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Ordering Patterns and Use as a Guide to Therapy

Anita C. Anderson, RN; Glenn R. Hodges, MD; William G. Barnes, PhD

Arch Intern Med. 1976;136(7):785-787.

Abstract
Determination of serum gentamicin levels (SGLs) is helpful in monitoring therapy in patients receiving this drug because there is a narrow therapeutic margin and serum levels may vary greatly between patients receiving similar doses. During a ten-month period, definite indications for obtaining SGL determinations were present for 189 of 212 serum samples (89.2%) submitted to the laboratory. However, 110 samples (51.9%) were improperly drawn and results of 85 samples (40.1%) were ignored. Only 26 of the 62 correctly drawn and not ignored samples (41.9%) were appropriately acted on. At most, 42 of the 212 samples (19.8%) were appropriately used in making patient-care decisions. Thus, in this study, an inordinately large number of SGLs were incorrectly drawn, apparently ignored, or inappropriately used in making patient-care decisions.

(Arch Intern Med 136:785-787, 1976)

Author Affiliations
From the Nursing Service (Ms Anderson), Medical and Research Services (Dr Hodges), and Laboratory Service (Dr Barnes), Veterans Administration Hospital, Kansas City, Mo, and the departments of medicine (Dr Hodges) and pathology (Dr Barnes), University of Kansas Medical Center, Kansas City, Kan.

Footnotes
Received for publication Nov 6, 1975; accepted Jan 22, 1976.

Reprint requests to Medical Service (111), Veterans Administration Hospital, 4801 Linwood Blvd, Kansas City, MO 64128 (Dr Hodges).

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