The Use of a Computerized Provider Order Entry Alert to Decrease Rates of Clostridium Difficile Testing in Young Pediatric Patients

Nicholson, Maribeth R; Freswick, Peter; Pentima, Cecilia Di; Wang, Li; Edwards, Kathryn M.; Wilson, Gregory J.; Talbot, Thomas R.

doi:10.1016/s0016-5085(17)31672-4

Cited by 8 publications

(12 citation statements)

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“…Of 2 studies of CCDS for C. difficile testing that targeted laxative use (an issue not addressed in our CCDS tool), only 1 demonstrated reduced rates of total tests and C. difficile events 9 10 Nicholson et al 11 observed reduced C. difficile testing rates with CCDS-based guidance in pediatric patients, but CDI rates were not compared.…”

Section: Discussionmentioning

confidence: 99%

Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive

Madden

Mesner

Cox

et al. 2018

Infect. Control Hosp. Epidemiol.

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We hypothesized that a computerized clinical decision support tool for Clostridium difficile testing would reduce unnecessary inpatient tests, resulting in fewer laboratory-identified events. Census-adjusted interrupted time-series analyses demonstrated significant reductions of 41% fewer tests and 31% fewer hospital-onset C. difficile infection laboratory-identified events following this intervention.Infect Control Hosp Epidemiol 2018;39:737–740

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Section: Discussionmentioning

confidence: 99%

Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive

Madden

Mesner

Cox

et al. 2018

Infect. Control Hosp. Epidemiol.

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show abstract

“…One study was RCT [28], one case-control [39], and the others (n = 14) were quasi experimental studies (appendix B). Most of the included studies (n = 11, 68.7%) were of intermediate quality, the remaining were of good quality.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…The results also indicated that the evidence pertaining to the effects of CDSSs on patient-related outcomes is limited. Overall, CDSSs may make little or no difference to patient outcomes including patient complications, patient disposition, or mortality rate [28,34,39,41]. For instance in Bates et al [28], study three of the eight urinalysis cancelled tests displayed a few red blood cells, while the previous specimen had been negative.…”

Section: Patient-related Outcomesmentioning

confidence: 99%

Laboratory Test Ordering in Inpatient Hospitals: A Scoping Review on the Effects and Features of Clinical Decision Support Systems

Zare

Meidani

Shirdeli

et al. 2020

Preprint

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Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review was aimed to evaluate the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes were categorized based on test-related, physician-related, and patient-related. The primary outcome measures were the number and cost of laboratory test ordered.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

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“…Patient-related outcomes were addressed in ve studies. Cancellation of redundant tests based on the displayed alerts in some studies [28,39,41] resulted in little or no loss of clinical information as well as no complication. Bridges et al [34] study showed that patients with duplicate tests had higher mortality rate than those without duplicate tests.…”

Section: Patient-related Outcomesmentioning

confidence: 99%

Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

Zare

Meidani

Shirdeli

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes related to the effect of CDSSs were categorized based on test-related, physician-related, and patient-related. Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

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The Use of a Computerized Provider Order Entry Alert to Decrease Rates of Clostridium Difficile Testing in Young Pediatric Patients

Cited by 8 publications

References 0 publications

Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive

Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive

Laboratory Test Ordering in Inpatient Hospitals: A Scoping Review on the Effects and Features of Clinical Decision Support Systems

Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

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