phc laboratory system strengthening in georgia saqartvelos laboratoriata sefaseba debrifingi...
TRANSCRIPT
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PHC Laboratory system strengthening in Georgia
saqarTvelos laboratoriaTa Sefaseba
debrifingi(pirveladi mignebebi)
antuan pirsoniMmamuka jibuti
21/10/05
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PHC Laboratory system strengthening in Georgia
mokle istoria
• ivlisi, 2002: laboratoraTa diagnostikuri SesaZleblobebis Sefaseba, vaqcinaciiT marTvad daavadebebze fokusiT (USAID-PHRplus proeqti)
• maisi, 2003: marTvadi daavadebebis laboratoriuli diagnostirebis xarisxis uzrunvelyofis saxelmZvanelo (USAID-PHRplus proeqti)
• dekemberi, 2004: laboratoriaTa qselis ganxorcieleba saqarTveloSi (USAID-PHRplus proeqti)
• agvisto- dekemberi, 2005: sjc laboratoriaTa gaZliereba saqarTveloSi
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PHC Laboratory system strengthening in Georgia
2004 wlis dekembris ZiriTadi rekomendaciebi
aRniSnuli sakonsultacio momsaxurebis rekomendaciebi aris mimdinare samuSaos bazisi:
• laboratoriaTa sakoordinacio erTeulis Seqmna (rolebisa da misiiis gansazRvris CaTvliT) xarisxis uzrunvelyofis erovnuli programa da misi koordinacia
• sakanonmdeblo CarCos gadaxedva– licenzirebis kriteriumebi da xangrZlivoba, xarisxis uzrunvelyofis
sqemaSi monawileoba– inspeqtirebis/zedamxedvelobis sakiTxebi– analizi, meTodologia da aRWurviloba doneebis mixedviT,
adamianuri resursebi • laboratoriaTa gadajgufebis strategiis momzadeba:
– laboratoriebis detaluri Sefaseba qveyanaSi– gaerTianeba/gadajgufeba/daxurva/trasformireba
• nimuSTa momzadeba/monacemTa dineba• …da SeTavazebis momzadeba partniorebisTvis da donori
saagentoebisTvis
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PHC Laboratory system strengthening in Georgia
2004 wlis dekembris misiis saboloo produqtebi
• saboloo angariSi, pirveladi da daskvniTi Sexvedrebi (inglisur-qarTul enaze)
• warsulSi Catarebul samuSaoTa istoria
• laboratoriis sferoSi CarTuli sxva partniorebi
• dokumentebi, meToduri miTiTebebi, normebi da standartebi
• sxva qveynebis kanonmdeblobebisa da aqtebis nimuSebi
• goris laboratoriaTa Sefasebis angariSi
• qarTuli rukebi da fontebi
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PHC Laboratory system strengthening in Georgia
Mmimdinare sakonsultacio momsaxurebis Sejameba
• mosamzadebeli faza (agvisto, 2005)
• faza 1: reprezentatiuli raodenobis laboratoriaTa Sefaseba (seqtemberi/oqtomberi)
oqtombris bolo
• faza 2: masterplanis winaswari varianti noembris bolo
• konsesusis Sexvedra 7-8 dekemberi
• faza 4: saboloo masterplani dekembris bolo
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PHC Laboratory system strengthening in Georgia
pirveli saerTaSoriso viziti
• b-ni sebastian kognati, 29/08 – 10/09/2005• ZiriTadi RonisZiebebi:
– erovnuli eqspertebis brifingi(amocanebi da saangariSgebo produqtebi)
– erovnul eqspertTa swavleba (Teoriuli da praqtikuli)– Sefasebis procesSi gamoyenebuli “saqarTvelos
laboratoriaTa Sefasebis instrumentis” (GLAT) gaumjobeseba
– laboratoriaTa winaswari Sefaseba/imereTis lanoratoriaTa rukaze datana
– tuberkulozis nimuSTa trasportirebis qselis Sefaseba
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PHC Laboratory system strengthening in Georgia
Sefasebuli laboratoriebi• SerCeva moxda licenzirebuli laboratoriebis siidan• imereTSi - 34 da aWaraSi - 27, sul 61 laboratoria• Sefasebul laboratoriaTa tipebi:
– regionuli– raionuli (saavdmyofoebis, bavSvTa saavadmyofoebis,
poliklinikebis da a.S.)– ambulatoriebis– sisxlis banki– tub baciloskopia– sanitaruli– qalTa konsultaciebi– sggd
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PHC Laboratory system strengthening in Georgia
saqarTvelos laboratoriaTa Sefasebis instrumenti (GLAT)
• inglisur-qarTuli cxrili Excel-Si• 9 sxvadasxva moduli:
1. Senoba da komunaluri momsaxureba2. biousafrTxoeba, higiena da daculoba3. nimuSTa Segroveba da aRricxvianoba4. aRWurviloba5. reaqtivebi da momarageba6. Sesrulebuli analizebi da testebi7. laboratoriis personali da samuSao dro8. saerTo xarisxi9. angariSgeba, analizi da komunikacia
TiToeuli moduli Seicavs 1-12 indikators sul 54 indikatori (saSualod 6/ 1 modulze)
