Munn Zachary, Giles Kristy, Aromataris Edoardo, Deakin Anita, Schultz Timothy, Mandel Catherine, Peters Micah Dj, Maddern Guy, Pearson Alan, Runciman William
The Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia.
Australian Patient Safety Foundation, Adelaide, South Australia, Australia.
J Med Imaging Radiat Oncol. 2018 Feb;62(1):32-38. doi: 10.1111/1754-9485.12633. Epub 2017 Jun 10.
The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists.
A mixed methods approach employing both quantitative and qualitative techniques was used for this study. Direct observations of checklist use during radiological procedures were performed to determine compliance. Medical records were also audited to investigate whether there was any discrepancy between practice (actual care measured by direct observation) and documentation (documented care measured by an audit of records). A focus group with Australian radiologists was conducted to determine attitudes towards the use of checklists.
Among the four participating radiology departments, overall observed mean completion of the components of the checklist was 38%. The checklist items most commonly observed to be addressed by the operating theatre staff as noted during observations were correct patient (80%) and procedure (60%). Findings from the direct observations conflicted with the medical record audit, where there was a higher percentage of completion (64% completion) in comparison to the 38% observed. The focus group participants spoke of barriers to the use of checklists, including the culture of radiology departments.
This is the first study of safety checklist use in radiology within Australia. Overall completion was low across the sites included in this study. Compliance data collected from observations differed markedly from reported compliance in medical records. There remain significant barriers to the proper use of safety checklists in Australian radiology departments.
在介入放射学中使用安全检查表是一项旨在降低死亡率和发病率的干预措施。目前对于其在澳大利亚放射科的实际使用情况知之甚少。这项混合方法研究的主要目的是评估澳大利亚医院放射科如何使用和完成安全检查表，以及澳大利亚放射科医生对其使用的态度。
本研究采用了定量和定性技术相结合的混合方法。在放射学程序中对检查表的使用进行直接观察以确定依从性。还对病历进行审核，以调查实践（通过直接观察衡量的实际护理）和记录（通过病历审核衡量的记录护理）之间是否存在差异。与澳大利亚放射科医生进行了焦点小组讨论，以确定对检查表使用的态度。
在四个参与研究的放射科中，检查表各组成部分的总体观察平均完成率为38%。观察期间手术室工作人员最常观察到处理的检查表项目是正确的患者（80%）和程序（60%）。直接观察的结果与病历审核结果相冲突，病历审核中的完成率（64%）高于观察到的38%。焦点小组参与者谈到了使用检查表的障碍，包括放射科的文化。
这是澳大利亚首次关于放射学中安全检查表使用的研究。本研究涵盖的各个地点的总体完成率较低。从观察中收集的依从性数据与病历中报告的依从性有显著差异。在澳大利亚放射科正确使用安全检查表仍然存在重大障碍。
