Browsing by Author "Warutere, Peterson"

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    Determination of the Accuracy of Quantitative Measurement Methods in the Clinical Chemistry Laboratory at Machakos Level V Hospital, Kenya
    (International Journal of Current Aspects, 2023) Mutie, Charles Kyalo; Mathenge, Scholastica Gatwiri; Warutere, Peterson
    Accuracy is the extent to which measurements are closely related to the actual values of the analyte. Accuracy is one of the key requirements in Laboratory method verification. Verification is a method of ensuring that tests are carried out per the manufacturer's specifications when tested by laboratory staff and patients at the facility. Other elements of verification include precision, linearity verified with reportable range, uncertainty of measurement, carry-over studies, reference ranges and limit of detection. This study aims to determine the accuracy of the quantitative measurement methods in the Clinical Chemistry laboratory in the month of January 2023. It also provides an alternative method for meeting accreditation requirements on accuracy by medical laboratories seeking accreditation in farstretched laboratories where interlaboratory comparison may not be feasible. A systematic review and meta-analysis at Machakos County, Kenya. The procedure involved analysing commercially available internal quality control material five (5) times a day for eight (8) days bearing the same lot number. Roche Diagnostics, Mannheim, Germany supplied all the reagents, internal quality control materials and calibrators. Accuracy was determined using Roche Cobas® Intergra 400 Clinical Chemistry analyser to perform a comparative descriptive analysis of albumin, alanine aminotransferase (ALT), alkaline phosphatase (Alk Phos), aspartate aminotransferase (AST), chloride, creatinine, Direct Bilirubin (D. Bil), Gammaglutamyl transferase (GGT), potassium, sodium, total bilirubin, total protein, and urea. The study followed guidelines issued by the Clinical Laboratory Improvements Amendment 1988 (CLIA) and Clinical Laboratory Standards Institute (2014). Data analysis was carried out using Excel Windows 10 MS Office 2021. Mean, standard deviation (SD), Z-score, bias %, coefficient of variation (CV) %, and total error allowable (Tea) were calculated from the results of measurement of the analytes. All the analytes achieved a mean which fell within the manufacturer verification interval and hence passed. The bias % score for the analytes was as follows 5 analytes level (19.2%) scored 0 - ±1, 10 analytes level (38.5%) scored ±1.1 - ±2, 7 analytes level (26.9%) ±2.1 - ±3 and 4 analytes level (15.4%) scored above ±3. All analytes were found to have an excellent Z-score performance between 0 to ± 1.96. The total error allowable was found to fall within CLIA and CLSI specifications limits except for chloride PCC1/ Normal control which failed at 5.82% (CLIA target being ± 5%). Analytes' mean was expected to fall within the given manufacturer's mean. The bias % for the analytes which was at zero or near ± zero was considered an excellent score the further away the score was, the poorer the performance. The Z-score was also calculated to establish how far the observed mean fell from the target mean. All analytes were found to have an excellent Z-score performance between 0 to ± 1.96. A Z-score of ± 1.96 to ± 2.57 indicates good performance while a Z-score of over ± 2.58 indicates failed performance. These good results are attributable to the fact that analysis was carried out within a very short duration by the same person, on the state-of-the-art instrument, in a well-controlled environment hence no room for analytical variation. Chloride being an electrolyte failed since it is physiologically controlled in a strict and narrow range.
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    Empirical investigation on the contents of the patients informed consent forms for medical imaging services in the government hospitals in Nairobi City County, Kenya.
