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Challenges amid COVID-19 times - Review of the changing practices in a clinical chemistry laboratory from a developing country.

ABSTRACT: Corona Virus Disease 2019 (COVID-19) pandemic is the defining global health crisis of our time. Compared with its neighbors China and Iran, which were rated as epi-centers of the outbreak, Pakistan has lower standards of health care, unstable economy and dearth of financial resources to tackle the outbreak. Like other institutes and industries in the country, clinical laboratories were succumbed to a variety of challenges. This article is based on the experience and adapted workflow measures from the Clinical Chemistry laboratory at the Aga Khan University Hospital (AKUH), Karachi, which serves as a national referral center with its widespread network of satellite laboratories and phlebotomy centers across the country. It highlights the challenges faced and the appropriate responses to ensure the provision of diagnostic facilities during the COVID-19 outbreak. Furthermore, the lessons acquired and necessary preparations for the post crisis situation are also incorporated.

SUBMITTER: Ahmed S

PROVIDER: S-EPMC7287176 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Challenges amid COVID-19 times - Review of the changing practices in a clinical chemistry laboratory from a developing country.

Ahmed Sibtain S Jafri Lena L Majid Hafsa H Khan Aysha Habib AH Ghani Farooq F Siddiqui Imran I

Annals of medicine and surgery (2012) 20200606

Corona Virus Disease 2019 (COVID-19) pandemic is the defining global health crisis of our time. Compared with its neighbors China and Iran, which were rated as epi-centers of the outbreak, Pakistan has lower standards of health care, unstable economy and dearth of financial resources to tackle the outbreak. Like other institutes and industries in the country, clinical laboratories were succumbed to a variety of challenges. This article is based on the experience and adapted workflow measures fro ...[more]

PMID: 32551102

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Project description:BackgroundThe lab professionals at one end are at increased risk of contracting the infection while on the other end have to deal with the various challenges during the Coronavirus Disease 2019 (COVID-19) outbreak. This survey was undertaken to analyze the lab professionals' perspectives, in terms of the challenges, financial implications, fears, motivation and satisfaction from organizational processes and policies adopted, amid the COVID-19 crisis.Material & methodsThe study utilized a cross-sectional survey design. The survey was administered online via the google docs survey tool from medical laboratory professionals (n = 64) serving at the section of Clinical Chemistry, department of Pathology and Laboratory Medicine, the Aga Khan University (AKU), Pakistan from June 4th to 14th 2020. A team consisting of three Clinical Chemistry consultants serving as faculty at the section, designed the survey questionnaire. The responses were recorded on a five-point Likert Scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree). The statistical analysis was performed using the Microsoft Excel 2013. Frequency and percentages were calculated for gender, experience and designation while descriptive results based on the responses were also recorded.ResultsThe response rate was 78% (n = 50). 60% responded that the current lifestyle adopted during the pandemic was not better than the traditional one. The fear of employment termination and financial challenges were being faced by 42% and 78% respondents respectively. The quality of family life was improved in 54% cases while 96% were of the view that their social activities at work have suffered. Whereas, 22% were not satisfied by the measures taking by the management during the outbreak.ConclusionThe findings of this survey provide laboratorians' perspective, in times of such crisis and provides us certain lessons to prepare for such unpredicted situations in future.

Project description:BackgroundOne of the main forthcoming challenges of healthcare systems against preparedness and management of the pandemic is the challenge of procurement and recruitment of the human resources. This study is aimed to explore the health human resources challenges during COVID-19 pandemic in Iran.MethodsThis qualitative content analysis study was conducted in 2020. The study population includes all the Iranian human resources managers affiliated in Universities of Medical Sciences, hospitals and health centers managers and the health networks managers all over the country. 23 participants were included via purposeful sampling considering the inclusion criteria and were interviewed individually. After 23 semi-structured interviews, data were saturated. Then the data were analyzed through content analysis approach applying MAXQDA10.ResultsThree main themes of "organizational challenges", "legal challenges", and "personal challenges" were explored as the main challenges of health human resources management during COVID-19. On the one hand, organizational challenges include restricted financial resources, compensation discrimination, staffing distinction points, imbalance in the workload, weak organizational coordination, inefficient inter-sectoral relationships, parallel decisions, inefficient distribution of the human resources, lack of applied education, lack of integrated health protocols, lack of appropriate evaluation of performance, employee turnover, lack of clear approaches for staffing, and shortage of specialized manpower, and on the other hand, the personal challenges include insufficient knowledge of the employees, psychological disorders, reduction of self-confidence, burnout, workload increase, reduced level of job satisfaction, effects of colleague and patients bereavement and unsafety sense against the work place. Finally, the legal challenges that mostly related to the governments laws and regulations include lack of protocols for continuous supportive services, inappropriate approaches and instructions for teleworking, and lack of alternative plans and regulations for the human resources.ConclusionOrganizational, legal and personal challenges are among three main challenges of health human resources management during COVID-19 pandemic. Serious attention to these challenges should be considered by health policymakers in order to be prepared for facing new probable outbreaks and managing the present condition. The integrated comprehensive planning of human resources management for COVID-19 along with supportive packages for the personnel can be helpful.

