ABSTRACT
The major cause of neonatal mortality and morbidity is bacterial sepsis. Blood culture is the most reliable method in neonatal sepsis. This study was conducted to study the usefulness of hematological parameters in the early diagnosis of neonatal sepsis and to assess the most sensitive and specific variables in diagnosing neonatal sepsis. This prospective study was conducted in a tertiary care hospital from January 2017 to January 2018. Peripheral blood smears were prepared from patients with clinical suspicion of sepsis or predisposing perinatal factors for sepsis and stained with Field's stain and examined. The hematological findings were analyzed according to the hematologic scoring system of Rodwell. It was found that immature PMN count, I: M ratio, and I: T ratio had the highest sensitivity (92.06%, 87.30%, and 74.60%, respectively) while I: M ratio, I: T ratio, and degenerative changes in PMN had the highest specificity (97.50%, 96.50%, and 94.0%, respectively) in the prediction of sepsis.
ABSTRACT
Introduction: Blood transfusion services is the important part of the modern healthcare system without which efficient medical care is not possible. Blood bank quality audits become an important assessment tool to check the efficiency of the quality system in terms of realization of quality policy, fulfilment of designed targets and implementation of quality system documents. Aim:To study the utility of vertical quality audits as a quality improvement tool, to compare vertical and horizontal audits and explore the differences between them. Methods and materials: The study duration was three years and two months, from November 2018 to December 2021. We conducted an observational prospective study of vertical and horizontal quality audits in a transfusion centre of our tertiary care hospital as per ISO 9001:2000 and National Accreditation Board for Hospitals & Healthcare Providers (NABH) guideline. Results:The most common non-conformities in vertical audit were related to documentation (80%). The donor area was the most common area of blood bank from where non-conformities were observed in vertical audit (60%). The most commonly observed non-conformities in horizontal audit were related to procedural or technical aspects (42.8%). The donor area was the most common area of blood bank from where non-conformities were observed in horizontal audit (57.14%). Conclusions:Quality audits verify compliance and therefore, they are driving continuous quality improvement in a blood bank. Vertical audit is a retrospective process and helps to identify near miss events and errors performed by blood bank staff. Horizontal audits are cumbersome to conduct as compared to vertical audits.
