Impact of Real-Time Clinical Decision Support on Blood Utilization and Outcomes in Hospitalized Patients with Solid Tumor Cancer

Passive order auditing associated with reductions in red blood cell utilization: National blood shortage experience

“…This observation is consistent with other studies that observed decreased RBC utilization while using CDS to increase compliance with restrictive transfusion strategies. [11][12][13][14][16][17][18][19][20] T A B L E 2 Single-unit RBC transfusion events and pre-transfusion hemoglobin levels by patient location The best practice alert is activated by the hemoglobin value from the most recent CBC. When blood gas is used to measure hemoglobin, the best practice alert does not consider these results, which explains the frequency of this indication.…”

“…[4][5][6]10 A restrictive transfusion policy incorporating active, passive, or retrospective audits can reduce unnecessary transfusions. [11][12][13][14][15][16][17] Active auditing involves reviewing RBC orders and contacting providers at the time of order. While effective at reducing transfusion, this strategy is resource intensive and delays blood product release.…”

“…5,11,[20][21][22] In addition to conserving inventory, reducing unnecessary transfusions also reduces associated risks and complications. 5,11,17,23 The 2016 Clinical Practice Guidelines from the AABB recommend a pre-transfusion hemoglobin threshold of 7-8 g/dL in most hemodynamically stable adult patients. 24 Lowering the pre-transfusion hemoglobin threshold from 7.0 to 6.5 g/dL or lower in stable, asymptomatic patients, while outside of evidence-based practice, has been proposed as one strategy to conserve RBCs during long-term severe blood supply shortages.…”

“…A restrictive transfusion policy incorporating active, passive, or retrospective audits can reduce unnecessary transfusions 11–17 . Active auditing involves reviewing RBC orders and contacting providers at the time of order.…”

Avaliação da acurácia de diagnósticos de enfermagem determinados por usuários de sistema de apoio à decisão clínica

“…A partir do ano 2000, as publicações se referem a modelos e métodos de desenvolvimento de SADC (Moen, 2003;Sim et al, 2001;Lyons & Richardson, 2003;Purcell, 2005). No ano de 2005, as publicações cresceram e o foco foi a usabilidade dos sistemas, os desafios da implantação, utilização e os casos de sucesso (Hardwick et al, 2007;Sperandio, 2008;Peres et al, 2009;Kader, 2009;Dal Sasso & Barra, 2010;Hao et al, 2013;Peres et al, 2015b;Gephart, Carrington & Finley, 2015;Lopes & Shmeil, 2016;Lopez et al, 2017;McBride et al, 2017;Nibbelink et al, 2018;Chang, 2018;Wachsberg et al, 2019).…”