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|Standard Operating Procedures
The Quality Assurance Training Manual has been tailor-made to meet the needs of primary health care laboratory workers in resource poor countries.
The manual has been designed as teaching aid for trainers conduction quality assurance training programmes. Each page can be used as transparency to support lectures or as reference to prepare more detailed teaching material for class work and practical sessions. The manual has been field tested in Nepal.
We are looking for sponsors to further field-test the Quality Assurance Training manual and make the manual available for broader dissemination.
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|Standard Operating Procedures (SOPs)
Standard Operating Procedures (SOPs) are written instruction protocols that include all aspects of work practices and reduce the chances of process variability. SOPs are an important part of any quality assurance programme, however they are effective only if used with rigorous training. Training enforces the standardisation of practical skills.
The initial investment for preparing SOPs is high, but over time, the return on the investment might prove higher than expected.
In developing countries, where resources are limited and needs are abandoned, health planners should keep in mind that writing SOPs involves great efforts, regarding manpower, time and resources. Initially it might be best to prepare SOPs for essential test procedures only. It might also be considered to write bench-level SOPs for all essential test procedures that can be used both for training and at laboratory units in the field.
The microscopic examination of specimens is the most common diagnostic tool in laboratories of developing countries and the diagnosis of many communicable diseases depends on image-based diagnostic tests. In spite of their importance, image-based diagnostic tests are not adequately taught at training institutions in developing countries and photographic images of specimens are frequently not available. Supervised instructions suffer from lack of equipment, availability of suitable samples, variability in microscope quality, and instructor know-how.
The University of Washington (Seattle, WA, USA), Department of Laboratory Medicine, has developed a number of image-based personal computer programs (TUTORs) that teach microscopic laboratory tests. Studies in the United States have shown that the TUTOR programs help medical technologist and medical students learn to interpret image-based laboratory tests.
Image-based personal computer programs that teach image-based laboratory tests are now widely used as learning resources and teaching aids in western countries. Very little is known about the use of image-based computer programs as learning resources for primary healthcare workers in developing countries.
Recently, three TUTOR programs have been introduced to primary healthcare laboratory personnel in Nepal. The PeripheralBlood-TUTOR, which teaches the interpretation of peripheral blood smears, the Urinalysis-TUTOR, which teaches the microscopic examination of urinary sediment and the GramStain-TUTOR, which teaches Gram stain interpretation.
Over 50% of the study subjects had never used a computer before, hence individual use of the software program seemed difficult. Plenary training sessions and individual sessions supported by an instructor were arranged. Over fifty participants with varying levels of education and professional experience participated in the study. Data collection took place through a self-completion questionnaire and informant interviews.
Information gathered through this limited study is encouraging. The study shows that it is feasible to integrate these programs into the curriculum of training institutions in developing countries. The study also establishes baseline data for more elaborate studies.
We are looking for sponsors to make such software programs available to a wider audience in developing countries. It is necessary to adapt existing software programs to the specific needs of laboratory personnel in developing countries and to develop additional TUTOR programs on subject areas, such as sputum examination for Tuberculosis, Malaria parasites or STD screening tests.
Our mission is to serve as a global resource and information exchange forum in support of laboratory services in resource-poor countries and thereby contribute to sustainable quality improvement in this field!
The Public Health Care Laboratory - 2001 � Gabriele Mallapaty