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A computer based intervention on the appropriate use of arterial blood gas
P Bansal1, D Aronsky, D Aronsky
1Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
Objective:
To evaluate impact of a computer-based intervention on arterial blood gas (ABG) usage in an intensive care setting.
Design:
Retrospectively examined, via mixed group analysis, the effects of the intervention on ABG usage in the intensive care unit (ICU).
Subjects:
Included all clinicians who placed ABG orders in an ICU using the computerized physician order-entry system, as well as controls in non-order entry units.
Methods:
Computer-based intervention presenting ordering clinician with patient s previous ABG values and limiting forward duration of tests ordered. Study spanned 12 weeks, 5 weeks pre-intervention and 7-weeks post-intervention. Of 8 ICUs, intervention implemented in 6, not implemented in 2. Data analyzed using the repeated measure ANOVA.
Results:
Physicians entered <40% ABG orders. 376 ABGs per week processed pre-intervention, 387 per week post. Results nonsignificant with a p= 0.09. Orders placed declined from 1039 per week, Jan 2000 to 662 per week, April 2001.
Discussion:
Study did not demonstrate significant change; limited power. Need longer study periods. Impact improved in the future by targeting physician users and tailoring intervention to specific work flow pattern of high utilization units.
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