OBJECTIVES: To evaluate the usefulness of a clinical protocol developed to reduce the number of orders for coagulation tests. MATERIAL AND METHODS: Quasi-experimental study with historical controls. We retrospectively included all patients whose records showed that a coagulation test had been ordered in the emergency department. We analyzed the number of tests ordered under the protocol and the number ordered during the period of standard practice. RESULTS: Orders for coagulation tests were given for 657 patients (77.2%) when physicians followed standard practices and for 448 (55.5%) when they followed the protocol (P <.001). Unnecessary tests numbered 431 (65.6%) and 227 (50.6%) in the standard-practice and protocol periods, respectively (P <.002). One patient (0.15% [95% CI, 0.004%-0.8%]) had significantly altered coagulation (international normalized ratio, 1.8), but none (0% [95% CI, 0%-0.6%]) required treatment and no treatment plans were changed based on a finding of unexpected coagulation disorder. CONCLUSION: The protocol to guide the ordering of coagulation tests has managed to reduce unnecessary tests and thus improve management of this health service resource.
OBJECTIVES: To evaluate the usefulness of a clinical protocol developed to reduce the number of orders for coagulation tests. MATERIAL AND METHODS: Quasi-experimental study with historical controls. We retrospectively included all patients whose records showed that a coagulation test had been ordered in the emergency department. We analyzed the number of tests ordered under the protocol and the number ordered during the period of standard practice. RESULTS: Orders for coagulation tests were given for 657 patients (77.2%) when physicians followed standard practices and for 448 (55.5%) when they followed the protocol (P <.001). Unnecessary tests numbered 431 (65.6%) and 227 (50.6%) in the standard-practice and protocol periods, respectively (P <.002). One patient (0.15% [95% CI, 0.004%-0.8%]) had significantly altered coagulation (international normalized ratio, 1.8), but none (0% [95% CI, 0%-0.6%]) required treatment and no treatment plans were changed based on a finding of unexpected coagulation disorder. CONCLUSION: The protocol to guide the ordering of coagulation tests has managed to reduce unnecessary tests and thus improve management of this health service resource.
Entities:
Keywords:
Blood coagulation tests; Clinical protocols; Emergency health services; Protocolos clínicos; Pruebas de coagulación sanguínea; Servicios Médicos de Urgencias
Authors: Adolfo Romero; Juan Gómez-Salgado; Adolfo Romero-Arana; José Antonio Gómez-Fernández; Andrés Cobos; María Carmen Ramos; María Rosa Iglesias Journal: J Med Biochem Date: 2020-10-02 Impact factor: 3.402