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

来源：

AMERICAN JOURNAL OF CLINICAL PATHOLOGY | 2014年 / 141卷 / 01期

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

页码：78 / 84

页数：7