Routine coagulation testing in intensive care

© 2016, Australasian Medical Publishing co. All Rights Reserved.Objective: To test a simple clinical guideline to reduce unnecessary routine testing of coagulation status. Design, setting and participants: A prospective, unblinded, observational study of coagulation testing frequency before and afte...

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Main Authors: Musca, S., Desai, S., Roberts, B., Paterson, T., Anstey, Matthew
Format: Journal Article
Published: Australasian Academy of Critical Care Medicine 2016
Online Access:http://hdl.handle.net/20.500.11937/5280
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author Musca, S.
Desai, S.
Roberts, B.
Paterson, T.
Anstey, Matthew
author_facet Musca, S.
Desai, S.
Roberts, B.
Paterson, T.
Anstey, Matthew
author_sort Musca, S.
building Curtin Institutional Repository
collection Online Access
description © 2016, Australasian Medical Publishing co. All Rights Reserved.Objective: To test a simple clinical guideline to reduce unnecessary routine testing of coagulation status. Design, setting and participants: A prospective, unblinded, observational study of coagulation testing frequency before and after introduction of a simple clinical guideline. We included 253 patients admitted to a tertiary intensive care unit: 100 patients consecutively enrolled before our intervention (May - July 2015) and 153 patients consecutively enrolled after our intervention (August - September 2015). Intervention: We introduced a clinical guideline and educational program in the ICU from 18 August 2015. Main outcome measures: The number of coagulation tests performed per patient bed-day, and the associated pathology costs. Results: Over the 3-month sample period, 999 coagulation profiles were performed for 253 patients: 720 (72%) in 100 patients before, and 279 (28%) in 153 patients after our intervention. The testing frequency fell from 1.12 to 0.41 per patient bed-day (P < 0.001). A total of 463 pre-intervention coagulation profiles (64%) were classified as unnecessary, and the cost of all coagulation tests fell by 60.5% per bed-day after the intervention. Conclusion: A simple clinical guideline and educational package reduced unnecessary coagulation tests and costs in a tertiary referral ICU.
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spelling curtin-20.500.11937-52802017-01-30T10:45:06Z Routine coagulation testing in intensive care Musca, S. Desai, S. Roberts, B. Paterson, T. Anstey, Matthew © 2016, Australasian Medical Publishing co. All Rights Reserved.Objective: To test a simple clinical guideline to reduce unnecessary routine testing of coagulation status. Design, setting and participants: A prospective, unblinded, observational study of coagulation testing frequency before and after introduction of a simple clinical guideline. We included 253 patients admitted to a tertiary intensive care unit: 100 patients consecutively enrolled before our intervention (May - July 2015) and 153 patients consecutively enrolled after our intervention (August - September 2015). Intervention: We introduced a clinical guideline and educational program in the ICU from 18 August 2015. Main outcome measures: The number of coagulation tests performed per patient bed-day, and the associated pathology costs. Results: Over the 3-month sample period, 999 coagulation profiles were performed for 253 patients: 720 (72%) in 100 patients before, and 279 (28%) in 153 patients after our intervention. The testing frequency fell from 1.12 to 0.41 per patient bed-day (P < 0.001). A total of 463 pre-intervention coagulation profiles (64%) were classified as unnecessary, and the cost of all coagulation tests fell by 60.5% per bed-day after the intervention. Conclusion: A simple clinical guideline and educational package reduced unnecessary coagulation tests and costs in a tertiary referral ICU. 2016 Journal Article http://hdl.handle.net/20.500.11937/5280 Australasian Academy of Critical Care Medicine restricted
spellingShingle Musca, S.
Desai, S.
Roberts, B.
Paterson, T.
Anstey, Matthew
Routine coagulation testing in intensive care
title Routine coagulation testing in intensive care
title_full Routine coagulation testing in intensive care
title_fullStr Routine coagulation testing in intensive care
title_full_unstemmed Routine coagulation testing in intensive care
title_short Routine coagulation testing in intensive care
title_sort routine coagulation testing in intensive care
url http://hdl.handle.net/20.500.11937/5280