RESUMEN
In environmental scanning, deans and directors of allied health units face the task of making sense of volumes of information from their internal and external environments. A study was conducted to detail the information processing of 108 allied health deans and directors of institutional members of the Association of Schools of Allied Health Professions. The study was a survey that included basic demographic questions and two scenarios, each representing a strategic situation. Respondents (n = 56, 52%) rated their general perceptions of the two strategic situations and their projected use of eight types of information cues to clarify the situations. Results indicated that deans and directors had high use of all types of information cues in both strategic situations. The results for the strategic situation based on a scenario about program closure showed that use of negative information cues was associated with proportionally greater use of internal, external, and formal information cues (Pearson correlation coefficients r = 0.72, 0.80, and 0.77, respectively, all with p < 0.005). Some differences were found in types of information used by respondents in academic health centers versus non-academic health centers. The results of this study provide insights on how allied health deans and directors process information in environmental scanning.
Asunto(s)
Empleos Relacionados con Salud , Gestión de la Información/organización & administración , Liderazgo , Escuelas para Profesionales de Salud , Estudios Transversales , Femenino , Humanos , Masculino , Estados UnidosRESUMEN
OBJECTIVE: To determine equivalency of hematocrit results by three methods. DESIGN: A total of 101 whole blood samples in EDTA tubes were analyzed in this repeated measures study. SETTING: East Carolina University's clinical laboratory science program, Greenville NC. PARTICIPANTS: The blood specimens were from adult patients at Nash General Hospital in Rocky Mount NC who had a CBC performed. MAIN OUTCOME MEASURE: Hematocrit values from a whole blood sample with EDTA anticoagulant performed by a Sysmex XE-2100 and by microcentrifuge with two different types of capillary tubes (i.e., heparinized and non-heparinized) filled from the EDTA tubes. RESULTS: The hematocrit means of the total sample for the three methods were 36.2%, 35.4%, and 35.6% for the Sysmex XE-2100, non-heparinized capillary tubes, and heparinized capillary tubes, respectively. Pearson correlation coefficient (pairwise) analyses produced significant r-values at an alpha of .01 for all three method comparisons. CONCLUSIONS: Based on statistically significant Pearson (pairwise) correlation coefficients, the hematocrit values by all three methods can be considered relatively equivalent. The differences between methods are quite small and would be clinically insignificant, thus likely not altering clinical decisions. Though this study was conducted under somewhat ideal conditions relative to the blood specimens selected, the results indicate that the additional dilution produced in a heparinized capillary tube when being filled from an EDTA-anticoagulated tube is not sufficient to produce clinically different microhematocrit results as compared to using the recommended non-heparinized capillary tube.
Asunto(s)
Anticoagulantes/farmacología , Recolección de Muestras de Sangre/métodos , Hematócrito/métodos , Hematología/métodos , Heparina/farmacología , Adulto , Centrifugación , Hematócrito/estadística & datos numéricos , Hematología/instrumentación , Humanos , Microquímica , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: To assess the predictive ability of various aspects of the work environment for organizational commitment. METHODS: A questionnaire measuring three dimensions of organizational commitment along with five aspects of work environment and 10 demographic and work setting characteristics was sent to a national, convenience sample of clinical laboratory professionals. SETTING AND PARTICIPANTS: All persons obtaining the CLS certification by NCA from January 1, 1997 to December 31, 2006. Only respondents who worked full-time in a clinical laboratory setting were included in the database. MAIN OUTCOME MEASURES: Levels of affective, normative, and continuance organizational commitment, organizational support, role clarity, role conflict, transformational leadership behavior of supervisor, and organizational type, total years work experience in clinical laboratories, and educational level of respondents. Questionnaire items used either a 7-point or 5-point Likert response scale. RESULTS: Based on multiple regression analysis for the 427 respondents, organizational support and transformational leadership behavior were found to be significant positive predictors of affective and normative organizational commitment. Work setting (non-hospital laboratory) and total years of work experience in clinical laboratories were found to be significant positive predictors of continuance organizational commitment. Overall the organizational commitment levels for all three dimensions were at the neutral rating or below in the slightly disagree range. CONCLUSIONS: The results indicate a less than optimal level of organizational commitment to employers, which were predominantly hospitals, by CLS practitioners. This may result in continuing retention problems for hospital laboratories. The results offer strategies for improving organizational commitment via the significant predictors.
Asunto(s)
Actitud del Personal de Salud , Personal de Laboratorio Clínico , Ciencia del Laboratorio Clínico , Lealtad del Personal , Demografía , Humanos , Satisfacción en el Trabajo , Modelos Organizacionales , Motivación , Encuestas y Cuestionarios , Lugar de TrabajoRESUMEN
Infants and toddlers are particularly vulnerable to developing iron deficiency, which can cause irreversible deficits in neurodevelopment. Children at highest risk include premature and low birth weight infants, those who are fed cow's milk rather than breast milk or formula prior to age one, and those who drink large amounts of cow's milk as toddlers. It is important to detect iron deficiency before it becomes frank anemia through the use of appropriate laboratory tests. Hemoglobin or hematocrit testing, at around age one, has been the usual screening test. These tests, however, do not become abnormally low until frank anemia has developed. Over the past decade, research has shown the assay for reticulocyte hemoglobin content to be a much earlier indicator of iron deficiency. This article provides an overview of the epidemiology, occurrence, and detection of iron deficiency and iron deficiency anemia in young children as well as a comparison of the utility of various laboratory tests.
Asunto(s)
Anemia Ferropénica/diagnóstico , Anemia Ferropénica/epidemiología , Preescolar , Índices de Eritrocitos , Ferritinas/sangre , Hemoglobinometría , Humanos , Lactante , Recién Nacido , Hierro/sangre , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To compare two manual methods for estimating platelet counts from Wright's stained peripheral blood smears regarding their correlation with each other and with automated platelet counts. This correlation was examined in relation to whether the platelet count was high, low, or normal and in relation to whether the hemoglobin value was low versus normal or high. DESIGN: Peripheral blood smears were Wright's stained and both platelet count estimation methodologies were performed on each slide. The traditional estimation method was the average number of platelets per oil immersion field (OIF) multiplied by 20,000 to yield a platelet count estimate per uL. The alternate estimation method was the average number of platelets per OIF multiplied by the patient's hemoglobin value in g/dL and then multiplied by 1,000 to yield a platelet count estimation per uL. The platelet count estimates were performed without the technologists having prior knowledge of the automated platelet counts which were produced on a Coulter LH750 analyzer. The agreement between the two manual methodologies with each other and each method with the automated count was assessed using the paired T-test and correlation coefficient analyses. These analyses were performed for the whole dataset as well as for subsets based on the automated platelet count and the hemoglobin value. SETTING: East Carolina University's Clinical Laboratory Science program in collaboration with the Clinical Pathology/Laboratory at Pitt County Memorial Hospital (PCMH) in Greenville NC. PARTICIPANTS: One hundred eighty-four blood samples in EDTA-anticoagulant VacutainerI tubes were used to conduct this study. Each blood sample had two peripheral blood smears made and stained on an automatic slide stainer. The blood samples were obtained from the Clinical Pathology/Laboratory of Pitt County Memorial Hospital in October and November of 2004. Each sample was given a unique numeric identifier with no personal identifying information from any sample being recorded. MAIN OUTCOME MEASURE: Platelet counts by two slide estimation methods and by an automated reference method. RESULTS: The traditional platelet count estimation method had a mean for the sample of 269,000/uL, while the alternate estimation method had a mean of 155,000/uL. The mean for the automated platelet counts was 268,000/uL. The traditional estimation method showed no statistically significant difference in mean from the automated platelet counts based on the paired T-test (p = 0.87). The traditional estimation method counts and automated counts had a high Pearson Product Moment correlation coefficient of r = .90 and a minimally dispersed scatterplot, thus showing strong agreement. The alternate platelet count estimation method had a mean for the sample of 155,000/uL which, based on the paired T-test, was highly significantly different from the automated count mean (p < 0.0001) and the traditional estimation method mean (p < 0.0001). The alternate estimation method and automated counts had a lower r value of .81 and greater dispersion in the scatterplot. In comparing the estimation methods with each other and with the automated method, the differences and similarities in agreement observed for the whole dataset were also observed with each platelet count and hemoglobin subset of data. CONCLUSIONS: Though the alternate platelet count estimation method has been recommended for use particularly with patients with low hemoglobin values, this study found that the traditional estimation method provided more agreement with automated counts than did the alternate estimation method for all samples as well as for the subset of samples with low hemoglobin values. For the present, the traditional method of estimating platelet counts from blood smears to evaluate automated results appears to provide adequate quality assurance.
Asunto(s)
Técnicas de Laboratorio Clínico/normas , Recuento de Plaquetas/métodos , Recuento de Plaquetas/normas , Estadística como Asunto , Técnicas de Laboratorio Clínico/métodos , HumanosRESUMEN
Health care employers of allied health personnel and the academic programs producing these professionals have had to cope with an environment of major changes and ongoing turbulence. To better understand the descriptions of and research on the health care environment in relation to strategic typologies, an integrative literature review was conducted. Drawing from multiple disciplines, the information presented offers potential models and approaches to assess and respond to a turbulent health care environment for both schools of allied health and allied health practice sites. The integrative literature review revealed that innovation can enhance profitability if not pursued with fragmentation of an organization's core identity. Prospector and analyzer approaches appear to offer greater viability in a turbulent health care environment than reactor or defender types. Differentiation of services can be pursued to produce a unique reputation for a health care organization.
Asunto(s)
Atención a la Salud/organización & administración , Escuelas para Profesionales de Salud/organización & administración , Técnicos Medios en Salud/educación , Humanos , Innovación Organizacional , Técnicas de Planificación , Estados UnidosRESUMEN
OBJECTIVE: A study was conducted to assess the impact of adverse storage environments, i.e., not manufacturer recommended, on the performance of reagent test strips used with a point of care testing (POCT) glucometer to measure whole blood glucose levels. DESIGN/SETTING: Glucose reagent test strips were placed in open, i.e., uncapped, and closed, i.e., capped vials. These vials were those used by the manufacturer to package and store the reagent test strips. One of each type of vial was placed in the manufacturer-recommended storage environment at room temperature and the adverse environments (incubator, direct light to mimic sunlight exposure, humidity, and refrigerated). The Accu-Chek Easy glucometer and reagent test strips as well as Accu-Chek Easy high and low glucose control solutions, manufactured by Roche, were used for this study. MAIN OUTCOME MEASURES: On day-3, day-7, and then once every 7 days, one strip from each vial in each environment was tested with the same glucometer using both a high and a low glucose control. The strip was considered failed for a type of vial and storage environment when either control was out of the reference range on a regular testing day and still out of range when tested the subsequent day. Testing continued up to 50 days. RESULTS: For the tested environments it was found that, overall, test strip stability lasted longer for closed vials than open vials. For open vials in adverse storage conditions, the refrigerator environment offered the longest stability at 35 to 50 days and direct light and humidity offered the shortest periods of stability at 3 to 14 days. CONCLUSIONS: The results of this study support the manufacturer's recommendations to store POCT glucose test strips in their original vial, capped, and at room temperature, though refrigeration may offer an alternative storage environment with acceptable stability. As compliance with testing, quality control, and storage instructions is often an issue with POCT, the manufacturers of these systems for blood glucose measurement should design storage systems that allow the patient to store the glucose meter and the reagent strips in the same location. Manufacturers may also need to consider designing storage systems that are more portable, knowing that patients must take the glucose meters and test strips with them when they travel. Roche's Accu-Chek Compact system is an example of such a design. The glucose test strips are incorporated into a drum that is stored in the Accu-Chek meter itself. When a patient performs a fingerstick blood glucose measurement, the drum advances to move a test strip outside the meter. When the test is complete, the test strip is ejected for disposal. Future studies to clarify the effect of adverse storage conditions, particularly refrigeration, on the integrity of POCT test systems and reagent strips is warranted with currently marketed brands.
