The Role of Clinical Informatics in Patient Care and Resource Management.

The clinical laboratory today is under increasing pressure to perform more efficiently in light of growing healthcare demands. Encumbered by heavier workloads, increased documentation requirements, and expanded training needs, laboratories are looking for solutions to help streamline workflow and inform decisions for more effective care. Integrated delivery networks (IDNs) face the added burden of tracking the performance of individual laboratories while standardizing processes throughout the network at large. This is while responding to the strain caused by hospital consolidations, population health management initiatives, and falling Centers for Medicare and Medicaid (CMS) reimbursement rates.

As healthcare has evolved to create these new challenges, the industry has responded. Leading innovators have worked to develop clinical IT solutions that complement the laboratory’s information system (LIS). These middleware and business analytics solutions can be used to assess and enhance capacity and efficiency, improve and monitor turnaround time (TAT), maximize staff resourcing, track specimens to reduce identification errors and improve issue management, and optimize test utilization.

Read more: The Role of Clinical Informatics in Patient Care and Resource Management.

Source: MedicalLaboratoryObserver

Proper Patient Preparation, Specimen Collection, and Sample Handling are Critical to Quality Care

Garbage In, Garbage Out (GIGO), as the saying goes. This adage has been applied in a universal manner in addressing human errors. It certainly applies to establishing laboratory procedures that ensure care in managing the pre-analytical phase of laboratory testing. Sixty years ago, many common laboratory tests were performed manually, and thus were prone to inaccuracy and analytical mistakes. Today’s advanced technology places laboratory science in a highly automated and quality-focused environment that ensures accurate testing processes.

Total Testing Process (TTP)

Medical errors are the third leading cause of death in the U.S. The laboratory’s contribution to this major healthcare concern is only 0.33 percent.1 While this number appears small, laboratory errors do occur, not always resulting is death, but nevertheless having an important impact on patient care. As clinical laboratory scientists, we must make every effort to produce accurate test results.

Read more: Proper Patient Preparation, Specimen Collection, and Sample Handling are Critical to Quality Care

Source: MedicalLaboratoryObserver

Blood Tests for Prion Disease.

Two studies describe methods for detecting these misfolded proteins in human blood samples.

Thousands of Europeans may be asymptomatic carriers of variant Creutzfeldt-Jakob disease (vCJD), a fatal prion disease that is the human variant of Mad Cow disease. But now, two studies published December 21 in Science Translational Medicine describe new methods for detecting even latent vCJD, which could make blood transfusions safer and help early detection and treatment of the disease.

The blood tests accurately diagnosed 32 patients between the two studies, distinguishing those with the disease from 391 healthy controls. In both cases, the tests were 100 percent sensitive and 100 percent specific and, in one of the studies, the test managed to identify vCJD prion particles in a blood donation more than a year before the onset of symptoms—a first for prion disease detection.

Read more: Blood Tests for Prion Disease.

Source: TheScientist

The Growing Impact of Cardiac Biomarkers in Clinical Chemistry.

Clinical chemistry measurements and calculations take into account an expansive set of analytes that reflect cardiac, liver, kidney, and other biological functions. Several of these discrete analytes are considered biomarkers, defined by Strimbu and Tavel as “a broad subcategory of medical signs [that are] objective indications of medical state observed from outside the patient which can be measured accurately and reproducibly.” In the case of cardiac biomarkers, the most common analytes are creatine kinase (CK), lactate dehydrogenase (LDH), and troponin (TNI). There are pros and cons to using these common chemistry tests as definitive cardiac biomarkers. However, other chemistry analytes and even some non-laboratory tests have been identified as potential cardiac biomarkers. Providing clinicians with accurate and thorough testing is important in contributing to diagnosis and ultimately to positive patient outcomes.

Read more: The Growing Impact of Cardiac Biomarkers in Clinical Chemistry.

Source: MedicalLaboratoryObserver

Table of Critical Limits in Laboratory Medicine

Critical limits define boundaries of life-threatening values of laboratory test results. Critical results or values are those that fall outside high and low critical limits. Urgent clinician notification of critical results is the lab’s responsibility. The system of critical value reporting was first implemented in a hospital by George D. Lundberg, MD, and first published in MLO in 1972. These tables are based on three national surveys by Gerald J. Kost, MD, PhD, MS, FACB, of the University of California Davis Health System. Adapted with permission from his articles,1-4 the tables summarize critical limits used by 92 responding U.S. medical centers, including 20 trauma centers, and 39 children’s hospitals. Mean and standard deviation (SD) data are presented. The frequency with which critical limits were listed can be found in the original articles.

