BACKGROUND: In hospital laboratory using Microscan, the search for an isolate or the analysis for antimicrobial susceptibility rates were obtained by the Data Management System (DMS) software. However, it is hard to convert DMS database to other file formats in addition to some limitation in using the database. We applied BacLink 2 and WHONET 5.1 softwares to convert and analyse DMS database for the utilization of the isolate profiles and the antimicrobial resistance rates. METHODS: Specimen and microbial data were printed as 'Short report form', an ASCII text file, from Microscan DMS. BacLink 2 software was used to convert the printed file to dBASE format file. Statistical analyses were performed using WHONET 5.1 software. RESULTS: Data of isolates were obtained as 'Short report form' in one month intervals. This file could be converted to other database file using BacLink 2 software. The antimicrobial resistant profiles were obtained, and the susceptibility, intermediate resistant, and resistant rates for each isolates could be analyzed. CONCLUSIONS: In this study, BacLink 2 and WHONET 5.1 software were successfully applied for the conversion of the database. Analysis of isolate profiles and antimicrobial resistant rates could be performed in other personal computer systems. The database management by BacLink 2 and WHONET 5.1 software could be applicable for the convenient statistical analysis in microbiology laboratories using Microscan.
Laboratories, Hospital ; Microcomputers

We have a step backwards in comparing with the previous 40 years in the education and the organization of medical laboratory examination. While our equipment and techniques have got new great success and the needs have increased. Typically, in clinical briefing, laboratory doctors and technicians have been always absent, it seems that it is due to the leak of a deep knowledge and a large skill of laboratory. Therefore their roles were reduced. An improvement in the programm of formation of laboratory doctors and experts with various branches: biochemia, hematology, blood perfusion was recommend
Outpatient Clinics, Hospital ; Technology, Medical ; Laboratories ; diagnosis ;

Serum consists of water (93% of serum volume) and nonaqueous components, mainly lipids and proteins (7% of serum volume). Sodium is restricted to serum water. In states of hyperproteinemia or hyperlipidemia, there is an increased mass of the nonaqueous components of serum and a concomitant decrease in the proportion of serum composed of water. Thus, pseudohyponatremia results because the flame photometry method measures sodium concentration in whole plasma. A sodium-selective electrode gives the true, physiologically pertinent sodium concentration because it measures sodium activity in serum water. Whereas the serum sample is diluted in indirect potentiometry, the sample is not diluted in direct potentiometry. Because only direct reading gives an accurate concentration, we suspect that indirect potentiometry which many hospital laboratories are now using may mislead us to confusion in interpreting the serum sodium data. However, it seems that indirect potentiometry very rarely gives us discernibly low serum sodium levels in cases with hyperproteinemia and hyperlipidemia. As long as small margins of errors are kept in mind of clinicians when serum sodium is measured from the patients with hyperproteinemia or hyperlipidemia, the present methods for measuring sodium concentration in serum by indirect sodium-selective electrode potentiometry could be maintained in the clinical practice.
Electrodes ; Humans ; Hyperlipidemias ; Laboratories, Hospital ; Photometry ; Plasma ; Potentiometry ; Sodium ; Water

BACKGROUND: To prevent medically significant errors, hospital laboratories must perform thorough statistical quality control (QC) procedures. We surveyed the QC status of small laboratories and created new statistical QC software that they can easily use for improving QC. METHODS: A questionnaire on the status of external and internal QC was created and sent to clinics and hospitals with small-scale laboratories. We then created QC software that can be downloaded and installed for free. RESULTS: External quality assessments were performed in 32% of the clinics (22 of 66) and 52% of the hospitals (12 of 23). Seventy-three percent of all institutions (66 of 90) carried out an internal quality assessment based on their own guidelines, mostly using commercialized QC materials. However, only 52% of clinics and 23% of hospitals used their own acceptable range instead of the manufacturer's expected range. In addition, the proportion of manual QC management reached 52% in clinics and 82% in hospitals. The QC software we designed covers all the basic functions of statistical QC and aims to improve the quality of laboratories. CONCLUSIONS: We obtained basic data on the current status of external and internal QC in small-scale laboratories using this survey. Furthermore, we suggested that new QC software may actually help to improve QC of small laboratories.
Laboratories, Hospital* ; Quality Assurance, Health Care ; Quality Control*

It's a effective way to promote the quality of the laboratory in hospital by passing the ISO15189.This paper introduces the changes made in rebuilding the LIS according to the certified documents of the ISO15189.
Accreditation ; Hospital Information Systems ; organization & administration ; Laboratories, Hospital ; organization & administration ; Quality Control

