Indian Pediatrics

, Volume 55, Issue 9, pp 784–787 | Cite as

Optimizing Utilization of Laboratory Investigations in Neonatal Intensive Care Unit

  • Sowmya Devarapalli
  • Shiv Sajan Saini
  • Venkataseshan Sundaram
  • Praveen KumarEmail author
Research Paper



To optimize utilization of laboratory tests by measuring baseline rates and appropriateness of investigations, assessing the barriers to rational use, and developing and implementing an educational package for resident doctors.


Quality improvement study.


Neonatal intensive care unit (NICU) from August, 2015 to December, 2016.


All neonates admitted in NICU and resident doctors working in NICU.


Addressing barriers, educational package, posters and group discussions.

Main outcome measures

Laboratory test rates for hematology, biochemistry and blood gas. Proportion of tests judged to be inappropriate.


At the baseline, median (IQR) laboratory test rate patient/day was 0.6 (0.2–1.5) and one-fifth of tests were classified as inappropriate. Mechanical ventilation and sepsis were independent predictors of laboratory test rates but could explain only 35% of the disparities, indicating variations in clinical practice. Following a short period of intervention, hematology investigations showed a trend towards reduction, though overall test rates did not change significantly.


Addressing barriers, creating awareness and educational interventions were able to bring down hematology laboratory test rates in a short period. A longer period of sustained intervention is required to demonstrate significant effects on test ordering behavior.


Biochemistry Blood gas Hematology Tests 


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Copyright information

© Indian Academy of Pediatrics 2018

Authors and Affiliations

  • Sowmya Devarapalli
    • 1
  • Shiv Sajan Saini
    • 1
  • Venkataseshan Sundaram
    • 1
  • Praveen Kumar
    • 1
    Email author
  1. 1.Division of Neonatology, Department of PediatricsPGIMERChandigarhIndia

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