Georgina Oakman MD, Alastair Anderson MD, Johann De Witt Oosthuizen FACRRM, Alexander Olaussen MBBS(Hons)
{"title":"Pathology requesting in a regional Australian Emergency Department; an observational study comparing current practice with college guidelines","authors":"Georgina Oakman MD, Alastair Anderson MD, Johann De Witt Oosthuizen FACRRM, Alexander Olaussen MBBS(Hons)","doi":"10.1111/ajr.13151","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>In 2018, the Australasian College for Emergency Medicine (ACEM) and the Royal College of Pathologists of Australasia (RCPA) produced a guideline to encourage appropriate pathology requesting in the Emergency Department (ED).</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To assess adherence to the ACEM/RCPA pathology testing guideline in a regional ED.</p>\n </section>\n \n <section>\n \n <h3> Methods, Design, Setting and Participants</h3>\n \n <p>This was a retrospective observational study conducted at a regional Australian ED over 7 days. Adults with a presenting complaint encompassed by the guideline were included. All blood tests were audited against the guideline recommendations and classified as indicated or non-indicated. Chi-squared analyses were performed to explore the association between presenting complaint and non-indicated testing.</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measure</h3>\n \n <p>The primary outcome was the number of non-indicated blood tests.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Forty percent of tests ordered were not clinically indicated, with non-indicated testing occurring during 87% of encounters. The C-reactive protein (CRP) was the test most frequently ordered outside of guidelines (94% non-indicated). Patients presenting with lower abdominal pain accounted for nearly one-quarter of all non-indicated tests.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Blood tests were commonly requested outside of the guideline recommendations and interventions to improve pathology stewardship are required.</p>\n </section>\n </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1062-1067"},"PeriodicalIF":1.9000,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Journal of Rural Health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajr.13151","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
In 2018, the Australasian College for Emergency Medicine (ACEM) and the Royal College of Pathologists of Australasia (RCPA) produced a guideline to encourage appropriate pathology requesting in the Emergency Department (ED).
Objective
To assess adherence to the ACEM/RCPA pathology testing guideline in a regional ED.
Methods, Design, Setting and Participants
This was a retrospective observational study conducted at a regional Australian ED over 7 days. Adults with a presenting complaint encompassed by the guideline were included. All blood tests were audited against the guideline recommendations and classified as indicated or non-indicated. Chi-squared analyses were performed to explore the association between presenting complaint and non-indicated testing.
Main Outcome Measure
The primary outcome was the number of non-indicated blood tests.
Results
Forty percent of tests ordered were not clinically indicated, with non-indicated testing occurring during 87% of encounters. The C-reactive protein (CRP) was the test most frequently ordered outside of guidelines (94% non-indicated). Patients presenting with lower abdominal pain accounted for nearly one-quarter of all non-indicated tests.
Conclusions
Blood tests were commonly requested outside of the guideline recommendations and interventions to improve pathology stewardship are required.
期刊介绍:
The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.