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一个质量改进项目:减少伦敦一家地区综合医院急诊科不必要的腹部平片检查数量。

A quality improvement project: Reducing the number of unnecessary plain abdominal radiographs performed in the emergency department of a London district general hospital.

作者信息

Kyriakides Jonathon, Khamar Rahul, Khani Aria, Khatkar Harman

机构信息

Department of Emergency Medicine, Barnet Hospital, Royal Free London NHS Foundation Trust, London.

Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London.

出版信息

J Family Med Prim Care. 2022 Jan;11(1):190-193. doi: 10.4103/jfmpc.jfmpc_1193_21. Epub 2022 Jan 31.

Abstract

BACKGROUND

Inappropriate completion of abdominal radiographs results in unnecessary exposure to ionizing radiation. This quality improvement project aimed to reduce the number of inappropriate abdominal radiographs performed in the emergency department.

MATERIALS AND METHODS

Abdominal radiograph request forms were analyzed with reference to the Royal College of Radiologists (RCR) iRefer guidance. A teaching session was then delivered to ED clinicians and posters were disseminated within the department. Post-intervention data collection followed.

RESULTS

Following the intervention, there was an increase in the proportion of abdominal radiographs meeting iRefer guidance, which was accompanied by an increased diagnostic yield of these investigations. There was a reduction in the number of requests post-intervention.

CONCLUSIONS

Our interventions helped increase awareness of both the guidelines and radiation dose associated with each study. Routine education of the iRefer guidelines will help reduce inappropriate requests. This in turn will reduce unnecessary radiation exposure, whilst also reducing the financial burden.

摘要

背景

腹部X光片的不恰当开具会导致不必要的电离辐射暴露。本质量改进项目旨在减少急诊科不恰当腹部X光片的开具数量。

材料与方法

根据皇家放射科医师学院(RCR)的iRefer指南对腹部X光片申请单进行分析。随后为急诊科临床医生举办了一次培训课程,并在科室内部张贴了海报。之后进行干预后的数据收集。

结果

干预后,符合iRefer指南的腹部X光片比例有所增加,同时这些检查的诊断率也有所提高。干预后申请数量有所减少。

结论

我们的干预措施有助于提高对指南以及每项检查相关辐射剂量的认识。对iRefer指南进行常规教育将有助于减少不恰当的申请。这反过来将减少不必要的辐射暴露,同时也减轻经济负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f80/8930155/862acbb6e116/JFMPC-11-190-g001.jpg

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