Effectiveness of Clinical Practice Guidelines for Preoperative Laboratory Investigations on their Completeness Enhancement and Unnecessary Reduction in Patients Receiving Non-urgent Operations at Nongbualamphu Hospital : ประสิทธิผลของแนวทางปฏิบัติในการส่งตรวจทางห้องปฏิบัติการก่อนผ่าตัดในการเพิ่มความครบถ้วนและลดการส่งตรวจที่ไม่จำเป็นในการผ่าตัดแบบไม่เร่งด่วน โรงพยาบาลหนองบัวลำภู

บทคัดย่อ

          Preoperative laboratory investigations are the procedures for risk assessment and then resolved it before operation. The under investigations might harm the patient whereas the over investigations result in cost wastage. In Nongbualamphu hospital, the ratios of appropriate preoperative investigations were still low. Therefore, the appropriate clinical practice guideline for preoperative investigation was applied. This research aimed to study the effectiveness of clinical practice guideline application for preoperative laboratory investigations on their completeness enhancing and unnecessary reducing and to analyse the cost of inappropriate investigations in patients received non-urgent operations. The study was a historical controlled design. Data were collected into 2 phases; prior to clinical practice guideline implementation from June to July, 2017 (n = 421) and after clinical practice guideline implementation from April to May, 2018 (n = 421). Data were presented as frequency and percentage and t-test and exact probability test were employed to assess the differences between two phases.

          The result showed that after using CPG, the overall completeness of preoperative laboratory investigations was increased and the unnecessary investigations were decreased. The completeness was increased significantly from 56.3% to 68.7% (p<0.001), particularly CXR examination (p<0.001) and blood sugar (p=0.001). The cost of inappropriate investigations was 5,990 baths decreased in one month. Therefore, the clinical practice guideline should be applied practically for the preoperative laboratory investigations. 

          Key words : preoperative, laboratory investigation, practice guidelines, costs