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1.
Glob Health Sci Pract ; 8(4): 689-698, 2020 12 23.
Article in English | MEDLINE | ID: covidwho-1000593

ABSTRACT

BACKGROUND: Providing professional development opportunities to staff working in clinical laboratories undergoing quality improvement programs can be challenged by limited funding, particularly in resource-limited countries such as Cambodia. Using innovative approaches such as video conferencing can connect mentors with practitioners regardless of location. This study describes and evaluates the methods, outputs, and outcomes of a quality improvement program implemented in 12 public hospital laboratories in Cambodia between January 2018 and April 2019. The program used mixed intervention methods including both in-person and remote-access training and mentorship. METHODS: Training outputs were quantified from the activity reports of program trainers and mentors. Program outcomes were measured by pre- and postimplementation audits of laboratory quality management system conformity to international standards. Variations in improved outcomes were assessed in relation to the time spent by laboratory personnel in video conference training and mentoring activity. An additional cross-sectional comparison described the difference in final audit scores between participating and nonparticipating laboratories. RESULTS: Laboratories significantly improved their audit scores over the project period, showing significant improvement in all sections of the ISO 15189 standard. Pre- and postaudit score differences and laboratory personnel participation time in remote mentoring activities showed a strong monotonic relationship. Average input per laboratory was 6,027±2,454 minutes of participation in video conference activities with mentors. Audit scores of participating laboratories were significantly higher than those of laboratories with no quality improvement program. CONCLUSION: Laboratories improved significantly in ISO 15189 conformity following structured laboratory quality management systems training supported by remote and on-site mentoring. The correlation of laboratory participation in video conference activities highlights the utility of remote video conferencing technology to strengthen laboratories in resource-limited settings and to build communities of practice to address quality improvement issues in health care. These findings are particularly relevant in light of the COVID-19 pandemic.


Subject(s)
Laboratories/organization & administration , Mentoring/organization & administration , Quality Improvement/organization & administration , Videoconferencing/organization & administration , Cambodia , Cross-Sectional Studies , Humans , Laboratories/standards , Quality Improvement/standards , Staff Development/organization & administration , United States
2.
J Occup Environ Hyg ; 17(10): 447-456, 2020 10.
Article in English | MEDLINE | ID: covidwho-786940

ABSTRACT

Bioaerosols are known to be an important transmission pathway for SARS-CoV-2. We report a framework for estimating the risk of transmitting SARS-CoV-2 via aerosols in laboratory and office settings, based on an exponential dose-response model and analysis of air flow and purification in typical heating, ventilation, and air conditioning (HVAC) systems. High-circulation HVAC systems with high-efficiency particulate air (HEPA) filtration dramatically reduce exposure to the virus in indoor settings, and surgical masks or N95 respirators further reduce exposure. As an example of our risk assessment model, we consider the precautions needed for a typical experimental physical science group to maintain a low risk of transmission over six months of operation. We recommend that, for environments where fewer than five individuals significantly overlap, work spaces should remain vacant for between one (high-circulation HVAC with HEPA filtration) to six (low-circulation HVAC with no filtration) air exchange times before a new worker enters in order to maintain no more than 1% chance of infection over six months of operation in the workplace. Our model is readily applied to similar settings that are not explicitly given here. We also provide a framework for evaluating infection mitigation through ventilation in multiple occupancy spaces.


Subject(s)
Air Pollution, Indoor/prevention & control , Coronavirus Infections/transmission , Laboratories/standards , Models, Statistical , Pneumonia, Viral/transmission , Ventilation/standards , Workplace/standards , Air Conditioning/standards , Betacoronavirus , Coronavirus Infections/epidemiology , Humans , Occupational Health , Pandemics , Pneumonia, Viral/epidemiology , Risk Assessment
3.
Am J Gastroenterol ; 115(10): 1575-1583, 2020 10.
Article in English | MEDLINE | ID: covidwho-737627

ABSTRACT

The American Neurogastroenterology and Motility Society Task Force recommends that gastrointestinal motility procedures should be performed in motility laboratories adhering to the strict recommendations and personal protective equipment (PPE) measures to protect patients, ancillary staff, and motility allied health professionals. When available and within constraints of institutional guidelines, it is preferable for patients scheduled for motility procedures to complete a coronavirus disease 2019 (COVID-19) test within 48 hours before their procedure, similar to the recommendations before endoscopy made by gastroenterology societies. COVID-19 test results must be documented before performing procedures. If procedures are to be performed without a COVID-19 test, full PPE use is recommended, along with all social distancing and infection control measures. Because patients with suspected motility disorders may require multiple procedures, sequential scheduling of procedures should be considered to minimize need for repeat COVID-19 testing. The strategies for and timing of procedure(s) should be adapted, taking into consideration local institutional standards, with the provision for screening without testing in low prevalence areas. If tested positive for COVID-19, subsequent negative testing may be required before scheduling a motility procedure (timing is variable). Specific recommendations for each motility procedure including triaging, indications, PPE use, and alternatives to motility procedures are detailed in the document. These recommendations may evolve as understanding of virus transmission and prevalence of COVID-19 infection in the community changes over the upcoming months.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/standards , Gastrointestinal Diseases/diagnosis , Infection Control/standards , Laboratories/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Advisory Committees/standards , Betacoronavirus/pathogenicity , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Gastroenterology/methods , Gastrointestinal Diseases/physiopathology , Gastrointestinal Motility/physiology , Humans , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Patient Selection , Personal Protective Equipment/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Prevalence , Societies, Medical/standards , Triage/standards , United States/epidemiology
5.
Ann Biol Clin (Paris) ; 78(4): 363-382, 2020 Aug 01.
Article in English | MEDLINE | ID: covidwho-709296

