Using Checklists to Keep Radiology Patients Safe

2012-09-19
 

X-Ray Review The National Patient Safety Agency (NPSA), a branch of the UK Health Department, established safety goals in 2002 to help accredited organizations address specific areas of concern regarding patient safety (Source: NPSA). Medical imaging providers and hospitals in the U.S. can benefit from these standards as well.

While radiology information systems (RIS) manage medical imaging and other data effectively, there’s no substitute for hands-on medical “know how” when it comes to a surgical situation. Specifically, using checklists to determine radiology interventions helps keep radiology patients safe.

World Health Organization (WHO) Safety Checklist

The NPSA has adapted the WHO surgical safety checklist which provides step-by-step instructions for radiological interventions. Their explicit “sign in”, “time out”, and “sign out” guidelines read like a Miranda warning, i.e. ensuring the patient’s safety “rights” are being attended to.

Of course, we’re not talking about any crime being committed; this example demonstrates how seriously the NPSA considers safety in the operating room.

Steps to Take Before Giving Local Anesthetic

The first stage for radiology safety is for the hospital team to assemble. Then, one member reads aloud the following:

  1. Have all team members introduce themselves by name and role.
  2. Review essential imaging.
  3. Confirm that the procedure site has been marked.
  4. Complete check of anesthesia machine/monitoring equipment.
  5. Determine if patient has any known allergies.
  6. Determine if antibiotic prophylaxis has been administered.
  7. Determine if the required equipment is available and in date.
  8. Identify any critical or unexpected steps you want the team to know about.

Steps to Take Before Giving General Anesthesia

For general anesthesia and before the start of a radiological intervention, the safety guidelines are specific to pre-op and designed to anticipate any critical events that may occur during surgery.

  1. Verbally confirm the patient’s name.
  2. Identify procedure, site and position planned.
  3. Have the patient confirm his or her identity, site, procedure and consent.
  4. Have the anesthesiologist complete a machine check.
  5. Determine if there’s a difficult airway/aspiration risk.
  6. Identify any patient concerns.
  7. Determine the patient’s American Society of Anesthesiologists (ASA) grade.
  8. Identify specific levels of support needed, e.g. blood.
  9. Perform the surgical skill infection (SSI) bundle, if applicable.

The Sign-out Procedure

The sign out represents another layer of accountability and should be completed before any member of the team leaves the room. You want to be certain the procedure and/or any implanted devices have been recorded; all equipment has been accounted for and any equipment issues have been identified and addressed; and that all specimens have been labeled correctly and include the patient’s name.

What patient safety initiatives have your organization found to be successful?  We encourage you to share your thoughts via a comment below.

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