PMID- 27329858
OWN - NLM
STAT- MEDLINE
DCOM- 20171003
LR  - 20181113
IS  - 2154-1663 (Print)
IS  - 2154-1671 (Electronic)
IS  - 2154-1671 (Linking)
VI  - 6
IP  - 7
DP  - 2016 Jul
TI  - Culture Pus, Not Blood: Decreasing Routine Laboratory Testing in Patients With 
      Uncomplicated Skin and Soft Tissue Infections.
PG  - 394-8
LID - 10.1542/hpeds.2015-0186 [doi]
AB  - BACKGROUND: Blood cultures and complete blood cell counts (CBCs) are commonly 
      used in evaluating patients with skin and soft tissue infections (SSTIs). 
      Published data have shown that these tests may not aid in patient management. The 
      objective of this study was to decrease the collection of blood test specimens in 
      children with uncomplicated SSTIs. METHODS: We designed a longitudinal 
      preintervention/postintervention study that used modifications of well-known 
      propaganda posters. These were displayed in work stations to discourage staff 
      from ordering routine blood cultures in children being evaluated for 
      uncomplicated SSTIs. We studied a total of 230 otherwise healthy patients with 
      SSTIs admitted to a freestanding children's hospital between September 1, 2013, 
      and August 31, 2014. Data were collected in 3 groups: a 4-month baseline period, 
      a 4-month poster display period, and a 4-month follow-up period to determine 
      practice change persistence. Data collected included baseline clinical 
      characteristics, the number of laboratory studies obtained, and outcomes 
      (including length of stay). RESULTS: Patients in the 3 groups were similar in 
      terms of clinical characteristics. Compared with baseline, posters were 
      associated with decreased blood cultures (47%-17%; P < .001) and CBCs (53%-36%; P 
      = .04). This effect partially persisted for results of blood cultures (27%; P = 
      .01) and CBCs (42%, P = .17). There was no change in median length of stay. 
      Seven-day emergency department returns increased in the poster group (0-7%; P = 
      .02) with no clear relation to laboratory testing, but not in the follow-up group 
      (3%; P = .15). CONCLUSIONS: A simple and creative poster campaign improved staff 
      laboratory testing practices.
CI  - Copyright (c) 2016 by the American Academy of Pediatrics.
FAU - Sloane, Amy J
AU  - Sloane AJ
AD  - Pediatric Residency Program, and.
FAU - Pressel, David M
AU  - Pressel DM
AD  - General Pediatrics, Jefferson Medical College and Nemours/Alfred I. duPont 
      Hospital for Children, Wilmington, Delaware dpressel@nemours.org.
LA  - eng
GR  - U54 GM104941/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - Hosp Pediatr
JT  - Hospital pediatrics
JID - 101585349
SB  - IM
MH  - Blood Culture/*statistics & numerical data
MH  - Child
MH  - Child, Preschool
MH  - Delaware
MH  - Female
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Infant
MH  - Longitudinal Studies
MH  - Male
MH  - Posters as Topic
MH  - Quality Improvement
MH  - Soft Tissue Infections/*therapy
MH  - Suppuration
MH  - *Unnecessary Procedures
PMC - PMC5656057
MID - NIHMS863771
COIS- POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential 
      conflicts of interest to disclose.
EDAT- 2016/06/23 06:00
MHDA- 2017/10/04 06:00
PMCR- 2017/10/25
CRDT- 2016/06/23 06:00
PHST- 2016/06/23 06:00 [entrez]
PHST- 2016/06/23 06:00 [pubmed]
PHST- 2017/10/04 06:00 [medline]
PHST- 2017/10/25 00:00 [pmc-release]
AID - hpeds.2015-0186 [pii]
AID - 10.1542/hpeds.2015-0186 [doi]
PST - ppublish
SO  - Hosp Pediatr. 2016 Jul;6(7):394-8. doi: 10.1542/hpeds.2015-0186.