Intensive and Critical Care Nursing
Volume 24, Issue 1 , Pages 8-19 , February 2008

Implementing and assessing an evidence-based electrolyte dosing order form in the medical ICU

  • Phillip Owen

      Affiliations

    • School of Pharmacy, C238, Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262, United States
  • ,
  • Martin F. Monahan

      Affiliations

    • Medical Intensive Care Unit, A021-230, University of Colorado Hospital, 4200 East Ninth Avenue, Denver, CO, United States
  • ,
  • Robert MacLaren

      Affiliations

    • School of Pharmacy, C238, Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262, United States
    • Corresponding Author InformationCorresponding author. Tel.: +1 303 315 4772; fax: +1 303 315 4630.

,Accepted 14 April 2007.

References 

  1. Adam C, Rosser D, Manji M. Impact of introducing a sedation management guideline in intensive care. Anesthesia. 2006;61:260–263
  2. Akobeng AK. Understanding systematic reviews and meta-analysis. Arch Dis Child. 2005;90:845–848
  3. Alaniz C, Rice TL. Evaluations of intravenous phosphate replacement in a university hospital. Hosp Pharm. 1993;28(385,388):391–392
  4. Bair N, Bobeck MB, Hoffman-Hogg L, Mion LC, Slomka J, Arroliga AC. Introduction of sedative, analgesic, and neuromuscular blocking agent guidelines in a medical intensive care unit: physician and nurse adherence. Crit Care Med. 2000;28:707–713
  5. Brook AD, Ahrens TS, Schaiff R, Prentice D, Sherman G, Shannon W, et al. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med. 1999;27:2609–2615
  6. Browman GP. Development and aftercare of clinical guidelines: the balance between rigor and pragmatism [editorial]. JAMA. 2001;286:1509–1511
  7. Brown KA, Dickerson RN, Morgan L, Alexander KH, Minard G, Brown RO. A new graduated dosing regimen for phosphorus replacement in patients receiving nutrition support. JPEN. 2006;30:209–214
  8. Clark CL, Sacks GS, Dickerson RN, Kudsk KA, Brown RO. Treatment of hypophosphatemia in patients receiving specialized nutrition support using a graduated dosing scheme: results for a prospective clinical trial. Crit Care Med. 1995;23:1504–1511
  9. Cook D, Jonghe BD, Brochard L, Brun-Buisson C. Influence of airway management on ventilator-associated pneumonia: evidence from randomized trials [review]. JAMA. 1998;279:781–787
  10. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997;126:376–380
  11. Cook DJ, Sibbald WJ, Vincent JL, Cerra F. Evidence based critical care medicine: what is it and what can it do for us?. Crit Care Med. 1996;24:334–337
  12. Davis DA, Taylor-Vaisey A. Translating guidelines into practice—a systematic review of the theoretic concepts, practical experiences and research evidence in the adoption of clinical practice guidelines. CMAJ. 1997;157:408–416
  13. DeBlock HF, Timm EG, Socaris S. The clinical and economic impact of the implementation of a neuromuscular blocking agent protocol (NMBAP). Crit Care Med. 1998;26(Suppl):A100;(abstract)
  14. De Jonghe B, Bastuji-Garin S, Fangio P, Lacherade JC, Jabot J, Appere-De-Vecchi C, et al. Sedation algorithm in critically ill patients without acute brain injury. Crit Care Med. 2005;33:120–127
  15. Devlin JW, Holbrook AM, Fuller HD. The effect of ICU sedation guidelines and pharmacist interventions on clinical outcomes and drug cost. Ann Pharmacother. 1997;31:689–695
  16. Dickerson RN, Gervasio JM, Sherman JJ, Kudsk KA, Hickerson WL, Brown ROl. A comparison of renal phosphorus regulation in the thermally injured and multiple trauma patients receiving specialized nutrition support. JPEN. 2001;25:152–159
  17. Dodek P, Keenan S, Cook DJ, Heyland D, Jacka M, Hand L, et al. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Ann Intern Med. 2004;141:305–313
  18. Duane TM, Riblet JL, Golay D, Cole FJ, Weireter LJ, Britt LD. Protocol-driven ventilator management in a trauma intensive care unit population. Arch Surg. 2002;137:1223–1227
  19. Eccles M, Freemantle N, Mason J. North England evidence base guidelines development project: methods of developing guidelines for efficient drug use in primary care. BMJ. 1998;316:1232–1235
  20. Garcia-Naveiro R, Rodriguez–Carmona A, Perez–Fontan M. Agreement between two routine methods of estimation of glomerular filtration rate in patients with advanced and terminal chronic renal failure. Clin Nephrol. 2005;64:271–280
  21. Godlee F. Getting evidence into practice needs the right resources and the right organization [editorial]. BMJ. 1998;317:6
  22. Green J, Britten N. Qualitative research and evidence based medicine. BMJ. 1998;316:1230–1232
  23. Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H. Attributes of clinical guidelines that influence use of guidelines in general practice: oberservational study. BMJ. 1998;317:858–861
  24. Gupta V. Development and implementation of guidelines for management of sedation and agitation in critically ill patients. Pharm Pract Manage Q. 1999;19:19–27
  25. Hadbavny AM, Hoyt JW. Promotion of cost-effective benzodiazepine sedation. Am J Hosp Pharm. 1993;50:660–661
  26. Haines A, Donald A. Making better use of research findings. BMJ. 1998;317:72–75
