Journal ArticleDOI
Impact of clinical guidelines to improve appropriateness of laboratory tests and chest radiographs
Gwenaël Prat,Montaine Lefèvre,Emmanuel Nowak,Jean-Marie Tonnelier,Anne Renault,Erwan L'Her,Jean-Michel Boles +6 more
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TLDR
The implementation of a laboratory tests and chest radiographs prescription protocol within the ICU induced an important cost saving, directly related to the protocol implementation.Abstract:
Objective
To assess the impact of clinical guidelines to improve appropriate use of routine laboratory tests and bedside chest radiographs in a medical intensive care.read more
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Anemia in critical illness: insights into etiology, consequences, and management.
TL;DR: Normal red blood cell physiology; etiologies of anemia in the intensive care unit; its association with adverse outcomes; and the risks, benefits, and efficacy of various management strategies, including blood transfusion, erythropoietin, blood substitutes, iron therapy, and minimization of diagnostic phlebotomy are reviewed.
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Managing demand for laboratory tests: a laboratory toolkit
TL;DR: This article aims to provide a ‘toolkit’ with the view to allowing laboratories to develop a standardised demand management strategy, and defines demand management and inappropriate requesting.
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Routine chest x-rays in intensive care units: a systematic review and meta-analysis
TL;DR: This meta-analysis did not detect any harm associated with a restrictive chest radiograph strategy, however, confidence intervals were wide and harm was not rigorously assessed, therefore, the safety of abandoning routine CXRs in patients admitted to the ICU remains uncertain.
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Influence of educational, audit and feedback, system based, and incentive and penalty interventions to reduce laboratory test utilization: a systematic review
TL;DR: Low investment strategies that use low investment strategies to reduce test utilization with one time changes in the ordering system are the most promising for achievable and durable reductions in inappropriate test use.
References
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Journal ArticleDOI
From best evidence to best practice: effective implementation of change in patients' care
Richard Grol,Jeremy M. Grimshaw +1 more
TL;DR: In this article, the authors provide an overview of present knowledge about initiatives to changing medical practice and suggest that to change behaviour is possible, but this change generally requires comprehensive approaches at different levels (doctor, team practice, hospital, wider environment), tailored to specific settings and target groups.
Journal Article
From best evidence to best practice: effective implementation of change in patients' care. Commentary
TL;DR: An overview of present knowledge about initiatives to changing medical practice is provided, showing that none of the approaches for transferring evidence to practice is superior to all changes in all situations.
Journal ArticleDOI
Anemia and blood transfusion in critically ill patients.
Jean Louis Vincent,Konrad Reinhart,Luciano Gattinoni,Lambert Thijs,A. R. Webb,Andreas Meier-Hellmann,Guy Nollet,Daliana Peres-Bota +7 more
TL;DR: This multicenter observational study reveals the common occurrence of anemia and the large use of blood transfusion in critically ill patients and provides evidence of an association between transfusions and diminished organ function as well as between transfusion and mortality.
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Personal paper: Beliefs and evidence in changing clinical practice
TL;DR: Clinicians, epidemiologists, health services researchers, educationalists, social scientists, economists, health authorities—often have different ideas on the best strategies to improve practice and the best way of making changes.
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Anemia, transfusion, and phlebotomy practices in critically ill patients with prolonged ICU length of stay: a cohort study
TL;DR: Small decreases in phlebotomy volume are associated with significantly reduced transfusion requirements in patients with prolonged ICU LOS, and erythropoietin therapy is used almost exclusively in dialysis dependent renal failure in this cohort of patients.