Laboratory Tests and X-ray Imaging in a Surgical Intensive Care Unit: Checking the Checklist

Yorkgitis, Brian K.; Loughlin, Jesse W.; Gandee, Zachary; Bates, Halla H.; Weinhouse, Gerald L.

doi:10.7556/jaoa.2018.060

Cited by 5 publications

(14 citation statements)

References 17 publications

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“…We included a total of 81 records representing 70 studies: 50 nonrandomized interventional studies (19–68) and 20 observational studies (69–88) ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-five out of 70 studies (36%) reported frequencies of all routine blood tests measured as tests per patient day (20, 23–25, 29, 33, 34, 36–38, 46, 48, 50, 52, 53, 59, 62, 64, 68, 75–78, 80, 88).…”

Section: Resultsmentioning

confidence: 99%

“…Transfusion Rates. Transfusion rates were assessed in 12 out of 50 (24%) interventional studies 24,25,36,38,42,44,53,56,63,64,66), six of which reported a reduction in the number of RBCs transfused per patient associated with an intervention targeting reduced use of routine blood testing (25,36,38,44,63,66).…”

Section: Factors Associated With Higher Frequencies Of Routine Blood ...mentioning

confidence: 99%

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Routine Versus On-Demand Blood Sampling in Critically Ill Patients: A Systematic Review*

Hjortsø

Møller

Perner

et al. 2023

Critical Care Medicine

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OBJECTIVES: We aimed to provide an overview of the current evidence on routine versus on-demand blood sampling in critical care. We assessed the reported proportion of patients exposed to daily routine blood sampling, the tests performed, characteristics associated with more frequent blood sampling, and the reported benefits and harms of routine blood sampling compared with on-demand sampling. DATA SOURCES: We systematically searched the Cochrane Library, the Excerpta Medica Database, and the Medical Literature Analysis and Retrieval System Online for studies assessing routine versus on-demand blood testing in critically ill patients from inception to September 2022. STUDY SELECTION: Abstracts and full texts were assessed independently and in duplicate by two reviewers. STUDY EXTRACTION: Data were extracted independently and in duplicate by two reviewers using predefined extraction forms. DATA SYNTHESIS: Of 12,212 records screened, 298 full-text articles were assessed for eligibility. We included 70 studies; 50 nonrandomized interventional studies and 20 observational studies. Exposure to routine blood testing was 52–100% (very low certainty of evidence). Blood testing seemed to occur more frequently in medical intensive care settings with a median of 18 blood tests per patient day (interquartile range, 10–33) (very low certainty of evidence). Mixed biochemistry seemed to be the most frequently performed blood tests across all settings (five tests per patient day; interquartile range, 2–10) (very low certainty of evidence). Reductions in routine blood testing seemed to be associated with reduced transfusion rates and costs without apparent adverse patient outcomes (low certainty of evidence). CONCLUSIONS: In this systematic review, routine blood testing in critically ill patients was common and varied considerably. A reduction in routine blood testing appeared to be associated with reduced transfusion rates and costs without adverse effects, but the evidence was very uncertain.

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“…We included a total of 81 records representing 70 studies: 50 nonrandomized interventional studies (19–68) and 20 observational studies (69–88) ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Factors Associated With Higher Frequencies Of Routine Blood ...mentioning

confidence: 99%

See 1 more Smart Citation

Routine Versus On-Demand Blood Sampling in Critically Ill Patients: A Systematic Review*

Hjortsø

Møller

Perner

et al. 2023

Critical Care Medicine

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show abstract

“…The database search yielded a total of 3362 results, from which a total of 28 studies were included in the qualitative synthesis (Fig. 1) [3, 5, 9, 12–14, 21, 26–46].…”

Section: Resultsmentioning

confidence: 99%

“…All studies demonstrated significant improvements in most criteria, such as the documentation of date and time, clinician leading ward round, impression, management plan, and venous thromboembolism (VTE) assessment. Alamri and colleagues [28] reviewed compliance against a proforma sticker utilised in a previous study [27] Resources and personnel Yorkgitis et al [46] introduced a laboratory tests and chest X-ray imaging section on their daily intensive care unit (ICU) checklist. There was no significant difference in the mean number of chest x-rays and coagulation tests requested each day.…”

Section: Documentation Criteriamentioning

confidence: 99%

Interventions to Improve Patient Care on Surgical Ward Rounds: A Systematic Review

He,

Bhat,

Varghese

et al. 2023

World j. surg.

