composite material formed by the combination of cement, sand, coarse aggregate, and water in a particular proportion so that concrete produced meets the needs regarding its workability, strength, durability, and economy. Typical textile sludge was having high heavy metal contents as per the United States Environmental Protection Agency (USEPA) guideline and should be properly disposed of. The sludge upon incineration at 625°C for four hours gives 78.1% moisture content, 61.2% volatile organic matter, and 59.6% inorganic ash content. The main reactive oxide elements such as SiO2, Fe2O3, CaO, and Al2O3 were found to be 18.51, 3.19, 23.87, and 12.73% by weight in the ash. The calorific value determined from the dried sludge were found to be 1973 cal/gm. Concrete block was manufactured by replacement of cement with 10, 20, 30, 40, and 50% incinerated textile sludge ash, and the manufactured block was evaluated in terms of their compressive strengths, leaching behavior, and water absorption. The replacement cement by the ash increases the hydration time reduced, and up to 20%, sludge ash incorporation in the concrete mix design gives the designed compressive strength. Eventhough water absorption increases with increasing content of the incorporation of the ash, for the 20% replacement of cement, the lethal concentration of heavy metals was obtained to be below the permissible limit set by USEPA. Consequently, the experiment work indicates that the potential use of textile sludge ash for cement concrete gives the possibilities of reduction of heavy metal contamination to surroundings upon sludge disposal, reduces the use of raw materials for producing cement and reduces environmental pollution during cement production