Prevention and management of allergic-like reactions to iodine contrast media: a best practice implementation project.

Abstract

INTRODUCTION With the wide application of iodine contrast media (ICM), the occurrence of allergic-like reactions to iodine contrast media (ALR-ICM) has increased. Strategies for the prevention and management of ALR-ICM need to be identified to provide quality care to patients undergoing enhanced computed tomography. AIM The overarching aim of this project was to improve the prevention and management of ALR-ICM at a medical imaging center of a nearly 5,000-bed tertiary hospital in China. METHODS This project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted to measure current practices against recommended best practices. Feedback from the audit was used to identify barriers and design strategies to improve practice. A follow-up audit was conducted to measure changes in compliance with best practices. RESULTS The results revealed a positive change in compliance with best practices. More than 60% compliance with the four audit criteria was observed. The overall ALR-ICM rate decreased from 0.56% to 0.19%, while emergency equipment management dramatically increased from 37.50% to 100%. The smallest improvement was observed for pre-procedure prophylactic treatment of high-risk patients (27.66%). CONCLUSIONS Most audit criteria showed moderate improvements in compliance with best practices. Further testing of this program in more hospitals is needed. SPANISH ABSTRACT http://links.lww.com/IJEBH/A269.