Audit of Routine Blood Tests on Children’s Intensive Care Unit, Leicester Royal Infirmary

Aim: Over an 8 week period, an audit was performed to analyse the blood tests performed overnight on paediatric inpatients on our unit with the aim of identifying whether more samples are taken than required and the financial impact of this.

Methods: This audit assessed essential (those blood tests which the consultant of the week recommended be taken overnight) versus those actually requested by the paediatric registrar working the night shift. The consultant of the day was asked to complete a short proforma, recording which essential bloods were needed overnight. This consultant recommendation was blinded from the registrar. We then retrospectively looked through iLab to record which bloods had actually been sent overnight.

Findings: Data was collected for 62 patients over 16 weekdays on CICU. In total, 165 tests were performed, with 90 of these classed as essential and 75 (45%) as non - essential tests. This resulted in avoidable expenditure of £123.74 (45 %.) Coagulation, urea and electrolytes and liver function tests were the areas of most non-essential expenditure. This is similar to results found when this audit was performed on the Paediatric Intensive Care Unit at Glenfield Hospital, where 115/1059 (48%) were found to be non-essential, resulting in avoidable expenditure of £647.64 (44 %.)

Conclusions: This audit has now been performed at both CICU’s within our trust and it demonstrates a lack of correlation between which tests are thought to be essential by the paediatric intensive care consultants and which tests are actually being performed by the paediatric registrars covering the units overnight. Therefore, children are likely to be subjected to additional blood investigations which are non-essential to their care and also has a financial impact upon the department. Further consideration of an appropriate quality improvement initiative is needed to address these discrepancies.