根据决策算法改进血清钙检测医嘱。
Improving serum calcium test ordering according to a decision algorithm.
机构信息
Divisão de Patologia Clínica, Departamento de Patologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Discipline of Emergency Medicine, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
出版信息
J Clin Pathol. 2019 Mar;72(3):232-236. doi: 10.1136/jclinpath-2018-205026. Epub 2018 May 18.
AIM
To detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm.
METHODS
We studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed. Adequacy of ordering was defined according to adherence to a decision algorithm implemented in 2014.
RESULTS
Total and ionised calcium tests per patient-day of hospitalisation significantly decreased after the algorithm implementation; and duplication of tests (total and ionised calcium measured in the same blood sample) was reduced by 49%. Overall adequacy of ionised calcium determinations increased by 23% (P=0.0001) due to the increase in the adequacy of ionised calcium ordering in non-critical conditions.
CONCLUSIONS
A decision algorithm can be a useful educational tool to improve adequacy of the process of ordering serum calcium tests.
目的
检测实施决策算法前后血清钙检测的开单模式差异。
方法
我们研究了 2013 年 4 月和 2016 年 4 月入住某大学附属医院内科病房的患者。在进行每项检测的当天，将患者分为危急和非危急。根据 2014 年实施的决策算法，判断开单是否合理。
结果
实施算法后，患者住院期间的总钙和离子钙检测次数/天显著减少；且重复检测（同一血样中同时检测总钙和离子钙）减少了 49%。由于非危急情况下离子钙检测开单合理性增加，离子钙测定的总体合理性提高了 23%（P=0.0001）。
结论
决策算法可作为一种有用的教育工具，提高血清钙检测开单过程的合理性。
Zotero 插件