The rational ordering of blood cultures in the emergency department.
A large number of patients with febrile illness are evaluated in emergency departments. Blood cultures are often obtained on such patients without reference to established guidelines. As a result of such practice, unnecessary blood cultures are being ordered with negative financial impact on both hospitals and patients. Generally speaking, as the number of blood cultures obtained increases so does the number of false positive results. Follow-up on these results directly impacts on patient care as these patients are often subjected to call backs, additional work up, and admission to the hospital. This study reviews the manner in which blood cultures were ordered before and after the introduction of general guidelines for their use. It outlines a process whereby excessive ordering of blood cultures can be eliminated and suggests that this approach may be effective in limiting inappropriate use of other laboratory and diagnostic studies.
Salluzzo
R
R
Department of Emergency, Albany Medical Center, NY 12208.
Reilly
K
K
D001800:Blood Specimen Collection / Q000706:statistics & numerical data*; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000592:standards*; D005069:Evaluation Studies as Topic; D006746:Hospital Bed Capacity, 500 and over; D008505:Medical Staff, Hospital / Q000592:standards*; D009518:New York; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D014600:Utilization Review