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PHC Laboratory system strengthening in Georgia
GLAT cxrili/ekrani
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PHC Laboratory system strengthening in Georgia
indikatorTa gamoangariSebis meTodi
• TiToeuli indikatori mTel rig SekiTxvebTan aris dakavSirebuli
• rogorc wesi, mosalodneli pasuxia “diax” • martivi gaangariSebis Sedegad pasuxebi ase
transformirdeba:– “diax” udris 100 procents– “ara” – 0 procents
• indikatori procentuli monacemebis saSualo maCvenebelia
• aRWurvilobis indikatorisTvis, arsebuli aRWurvilobis sia dardeba idealur sias (laboratoriis tipidan gamomdinare)
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PHC Laboratory system strengthening in Georgia
TiToeuli Sefasebuli laboratoriis saangariSgebo produqti
6 sxvadasxva produqti:
• Sevsebuli GLAT cxrili indikatorebis CaTvliT• orgverdiani Sejameba, sabaziso informacia da
komentarebi• 3 ZiriTadi rekomendacia• laboratoriaTa kompiuterizebuli ruka• zusti GPS pozicia TiToeuli laboratoriisaTvis • cifruli fotoebis kompleqti
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PHC Laboratory system strengthening in Georgia
instrumentis polivalenturoba
• SesaZlebelia mxolod 3 pasuxi:– diax (« Y »)– ara (« N »)– Seusabamoa (« na »)
• Sefasebis instrumenti SesaZlebelia gamoyenebul iqnas nebismieri donis/tipis laboratoriisTvis (ramdenadac konkretul SekiTxva, pasuxiT “Seusabamoa”, saerTo maCveneblis gamoTvlisas gamoiricxeba)
• magaliTi: tub baciloskopiis laboratoria (inkubatoris gareSe)
«gaqvT Tu ara temperaturis amsaxveli cxrilebi inkubatorebisTvis? »
Pasuxi - ”Seusabamoa”
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PHC Laboratory system strengthening in Georgia
indikatoris nimuSi
• indikatori “profilaqtikuri SekeTebis warmoeba” (moduli 8: jamuri xarisxi)
• sul 5 SekiTxva, «diax»=100%, «ara»=0% • indikatori = 5 procentuli monacemis saSualo
maCvenebli• SesaZlo maCvenebeli = 0%, 20%, 40%, 60%, 80%, 100%
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PHC Laboratory system strengthening in Georgia
kompiuterizebuli ruka TiToeuli laboratoriisTvis
magaliTi: tatiSvilis laboratoria, Tbilisi (pirveladi treiningi)
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PHC Laboratory system strengthening in Georgia
cifruli fotoebi
laboratoriisamsaxveli 4-5 foto
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PHC Laboratory system strengthening in Georgia
indikatorTa geografiuli gamosaxva
# Sample per day
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PHC Laboratory system strengthening in Georgia
indikatorTa geografiuli gamosaxva
Equipment availability
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PHC Laboratory system strengthening in Georgia
laboratoriebis Zlieri mxareebi
• maRali kvalifikaciis TanamSromlebi• monacemTa da analizis registracia
(saregistracio Jurnalebi)• saqmianobebisa da sinjebis registracia, • dezinfeqcia/xelebis dabana/sanitrebi• Sinjebis xarisxi (magram ara
transportireba)
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PHC Laboratory system strengthening in Georgia
sisusteebi
• Senobebi (Zveli/wyali da kondicireba)• aRWurviloba (ararseboba/siZvele/
SekeTeba)• xarisxis uzrunvelyofa da procedurebi• xarisxis Sida da gare kontroli• biousafrTxoeba• ganmxoloebiT muSaoba (ar arsebobs
qseli, tubBlab qselis garda)• arasakmarisi supervisia
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PHC Laboratory system strengthening in Georgia
yvela moduli erTad
Global assessment summary (61 labs in 2 regions)
0% 25% 50% 75% 100%
1-building facilities and utility service
2-biosafety, hygiene and security
3-specimen collection and recording
4-equipment
5-reagents and supply
6-analysis and test performed
7-laboratory staff & working time
8-total quality
9-reporting, analysis & communication
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PHC Laboratory system strengthening in Georgia
Senoba
Building facilities and utility service
0% 25% 50% 75% 100%
Building conditions
Water, sew age and electricity
Number of benched rooms (level dpt)
Communication
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PHC Laboratory system strengthening in Georgia
biousafrTxoeba
