The influence of the full blood count on medical inpatient management.
OBJECTIVE
This investigation studied the use of the full blood count (FBC) in a general medical inpatient ward at Groote Schuur Hospital.


OBJECTIVE
To determine the relative frequency of the reasons for which FBCs were requested (clinically indicated v. routine) and how they influenced patient management.


METHODS
One hundred and sixty-five consecutive general medical inpatients admitted to the ward between September and December 1993 were included. Each patient underwent an FBC and differential white cell count prior to entering the ward.


METHODS
After taking a history and examining the patient, the physician responsible for each of the 165 patients completed a questionnaire.


METHODS
Physicians had to indicate whether the FBC was routine or clinically indicated and how the FBC result influenced their patient management.


RESULTS
In 67.9% of cases the FBC was considered to be clinically indicated, while in 32.1% of cases it was routine. Although it was felt that 76.4% of the clinically indicated tests influenced patient care, patient management was changed in only 24.7% of cases. In the case of routine tests, care was influenced in only 2.0% of cases.


CONCLUSIONS
Routine tests have a very low clinical yield. There is no substitute for good clinical judgement and the practice of routine tests must be reviewed, as much time, money and patient discomfort could be saved by the elimination of unnecessary investigations.
King
M S
MS
Department of Community Health, Groote Schuur Hospital.
White
N
N
D001772:Blood Cell Count; D006801:Humans; D007297:Inpatients; D010347:Patient Care Planning / Q000592:standards / Q000639:trends