Pathology requesting in a regional Australian Emergency Department; an observational study comparing current practice with college guidelines

IF 1.9 4区 医学 Q2 NURSING Australian Journal of Rural Health Pub Date : 2024-06-13 DOI:10.1111/ajr.13151
Georgina Oakman MD, Alastair Anderson MD, Johann De Witt Oosthuizen FACRRM, Alexander Olaussen MBBS(Hons)
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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.

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澳大利亚一个地区急诊科的病理申请;一项观察性研究,将当前做法与学院指南进行比较。
导言:2018 年,澳大拉西亚急诊医学院(ACEM)和澳大拉西亚皇家病理学院(RCPA)制定了一项指南,鼓励在急诊科(ED)中提出适当的病理请求:评估地区性急诊科对 ACEM/RCPA 病理检验指南的遵守情况:这是一项回顾性观察研究,在澳大利亚一个地区性急诊室进行,历时 7 天。研究对象包括主诉符合指南要求的成年人。根据指南建议对所有血液化验进行审核,并将其分为有指征或无指征。主要结果测量:主要结果是非指示性血液化验的数量:结果:40%的化验单没有临床指征,87%的化验单没有指征。C反应蛋白(CRP)是最常见的不符合指南要求的化验项目(94%为非指示性化验)。出现下腹痛的患者占所有未指定检测项目的近四分之一:结论:在指南建议之外申请血液化验很常见,因此需要采取干预措施来改善病理管理。
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来源期刊
Australian Journal of Rural Health
Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.30
自引率
16.70%
发文量
122
审稿时长
12 months
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.
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