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PHC Laboratory system strengthening in Georgia
nimuSTa aReba
Specimen collection and recording
0% 25% 50% 75% 100%
Quality of samples received
Sampling procedures
Availability of sampling request form
Quality of the logbook
Macroscopic examination
Quality of the specimen tracking
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PHC Laboratory system strengthening in Georgia
aRWurviloba
Equipment
0% 25% 50% 75% 100%
Availability of equipment (level dependant)
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PHC Laboratory system strengthening in Georgia
reaqtivebi
Reagents and supply
0% 25% 50% 75% 100%
In-lab reagents preparation
Quality of reagent management
Availability of funds for reagents
Use of expired reagents
Reagents availability
Consumables availability
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PHC Laboratory system strengthening in Georgia
testebi (laboratoriebis/testebis raodenoba)
Number of laboratories supposed to perform each discipline
0 5 10 15 20 25 30 35 40 45 50 55 60
Hematology analysisBlood parasites analysis
Urine analysisStool analysis
Blood safety/blood groupingHemostasis analysisImmunological tests Classical chemistryEnzymes analysis
MicroscopyMicrobiology
SerologyWater testing
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PHC Laboratory system strengthening in Georgia
testebi (laboratoriaTa muSaoba)
Percentage of labs effectively performing the analysis when they are supposed to
0% 25% 50% 75% 100%
Hematology analysisBlood parasites analysis
Urine analysisStool analysis
Blood safety/blood groupingHemostasis analysisImmunological tests Classical chemistryEnzymes analysis
MicroscopyMicrobiology
SerologyWater testing
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PHC Laboratory system strengthening in Georgia
personali
Laboratory staff & working time
0% 25% 50% 75% 100%
Presence of a senior staff% of senior staff
Presence of cleaning staffAvailability of staff training
Availability of formal trainingWorking hours and days of w ork
Accept samples outside w orking hours
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PHC Laboratory system strengthening in Georgia
xarisxi
Total quality
0% 25% 50% 75% 100%
Availability of technical procedures
Availability of IQC
Availability of EQC
Availability of temperature chartsPerforming of preventive maintenance
Performing of equipment adjustments
Availability of documentation and spare parts
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PHC Laboratory system strengthening in Georgia
angariSgeba
Reporting, data analysis & communication
0% 25% 50% 75% 100%
Availability of disease reporting
Availability of activity recording
Availability of sample refering
Laboratory supervision
Availability of lab/lab collaboration
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PHC Laboratory system strengthening in Georgia
indikatorebis saerTo jami
• saSualo: 46%• mediana: 43%• SD: 16%
• umaRlesi qula: wyaltubos imunologiisa da alergologiis in-i (82%)
• yvelaze mniSvnelovani problema: dioknises poliklinika, xulo (11%)
0%
25%
50%
75%
100%
1 11 21 31 41 51
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PHC Laboratory system strengthening in Georgia
Sefasebis saboloo saangariSgebo produqti
• interaqtiuli kompaqt-diski• orenovani angariSi• TiToeuli laboratoriisTvis Semdegi dokumentebi:
– Sefaseba– nagebobis dizaini– fotoebi
• TiToeuli Sefaseba unda moicavdes – cxrilebsa da grafikebs – indikatorebis geografiul gamosaxulebas– GIS failebi
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PHC Laboratory system strengthening in Georgia
momavali masterplanis ZiriTadi koncefcia
• pjd done: (ix. detalebi danarTSi)– bazisuri analizi (test-Cxirebi)– sinjis Segrovebis centrebi daSorebul ambulatoriebSi)– sinjebis transportireba adgilobrivi transportis
gamoyenebiT• raionuli done:
– erTi kargi polivalenturi laboratoria raionSi (iq sadac darCeba raisaavadmyofo)
– sinjebis miReba pjd-dan– Sinjebis transportireba regionul laboratoriaSi
• regionuli done:– ufro specializirebuli analizi– Sinjebos miReba raionuli donidan
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PHC Laboratory system strengthening in Georgia
gmadlobT
!