Journal of Radiology Nursing最新文献

Problem and Purpose

Within the Interventional Radiology (IR) department at a large, academic medical center, instances of patient harm and sentinel events have occurred due to improper patient, procedure, or site verification. Literature review reveals the use of a pre-procedure safety checklist may contribute to the prevention of wrong-patient, wrong-procedure, or wrong-site events, and supports the use of the Situation, Background, Assessment, Recommendation model (SBAR) for pre-procedure handoff to improve communication among staff. The aim of this quality improvement initiative was to implement a pre-procedure handoff bundle to prevent wrong-patient, wrong-procedure, or wrong-site events.

Methods

The pre-procedure handoff bundle, including completion of the Procedure Pass checklist and the performance of bedside handoff using Situation, Background, Assessment, Recommendation model was implemented over 15 weeks within the IR department. All inpatients and outpatients undergoing vascular or neurovascular intervention who were prepped for a procedure within the prep and recovery area were included for intervention. Weekly chart audits and review of morbidity and mortality reports were performed using the electronic health record to determine whether project outcomes were met.

Results

100% of eligible patients (952/952) were included in data collection, with no occurrences of wrong-patient, wrong-procedure, or wrong-site events. Average Procedure Pass compliance was 31% (295/952), while average pre-procedure handoff compliance was 20% (190/952).

Conclusions

Findings suggest that the implementation of a pre-procedure handoff bundle within the IR department was successful at preventing wrong-patient, wrong-procedure, or wrong-site events. The inclusion of a pre-procedure handoff bundle was both feasible and necessary to improve patient safety and staff communication within the IR department.

Tuberculosis (TB)is endemic in various parts of the world and health-care practitioners should have high-end suspicion of TB knee in various cases of monoarthritis of the knee with atypical findings. We present a case of monoarthritis knee with an initial diagnosis being septic arthritis, with TB- cartridge-based nucleic acid amplification test negative for aspirated synovial fluid; followed by radiographic findings and synovial biopsy positive for chronic nonspecific inflammation with giant cells suggestive of TB, hence diagnosed as TB.

Spinal ultrasound (US) is an invaluable tool in screening the newborn for congenital spine abnormalities and characterizing them when present. If unrecognized, spinal anomalies can lead to devastating neurological consequences. Knowledge of spine US indications is essential to maximize its utility, and proper technique is critical in obtaining diagnostic images. Knowledge of normal anatomy, pathologic findings, and anatomic variants is paramount in interpretation of images. In this review, we discuss indications for screening US, imaging technique, and illustrate the normal anatomy on US, abnormal findings, and nonpathologic anatomic variants.

Patients with radiology reports that contain recommendations unrelated to the study indications are at high risk of being lost to follow-up. Known as actionable incidental findings, attempts to improve patient follow-up adherence through nurse navigator–led tracking programs have faced challenges due to system wide limitations in communication, standardization, scalability, cost, and patient compliance. Leveraging recent advances in artificial intelligence, strategic automation of many of the steps associated with incidental finding detection and follow-up management tracking empowers nurse navigators and health systems to address the historical challenges and confidently close the loop on patient follow-up. With improved patient outcomes, the tool is becoming a fundamental component in healthcare delivery so it is imperative that nurse navigators be up to date on the solution capabilities.

Background

Contrast media extravasation (CME) is a well-known adverse event that can occur during the computerized tomography (CT). Studies about the risk factors related to these events are necessary to prevent its occurrence.

Purpose

The purpose of the study was to identify risk factors and possible related causes associated with CME in patients undergoing CT.

Methods

A retrospective and quantitative study performed in a hospital in southern Brazil. Data from patients who had undergone intravenous contrast computer tomography scanning between March 2022 and May 2023 were collected and descriptive statistics was used.

Findings

This study demonstrated that the highest incidence of CME occurred in males and inpatients, with age >60 being the greatest risk factor (82%). Additional risk factors such as fragile veins and contrast infusion rates >3 mL/sec were associated with more than 75% of the extravasations. In the absence of severe injury, all patients were treated with conservative medical management.

Conclusion

Risk factors such as male, inpatient, age >60, and fragile veins are likely to predispose the patient to a higher incident of a CME event. Although severe injuries are rare, identifying the risk factors is important to minimize its incidence.

Background

Anxiety is a common problem in patients scheduled for a procedure, and their level of anxiety increases as the procedure date approaches; pre-procedural anxiety is observed in hepatocellular carcinoma (HCC) patients scheduled for liver ablation treatment. There is currently a lack of standardized education provided to patients about liver ablation treatment, which may contribute to patients’ anxiety.

Purpose

To test the effectiveness of a pre-procedural video educational tool to reduce patient anxiety and increase knowledge in HCC patients in an interventional radiology clinic setting.

Methods

This was a quasi-experimental, single-arm study, with a pre-test/post-test. Participant recruitment was based on a convenience sample. Inclusion criteria included: patients ages 18 and older; have biopsy-proven HCC or have a liver mass suspicious for HCC based on LI-RADS criteria imaging; no prior liver ablation treatment within three months of study onset. Participants watched a 7:04 minutes video and completed a 40-item State-Trait Anxiety Inventory and 10-item Knowledge Questionnaire before and after the video intervention to assess changes in anxiety and knowledge. Demographic variables evaluated included age, gender, education, and primary language.

Results

There were 16 participants who met inclusion criteria. The state anxiety scores were significantly lower after the intervention (Md = 33.50, n = 16) compared to before (Md = 47.50, n = 16), z = −2.67, p = .009, with a medium effect size, r = 0.47. The trait anxiety scores did not show sufficient evidence for a difference after the intervention (Md = 40.00, n = 16) compared to before (Md = 39.50, n = 16), z = 0.71, p = .50, with a small effect size, r = 0.13. The knowledge scores were significantly higher after the intervention (Md = 9.00, n = 16) compared to before (Md = 2.00, n = 16), z = −3.53, p = .0005, with a large effect size, r = 0.62. A nonparametric bootstrap and nonparametric permutation test also showed evidence for a difference in mean between the distributions of the state anxiety and knowledge pre- and post-intervention scores.

Discussion

The results of this study showed evidence for the effectiveness of video education in decreasing anxiety and increasing knowledge in HCC patients. A standardized pre-procedural video educational tool can be a useful practice across all interventional radiology departments as it is associated with improved quality of care and positive health outcomes.