Asunto(s)
Automonitorización de la Glucosa Sanguínea/instrumentación , Ambiente , Tiras Reactivas , Glucemia/análisis , Humanos , Sistemas de Atención de Punto , Valores de Referencia , Reproducibilidad de los ResultadosRESUMEN
Health care managers and supervisors work in an environment of major changes and ongoing turbulence. Basic terms and strategic approaches are described to enable managers and supervisors to better understand the process of environmental scanning in the turbulent health care environment. Drawing from multiple disciplines, the information allows health care managers and supervisors to improve their skills as environmental scanners as they develop and implement strategic plans in this environment.
Asunto(s)
Administradores de Instituciones de Salud , Técnicas de Planificación , Competencia Profesional , Comercio/organización & administración , Estados UnidosRESUMEN
OBJECTIVE: To identify the degrees held and the graduate majors or fields of study for faculty teaching full-time and part-time in university-based, baccalaureate-degree clinical laboratory science/medical technology (CLS/MT) programs. DESIGN AND PARTICIPANTS: A survey and letter of project explanation was sent electronically to the 110 program directors of NAACLS-accredited university-based CLS/MT programs in the United States in May, 2003. Program directors were requested to provide for each full-time and part-time faculty member the following information: titles for all degrees held, major/field of study for each degree held, all specialist certifications held, all other formal degrees or certificates held, and all courses/areas taught in the CLS curriculum. RESULTS: Information was provided on 288 faculty in 52 CLS/MT programs, for a response rate of 47%. The majority of faculty (75%) described were full-time. A doctorate was held by 43% of the reported faculty, while 46% held a master's degree as their highest degree, and 11 % only a BS in CLS or in biology plus a certificate from a hospital-based CLS/MT program. Graduate degrees in a science major or field represented 52% of the degrees held by the reported faculty, while 48% of the graduate degrees were in education, public health, or administration. Only 13% of the reported faculty held master's degrees specifically in CLS. Detailed results are provided for degrees held, majors/fields of study, and specialist certifications by specific courses/areas of the curriculum taught. CONCLUSIONS: The results of this survey indicate that many faculty teaching in university-based CLS/MT programs are extending their preparation as scientists to the graduate level. This should prepare these faculty for their responsibilities in not only teaching but also research. A case cannot be made that a doctorate, as opposed to a master's degree, is viewed as the 'terminal degree' as less than half of the reported faculty in this study as well as others, held a doctorate. The results reported provide a national perspective on the graduate backgrounds of CLS faculty for comparison to an individual program's faculty during programmatic or institutional accreditation reviews.
Asunto(s)
Educación de Postgrado , Docentes , Ciencia del Laboratorio Clínico/educación , Docentes/estadística & datos numéricos , Humanos , Estados UnidosRESUMEN
Deans and directors of allied health units in member institutions of the Association of Schools of Allied Health Professions (ASAHP) were surveyed to determine their approaches to leadership development. Of 99 deans and directors surveyed, 75 (76%) responded. All respondents had held at least one academic administrative position before their current position; assistant or associate dean were the most common positions. The respondents' leadership development included participation in service to the ASAHP or another health or allied health association. More female respondents (67%) than male respondents (47%) reported being mentored. Most frequently listed programs, workshops, and activities for leadership development were Harvard University's Management Development Program, regional allied health deans groups, and institutional leadership programs. Of respondents, 60% viewed professional experience as being more beneficial in leadership development than formal programs, workshops, and activities. The most important skills directly developed from such activities were strategic planning and forecasting, having a vision, and team or collaboration building.