Project description:Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammation in the lungs that causes obstruction in the airway, poor airflow, and irreversible loss of lung function. In clinical practice, comprehensive care for COPD patients includes the diagnosis using spirometry, clinical examination and comprehensive pharmacological and non-pharmacological management. The diagnosis is based on symptoms, dyspnea and lung function impairment and can be mild to very severe. Symptoms are examined using the COPD assessment test (CAT) score, and dyspnea grade are examined using a modified MRC from GOLD guidelines. When mild, the care includes self-management education, smoking cessation, lifestyle modifications, vaccination, and short-acting bronchodilators. Self-management education involves inhaler device training, breathing technique, early recognition of acute exacerbations and writing action plans. As the disease progresses, other care measures are added. These measures include the addition of long-acting inhaler therapies, pulmonary rehabilitation, oral therapies, oxygen and lung transplantation. During the final stages of COPD, patients receive end-of-life care (Bourbeau et al., 2019).1 The novel coronavirus disease (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is spread through respiratory droplets. This infectious disease has led to a pandemic and is affecting the lives of many around the world, including Canadians. During this pandemic, the non-essential health services, including caring for patients with COPD, have been put on hold to reduce the risk of spread. Other implications of this pandemic for COPD patients include the health risk in case of infection. A meta-analysis including studies from January to March 2020 in Wuhan showed that pre-existing COPD worsens the risk of COVID-19 progression and leads to poorer prognostics. The sub-group analysis showed a significantly higher risk of ICU requirements and death in COPD patients who are infected with the SARS-CoV-2 virus. Studies suggest strong efforts to mitigate the risk of infection in this population (Zhao et al., May 2020).2 This makes caring for this population even more critical during the pandemic.

Project description:Background: Despite being known abroad as a viable alternative to face-to-face consultation and therapy, telerehabilitation has not fully emerged in developing countries like the Philippines. In the midst of the coronavirus disease 2019 (COVID-19) pandemic, wherein social distancing disrupted the in-clinic delivery of rehabilitation services, Filipinos attempted to explore telerehabilitation. However, several hindrances were observed especially during the pre-implementation phase of telerehabilitation, necessitating a review of existing local evidences. Objective: We aimed to determine the challenges faced by telerehabilitation in the Philippines. Method: We searched until March 2020 through PubMed, Scopus, Embase, Cochrane Library, and HeRDIN for telerehabilitation-related publications wherein Filipinos were involved as investigator or population. Because of the hypothesized low number of scientific outputs on telerehabilitation locally, we performed handsearching through gray literature and included relevant papers from different rehabilitation-related professional organizations in the Philippines. We analyzed the papers and extracted the human, organizational, and technical challenges to telerehabilitation or telehealth in general. Results: We analyzed 21 published and 4 unpublished papers, which were mostly reviews (8), feasibility studies (6), or case reports/series (4). Twelve out of 25 studies engaged patients and physicians in remote teleconsultation, teletherapy, telementoring, or telemonitoring. Patients sought telemedicine or telerehabilitation for general medical conditions (in 3 studies), chronic diseases (2), mental health issues (2), orthopedic problems (2), neurologic conditions (1), communication disorders (1), and cardiac conditions (1). Outcomes in aforementioned studies mostly included telehealth acceptance, facilitators, barriers, and satisfaction. Other studies were related to telehealth governance, legalities, and ethical issues. We identified 18 human, 17 organizational, and 18 technical unique challenges related to telerehabilitation in the Philippines. The most common challenges were slow internet speed (in 10 studies), legal concerns (9), and skepticism (9). Conclusion: There is paucity of data on telerehabilitation in the Philippines. Local efforts can focus on exploring or addressing the most pressing human, organizational, and technical challenges to the emergence of telerehabilitation in the country.

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Challenges amid COVID-19 times - Review of the changing practices in a clinical chemistry laboratory from a developing country.

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Challenges amid COVID-19 times - Review of the changing practices in a clinical chemistry laboratory from a developing country.

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