Instrument to streamline the process of sending biological samples to an epidemiological surveillance center, from a Reference Unit for infectious and parasitic diseases.

Evela da Silva Magno^1*, Eyde Cristianne Saraiva-Bonatto² and Maria das Graças Gomes Saraiva^1,3
*Correspondence: Evela da Silva Magno, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Gerência de Epidemiologia.Av, Pedro Teixeira, nº 25, Bairro Dom Pedro, Manaus, Amazonas, Brasil, Email:

Keywords

Epidemiology • Cheklist • Operationalization

Introduction

Parameters and standards of effectiveness and efficiency of health actions, instruments for monitoring and evaluating services, concrete mechanisms for defining agreed goals, as well as quality certification practices have been identified as essential in the processes of integration of care [1,2].

Standardization aims to guarantee the execution of processes always in the same way in order to obtain greater predictability of results. Because it contributes to reducing the variability of production processes, standardization plays an important role in controlling and improving quality in companies [3].

Standardizing processes occurs when the company starts to document its activities, in order to standardize macro and micro processes. That way, regardless of who will perform a specific task, the expected result will always be obtained [4].

Thus, it is possible to constantly manage the quality of activities, bringing improvements and correcting them whenever necessary [4].

The main objective of any process improvement in the health area is to improve the quality of services provided to the patient [5]. Therefore, the objective of this work was to create checklists for the process of sending samples to the Public Health Laboratory (LACEN-AM).

Description of Work Techniques, Methods or Processes

For a list on paracoccidioidomycosis, a LACEN-AM technician was consulted, who informed the registration of the exam as a search for deep mycoses (Aspergillosis, Histoplasmosis and Paracoccidioidomycosis) and guided the need for clinical history and SUS exam request form, to accompany the delivery of the sample in the laboratory. The LAG was consulted to verify the technique used in the exam and the service practice ordered the sequence of activities on the list.

Hydatidosis

A consultation with the LACEN-AM technician was carried out, who informed that the hydatidosis form was available electronically for printing and, together with the clinical history and SUS exam request form, are documents that accompany the delivery of the sample at laboratory. The LAG was consulted to verify the technique for performing the exam and the service practice ordered the activities on the list.

Severe Acute Respiratory Syndrome (Sars)

Technical note 010/2019-FVS-AM/SUSAM-conduct was consulted in the case of SARS-AM of March 4, March 19. The technique used to perform the exam was consulted at the GAL and the activities on the list followed the order in which the service was operationalized.

For the list of acute flaccid paralysis, human rabies and botulism - The health surveillance guide and the botulism manual for instruction in the collection of biological material were consulted. The LAG was consulted to verify the techniques used to perform the exams and the service's actions served to order the activities on the list.

Results

Six instruments (checklist) were carried out from 2017 to 2019, one for each disease (Paracoccidioidomycosis, Hydatidosis, Severe Acute Respiratory Syndrome, Acute Flaccid Paralysis, Human Rabies and Botulism) Tables 1 and 2, which simplified the sending of biological material to the Public Health Laboratory of Amazonas (LACEN-AM), even if these exams were occasionally requested.

Table 1. Diseases not included in the Health Surveillance Guide, (1) paracoccidioidomycosis, (2) hydatidosis and (3) severe acute respiratory syndrome.

Table 2. Diseases guided by the Health Surveillance Guide, (4) acute flaccid paralysis, (5) human rabies and (6) botulismo.

The product is a resource that establishes the sequence of tasks to be accomplished by organizing the activities for sending a sample of biological material to the Public Health Laboratory.

Regardless if the health professional knows the specific manuals for the illnesses, the technical notes, the corresponding chapter in the Health Surveillance Guide or consulted a laboratory reference technician to clarify any doubts, even so this worker only using the instrument (checklist) ) will be able to explain the techniques that will be used in carrying out the exams, inform the material to be collected and the time in which the collection should be carried out, will even know if the notification uses a specific form or not and when registering a sample in the GAL only using the specific list you will be able to complete the registration, fulfilling the routine of sending biological material, with minimal knowledge of the operationalization of the epidemiological surveillance sector, optimizing the time and speeding up the sending of material.

Conclusion

Some diseases, despite not occurring in an endemic way or being in the process of monitoring, have the tests carried out at the Public Health Laboratory (LACEN), and a Reference Unit in infectious disease may eventually have this demand even if occasionally to meet, therefore, It is of fundamental importance to know this flow, even if a quick check to the checklist is carried out, preventing an examination from being carried out, to clarify the diagnosis or to monitor possible re-introduction of the disease.

With the diseases not covered in the Health Surveillance Guide, we had great difficulty in obtaining the first information about the exam and if it was performed by the central laboratory (LACEN), so the creation of tools that standardize this task can help in the routine of the professional who it usually deals with other demands in the epidemiological surveillance activity.

It is necessary to simplify the procedures related to the notification activities for sending biological material, to improve operationalization, especially for paracocociodiomycosis, hydatidosis and Severe Acute Respiratory Syndrome (SARS) diseases that are not covered in the Health Surveillance Guide (GVS), making it difficult to understanding of the flow of sending biological materials when requested or of diseases such as Acute Flaccid Paralysis (PFA), human rabies and botulism which, due to being in the process of monitoring, have their flows difficult to discern. Therefore, disseminating these procedures through an instrument can contribute to the improvement and understanding of the technicians who work in epidemiological surveillance, and it will certainly speed up their actions, guaranteeing speed in sending the samples in the diagnostic clarification and in the monitoring of diseases that can be reintroduced.

References

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