Sa1159 Venous Blood Gas Calculated Hematocrit is an Accurate Predictor of Hematocrit in Patients With Acute Upper Gastrointestinal Hemorrhage

Abstract

Background: Proton pump inhibitors (PPI) are a commonly used medication in the medical intensive care unit (MICU). Overuse of PPIs can lead to increased healthcare costs as well as a possible risk of Clostridium difficile infection and aspiration pneumonia. The aim of our study is to analyze the prescribing patterns of PPIs in the MICU in order to identify opportunities for improvement. Materials and Methods: 507 MICU admissions were retrospectively reviewed for data concerning PPI use. PPI prescriptions and their indications were analyzed. Results: Of 507 MICU admissions reviewed, 342 (67.5 %) received a PPI. Of the 342 who received a PPI, 40 patients (11.7%) had no documented indication. In addition, 78 admissions out of the 342 (22.8%) received PPI solely for stress ulcer prophylaxis, where an H-2 blocker would have sufficed. Discussion: Our study revealed that PPIs were frequently prescribed in our MICU, but that up to one third (34.5%) of the prescriptions were inappropriate, and represent opportunities for cost savings and possibly reduced clinical complications. Our next step is to improve the rate of appropriate PPI prescription in our ICU through a combination of educational modules and direct interventions to the availability of the drug in current pharmacy order sets.