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Troponin testing: an audit in three metropolitan hospitals
Author(s) -
Davey Richard X
Publication year - 2003
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2003.tb05440.x
Subject(s) - audit , metropolitan area , business , medicine , medical emergency , accounting , pathology
Objective: To audit the appropriateness of use of a troponin I assay in three hospitals. Design: Cross‐sectional survey of use of a troponin assay. Setting: Three hospitals in Melbourne, Victoria, each with an emergency department and a coronary care unit. Participants: Patients for whom a troponin I assay was requested between 1 and 7 May 2002, 27–42 months after introduction of the assay. Interventions: User‐focused dissemination of relevant information, including protocols for use, from opinion leaders when the assay was introduced; continuous reinforcement of information in pathology reports. Main outcome measures: Adherence to protocol for assay use. Results: Troponin assays were requested for 333 patients during 351 symptom episodes. A single assay was used in 194 symptom episodes (55%), and serial assays in 157 (45%); proportions were statistically indistinguishable across all three hospitals (χ 2 ; P = 0.71). Of the 194 single assays, 13 (7%) diagnosed a myocardial infarction. Serial troponin testing in all three hospitals followed the suggested protocol, with mean time between serial assays being more than 6 hours at all hospitals. Conclusions: Adherence to the protocol for serial troponin assay intervals was adequate, but single troponin assays were used extensively and probably inappropriately.