BACKGROUND: Multi-drug resistant (MDR) Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine the molecular characterization of MDR A. baumannii clinical isolates. METHODS: Two hundred eighty-five strains of non-duplicated A. baumannii collected from March to November 2011 from a university hospital laboratory located in the Wonju area of the Gangwon province of Korea were analyzed for MDR genes. RESULTS: All of the 285 imipenem-resistant A. baumannii isolates were encoded by a blaOXA-23-like gene, and all isolates with the blaOXA-23-like gene had the upstream element ISAba1. The 16S rRNA methylase gene armA was detected in 153 (50.2%) clinical isolates, but rmtA, rmtB, rmtC, rmtD and npmA were not detected in any isolates in the present study. The gene encoding aac(6')-Ib was the most prevalent aminoglycoside-modifying enzyme. The sequencing data for the quinolone resistance-determining region of gyrA and parC revealed the presence of Ser (TCA) 83 to Leu (TTA) and Ser (TCG) 80 to Leu (TTG) substitutions. All but one of the 285 A. baumannii isolates showed similar band patterns on repetitive extragenic palindromic-PCR profiles. CONCLUSION: The molecular characteristics of the resistance genes of MDR A. baumannii isolates obtained from the Wonju area of Gangwon province were similar to those of other areas in Korea.
Acinetobacter ; Acinetobacter baumannii ; beta-Lactamases ; Genes, MDR ; Imipenem ; Korea ; Laboratories, Hospital ; Methyltransferases

BACKGROUND: In developed countries, food-born diseases have decreased and hospital laboratory have taken more simple method rather than complex enrichment-selective methods. But detection rate of pathogenic bacteria in stool culture was not so high. METHODS: We mixed 4 pathogenic bacteria (S. typhi, S. flexneri, V. cholerae and Y. enterocolitica) with 3 stool specimens from healthy persons (for Y. enterocolitica, 5 specimens) and innoculated directly or after enrichment (105 bacteria/plate). After proper incubation, we counted suspected colonies and calculated true positive rate after identification of each colonies. RESULTS: For S. typhi, in the case of direct innoculation on the MacConkey, XLD and SS agar, positive rate of selected colonies were below 36.6%. After enrichment in SF broth for 8 hours, the rate were 80.0%, 83.0% and 70.0% respectively. For S. flexneri, the rates were 86.7%, 100%, 93.3% in direct innoculation, and were highest after enrichment in GN broth for two hours (93.3% in MacConkey and 100.0% in both XLD and SS agar). For V. cholerae, inspite of screening by catalase and oxidase tests, positive rate of selected colonies were 0% (0/7 colonies) in direct innoculation on the MacConkey. After enrichment in APW about 1 day and on TCBS agar, the rate were 100%. For Y. enterocolitica, after incubation at room temperature for 2 days, most selected colonies were Y. enterocolitica on CIN media. CONCLUSION: For more efficient detection of pathogenic bacteria in stool culture, combination of direct innoculation on MacConkey agar and on one or two selective media after proper enrichment process, should be considered.
Agar ; Bacteria ; Catalase ; Cholera ; Developed Countries ; Humans ; Laboratories, Hospital ; Mass Screening ; Oxidoreductases ; Salmonella ; Shigella ; Vibrio ; Yersinia

BACKGROUND: Documentation is very important; a considerable number of documents exist for use in accreditation inspection. However, most laboratories do not effectively manage the processes of documentation, organization, and storage. The purpose of this study was to facilitate the establishment of a strategically effective and sustainably standardized document management system. METHODS: A document code formatting system was modified by comparing the document list data received from 3 major university hospitals. In addition, a questionnaire regarding document code standardization was created and sent to 268 institutes to establish document classifications and generate a standard coding scheme. A computerized document management system was developed. RESULTS: Only 32% (8 out of 25 institutes) answered that they were able to identify all of the document types and their numbers. In total, 76% of institutes (19 out of 25) answered that a systematic document management system was necessary. Disorganized document files were systemized by classifying them into 8 major groups according to their characteristics: patient test records (T), test quality control (Q), manuals (M), equipment and environment management (E), statistics (S), division administration (A), department administration (R), and others (X). CONCLUSIONS: Our documentation system may serve as a basis for the standardization of documents and the creation of a document management system for all hospital laboratories.
Documentation/*standards ; Hospitals, University ; Laboratories, Hospital/*standards ; Questionnaires ; Tertiary Healthcare ; User-Computer Interface

BACKGROUND: A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. METHODS: Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. RESULTS: Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. CONCLUSIONS: For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.
Clinical Laboratory Techniques/*economics ; Female ; Humans ; *Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital/economics ; Male ; Questionnaires

Hemolysis frequently causes preanalytical errors in laboratory measurements. We aimed to develop a quality improvement indicator for evaluating the extent of inappropriate procedures causing hemolysis in clinical samples collected in medical care units. We defined the threshold value of the hemolysis index (H index) causing significant interference with analyte measurement and analyzed the H index values of clinical samples in relation to the threshold. The H index threshold value causing a 10% bias in the measurement of lactate dehydrogenase was found to be 25. The monthly mean H index and monthly frequency of samples with an H index >25 were significantly different among the types of ward (P=0.001, respectively), and significantly decreased after replacement of a laboratory centrifuge lacking temperature control (20.6±0.58 vs 23.30±1.08, P=0.01; 23.4±1.69% vs 32.6±1.78%, P=0.01). The monthly mean H index and the monthly frequency of samples with an H index above a threshold value may be useful quality improvement indicators for detection of inappropriate procedures in the acquisition and handling of blood samples in medical care units.
Hemoglobins/analysis ; Hemolysis ; Humans ; L-Lactate Dehydrogenase/analysis ; Laboratories, Hospital/*standards ; Quality Improvement/*standards ; Specimen Handling