Mehari S M, Havill J H
Intensive Care Unit, Waikato Hospital, Hamilton, New Zealand.
Crit Care Resusc. 2001 Sep;3(3):158-62.
The aim of the study was to examine the effect of time on written guidelines for laboratory testing in an intensive care unit by comparing the numbers of tests performed with those performed three years previously.
In 1995, guidelines were developed for blood test ordering in the Waikato Hospital intensive care unit, which when implemented resulted in a decrease in all blood tests performed by 16.6% in a group of general intensive care patients and by 25.9% in a group of post cardiac surgery patients. We repeated this study on similar groups of patients to see if the guidelines were still effective. Data on age, APACHE II score, diagnosis, and ventilation time were collected. Comparisons were made of tests performed per patient and per ventilation time in hours.
In the general intensive care patient group, there was an increase of 2.1% tests performed per patient, but a decrease in tests performed per ventilation time of 5.6%. In the postoperative cardiac surgery patient group, the total number of tests performed per ventilation time decreased by 4%. The arterial blood gases performed per patient increased by 10.7% in the general intensive care patient group, and decreased by 14.3% in the postoperative cardiac surgery patient group. However, when the number of arterial blood gases performed per ventilation time were compared with the 1995 study, there was no difference in the general intensive care patient group, while there was a reduction by 8.3% in the postoperative cardiac surgery patient group.
Three years after the implementation of guidelines for laboratory testing in an intensive care unit, there was no return to the level of testing recorded before the guidelines were introduced. The number of tests per ventilation time decreased by 4% in postoperative cardiac surgery patients and decreased by 5.6% in the general intensive care patients. In our study written guidelines remained effective three years after their introduction.
本研究旨在通过比较当前与三年前的实验室检测执行数量，探讨时间对重症监护病房（ICU）实验室检测书面指南效果的影响。
1995年，怀卡托医院重症监护病房制定了血液检测医嘱指南，实施后，一组普通重症监护患者的所有血液检测量减少了16.6%，心脏手术后患者组减少了25.9%。我们对类似患者群体重复了这项研究，以观察该指南是否仍然有效。收集了患者的年龄、急性生理与慢性健康状况评分系统（APACHE II）评分、诊断结果及通气时间等数据。对每位患者的检测量以及每小时通气时间的检测量进行了比较。
在普通重症监护患者组中，每位患者的检测量增加了2.1%，但每通气时间的检测量减少了5.6%。在心脏手术后患者组中，每通气时间的检测总量减少了4%。普通重症监护患者组中，每位患者的动脉血气检测量增加了10.7%，心脏手术后患者组减少了14.3%。然而，将每通气时间的动脉血气检测量与1995年的研究进行比较时，普通重症监护患者组没有差异，而心脏手术后患者组减少了8.3%。
重症监护病房实施实验室检测指南三年后，检测水平并未回到指南实施前的记录水平。心脏手术后患者每通气时间的检测量减少了4%，普通重症监护患者减少了5.6%。在我们的研究中，书面指南在引入三年后仍然有效。
Zotero 插件