Sarah Brinson, PharmD,
Clinical Pharmacist
Memorial Hermann Texas Medical Center, United States
Disclosure information not submitted.
Jennifer Cortes, BCCCP, BCPS, PharmD
Clinical Pharmacy Specialist- MICU
Memorial Hermann-Texas Medical Center
Houston, Texas
Disclosure information not submitted.
Megan Hooven, PharmD
Clinical Pharmacist
Memorial Hermann-Texas Medical Center, United States
Disclosure information not submitted.
Bethany Kummer, PharmD
Clinical Pharmacist
Memorial Hermann-Texas Medical Center, United States
Disclosure information not submitted.
Brittany Pelsue, BCCCP, BCPS, PharmD
Pharmacist
n/a, United States
Disclosure information not submitted.
Title: Reducing overutilization of procalcitonin lab draws in critically ill patients
Introduction: In the intensive care unit procalcitonin (PCT) is ordered to help aid clinical decisions for the management of bacterial infections and utilization of antibiotics. When ordered routinely without an appropriate indication, there can be an increase in healthcare costs, unnecessary lab draws and waste of resources.
Methods: This is a prospective, quasi-experimental study evaluating utilization practices with the aim of reducing PCT in select intensive care units. An algorithm was created and implemented to guide PCT lab draws in select ICUs. Pre and post-intervention data were compared to assess the impact of the protocol on the utilization and frequency of PCT lab draws.
Results: During the pre-intervention period, 1,215 PCT labs were drawn, compared to 567 post-intervention, for a reduction of PCT lab draws >50% and cost savings exceeding $13,000. The median time between PCT levels significantly increased from 35.2 to 58.5 hours, p < 0.001. The number of times PCT was ordered within 24 hours of previous order was significantly reduced, 232 (23%) vs. 63 (14%), p < 0.001. There was no difference in clinical response to PCT levels. Appropriate use of PCT lab increased in the post intervention group, 41.3% vs. 74%, p < 0.001.
Conclusions: PCT algorithm decreased lab draws and associated costs in select intensive care units.