Read more: Table of Critical Limits in Laboratory Medicine

Source: ClinicalLaboratoryReference

MicroRNA: A Tiny Molecule Yields Big Insights Into Disease States

Regular readers of this column will know that there are two main categories of nucleic acids—DNA and RNA. They’ll also know that while for living organisms DNA acts as the genetic data repository, RNA has a messenger role (mRNAs, transcribed from DNA to direct protein synthesis). Most will also recall that there are other classes of RNA molecules, particularly tRNAs (used to tag and identify amino acids for protein synthesis) and rRNAs (structural components of the ribosome, the cellular “machinery” for protein synthesis). In addition to these, there’s increasing interest in the molecular diagnostics community in a less widely known but no less common RNA form, the microRNA or miRNA.

Read more: MicroRNA: A Tiny Molecule Yields Big Insights Into Disease States

Source: MedicalLaboratoryObserver

Scientists Fingerprint the Brain

The brain’s structural connections are unique to an individual, a new imaging technique reveals.

Every brain is unique, and scientists now have the means to pin down precisely how unique. Disease, environment, and genetic factors all influence the pattern of connections between neurons, called the local connectome. A new imaging technique quantifies differences between the local connectomes of individual brains, allowing researchers to identify a brain by its connectome “fingerprint.”

The technique uses diffusion MRI to track the movement of water molecules along pathways in the brain’s white matter, creating a fine-scale image of structural connections. The team took repeat MRI scans of a few individuals, and found that they could tell whether two local connectome fingerprints came from the same individual with 100 percent accuracy over the 17,398 identification tests they ran. The team’s findings were reported this week (November 15) PLOS Computational Biology.

Read more: Scientists Fingerprint the Brain

WIKIPEDIA, THOMAS SCHULTZ

Source: TheScientist

Neurometabolic Disorders Could Contribute to Depression

Impairments in the production of neurotransmitters may lead to depression in some patients, preliminary results show, opening new avenues for research.

In 2002, psychiatrist Lisa Pan, a depression and suicide prevention researcher at the University of Pittsburgh Medical Center (UPMC), met Kyle, a 19-year-old suffering from depression (name altered to preserve confidentiality). He was among the estimated 15 percent of depression patients in the U.S. for whom treatments such as antidepressants or therapy do not help. He “had been through every available treatment” including electroconvulsive therapy, but nothing worked, Pan recalls. “At one time, he was on 17 medications simultaneously.” The teenager had attempted suicide, and doctors determined that he was at risk for similar episodes. The next step for him would be state hospitalization.

Read more: Neurometabolic Disorders Could Contribute to Depression

STAVING OFF DEPRESSION: Deficiencies in key compounds that help the body make
neurotransmitters may contribute to the intractability of depression in some people
© ISTOCK.COM/JM1366

Source: TheScientist

Standardization And Implementation of Lab Policies Ensure Hemostasis Sample Quality

How many of us remember the tilt-tube method for basic hemostasis testing? Fortunately, today’s instruments have automated most of these manual steps. However, until recently, assuring sample quality in the pre-analytical phase of testing had remained a manual process and had been difficult to implement and standardize.

Several questions must be considered when evaluating the integrity of a hemostasis sample: Is the sample tube under-filled? Is the sample hemolyzed, icteric, or lipemic? If so, do the levels of the interferent impact the testing results? Is there a clot in the sample?

All labs have policies on sample acceptance and rejection. Inappropriate rejection of acceptable samples—requiring redraw—directly impacts patient care, patient satisfaction, and cost. Failing to reject inappropriate samples can lead to the reporting of erroneous results, impacting the quality of patient care and associated cost. Let’s take a look at the most common pre-analytical quality issue culprits.

Read more: Standardization And Implementation of Lab Policies Ensure Hemostasis Sample Quality

Source: MedicalLaboratoryObserver

Why Is My Urine Bright Yellow? Colors Changes and Causes

Normal urine should be a pale yellow color. It should be clear, without cloudiness or particle deposits.

"Why is my urine bright yellow?" is a question that can be answered if the meaning of bright yellow is clear.

This page will explain the full range of possible colors of urine and why they change. If bright yellow means neon yellow, this has a specific cause.

Read more: Why Is My Urine Bright Yellow? Colors Changes and Causes

If anyone has concerns about urine, it is recommended that they visit a doctor. Some drugs may turn

the urine orange, brown, or green. Urine color may be used to work out hydration levels.

Source: MedicalNewsToday