  27. Hamill RJ, Robinson LM, Wexler HR, Moote C. Efficacy and safety of potassium infusions therapy in hypokalemic critically ill patients. Crit Care Med. 1991;9:694–699
  28. Hamill-Ruth RJ, McGory R. Magnesium repletion and its effect on potassium homeostasis in critically ill adults: results of a double-blind, randomized, controlled trial. Crit Care Med. 1996;24:38–45
  29. Haynes B, Haines A. Barriers and bridges to evidence based clinical practice. BMJ. 1998;317:273–276
  30. Hebert P, Mehta N, Wang J, Hindmarsh T, Jones G, Cardinal P. Functional magnesium deficiency in critically ill patients using a magnesium-loading test. Crit Care Med. 1997;25:749–755
  31. Hoste EAJ, Damen J, Vanholder RC, Lameire NH, Delanghe JR, Van den Hauwe K, et al. Assessment of renal function in recently admitted critically ill patients with normal serum creatinine. Nephrol Dial Transpl. 2005;20:747–753
  32. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Clinical review: treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health—Syst Pharm. 2005;62:1663–1682
  33. Kruse JA, Carlson RW. Rapid correction of hypokalemia using concentrated intravenous potassium chloride infusions. Arch Intern Med. 1990;150:613–617
  34. Kruse JA, Clark VL, Carlson RW, Geheb MA. Concentrated potassium chloride infusions in critically ill patients with hypokalemia. J Clin Pharmacol. 1994;34:1077–1082
  35. Kuan Y, Hossain M, Surman J, Al Nahas AM, Haylor J. GFR prediction using MDRD and Cockcroft and Gualt equations in patients with end-stage renal disease. Nephrol Dial Transpl. 2005;20:2394–2401
  36. Levey AS, Bosch JP, Lewis JB, Green T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130:461–470
  37. MacLaren R, Obritsch ML, Sherman SD, Jung R, Fish DN. Assessing adherence to an intravenous pantoprazole guideline. J Pharm Technol. 2006;22:15–21
  38. MacLaren R, Plamondon JM, Ramsay KB, Rocker GM, Patrick WD, Hall RI. A prospective evaluation of empiric versus protocol-based sedation and analgesia. Pharmacotherapy. 2000;20:662–672
  39. MacLaren R, Ramsay KB, Liiva MT, Connell KA, Rocker GM, Hall RI. The development and implementation of evidence-based electrolyte replacement guidelines in the intensive care unit. Can J Hosp Pharm. 1999;52:393–396
  40. MacLaren R, Toombs KL, Plamondon JM, Rocker GM, Patrick WD, Hall RI. Implementing protocol based therapy of continuous neuromuscular blockade provides cost minimization. J Pharm Technol. 2001;17:49–55
  41. Maloney M, Camamo J, Crinnion C, Johnson SB, Erstad BL. Development of algorithms for treating patients in the intensive care unit. Am J Health—Syst Pharm. 1997;54:1841–1845
  42. Mascia MF, Koch M, Medicis JJ. Pharmacoeconomic impact of rational use guidelines on the provision of analgesia, sedation, and neuromuscular blockade in critical care. Crit Care Med. 2000;28:2300–2306
  43. McQueen MJ. Overview of evidence-based medicine: challenges for evidence-based laboratory medicine. Clin Chem. 2001;47:1536–1546
  44. Micek S, Barnes BJ, Grauer DW, Johnson DC. Long-term sedation with protocol-directed midazolam and lorazepam: a cost-effectiveness analysis. Crit Care Med. 2004;32(Suppl):A174;(abstract)
  45. Perreault MM, Ostrop NJ, Tierney MG. Efficacy and safety of intravenous phosphate replacement in critically ill patients. Ann Pharmacother. 1997;31:683–688
  46. Pitimana-aree S, Forrest D, Brown G, Anis A, Wang X-h, Dodek P. Implementation of a clinical practice guideline for stress ulcer prophylaxis increases appropriateness and decreases cost of care. Intens Care Med. 1998;24:217–223
  47. Rosen GH, Boullata JI, O’Rangers EA, Enow NB, Shin B. Intravenous phosphate repletion regimen for critically ill patients with moderate hypophosphatemia. Crit Care Med. 1995;23:1204–1210
  48. Sacks GS, Brown RO, Dickerson RN, Bhattacharya S, Lee PD, Mowatt-Larson C, et al. Mononuclear blood cell magnesium content and serum magnesium concentration in critically ill hypomagnesemic patients after replacement therapy. Nutrition. 1997;13:303–307
  49. Stevens LA, Coresh J, Greene T, et al. Assessing kidney function–measured and estimated glomerular filtration rate. N Engl J Med. 2006;354:2473–2483
  50. Taylor BE, Way HY, Buchman TG, Boyle WA, Coopersmith CM. Treatment of hypophosphatemia using a protocol based on patient weight and serum phosphorus level in a surgical intensive care unit. J Am Coll Surg. 2004;198:198–204
  51. Vannatta JB, Andress DL, Whang R, Papper S. High–dose intravenous phosphorus therapy for severe complicated hypophosphatemia. South Med J. 1983;76:1424–1426
  52. Vannatta JB, Whang R, Papper S. Efficacy of intravenous phosphorus therapy in the severely hypophosphatemic patient. Arch Intern Med. 1981;141:885–887
  53. Vincent JL, Berre J. An evidence-based approach to round tables and consensus conferences. Crit Care Clin. 1998;14:539–547
  54. Woolf SH. The need for perspective in evidence-based medicine. JAMA. 1999;282:2358–2365

 The results have been accepted as a poster presentation at the Society of Critical Care Medicine Annual Congress in February, 2007 in Orlando, FL.

PII: S0964-3397(07)00049-3

doi: 10.1016/j.iccn.2007.04.006

Intensive and Critical Care Nursing
Volume 24, Issue 1 , Pages 8-19 , February 2008