Issue |
J Extra Corpor Technol
Volume 54, Number 2, June 2022
|
|
---|---|---|
Page(s) | 123 - 127 | |
DOI | https://doi.org/10.1051/ject/202254123 | |
Published online | 15 June 2022 |
Original Articles
Eliminate Unnecessary Laboratory Work to Mitigate Iatrogenic Anemia and Reduce Cost for Patients on Extracorporeal Membrane Oxygenation
* Pediatric Critical Care, Children’s Hospital of Illinois at OSF HealthCare Saint Francis Medical Center, Peoria, Illinois; and
† Acute Care Pediatric Nurse Practitioner Program, Department of Women, Children, and Family Nursing, Rush University College of Nursing, Chicago, Illinois
Address correspondence to: Maureen Welty, DNP, Nurse Practitioner, Children’ s Hospital of Illinois at OSF HealthCare Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637. E-mail: maureen.e.welty@osfhealthcare.org
Received:
12
January
2022
Accepted:
14
May
2022
Laboratory testing is a helpful tool for clinicians, but can be costly and harmful to patients. A quality improvement project was initiated to reduce laboratory testing for patients receiving extracorporeal membrane oxygenation (ECMO) in a pediatric intensive care unit (PICU) at a tertiary care center. Preliminary data was gathered to demonstrate preimplementation practice, cost, and patient need for packed red blood cell (pRBC) transfusions. A new protocol was created by an interprofessional team based on best practice and benchmarking with high-performing organizations. The project was evaluated using two comparison groups, pre- and postimplementation for anyone receiving ECMO therapy in the PICU. The average laboratory tests per ECMO day decreased by 52% (128.4 vs. 61.1), cost per case decreased by 14.7%, pRBC transfusions decreased from 100% to 85%, length of stay (LOS) decreased by 8 days, and mortality rates decreased by 9.5%. The revised pediatric ECMO laboratory testing guidelines were successfully implemented and reduced laboratory cost without adverse effects on mortality rates or LOS.
Key words: pediatric ECMO / pediatric ECLS / iatrogenic anemia / pediatric critical care / laboratory testing.
© 2022 AMSECT
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