The Hillingdon Hospitals NHS Foundation Trust, London, UK.
Int J Risk Saf Med. 2022;33(S1):S53-S56. doi: 10.3233/JRS-227024.
During the COVID-19 pandemic, the Hillingdon Hospitals NHS Foundation Trust produced trust guidelines for the initial blood investigation of COVID-19 inpatients. However, insufficient education meant inconsistent adherence to this guidance.
To examine whether the implementation of a COVID-19 blood request panel improves adherence to local trust guidelines.
Between March and April 2020, initial blood investigations performed for positive COVID-19 cases were compared to guidelines. Results were presented locally and a COVID-19 panel was added to the electronic system that provided prompts for appropriate investigations. A re-audit between May and June 2020 was conducted to assess adherence post-intervention.
383 patients were identified in the initial audit cohort and a sample of 20 patients were re-audited. Adherence to Full Blood Count, Urea and Electrolytes, C-reactive Protein and Liver Function Tests increased to 100% from 99.7% (p = 0.8), 99.2% (p = 0.69), 98.7% (p = 0.61), and 96.6% (p = 0.4) respectively. Coagulation screen adherence increased to 90% from 72.8% (p = 0.09). Appropriate requesting of D dimers increased to 50% from 19.9% (p = 0.001). Inappropriate troponin requesting decreased to 26.3% from 38.9% (p = 0.23).
A user-friendly COVID-19 panel of investigations resulted in improved adherence to guidelines. Clear communication and education are essential to help alleviate uncertainty during a pandemic.
在 COVID-19 大流行期间，希灵登医院 NHS 基金会信托基金会为 COVID-19 住院患者的初始血液检查制定了信托指南。然而，由于教育不足，导致对该指南的遵守情况不一致。
研究 COVID-19 血液检查面板的实施是否能提高对当地信托指南的遵守程度。
2020 年 3 月至 4 月期间，对阳性 COVID-19 病例进行的初始血液检查与指南进行了比较。结果在当地进行了汇报，并在电子系统中添加了 COVID-19 面板，为进行适当的检查提供了提示。2020 年 5 月至 6 月进行了再审核，以评估干预后的依从性。
在初始审核队列中确定了 383 名患者，并对 20 名患者进行了再审核。全血细胞计数、尿素和电解质、C 反应蛋白和肝功能检查的依从率从 99.7%（p = 0.8）、99.2%（p = 0.69）、98.7%（p = 0.61）和 96.6%（p = 0.4）分别提高到 100%。凝血筛查的依从率从 72.8%（p = 0.09）提高到 90%。适当请求 D-二聚体的比例从 19.9%（p = 0.001）提高到 50%。不适当的肌钙蛋白请求减少到 26.3%（p = 0.23）。
一个用户友好的 COVID-19 检查面板提高了对指南的遵守程度。在大流行期间，清晰的沟通和教育对于帮助减轻不确定性至关重要。
