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:10/12/2017)... ... 12, 2017 , ... HMP , a leader in healthcare events and ... Eddie Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the Eddie ... annual award competition recognizes editorial and design excellence across a range of sectors. This ...
(Date:10/12/2017)... ... October 12, 2017 , ... On Saturday, October 21, the Health ... Miles by Moonlight to raise money for the American Heart Association Heart Walk. Teams ... Teams will work together to keep their treadmills moving for 5 hours. Treadmills will ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health Literacy Innovations (HLI), creator ... tool, and the Cancer Patient Education Network (CPEN), an independent professional organization that ... new strategic alliance. , As CPEN’s strategic partner, HLI will help support ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... the latest in wound care advancements to physician colleagues, skilled nursing facility medical ... titled, "Navigating the Treacherous Waters of Wound Care." , "At many of these ...
(Date:10/12/2017)... CHICAGO (PRWEB) , ... October ... ... innovator in life sciences content management, presents its enhanced Pepper Flow promotional ... Oct. 16 -18, 2017. Pepper Flow’s increased insight-driven capabilities help marketers streamline ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... INDIANAPOLIS , Oct. 2, 2017  Eli Lilly ... its financial results for the third quarter of 2017 ... a conference call on that day with the investment ... performance. The conference call will begin at ... public can access a live webcast of the conference ...
(Date:9/28/2017)... -- Hill-Rom Holdings, Inc. (NYSE: HRC), will host its ... on Friday, November 3, 2017, beginning at 7:00 a.m. ... 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... and guidance for 2018, Hill-Rom executives will also highlight ... and long-range financial outlook through 2020. ...
(Date:9/25/2017)...   Montrium , an industry leader in ... IQPC Trial Master Files & Inspection Readiness Conference ... Clinical Services has selected eTMF Connect ... EastHORN, a leading European contract research organization (CRO), ... to enable greater collaboration with sponsors, improve compliance ...
Breaking Medicine Technology: