Papers by Adolfo ROMERO RUIZ
Journal of Nursing Management
Clinical Chemistry and Laboratory Medicine (CCLM), 2017
Background:The presence of preanalytical mistakes (PM) in samples from primary care centres (PCC)... more Background:The presence of preanalytical mistakes (PM) in samples from primary care centres (PCC) is a widely studied topic. Different correcting strategies have been proposed, with variable success. We planned a series of multidisciplinary sessions for clinical update, with the aim to decrease PM rates in samples from PCC.Methods:The incidence of PM in samples from PCC processed at the laboratories of University Hospital Virgen de la Victoria (LAB1) and University Hospital Juan Ramon Jimenez (LAB2) was assessed during two time periods (October to November 2013 and January to May 2014). Clinical update sessions were conducted between periods (2014). Differences in PM rates between observation periods were evaluated.Results:With respect to 2014, we observed a significant reduction of PM rates in blood samples processed at LAB1 during 2015, whereas those in LAB2 were slightly increased. The most common PMs were haemolysed sample at LAB1 and missed sample at LAB2.Conclusion:Although th...
Laboratory medicine, Jan 13, 2018
Reducing errors in the preanalytical phase is difficult, which suggests the issue may be multidim... more Reducing errors in the preanalytical phase is difficult, which suggests the issue may be multidimensional. As such, qualitative research may be truly innovative in this context. We carried out a descriptive study using a qualitative method incorporating 4 focus groups. Data analysis followed the principles of Grounded Theory. We queried in each of the 4 focus groups collectively to identify weaknesses in the system. Those weaknesses that were most cited were logistics, coupled with uneven compliance with regulations. All 4 focus groups mapped out directives for future work, so that regulatory aspects, process management, communication and resources could be identified as key areas where error reduction is critical.
Descriptive analysis of preanalytical mistakes detected in a stat laboratory. Results shown a num... more Descriptive analysis of preanalytical mistakes detected in a stat laboratory. Results shown a number under presumed results, very near to optimal rejected samples number.
Nutrición hospitalaria
For critically patients, enteral immunonutrition results in notable reductions in infections and ... more For critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome. This prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy. Full blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturat...
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2004
Recibido el 2 de septiembre de 2013; aceptado el 6 de septiembre de 2013 Disponible en Internet e... more Recibido el 2 de septiembre de 2013; aceptado el 6 de septiembre de 2013 Disponible en Internet el 14 de noviembre de 2013 Kääriäinen M, Paukama M, Kyngäs H. Adherence with health regimens of patients on warfarin therapy. J Clin Nurs. 2013;22:89-96
Transfusion, 2002
Although transfusion or return of salvaged shed blood has become popular in major orthopedic proc... more Although transfusion or return of salvaged shed blood has become popular in major orthopedic procedures, this blood-saving method is still controversial because shed blood may be contaminated with chemical and tissular debris, such as fat particles, which may increase the risk of fat embolism after bone surgery.
Enfermería Clínica, 2001
Para realizar los recuentos hematológicos, nuestro centro dispone de tubos de cristal con EDTA 3K... more Para realizar los recuentos hematológicos, nuestro centro dispone de tubos de cristal con EDTA 3K, preparados para extracción al vacío. No obstante, diversas consideraciones nos hacen pensar en la posibilidad de cambiarlos por otros, también preparados para extracciones por sistema de vacío, pero fabricados en polipropileno (plástico) y con EDTA 2K como anticoagulante. El objetivo de este estudio es comprobar si el cambio en el sistema de tubos empleado puede hacer resentir la calidad en el servicio prestado.