    (I nternational Academic Journal of Health, Medicine and Nursing (IAJHMN), 2020) Koi, Victoria Otysula; Yitambe, Andrea; Warutere, Peterson
    Informed consent is a requirement by the law to allow patients to make decisions with respect to their health and well-being. It is an ethical and legal requirement that patients seeking medical imaging services should give an informed consent prior to seeking treatment with respect from healthcare providers. However, the extent of usage of the informed consent process vary across medical procedures. The study therefore seeks to assess the contents of the patients Informed Consent Forms for medical imaging services in the government hospitals in Nairobi City County, Kenya. The study adopted a descriptive cross-sectional study design. The study specifically focused on administration of informed consent, contents of the patients Informed Consent Forms and modes of informed consent used among patients for medical imaging services. Imaging departments in Kenyatta National hospital, Mbagathi, Mama Lucy, National spinal injury and National Mathare Hospitals in Nairobi City County were chosen as the area of study. Patients in the imaging departments of the selected hospitals were recruited for study. The sample size selected was 307 respondents. The respondents were selected using systematic random sampling at a predetermined interval of 3. Collected data was coded for analysis by use of SPSS. Analysis was conducted on descriptive and inferential statistics. Frequency tables, pie-charts and graphs were used to present the quantitative data. Inferential statistics were done using Chi Square tests to determine the association between study variables at 95% confidence interval (p<0.05). The ethical considerations were strictly followed during data collection. It was further revealed that age (χ2=3.782; df= 4; p=0.016;), level of education (χ2=3.89; df= 4; p=0.030), revelation of reason for referral (χ2=26.081; df=1; p=0.001), provision of right to refuse or defer imaging (χ2=33.468; df= 1; p=0.001), giving consent for treatment (χ2=70.733; df=1; p=0.001), decision making for wellbeing (χ2=12.056; df=1; p=0.001), pre-operative counseling (χ2=9.533; df=1; p=0.002), cases of negligence from clinicians (χ2=22.414; df=1; p=0.001), understanding information provided by clinicians (χ2=4.394; df=1; p=0.036), adaptation of informed consent doctrine meeting physicians and patients (χ2=7.648; df=1; p=0.006), performance of diagnosis from patients’ past medical history (χ2=9.788; df=1; p=0.002), advice on alternative treatment options available (χ2=8.065; df=1; p=0.005), disclosure of information by practitioners (χ2=19.406; df=1; p=0.001) and physical examination done before medication (χ2=9.006; df=1; p=0.003) were significantly associated with informed consent administration among respondents. The study concludes majority of the domains of the contents of informed consent had a significant statistical association with administration of informed consent among respondents. These research findings provide a great insights and information to leaders, managers, law makers, governing and oversight authorities in decision making, policy formulation, strategic planning and regulation in a context specific to provide a conducive environment for practicing medical imaging procedures in an ethical and legal manner.
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    Knowledge about Physical Hazards and Use of Personal Protective Equipment Based on Demographic Characteristics and among Small Scale Welders in Nairobi City, Kenya
    (Journal of Scientific Research & Reports, 2020) Onguto, Nicholas Odhiambo; Warutere, Peterson; Mwanzo, Isaac
    Introduction: The sprawling of small and medium-sized enterprises (SMEs) in the developing world provides several challenges to ensuring health and safety practices among workers in the urban poor. Purpose: The main objective of the study will be to determine the knowledge of physical hazards and the use of PPEs based demographic characteristics among welders in Embakasi constituency, Nairobi County. Methods: This was a cross-sectional descriptive study conducted among 214 welders from 72 workshops in the Embakasi region, namely in Kariobangi South Light Industries, Kayole, and Umoja. Data collection procedure entailed observation, focus group discussions, and interviews with welders in Embakasi, Nairobi. Data were analysed using SPSS version 22 and both descriptive statistics and inferential statistics were conducted to explain the association between the study variables. Results: The study indicated that 90.2% of welders knew the activities at the workplace that pose health hazards. Welders’ knowledge of physical hazards at their workplace was significantly associated with experience (Fishers Exact Test =45.025, p = .05), number of hours worked per day (Fishers Exact Test = 9.322, p = .05), and PPE use (2 = 3.884, df = 1, p = .05). Conclusion: Factors such as age, earning a level, hours per day worked, level of education, type of training, and knowledge of physical hazards or PPE use are significantly associated with selfreported injuries among welders.