Related Experiment Video
Updated: Aug 5, 2025
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
The pre-analytical process management status and influencing factors of laboratory test before prescribing
Feiyang Zheng1, Kang Wang2, Qianning Wang1
1School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Introduction:
The results of laboratory testing are crucial basis for clinicians to prescribe antimicrobial. Laboratory testing is a highly complex process, and increasing evidence suggests that errors and obstacles in the pre-analytical process (PP) will affect reasonable antimicrobial use. However, PP was an easily neglected link in hospital infection management and the current situation of it and the influencing factors of management are not clear.
Methods:
A cross-sectional survey was conducted in the department of clinical, specimen collection, transportation, and inspection in 109 secondary and tertiary hospitals in Central China. The rate of antimicrobial susceptibility test request (AST) and related indexes of above departments were calculated to describe the situation. Management characteristics (frequency of training etc.) were described as proportions and fractional probit regression analysis was used to determine the influencing factors.
Results:
The average rate of non restricted-use antimicrobial was 63%, the restricted-use was 86%, the special-use was 95%. The zero obstacle rate of specimen collection was 27.3%, of specimen transportation was 19.4% and of inspection feedback was 61.7%. There was a difference between the secondary and tertiary hospitals on non restricted-use (X2 = 22.968, P < 0.001); restricted-use (X2 = 29.466, P < 0.001); special-use (X2 = 27.317, P < 0.001). Taking non restricted-use as an example, training (OR = 0.312, 95%CI: 0.148,0.429), low-frequency appraisal (OR = 0.153, 95%CI: 0.082,0.224), guidance (OR = 0.32, 95%CI: 0.237,0.403) and information technology (OR = 0.104, 95%CI: 0.009,0.199) were positive factors.
Conclusions:
There were substantial differences in the rate of AST request in clinical department between secondary and tertiary hospitals. The zero obstacle rate in collection, transportation and inspection department were still low. In most departments, training and performance appraisal were positive factors, guidance and information technology were positive supporting factors.
Insights
Pre-analytical process errors in laboratory testing impact antimicrobial prescribing. Improving training and management systems in hospitals can enhance antimicrobial stewardship and reduce errors.
Area of Science:
- Clinical Laboratory Science
- Infectious Disease Management
- Antimicrobial Stewardship
Background:
- Laboratory testing is critical for antimicrobial prescribing decisions.
- Pre-analytical process (PP) errors significantly affect appropriate antimicrobial use.
- The current status and influencing factors of PP management in hospitals remain unclear.
Purpose of the Study:
- To investigate the current situation of the pre-analytical process in hospitals.
- To identify factors influencing the management of the pre-analytical process.
- To provide insights for improving antimicrobial stewardship through better laboratory practices.
Main Methods:
- A cross-sectional survey was conducted in 109 hospitals in Central China.
- Data on antimicrobial susceptibility test (AST) request rates and pre-analytical process indicators were collected.
- Fractional probit regression analysis was used to determine influencing factors.
Main Results:
- Significant differences in antimicrobial use rates were observed between secondary and tertiary hospitals.
- Low zero obstacle rates were found in specimen collection (27.3%), transportation (19.4%), and inspection feedback (61.7%).
- Training, performance appraisal, guidance, and information technology were identified as key influencing factors for antimicrobial use.
Conclusions:
- Substantial disparities exist in AST request rates between hospital types.
- Pre-analytical processes in specimen handling require significant improvement.
- Training and performance appraisal positively influence pre-analytical processes, supported by guidance and information technology.
More Related Videos
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
08:58Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Related Concept Videos
01:28Antimicrobial Effectiveness
01:19Factors Affecting Drug Distribution: Miscellaneous Factors
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
01:21Factors Affecting Drug Response: Overview
01:28Factors Influencing Drug Absorption: Pharmaceutical Parameters
01:19Factors Affecting Drug Biotransformation: Biological
Species differences: Variations in enzyme systems across species can cause disparities in drug metabolism. For instance, humans may metabolize certain drugs faster than rodents, altering therapeutic effects.
Strain differences: Genetic variations within a species can result in differing enzyme activity, impacting drug response and toxicity. For example, some mouse strains may...
01:21Factors Affecting Drug Biotransformation: Physicochemical and Chemical Properties of Drugs
The drug's acidity or basicity is essential in...