A computer based intervention on the appropriate use of arterial blood gas

Objective: To evaluate impact of a computer-based intervention on arterial blood gas (ABG) usage in an intensive care setting. Design: Retrospectively examined, via mixed group analysis, the effects of the intervention on ABG usage in the intensive care unit (ICU). Subjects. Included all clinicians who placed ABG orders in an ICU using the computerized physician order-entry system, as well as controls in non-order entry units. Methods. Computer-based intervention presenting ordering clinician with patient's previous ABG values and limiting forward duration of tests ordered. Study spanned 12 weeks, 5 weeks pre-intervention and 7-weeks post-intervention. Of 8 ICUs, intervention implemented in 6, not implemented in 2. Data analyzed using the repeated measure ANOVA. Results. Physicians entered <40% ABG orders. 376 ABGs per week processed pre-intervention, 387 per week post. Results nonsignificant with a p=0.09. Orders placed declined from 1039 per week, Jan 2000 to 662 per week, April 2001. Discussion: Study did not demonstrate significant change; limited power. Need longer study periods. Impact improved in the future by targeting physician users and tailoring intervention to specific work flow pattern of high utilization units.