ABSTRACT

The point-of-care tests (POCT) are subject to accreditation. A national inventory survey provides a synthesis of knowledge. The survey distributed 31 questions in 2019. 147 responses were received (75% biologists, 49% CHU, 42% CHG). Only 20.41% are accredited ISO22870, the majority for <50% of the medical departments; 70% say they are going there at the end of 2019 or in 2020. The maps are unknown for 32% (EBMD) and 82% (TROD). Visibility is poor with: medical establishment committee (40%), IT department (31%). Connection is necessary for 87-95% depending on the criterion (QC, authorizations, etc.) and 66% of answers highlight that less than 50% of connexion is effective. The major advantage is the delay of the result (62.5%), then the relationship with the health teams (33.3%). The disadvantages: difficulty of the quality approach (45%), cost of tests (34.3%). Human resource requirements are identified for technicians (82%) and biologists (76%). The multiplicity of sites, devices and operators means that it is difficult to set up and maintain. Biology outside the laboratories, under biological responsibility, must meet a rigorous imperative quality approach.


Subject(s)
Clinical Laboratory Techniques , Global Health , Laboratories/statistics & numerical data , Laboratories/standards , Point-of-Care Testing , Accreditation , Clinical Laboratory Services/standards , Clinical Laboratory Services/statistics & numerical data , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , France/epidemiology , Global Health/standards , Global Health/statistics & numerical data , History, 21st Century , Humans , Internationality , Laboratory Proficiency Testing/standards , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Point-of-Care Systems/standards , Point-of-Care Systems/statistics & numerical data , Point-of-Care Testing/organization & administration , Point-of-Care Testing/standards , Point-of-Care Testing/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Surveys and Questionnaires
6.
Indian J Pathol Microbiol ; 63(3): 350-357, 2020.
Article in English | MEDLINE | ID: covidwho-706335

ABSTRACT

Declared as a pandemic by WHO on March 11, 2020, COVID-19 has brought about a dramatic change in the working of different laboratories across the country. Diagnostic laboratories testing different types of samples play a vital role in the treatment management. Irrespective of their size, each laboratory has to follow strict biosafety guidelines. Different sections of the laboratory receive samples that are variably infectious. Each sample needs to undergo a proper and well-designed processing system so that the personnel involved are not infected and also their close contacts. It takes a huge effort so as to limit the risk of exposure of the working staff during the collection, processing, reporting or dispatching of biohazard samples. Guidelines help in preventing the laboratory staff and healthcare workers from contracting the disease which has a known human to human route of transmission and high rate of mortality. A well-knit approach is the need of the hour to combat this fast spreading disease. We anticipate that the guidelines described in this article will be useful for continuing safe work practices by all the laboratories in the country.


Subject(s)
Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Occupational Exposure/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Specimen Handling/methods , Betacoronavirus , Disinfection/methods , Guidelines as Topic , Hazardous Substances , Health Personnel/standards , Humans , Laboratories/standards , Pathologists/standards , Waste Management/methods
8.
J Pak Med Assoc ; 70(Suppl 3)(5): S48-S51, 2020 May.
Article in English | MEDLINE | ID: covidwho-609380

ABSTRACT

COVID-19 poses a great challenge to clinical and diagnostic services around the world. The need of biosafety practices can never be emphasised more than under current circumstances. The four pillars of biosafety namely, leadership, standard operating procedures, personal protective equipment (PPE) and engineering controls must be employed for effective and safe practices in the clinical setting in general and laboratory settings in particular. Risk assessment must be carried out before meeting up the diagnostic challenge for COVID-19 and essential biorisk management measures are required to be taken. In our resource-poor settings, we need to adapt safe but cost-effective and improvised solutions to ensure safe handling of clinical samples from COVID-19 patients in the laboratories. The correct use of PPE and their suitable alternatives are available for selection and use. Disinfection of the lab areas and safe disposal of the clinical samples from such patients is also of paramount importance.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/standards , Containment of Biohazards , Coronavirus Infections , Pandemics , Pneumonia, Viral , Containment of Biohazards/methods , Containment of Biohazards/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Humans , Infection Control/standards , Laboratories/standards , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Risk Assessment
9.
Clin Anat ; 33(6): 975-976, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-596132

ABSTRACT

Severe acute respiratory syndrome (SARS CoV-2/COVID-19) is a highly contagious and deadly disease caused by a virus belonging to the coronaviridae family. Researchers working in histopathology laboratories, dealing with morbid samples, are particularly vulnerable to infection unless they have very strong immunity. Hence, a proper precautionary protocol is required for the safety of the laboratory staff. The current review highlights the biological and physical agents that can be used to inactivate the virus and disinfect the surrounding environment in the laboratory.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/prevention & control , Disinfectants/pharmacology , Disinfection/methods , Histology , Laboratories/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Coronavirus Infections/epidemiology , Humans , Infection Control/methods , Medical Laboratory Personnel , Pathology Department, Hospital/organization & administration , Pathology Department, Hospital/standards , Pneumonia, Viral/epidemiology
10.
Cytometry A ; 97(7): 674-680, 2020 07.
Article in English | MEDLINE | ID: covidwho-505930

ABSTRACT

In response to the recent COVID-19 pandemic, many laboratories are involved in research supporting SARS-CoV-2 vaccine development and clinical trials. Flow cytometry laboratories will be responsible for a large part of this effort by sorting unfixed antigen-specific lymphocytes. Therefore, it is critical and timely that we have an understanding of risk assessment and established procedures of infectious cell sorting. Here we present procedures covering the biosafety aspects of sorting unfixed SARS-CoV-2-infected cells and other infectious agents of similar risk level. These procedures follow the ISAC Biosafety Committee guidelines and were recently approved by the National Institutes of Health Institutional Biosafety Committee for sorting SARS-CoV-2-infected cells. © 2020 International Society for Advancement of Cytometry.


Subject(s)
Betacoronavirus/isolation & purification , Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Flow Cytometry/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Specimen Handling/methods , Coronavirus Infections/diagnosis , Humans , Laboratories/standards , Medical Laboratory Personnel/standards , Pneumonia, Viral/diagnosis , Risk Assessment
11.
Emerg Infect Dis ; 26(8): 1944-1946, 2020 08.
Article in English | MEDLINE | ID: covidwho-326416
12.
J Mol Diagn ; 22(7): 844-846, 2020 07.
Article in English | MEDLINE | ID: covidwho-260268

ABSTRACT

The laboratory response to the current severe acute respiratory syndrome coronavirus 2 pandemic may be termed heroic. From the identification of the novel coronavirus to implementation of routine laboratory testing around the world to the development of potential vaccines, laboratories have played a critical role in the efforts to curtail this pandemic. In this brief report, we review our own effort at a midsized, rural, academic medical center to implement a molecular test for the virus; and we share insights and lessons learned from that process, which might be helpful in similar situations in the future.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Delivery of Health Care/organization & administration , Emergencies , Health Plan Implementation , Laboratories/legislation & jurisprudence , Pneumonia, Viral/diagnosis , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Humans , Laboratories/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/virology
14.
J Histotechnol ; 43(2): 102-104, 2020 06.
Article in English | MEDLINE | ID: covidwho-2831

ABSTRACT

The 2019 Coronavirus epidemic, provisionally called 2019-nCoV, was first identified in Wuhan, China, in persons exposed to a seafood or wet market. There is an international push to contain the virus and prevent its spread. It is feasible that potentially infectious samples may be received in histopathology laboratories for diagnosis. This technical note presents disinfection procedures and histotechnology processes that should alleviate the risk of infection to laboratory staff. Using data obtained from similar coronaviruses, e.g. severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), experts are confident that 70% ethanol and 0.1% sodium hypochlorite should inactivate the virus. Formalin fixation and heating samples to 56oC, as used in routine tissue processing, were found to inactivate several coronaviruses and it is believed that 2019-nCoV would be similarly affected.


Subject(s)
Betacoronavirus , Containment of Biohazards/methods , Coronavirus Infections , Disinfection/methods , Pandemics , Pathology, Clinical/methods , Pneumonia, Viral , Containment of Biohazards/standards , Disinfection/standards , Histological Techniques/standards , Humans , Laboratories/standards , Pathology, Clinical/standards
15.
Euro Surveill ; 25(6)2020 02.
Article in English | MEDLINE | ID: covidwho-664

ABSTRACT

Timely detection of novel coronavirus (2019-nCoV) infection cases is crucial to interrupt the spread of this virus. We assessed the required expertise and capacity for molecular detection of 2019-nCoV in specialised laboratories in 30 European Union/European Economic Area (EU/EEA) countries. Thirty-eight laboratories in 24 EU/EEA countries had diagnostic tests available by 29 January 2020. A coverage of all EU/EEA countries was expected by mid-February. Availability of primers/probes, positive controls and personnel were main implementation barriers.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus/genetics , Coronavirus/isolation & purification , Laboratories/standards , Pneumonia, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction/methods , Clinical Laboratory Techniques/methods , Coronavirus/classification , Coronavirus Infections/genetics , Coronavirus Infections/virology , Disease Outbreaks , European Union , Humans , RNA, Viral/genetics , Reference Standards , Sensitivity and Specificity , Sentinel Surveillance , Sequence Analysis
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