phc laboratory system strengthening in georgia saqartvelos laboratoriata sefaseba debrifingi...

PHC Laboratory system strengthening in Georgia

saqarTvelos laboratoriaTa Sefaseba

debrifingi(pirveladi mignebebi)

antuan pirsoniMmamuka jibuti

21/10/05


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


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


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


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


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


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


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)


GLAT cxrili/ekrani


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)


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


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”


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%


kompiuterizebuli ruka TiToeuli laboratoriisTvis

magaliTi: tatiSvilis laboratoria, Tbilisi (pirveladi treiningi)


cifruli fotoebi

laboratoriisamsaxveli 4-5 foto


indikatorTa geografiuli gamosaxva

# Sample per day


indikatorTa geografiuli gamosaxva

Equipment availability


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)


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


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


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


biousafrTxoeba


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


aRWurviloba

Equipment

0% 25% 50% 75% 100%

Availability of equipment (level dependant)


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


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


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


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


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


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


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


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


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


gmadlobT

!

phc laboratory system strengthening in georgia saqartvelos laboratoriata sefaseba debrifingi...

Documents

phc laboratory system

fontebi slide

modulze slide

pasuxi seusabamoa slide

donori saagentoebistvis

georgia mokle istoria

dekemberi faza

procents ara