Navigation Links
What is a critical lab value? it depends, Hopkins researchers find
Date:10/28/2007

When it comes to lab tests, interpreting the clinical importance of an out-of-range result depends on how much experience a physician has, suggests research from the Johns Hopkins Childrens Center. Investigators are presenting their findings at the American Academy of Pediatrics Conference Oct. 26 through Oct. 30 in San Francisco.

In the study involving 31 residents, six fellows and 10 senior attending physicians in the neonatal intensive care unit (NICU) at Hopkins Childrens, senior, more experienced doctors (attending physicians) were less likely to want certain abnormal results reported to them immediately. By contrast, the less experienced doctors (residents) were most likely to want all out-of-range values right away, while those in the middle of the experience curve (fellows) fell in between.

Theoretically, there should be no difference in which abnormal values doctors consider critical to get by instant pager, so we were quite surprised to see how their views of critical varied, says lead investigator Theodora Stavroudis, M.D., a neonatologist at Hopkins Childrens.

The differences could mean that younger, less experienced doctors are simply more anxious and prefer to err on the side of caution, researchers speculate.

With increased experience, you tend to learn which alerts you can ignore safely and which ones you cant, says senior investigator Christoph Lehmann, M.D. Unfortunately, this isnt something you can teach in medical school, but it is something that comes with experience.

Researchers asked doctors to define which out-of-range lab values they considered critical enough to require the lab to page them. Under the current system, a lab technician reports the lab results to a nurse, who then reports them to a doctor, which means that up to 20 minutes can pass before a doctor finds out about a patients abnormal labs. In an effort to cut lab-to-doctor time, streamline communication and improve patient safety, Hopkins Childrens researchers are preparing to launch a system that feeds critical lab values directly into a doctors pager.

To avoid overload, however, it was important that only truly critical resultsthose signaling true urgency or emergency in terms of clinical carebe sent. But which out-of-range results require an instant alert and which ones can wait" Four out of 15 abnormal lab values (low ionized calcium, high sodium, high potassium and high creatinine) generated the most difference in opinion. Most attending physicians said none of these required a page. Most fellows said all four but high creatinine should trigger a pager alert. Most residents said pagers should go off for all four, except high sodium.

The study also points to the need to define what truly critical values are for newborns and stop extrapolating from adult lab values, an archaic, round-about system that is currently the status quo in hospitals nationwide, researchers say.

Since last spring, when this study was conducted, the Hopkins NICU has moved on to use both the current and the new systems side by side, allowing researchers to compare them in action.

This study is part of Hopkins ongoing efforts to prevent medical errors and improve patient safety. Traditionally, intensive care units have been the most vulnerable to errors because of the severity of cases and the many distractions in the environment.


'/>"/>

Contact: Katerina Pesheva
Epeshev1@jhmi.edu
410-926-6780
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Cells critical for asthma development found
2. Ultrasound Screening Could Improve The Outcome Of Critically ill Patients
3. Sleep Not Critical For Early Brain Development Of Baby Dolphins
4. Critically Ill Patients More At Risk Of Infection If Glucose Is Present In Their Lung Secretions
5. Dietary supplementation of Folic Acid Requires Critical Evaluation
6. Past President Narayanans Condition Still Critical
7. Bacterial infestation in food very critical!
8. Critical Decisions Have To Be Taken By Mothers Of Premature Babies
9. Heart Transplant Twin Recovering, But Brother Critical
10. Australia In Search Of A Better Way to Handle Critically Ill Patients and Balance Elective Surgery
11. Yeast Genome Unravels Genes Critical For Maintaining DNA Integrity
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, actor Rob Lowe, ... in a new episode of "Success Files," which is an award-winning educational program ... investigates each subject in-depth with passion and integrity. , Sciatica occurs when the ...
(Date:10/13/2017)... ... 2017 , ... “America On The Brink”: the Christian history of the United ... the creation of published author, William Nowers. Captain Nowers and his wife, Millie, ... spent thirty years in the Navy. Following his career as a naval aviator ...
(Date:10/12/2017)... Orleans, LA (PRWEB) , ... October 12, 2017 , ... ... centers in the U.S., announced today its plans to open a flagship location in ... will occupy the former Rooms To Go store next to Office Depot in the ...
(Date:10/12/2017)... ... 12, 2017 , ... The American College of Medical Informatics (ACMI) will present ... the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... Collen, a pioneer in the field of medical informatics, this prestigious award is presented ...
(Date:10/12/2017)... LOS ANGELES (PRWEB) , ... October 12, 2017 ... ... of Parsa Mohebi Hair Restoration, has recently contributed a medical article to the ... doctors, on cosmetictown.com. Dr. Mohebi’s article spotlights the hair transplant procedure known as ...
Breaking Medicine News(10 mins):
(Date:9/19/2017)... venture-backed medical device company developing a non-invasive, robotically assisted, platform therapy that uses pulsed sound ... ... Jim Bertolina, PhD ... Tom Tefft ... device executive Josh Stopek , PhD, who has led R&D and business development teams ...
(Date:9/18/2017)... , Sept. 18, 2017 EpiVax, ... of bioinformatics and immune engineering, today announced ... influenza A (H7N9) vaccine. ... to seasonal influenza and presents a challenge ... prior exposure to be effective. Using state-of-the-art ...
(Date:9/12/2017)... , Sept. 12, 2017  Consumer reviews on the independent ... as the number one company for hearing aids, ranking it ... fifteen other brands. ... Hearing Named #1 by Consumers For Hearing Aids ... Embrace Hearing is an online store that provides high performance, ...
Breaking Medicine Technology: