A computer based intervention on the appropriate use of arterial blood gas.
OBJECTIVE
To evaluate impact of a computer-based intervention on arterial blood gas (ABG) usage in an intensive care setting.


METHODS
Retrospectively examined, via mixed group analysis, the effects of the intervention on ABG usage in the intensive care unit (ICU).


METHODS
Included all clinicians who placed ABG orders in an ICU using the computerized physician order-entry system, as well as controls in non-order entry units.


METHODS
Computer-based intervention presenting ordering clinician with patient s previous ABG values and limiting forward duration of tests ordered. Study spanned 12 weeks, 5 weeks pre-intervention and 7-weeks post-intervention. Of 8 ICUs, intervention implemented in 6, not implemented in 2. Data analyzed using the repeated measure ANOVA.


RESULTS
Physicians entered <40% ABG orders. 376 ABGs per week processed pre-intervention, 387 per week post. Results nonsignificant with a p= 0.09. Orders placed declined from 1039 per week, Jan 2000 to 662 per week, April 2001.


CONCLUSIONS
Study did not demonstrate significant change; limited power. Need longer study periods. Impact improved in the future by targeting physician users and tailoring intervention to specific work flow pattern of high utilization units.
Bansal
P
P
Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
Aronsky
D
D
Aronsky
D
D
Talbert
D
D
Miller
R A
RA
D000704:Analysis of Variance; D001784:Blood Gas Analysis / Q000706:statistics & numerical data; D003658:Decision Making, Computer-Assisted; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005103:Expert Systems; D006801:Humans; D007362:Intensive Care Units; D016347:Medical Records Systems, Computerized; D012189:Retrospective Studies