Wimol Chinswangwatanakul

Mahidol University, Krung Thep, Bangkok, Thailand

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Publications (5)2.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose – The purpose of this pilot paper is to use on-site assessment to determine common non-compliance in point-of-care (POC) glucose testing, deficiencies that should be improved by the POC team or emphasized in further training. Design/methodology/approach – Assessment forms for POC site and staff competency were developed and used for direct observation in four POC sites. Nurses were sampled in these sites. Findings – The on-site assessment demonstrated that initial operator training was insufficient. Only three of 15 nurses achieved a satisfactory score on the first assessment. In all nine participants who had been assessed at least twice improved their performance. In total, 16 (30 percent) of 53 competency items were not achieved, so these should be addressed during refresher training. Improved compliance with the checklist was observed in two of four POC sites. Research limitations/implications – Medical students and residents also perform the test, so more representative samples are needed. Practical implications – The assessment of staff performance in the workplace with constructive input and POC site inspections to identify common deficiencies are recommended. Refresher trainings should be focussed on the deficiencies identified. Social implications – Assessing staff performance in the workplace with constructive input and POC site inspections to identify common deficiencies are recommended. Refresher trainings should focus on deficiencies. Originality/value – This study involved directly observing POC site staff during glucose testing. The assessment forms were based on ISO 22870:2006 technical requirements.
    International Journal of Health Care Quality Assurance 07/2014; 27(5):373 - 381.
  • Panutsaya Tientadakul, Chulalak Kongkan, Wimol Chinswangwatanakul
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    ABSTRACT: Context.-Heparin contamination in blood samples may cause false prolongation of activated partial thromboplastin time (aPTT) and prothrombin time results. Polybrene can neutralize heparin, but it affects coagulation by itself. Objectives.--To determine the optimal concentration of polybrene to neutralize heparin, to determine the suitable sequence of reagents for the neutralization method performed on the analyzer at the same time as prothrombin time and aPTT testing, and to detect the heparin contamination in blood samples for coagulation tests in our hospital using this method. Design.-Various concentrations of heparin were added to 10 normal and 76 abnormal plasma samples to study the efficacy of polybrene. Two programs of reagent sequencing for aPTT with polybrene performed on the analyzer were tested. Samples suspected of heparin contamination according to our criteria were selected for neutralization during a 3-month period. Results.--The optimal final concentration of polybrene was 25 μg/mL. Polybrene should be added after the aPTT reagent to minimize its interference effect. Even though results of prothrombin time and aPTT after neutralization did not equal those before the spike of heparin, the differences might not be clinically significant. Eighty-one of 4921 samples (1.6%) were selected for aPTT with the neutralization method, and the detection rate of heparin contamination was 84% (68 of 81), giving an overall incidence of 1.4% (68 of 4921). Conclusions.-This method is inexpensive and can be performed rapidly with prothrombin time and aPTT on the automated analyzer, which makes it easy to practice with no need for extra plasma volumes.
    Archives of pathology & laboratory medicine 11/2013; 137(11):1641-7. · 2.78 Impact Factor
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    ABSTRACT: In Thailand, the spun microhematocrit method is usually performed using glass microhematocrit tubes even though broken glass tube during use may result in a risk of injury and blood-borne infection. The main reason is that the safer product alternatives such as plastic microhematocrit tubes are more expensive. Now, plastic tubes for hematocrit determination can be produced in Thailand at a much cheaper price. However precision and accuracy studies are necessary before being able to use them. To compare the accuracy and precision of Thai plastic microhematocrit tubes against the routinely used glass microhematocrit tubes and imported plastic microhematocrit tubes using spun microhematocrit method. One hundred residual EDTA blood samples from the Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand along with the three level hematology control materials were measured with spun microhematocrit values using three different types of plastic microhematocrit tubes. This was compared to the routinely used glass microhematocrit tubes as a gold standard. The repeated measures one-way ANOVA found no significant difference between the hematocrit values from each type of tubes with an F(1,99) = 0.667 and p-value = 0.574. Intraclass correlation coefficient (ICC) between four types of microhematocrit tubes ranged from 0.996-0.998 (p-value < 0.001). Correlation coefficients (r) between four types of microhematocrit tubes ranged from 0.996-0.998 (p-value < 0.05). Coefficient of variation (CV) for precision of both within run and between run of Thai plastic microhematocrit tubes ranged from 1.44 to 2.17% compared to 1.39 to 4.01% of the imported plastic microhematocrit tubes. The hematocrit values determined by all plastic microhematocrit tubes can be considered relatively equivalent to those of glass microhematocrit tubes in terms of accuracy and precision. The Thai plastic microhematocrit tubes are economical and with the cost-benefit over other plastic tubes of about 12 to 16 times. Therefore, the Thai plastic microhematocrit tubes should be the choice for glass tube replacement.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 06/2012; 95(6):809-15.
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    ABSTRACT: The ABO system is the most important of all blood group systems in transfusion practice. The subgroup gives a weak reaction when treated with anti-A or anti-B. The most common subgroup found in Thai blood donors is subgroup A3, which is characterized by mixed-field agglutination when reacted with anti-A and anti-A,B, was caused by mutation in the ABO gene, especially in the exon 7. In the present study mutation in A3 were charactered in exon 7 of the ABO gene in 10 A3 phenotype Thai blood donors from the National Blood Centre, Thai Red Cross Society by PCR amplification and DNA sequencing. Mutations in exon 7 were identified in the A allele of six cases. In four cases, mutations were detected at positions 646T > A, 681G > A, 771C > T and 829G > A. One case showed a double mutations at positions 467C > Tand 745C > T and one case showed a mutation at position 467C > T. Four cases showed wild type exon 7 as A101 allele. These mutations were previously reported in BGMUT database and no novel mutation was identified These data suggest genetic heterogeneity in A3phenotype in Thai blood donors.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 03/2011; 94(3):379-85.
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    ABSTRACT: Abstract: Participation in an external quality assessment system is a requirement of the ISO 22870:2006, which is specific for point-of-care (POC) testing. However, in the absence of external quality assessment, the ISO 22870 allows the laboratory director to alternatively establish its own internal quality assessment (IQA) program. To achieve this requirement, an IQA program for POC glucose testing was established at our hospital, in which there were 147 POC testing sites. The control samples for IQA were prepared from expired whole blood supplied by the Department of Transfusion Medicine. The stability of the glucose control sample was preserved by adding a combination of 2 antiglycolytic agents: glyceraldehydes and sodium iodoacetate. The control samples were stable for at least 8 hours. The samples were sent to all POC sites 3 times per year to evaluate the performance of POC glucose testing. The results of the analysis and comments were sent back to the POC sites, and the response rate increased. The coefficients of variation of the IQA results ranged from 4.7% to 7.9%. The number of POC sites where the results were not in the acceptable ranges and needed for corrective action was less than 6%. The IQA for POC glucose testing was successfully established and implemented at the largest public university hospital in the country. The program requires neither sophisticated equipment nor complicated procedures and provides enough volume of control materials for many POC sites.
    Point of Care. 11(1):37-41.