Asunto(s)
Empleos Relacionados con Salud/educación , Liderazgo , Escuelas para Profesionales de Salud , Docentes , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Estados Unidos , Recursos HumanosRESUMEN
The School of Allied Health Sciences (SAHS) at East Carolina University administered a cultural competence survey to assess baseline competence for comparison with future, longitudinal assessments. This cultural competence assessment of students and faculty offers a comparison groupfor other schools of allied health that conduct similar studies. The faculty response rate was 59% with 35 completed surveys, and the student response rate was 28% with 151 respondents. The SAHS response rate for the faculty and students combined was 32% (N = 186). The allied health students consistently had higher mean scores than the faculty on knowledge of communities, personal involvement, and total score, although the differences were not statistically significant. This difference may be a reflection of the greater, although still relatively low, ethnic/cultural diversity among the students (82% white) compared with the faculty (97% white). The results are limited in generalizability to other schools of allied health with a predominately white female population.
Asunto(s)
Diversidad Cultural , Docentes , Escuelas para Profesionales de Salud , Estudiantes del Área de la Salud , Femenino , Humanos , Relaciones Interpersonales , Masculino , Competencia ProfesionalRESUMEN
Laboratories across the U.S. have implemented needle safety devices to varying degrees and are making efforts to comply with the most recent legislation in this area, The Needlestick Safety and Prevention Act. A survey was conducted among hospital clinical laboratories in North Carolina, with a 70% response rate. Of 86 responding laboratories that offered either inpatient and/or outpatient phlebotomy, 88% reported currently using safety devices, and only two of the nonusers indicated no plans for adoption of such devices. The most commonly reported types of venipuncture safety devices in use or being adopted were the modified vacuum-tube holder for either one-handed needle release or needle retraction and sheathing, followed by needle clips. Despite studies demonstrating reduced needlestick rates and cost savings with use of needle safety devices, respondents' concerns included added cost, staff dissatisfaction with devices because they were cumbersome, and being uncertain that the devices would reduce needlesticks.
Asunto(s)
Laboratorios de Hospital/organización & administración , Lesiones por Pinchazo de Aguja/prevención & control , Flebotomía/instrumentación , Equipos de Seguridad , Recolección de Datos , Humanos , Personal de Laboratorio Clínico , Lesiones por Pinchazo de Aguja/epidemiología , North Carolina/epidemiologíaRESUMEN
OBJECTIVE: The purpose of this study was to compare results obtained for the prothrombin time (PT) and the activated partial thromboplastin time (APTT) using specimens drawn with and without a discard tube in healthy adults. DESIGN: A specimen of blood in a 3.2% sodium citrate, 5.0 mL tube was drawn from one arm with a discard tube and from the other arm without a discard tube on 35 healthy adults. A PT and APTT were performed on each specimen using a fibrometer. SETTING: The PT and APTT tests were all performed in the student laboratory of the Clinical Laboratory Science Program at East Carolina University. PATIENTS OR OTHER PARTICIPANTS: Study subjects induded technician, technologist, and phlebotomist employees of the clinical laboratory at Pitt County Memorial Hospital, and faculty and junior and senior students in the Clinical Laboratory Science Program at East Carolina University, Greenville, North Carolina. All participants signed an informed consent prior to venipuncture. INTERVENTIONS: Two coagulation specimens were drawn from each subject. Specimens in a discard (no anticoagulant) tube and then an anticoagulated tube were drawn from one arm, and a specimen in a single anticoagulant tube was drawn from the other arm. The PT and APTT were performed using standardized procedures with Pacific Hemostasis reagents and controls and a BBL FibroSystem fibrometer. MAIN OUTCOME MEASURES: The degree of difference between PT results and between APTT results for specimens drawn with and without a discard tube. RESULTS: Based on paired t-test analyses, no difference in mean PT results and no difference in mean APTT results were found between specimens drawn with a discard tube and those drawn without a discard tube at an alpha of 0.05. Paired-samples correlation coefficients were significant for both the PT and the APTT at an alpha of 0.05, showing precision between results with and without a discard tube for both coagulation tests. CONCLUSIONS: Relative to sampling from a population of healthy adults, drawing a discard tube before a sodium citrate tube for coagulation testing appears to make an insignificant difference. Replication of these results with patients receiving anticoagulant therapy and/or patients with abnormal coagulation results, would offer cost savings by justifying elimination of discard tubes for blood draws for coagulation testing only. Such a change in protocol would also reduce the likelihood of nosocomial blood loss in vulnerable patient populations.
