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Proceedings of the AMIA Symposium logoLink to Proceedings of the AMIA Symposium
. 2001:32–36.

A computer based intervention on the appropriate use of arterial blood gas.

P Bansal 1, D Aronsky 1, D Aronsky 1, D Talbert 1, R A Miller 1
PMCID: PMC2243306  PMID: 11825152

Abstract

OBJECTIVE: To evaluate impact of a computer-based intervention on arterial blood gas (ABG) usage in an intensive care setting. DESIGN: Retrospectively examined, via mixed group analysis, the effects of the intervention on ABG usage in the intensive care unit (ICU). SUBJECTS: Included all clinicians who placed ABG orders in an ICU using the computerized physician order-entry system, as well as controls in non-order entry units. METHODS: Computer-based intervention presenting ordering clinician with patient s previous ABG values and limiting forward duration of tests ordered. Study spanned 12 weeks, 5 weeks pre-intervention and 7-weeks post-intervention. Of 8 ICUs, intervention implemented in 6, not implemented in 2. Data analyzed using the repeated measure ANOVA. RESULTS: Physicians entered <40% ABG orders. 376 ABGs per week processed pre-intervention, 387 per week post. Results nonsignificant with a p= 0.09. Orders placed declined from 1039 per week, Jan 2000 to 662 per week, April 2001. DISCUSSION: Study did not demonstrate significant change; limited power. Need longer study periods. Impact improved in the future by targeting physician users and tailoring intervention to specific work flow pattern of high utilization units.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barie P. S., Hydo L. J. Lessons learned: durability and progress of a program for ancillary cost reduction in surgical critical care. J Trauma. 1997 Oct;43(4):590–596. doi: 10.1097/00005373-199710000-00005. [DOI] [PubMed] [Google Scholar]
  2. Bates D. W., Boyle D. L., Rittenberg E., Kuperman G. J., Ma'Luf N., Menkin V., Winkelman J. W., Tanasijevic M. J. What proportion of common diagnostic tests appear redundant? Am J Med. 1998 Apr;104(4):361–368. doi: 10.1016/s0002-9343(98)00063-1. [DOI] [PubMed] [Google Scholar]
  3. Bates D. W., Kuperman G. J., Rittenberg E., Teich J. M., Fiskio J., Ma'luf N., Onderdonk A., Wybenga D., Winkelman J., Brennan T. A. A randomized trial of a computer-based intervention to reduce utilization of redundant laboratory tests. Am J Med. 1999 Feb;106(2):144–150. doi: 10.1016/s0002-9343(98)00410-0. [DOI] [PubMed] [Google Scholar]
  4. Geissbühler A., Miller R. A. A new approach to the implementation of direct care-provider order entry. Proc AMIA Annu Fall Symp. 1996:689–693. [PMC free article] [PubMed] [Google Scholar]
  5. Harrison R. V., Payne B. C. Developing criteria for ordering common ancillary services. Med Care. 1991 Sep;29(9):853–877. doi: 10.1097/00005650-199109000-00006. [DOI] [PubMed] [Google Scholar]
  6. Inman K. J., Sibbald W. J., Rutledge F. S., Speechley M., Martin C. M., Clark B. J. Does implementing pulse oximetry in a critical care unit result in substantial arterial blood gas savings? Chest. 1993 Aug;104(2):542–546. doi: 10.1378/chest.104.2.542. [DOI] [PubMed] [Google Scholar]
  7. Kress J. P., Pohlman A. S., O'Connor M. F., Hall J. B. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000 May 18;342(20):1471–1477. doi: 10.1056/NEJM200005183422002. [DOI] [PubMed] [Google Scholar]
  8. Le Bourdellès G., Estagnasié P., Lenoir F., Brun P., Dreyfuss D. Use of a pulse oximeter in an adult emergency department: impact on the number of arterial blood gas analyses ordered. Chest. 1998 Apr;113(4):1042–1047. doi: 10.1378/chest.113.4.1042. [DOI] [PubMed] [Google Scholar]
  9. Muakkassa F. F., Rutledge R., Fakhry S. M., Meyer A. A., Sheldon G. F. ABGs and arterial lines: the relationship to unnecessarily drawn arterial blood gas samples. J Trauma. 1990 Sep;30(9):1087–1095. [PubMed] [Google Scholar]
  10. Raffin T. A. Indications for arterial blood gas analysis. Ann Intern Med. 1986 Sep;105(3):390–398. doi: 10.7326/0003-4819-105-3-390. [DOI] [PubMed] [Google Scholar]
  11. Roberts D., Ostryzniuk P., Loewen E., Shanks A., Wasyluk T., Pronger L., Hasinoff I., Roberts E., McEwen T. A. Control of blood gas measurements in intensive-care units. Lancet. 1991 Jun 29;337(8757):1580–1582. doi: 10.1016/0140-6736(91)93271-a. [DOI] [PubMed] [Google Scholar]
  12. Schnapp L. M., Cohen N. H. Pulse oximetry. Uses and abuses. Chest. 1990 Nov;98(5):1244–1250. doi: 10.1378/chest.98.5.1244. [DOI] [PubMed] [Google Scholar]
  13. Tierney W. M., McDonald C. J., Martin D. K., Rogers M. P. Computerized display of past test results. Effect on outpatient testing. Ann Intern Med. 1987 Oct;107(4):569–574. doi: 10.7326/0003-4819-107-4-569. [DOI] [PubMed] [Google Scholar]

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