Literature DB >> 11825152

A computer based intervention on the appropriate use of arterial blood gas.

P Bansal1, D Aronsky, D Aronsky, D Talbert, R A Miller.   

Abstract

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.

Entities:  

Mesh:

Year:  2001        PMID: 11825152      PMCID: PMC2243306     

Source DB:  PubMed          Journal:  Proc AMIA Symp        ISSN: 1531-605X


  13 in total

1.  A randomized trial of a computer-based intervention to reduce utilization of redundant laboratory tests.

Authors:  D W Bates; G J Kuperman; E Rittenberg; J M Teich; J Fiskio; N Ma'luf; A Onderdonk; D Wybenga; J Winkelman; T A Brennan; A L Komaroff; M Tanasijevic
Journal:  Am J Med       Date:  1999-02       Impact factor: 4.965

Review 2.  Pulse oximetry. Uses and abuses.

Authors:  L M Schnapp; N H Cohen
Journal:  Chest       Date:  1990-11       Impact factor: 9.410

3.  Control of blood gas measurements in intensive-care units.

Authors:  D Roberts; P Ostryzniuk; E Loewen; A Shanks; T Wasyluk; L Pronger; I Hasinoff; E Roberts; T A McEwen
Journal:  Lancet       Date:  1991-06-29       Impact factor: 79.321

4.  Indications for arterial blood gas analysis.

Authors:  T A Raffin
Journal:  Ann Intern Med       Date:  1986-09       Impact factor: 25.391

5.  A new approach to the implementation of direct care-provider order entry.

Authors:  A Geissbühler; R A Miller
Journal:  Proc AMIA Annu Fall Symp       Date:  1996

6.  ABGs and arterial lines: the relationship to unnecessarily drawn arterial blood gas samples.

Authors:  F F Muakkassa; R Rutledge; S M Fakhry; A A Meyer; G F Sheldon
Journal:  J Trauma       Date:  1990-09

7.  Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation.

Authors:  J P Kress; A S Pohlman; M F O'Connor; J B Hall
Journal:  N Engl J Med       Date:  2000-05-18       Impact factor: 91.245

8.  Lessons learned: durability and progress of a program for ancillary cost reduction in surgical critical care.

Authors:  P S Barie; L J Hydo
Journal:  J Trauma       Date:  1997-10

9.  Does implementing pulse oximetry in a critical care unit result in substantial arterial blood gas savings?

Authors:  K J Inman; W J Sibbald; F S Rutledge; M Speechley; C M Martin; B J Clark
Journal:  Chest       Date:  1993-08       Impact factor: 9.410

10.  Computerized display of past test results. Effect on outpatient testing.

Authors:  W M Tierney; C J McDonald; D K Martin; M P Rogers
Journal:  Ann Intern Med       Date:  1987-10       Impact factor: 25.391

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  5 in total

1.  Novel displays of patient information in critical care settings: a systematic review.

Authors:  Rosalie G Waller; Melanie C Wright; Noa Segall; Paige Nesbitt; Thomas Reese; Damian Borbolla; Guilherme Del Fiol
Journal:  J Am Med Inform Assoc       Date:  2019-05-01       Impact factor: 4.497

2.  Integrating "best of care" protocols into clinicians' workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction.

Authors:  Asli Ozdas; Theodore Speroff; L Russell Waitman; Judy Ozbolt; Javed Butler; Randolph A Miller
Journal:  J Am Med Inform Assoc       Date:  2005-12-15       Impact factor: 4.497

3.  Computerised order entry systems and pathology services--a synthesis of the evidence.

Authors:  Andrew Georgiou; Johanna I Westbrook
Journal:  Clin Biochem Rev       Date:  2006-05

4.  Critical care information display approaches and design frameworks: A systematic review and meta-analysis.

Authors:  Melanie C Wright; Damian Borbolla; Rosalie G Waller; Guilherme Del Fiol; Thomas Reese; Paige Nesbitt; Noa Segall
Journal:  J Biomed Inform X       Date:  2019-06-22

Review 5.  Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis.

Authors:  Matthew Rubinstein; Robert Hirsch; Kakali Bandyopadhyay; Bereneice Madison; Thomas Taylor; Anne Ranne; Millie Linville; Keri Donaldson; Felicitas Lacbawan; Nancy Cornish
Journal:  Am J Clin Pathol       Date:  2018-02-17       Impact factor: 2.493

  5 in total

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