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Background Ward rounds are an essential component of surgical and perioperative care. However, the relative effectiveness of different interventions to improve the quality of surgical ward rounds remains uncertain. The aim of this systematic review was to evaluate the efficacy of various ward round interventions among surgical patients. Methods A systematic literature search of the MEDLINE (OVID), EMBASE (OVID), Scopus, Cumulative Index of Nursing and Allied Health (CINAHL), and PsycInfo databases was performed on 7 October 2022 in accordance with PRISMA guidelines. All studies investigating surgical ward round quality improvement strategies with measurable outcomes were included. Data were analysed via narrative synthesis based on commonly reported themes. Results A total of 28 studies were included. Most were cohort studies (n = 25), followed by randomised controlled trials (n = 3). Checklists/proformas were utilised most commonly (n = 22), followed by technological (n = 3), personnel (n = 2), and well-being (n = 1) quality improvement strategies. The majority of checklist interventions (n = 21, 95%) showed significant improvements in documentation compliance, staff understanding, or patient satisfaction. Other less frequently reported ward round interventions demonstrated improvements in communication, patient safety, and reductions in patient stress levels. Conclusions Use of checklists, technology, personnel, and well-being improvement strategies have been associated with improvements in ward round documentation, communication, as well as staff and patient satisfaction. Future studies should investigate the ease of implementation and long-term durability of these interventions, in addition to their impact on clinically relevant outcomes such as patient morbidity and mortality.

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Interventions to reduce low-value care in intensive care settings: a scoping review of impacts on health, resource use, costs, and the environment

Williams,

Moraga Masson,

McGain

et al. 2024

Intensive Care Med

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Purpose Low-value care is common in intensive care units (ICUs), unnecessarily exposing patients to risks and harms, incuring costs to the patient and healthcare system, and contributing to healthcare’s carbon footprint. We aimed to identify, collate, and summarise published evidence on the impact of interventions to reduce low-value care in ICUs. Methods We searched MEDLINE, Embase, and Cochrane CENTRAL from inception to 22 September 2023 for evaluations of interventions aiming to reduce low-value care, supplemented by reference lists and recently published articles. We recorded impacts on the low-value target, health outcomes, resource use, cost, and the environment. Results From 1155 studies screened, 32 eligible studies were identified evaluating interventions to reduce: routine blood testing ( n = 13), routine chest X-rays ( n = 10), and other types (or multiple types) of low-value care ( n = 9). All but 3 of the interventions found reductions in the immediate low-value care target (usually the primary outcome). Although the small sample size of most included studies, limited their ability to detect impacts on other outcomes, many interventions were also associated with improved health outcomes and financial savings. The only study that reported environmental impacts found the intervention was associated with reduced carbon dioxide equivalent (CO 2 -e) emissions. Conclusions Interventions to reduce low-value care in ICUs may have important health, financial, and environmental co-benefits. Further research may inform wider scale-up and sustainability of successful strategies to decrease low-value healthcare. More empirical evidence on potential environmental benefits may inform policies to lower healthcare’s carbon footprint. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-024-07670-7.

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Laboratory Tests and X-ray Imaging in a Surgical Intensive Care Unit: Checking the Checklist

Cited by 5 publications

References 17 publications

Routine Versus On-Demand Blood Sampling in Critically Ill Patients: A Systematic Review*

Routine Versus On-Demand Blood Sampling in Critically Ill Patients: A Systematic Review*

Interventions to Improve Patient Care on Surgical Ward Rounds: A Systematic Review

Interventions to reduce low-value care in intensive care settings: a scoping review of impacts on health, resource use, costs, and the environment

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