Clinical Chemistry and Laboratory Medicine (CCLM), 2015
The presence of errors in the preanalytical phase is a widely studied topic. However, information... more The presence of errors in the preanalytical phase is a widely studied topic. However, information regarding the perspective of those professionals involved is rather scant. Two focus groups of professionals from Primary Care involved in the preanalytical phase (general practitioners [GP], community nurses [CN], and other auxiliary health workers, including administrative personnel [AHW]) were convened. A qualitative analysis with a phenomenological approach was performed by using the structure of SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis as a guide, and results were categorized by grouping the resultant dimensions according to this structure. Overall, 12 professionals (3 GP, 6 CN, and 3 AHW) were distributed in two groups. Age and gender distribution were similar between groups. The most commented strengths were organizational capability and teamwork. The main weakness was the workload increase (compared to the short time spent on sample collection). Opportunities were related to workload optimization through on-line analytical requests. Threats were related to the long time elapsed between sample drawing at Primary Care and delivery to the Central Laboratory. The phenomenological approach allows revealing those aspects that cannot be entirely elucidated by objective data measurement. Attitudes considered as positive can be exploited by the institution, whereas those considered as negative alert us to possible future problems. Primary Care professionals offered a different point of view to laboratory staff, but both recognized high workload as the main threat and on-line analytical request as the best opportunity. These perspectives may help to improve detection and decrease the number of errors.
Nutrición …, 2005
... Henche Morilla AL, Romero Montero C, Llorente González C: Niveles de oligoelementos y element... more ... Henche Morilla AL, Romero Montero C, Llorente González C: Niveles de oligoelementos y elementos trazas en el momento de la admisión de los pacientes ... Vincent JL, Baron JF, Reinhart K, Gattinoni L, Thijs L, Webb A et al.: Anemia and blood transfusion in critically ill patients ...
Clinical and Laboratory Haematology, 2005
Measurement of haemoglobin (Hb) concentration provides a reliable indication of the presence and ... more Measurement of haemoglobin (Hb) concentration provides a reliable indication of the presence and severity of anaemia. However, other laboratory parameters are usually requested as well, leading to an increase in socio-sanitary costs. Accordingly, this study was undertaken to ascertain the reliability of point-of-care Hb determination with the portable photometer HemoCue-B haemoglobin (HBH) and to evaluate its utility for the initial diagnosis of anaemia. Hb was measured (x3) in 20 venous blood samples diluted with saline (v/v; 1 : 0, 2 : 1, 1 : 1, 2 : 1 and 3 : 1) to obtain a wide range of Hb and in venous and capillary blood samples from 247 primary health care patients. All HBH results were compared with those yielded by the reference cell counter Pentra 120 Retic (ABX). In diluted samples, Hb values obtained with either method were not significantly different (ABX-HBH, -0.01 +/- 0.32 g/dl; 95% CI, -0.04 to 0.028 g/dl) and showed an excellent Pearson's coefficient of correlation (r = 0.992; P < 0.01). HBH provides accurate values if at least 4 mul of blood is loaded into the cuvette. There were no significant differences between Hb measured in venous (v) and capillary (c) blood samples in primary care patients. Eighteen anaemic patients were detected by ABX measurements (7.3%; 15 female/3 male), 18 by HBHv (specificity, 100%; sensitivity, 100%) and 25 by HBHc (eight false positives; one false negative; specificity, 94.4%; sensitivity, 96.5%). Compared with ABX, HBH provides accurate and precise measurements for a wide range of Hb and its use in primary health care seems to be a good method for the initial diagnosis of anaemia.
Clinical Chemistry and Laboratory Medicine, 2000
ABSTRACT This study was aimed at understanding the perspective on preanalytical errors from the p... more ABSTRACT This study was aimed at understanding the perspective on preanalytical errors from the point of view of the professionals involved in the preanalytical process. A significant contribution of their specialized knowledge and experience in day-to-day practice for identifying these kinds of mistakes, and their most frequent causes, was expected.
Clinical Chemistry and Laboratory Medicine, 2000
Background: Preanalytical mistakes (PAMs) in samples usually led to rejection upon arrival to the... more Background: Preanalytical mistakes (PAMs) in samples usually led to rejection upon arrival to the clinical laboratory. However, PAMs might not always be detected and result in clinical problems. Thus, PAMs should be minimized. We detected PAMs in samples from Primary Health Care Centres (PHCC) served by our central laboratory. Thus, the goal of this study was to describe the number and types of PAMs, and to suggest some strategies for improvement.
