Factors Affecting Quality Of Laboratory Services At Infectious Diseases Hospital
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Factors Affecting Quality Of Laboratory Services At Infectious Diseases Hospital
ABSTRACT
Quality laboratory services are a key component of improved health outcomes, particularly for HIV/AIDS patients receiving ART. We wanted to analyse client satisfaction with laboratory services as a quality indicator, as well as factors influencing laboratory service quality from the perspective of service providers.
Between January and April 2014, we conducted a hospital-based cross-sectional study among adult HIV/AIDS patients at IDH Kano in Nigeria. Clients and laboratory service providers each received an exit and service provider questionnaire.
We used the SLIPTA laboratory inventory checklist to determine the availability of equipment, reagents, consumables, and test profiles for patients on ART. The study included 212 HIV-positive individuals who visited IDH’s laboratory for ART monitoring testing. Of these, 65.6% were female.
The participants’ mean (±SD) age was 36.7 ± 10.2, with 36.3% being in the 30-39 age range. 58% were married, 10% were single, and 6% and 26% were divorced and widowed. The majority of the customers (70%) were on antiretroviral therapy (ART).
The overall degree of satisfaction with laboratory services was determined using a single indicator variable and was 97.6%. Internal quality control (IQC) is always performed for chemistry and CD4 counts, according to more than 90% of respondents (records seen), however IQC for haematological indices is only done on occasion due to a lack of control reagents.
The equipment utilised for HIV/AIDS monitoring assays for CD4 count, haematology, and chemistry was available and functioning, however more than half had been in use for over 5 years. Repairs and service maintenance are completed on-site under a service contract signed by donor organisations.
In conclusion, clients were highly satisfied with the laboratory services they received, indicating that the services supplied were of acceptable quality. Client satisfaction was found to be connected with the kind of visit to HF (follow-up visit) and the waiting time before service providers attended to them.
Inadequate work force was identified as one of the major factors affecting the quality of laboratory services by 80% of service providers, followed by insufficient training of laboratory personnel (72%), a lack of EQA and IQC on some tests (45%), an interrupted power supply that resulted in frequent equipment breakdowns (86%), and infrastructural inadequacy (space) to accommodate all of the equipment, staff, and patients (64%).
Clients mentioned stigma, the laboratory’s distance from the ART clinic, and a lack of information about the necessity of laboratory tests in patient care as barriers to receiving laboratory services.
INTRODUCTION
1.1 Background Information.
Medical laboratory services are critical for diagnosing and evaluating patients’ health. Their services include requisitioning, patient preparation and identification, sample collection, transportation, storage, processing, and inspection of clinical samples, as well as result validation, interpretation, reporting, and guidance.
For HIV/AIDS patients, these services are crucial for initiating antiretroviral therapy (ART) and monitoring disease progression over time. In the West African region, laboratory services are among the most underutilised components of health-care systems, particularly in terms of HIV/AIDS treatment and surveillance.
Lack of access to necessary quality diagnostic tests in support of HIV/AIDS treatment and monitoring, such as CD4 cell counts, viral load, complete blood count (CBC), and chemistry tests, has had a significant impact on drug therapy provision for more than two decades, dating back to the emergence of HIV/AIDS in the region.
5 This component alone acted as a catalyst for rising morbidity, resulting in an increased burden on global public health. 4 Prior to significant efforts to reform laboratory systems as part of the Global HIV/AIDS Initiative, clinical laboratory services in Nigeria were a serious concern.
All laboratories at hospitals that provide ART services encountered significant problems, including limited infrastructure, insufficiently qualified people, and a lack of standardised operating processes, which could jeopardise patient care quality.
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