Evaluation of Real-Time Clinical Decision Support Systems for Platelet and Cryoprecipitate Orders

被引:26
作者
Collins, Ryan A. [1 ]
Triulzi, Darrell J. [1 ,2 ]
Waters, Jonathan H. [3 ,4 ]
Reddy, Vivek [5 ]
Yazer, Mark H. [1 ,2 ]
机构
[1] Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA
[2] Inst Transfus Med, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Dept Anesthesiol, Pittsburgh, PA USA
[4] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA
[5] Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA
关键词
Platelet; Cryoprecipitate; Alert; Computerized order entry; Audit; Patient blood management; INTENSIVE-CARE-UNIT; TRANSFUSION TRIGGERS; PATIENT OUTCOMES; BLOOD MANAGEMENT; PERFORMANCE; PROGRAM; ENTRY;
D O I
10.1309/AJCP1OSRTPUJE9XS
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Objectives: To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. Methods: Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines. Results: There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders. Conclusions: CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.
引用
收藏
页码:78 / 84
页数:7
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