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Recolección de Muestras de Sangre/métodos , Tiempo de Tromboplastina Parcial , Tiempo de Protrombina , Humanos , Análisis por ApareamientoRESUMEN
This study was conducted as the second phase of a larger study assessing leadership development in schools or units of member institutions of the Association of Schools of Allied Health Professions. A survey was mailed to the chairs of 21 search committees for the position of lead administrator (i.e., dean or director) of an allied health school or unit; 20 (95%) responded. Of the respondents, 55% reported that filling the dean/director position was very easy (15%) or moderately easy (40%). The mean number of viable candidates was 11.7, and the mean time to recruit a new dean/director was 6.9 months. Most (65%) new deans/directors had backgrounds in the health professions, with the greatest number being nursing (n = 3). The greatest proportion (30%) were assistant/associate deans before becoming dean/director. The actual experiences of search committees in this study showed a relatively adequate pool of applicants for dean/director of allied health positions.
Asunto(s)
Personal Administrativo , Empleos Relacionados con Salud/educación , Selección de Personal , Escuelas para Profesionales de Salud/organización & administración , Recolección de Datos , Humanos , Liderazgo , Estados UnidosRESUMEN
As part of the 2001 Coalition for Allied Health Leadership, a review of curriculum resources for teaching diversity courses in allied health programs was conducted. A synopsis of the most relevant resources and an example of a generic diversity course for programs preparing entry-level allied health professionals, are presented.
Asunto(s)
Empleos Relacionados con Salud/educación , Diversidad Cultural , Curriculum , Materiales de Enseñanza , Bibliografías como Asunto , Humanos , Estados UnidosRESUMEN
OBJECTIVE: A study was conducted to determine if HIV/AIDS patients have smaller than normal size neutrophils and increased prevalence of abnormal platelet morphology. DESIGN: Wright's-stained peripheral blood smears from 100 HIV/ AIDS patients were evaluated for size of segmented neutrophils and degree of abnormal platelet morphology. SETTING: East Carolina University, Greenville, North Carolina. PARTICIPANTS: The study subjects consisted of 100 HIV/AIDS patients seen in an outpatient clinic in a teaching hospital in an academic health center. Peripheral blood smears were made from EDTA tubes drawn as a part of a routine immunology panel. MAIN OUTCOME MEASURES: Segmented neutrophils from each of ten oil immersion fields were measured for diameter with a micrometer and the average diameter calculated. In addition, any platelet morphology abnormality, which was noted in at least five oil immersion fields, was recorded. One researcher evaluated one slide on each patient, and the second researcher randomly selected 20% of the subjects and performed the same procedure on a second slide for quality assurance of results. RESULTS: A segmented neutrophil mean diameter of 15.1 microns was found. Though this mean is a mere 0.1 microns above the upper limit of the normal range of 10 to 15 microns, 53% of the patients had an observed average diameter above 15 microns. The HIV/AIDS patients' mean diameter was statistically different when compared to a normal population mean of 12.0 microns (T-test = 16.15, p < .0001), thus, showing a tendency for HIV/AIDS patients' segmented neutrophils to be large. Over half of the study subjects demonstrated abnormal platelet morphology including agranularity, small size, and giant size. CONCLUSION: Neutrophil size as based on cell diameter, was found to be significantly larger for a sample of HIV/AIDS patients than the normal mean size. There was also a tendency for platelet morphology to be abnormal.