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Pathology requesting in a regional Australian Emergency Department; an observational study comparing current practice

Georgina Oakman1, Alastair Anderson1, Johann De Witt Oosthuizen2

  • 1Critical Care SRMO, Northeast Health Wangaratta, Wangaratta, Victoria, Australia.

The Australian Journal of Rural Health
|June 13, 2024
PubMed

Insights

Forty percent of blood tests in a regional emergency department were not indicated, highlighting a need for improved pathology stewardship. Interventions are required to ensure appropriate test ordering and reduce unnecessary C-reactive protein (CRP) tests.

Area of Science:

  • Medical Science
  • Clinical Pathology
  • Emergency Medicine

Background:

  • The Australasian College for Emergency Medicine (ACEM) and Royal College of Pathologists of Australasia (RCPA) issued a guideline in 2018 to promote appropriate pathology test requests in the Emergency Department (ED).

Purpose of the Study:

  • To evaluate adherence to the ACEM/RCPA pathology testing guideline within a regional ED setting.

Main Methods:

  • A retrospective observational study was conducted over 7 days in a regional Australian ED.
  • Adult patients with complaints covered by the guideline were included.
  • Blood tests were audited against guideline recommendations, categorized as indicated or non-indicated.

Main Results:

  • Forty percent of all ordered blood tests were non-indicated, occurring in 87% of patient encounters.
  • C-reactive protein (CRP) was the most frequently non-indicated test (94%).
  • Lower abdominal pain presentations accounted for nearly 25% of all non-indicated tests.

Conclusions:

  • Pathology tests are frequently requested outside of established guideline recommendations.
  • Interventions are necessary to enhance pathology stewardship and ensure appropriate test utilization in the ED.
Abstract

Keywords:
Australiadiagnostic techniques and proceduresemergency service; hospitalguideline adherencepathology testing

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