Clinical Chemical Laboratory Medicine, 2000
Clinical Chemistry and Laboratory Medicine, 2000
The aim of this study was to compare the performance of the automatic TEST 1 ESR system, SIRE Ana... more The aim of this study was to compare the performance of the automatic TEST 1 ESR system, SIRE Analytical Systems (TEST 1), with that of the the Sedisystem 15, Becton Dickinson (SEDI), and the International Council for Standardization in Haematology reference method (Westergren) for measuring the length of sedimentation reaction in blood (LSRB). This reaction was measured in 418 paired blood samples drawn in K2-EDTA vacuum tubes and specific tubes from patients scheduled for routine LSRB measurement. The TEST 1 system uses micro-sedimentation and quantitative capillary photometry technology, whereas the SEDI uses a CCD camera. For Westergren, a 200 mm column with 3.0 mm internal diameter was used. Compared to Westergren, TEST 1 gives accurate values of LSRB in most of the samples (mean of differences: 0.99 +/- 10.4 mm; 95% CI, -0.807 to 2.78 mm; n =131). Similar results were obtained in the comparison with SEDI (mean of differences: -0.626 +/- 8 mm; 95% CI, -1.756 to 0.5 mm; n = 195). Compared to those of fresh blood samples, LSRB values were significantly lower in 24 h stored samples, either at 4 degrees C (21.5 +/- 2.3 vs. 19.4 +/- 2.2 mm; p (Spearman's coefficient of correlation): 0.981; n = 44) or at room temperature (19.1 +/- 2.5 vs. 16.2 +/- 2.1 mm; p: 0.903; n = 46). In conclusion, TEST 1 is a rapid, reliable system for automatic measurement of LSRB in standard K2-EDTA blood samples. It has a very low imprecision and maintains a good performance in 24 h stored samples. In addition, due to its operational characteristics (60 samples/20 min) it is a suitable tool for clinical laboratories with a high work load as well as for emergency laboratories.
Clinica Chimica Acta, 2012
The presence of pre-analytical errors (PE) is a usual contingency in laboratories. The incidence ... more The presence of pre-analytical errors (PE) is a usual contingency in laboratories. The incidence may increase where it is difficult to control that period, as it is the case with samples sent from primary care (PC) to clinical reference laboratory. Detection of a large number of PE in PC samples in our Institution led to the development and implementation of preventive strategies. The first of these has been the realization of a cycle of educational sessions for PC nurses, followed by the evaluation of their impact on PE number. Methods: The incidence of PE was assessed in two periods, before (October-November 2007) and after (October-November, 2009) the implementation of educational sessions. Eleven PC centers in the urban area and 17 in the rural area participated. In the urban area, samples were withdrawn by any PC nurse; in the rural area, samples were obtained by the patient's reference nurse. The types of analyzed PE included missed sample (MS), hemolyzed sample (HS), coagulated sample (CS), incorrect sample (ISV) and others (OPE), such as lipemic or icteric serum or plasma. Results: In the former period, we received 52,669 blood samples and 18,852 urine samples, detecting 3885 (7.5%) and 1567 (8.3%) PEs, respectively. After the educational intervention, there were 52,659 and 19,048 samples with 5057 (9.6%) and 1.256 (6.5%) PEs, respectively (pb 0.001). According to the type of PE, the incidents compared before and after compared incidences were: MS, 4.8% vs. 3.8%, p b 0.001; HS, 1.97% vs. 3.9%, p b 0.001; CS, 0.54% vs. 0.25%, p b 0.001; ISV, 0.15% vs. 0.19% p = 0.08; and OPE, 0.3% vs. 0.42%, p b 0.001. Conclusions: Surprisingly the PE incidence increased after the educational intervention, although it should be noted that it was primarily due to the increase of HS, as the other EP incidence decreased (MS and CS) or remained unchanged (ISV). This seems to indicate the need for a comprehensive approach to reduce the incidence of errors in the pre-analytical period, as one stage interventions do not seem to be effective enough.
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Papers by Adolfo ROMERO RUIZ