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Published on: January 16, 2019
Written guidelines for laboratory testing in intensive care--still effective after 3 years
1Intensive Care Unit, Waikato Hospital, Hamilton, New Zealand.
Summary
Written guidelines for laboratory testing in intensive care units remain effective three years later. Test numbers per ventilation time decreased, showing sustained impact on reducing unnecessary laboratory investigations.
Area of Science:
- Clinical Laboratory Science
- Intensive Care Medicine
- Health Services Research
Background:
- Written guidelines for laboratory testing were implemented in a hospital intensive care unit in 1995.
- Initial implementation led to significant reductions in blood tests: 16.6% in general ICU patients and 25.9% in post-cardiac surgery patients.
Purpose of the Study:
- To evaluate the long-term effectiveness of written laboratory testing guidelines in an intensive care unit.
- To compare laboratory test utilization three years after guideline implementation with initial results.
Main Methods:
- A comparative study was conducted on general ICU and post-cardiac surgery patients.
- Data collected included patient demographics, APACHE II scores, diagnoses, and ventilation time.
- Tests performed per patient and per ventilation hour were analyzed.
Main Results:
- General ICU patients: 2.1% increase in tests/patient, 5.6% decrease in tests/ventilation hour.
- Post-cardiac surgery patients: 4% decrease in tests/ventilation hour.
- Arterial blood gas (ABG) tests showed varied trends, but ABGs per ventilation hour decreased by 8.3% in post-cardiac surgery patients.
Conclusions:
- Written guidelines for laboratory testing maintained their effectiveness three years post-implementation.
- Sustained reduction in tests per ventilation time was observed in both patient groups.
- The study demonstrates the lasting impact of guidelines on optimizing laboratory test utilization in ICUs.
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