Using a contrast reaction management checklist reduces the number of mistakes radiologists make during simulated severe contrast reactions, according to a new study published in the American Journal of Roentgenology.
“In radiology, contrast reaction management is particularly prone to preventable error and often has life-threatening implications,” wrote author Sana Parsian, with the department of radiology at the University of Washington School of Medicine in Seattle, and colleagues. “It has been shown that radiology staff members often mismanage severe contrast reactions, regardless of their level of training.”
Parsian et al. crafted a safety checklist based on the five most common adverse events that occur after the administration of IV contrast medium. A group of 43 radiology residents was then split up into two groups, a checklist group and a control group. Residents then participated in a “high-fidelity simulation scenario,” taking written tests two weeks before and immediately after.
Overall, while the groups had similar scores to the written tests, the checklist group performed significantly better than the control group when it came to their management of the simulated severe contrast reaction. While the checklist group had a mean score of 85.1 percent, the control group had a mean score of 64.8 percent. The checklist group also scored better when it came to first-line treatment of bronchospasm (mean scores of 97 percent versus 91.3 percent), epinephrine actions (mean scores of 77.3 percent versus 45.2 percent) and other treatments (mean scores of 77.3 percent versus 51.2 percent).
“Our study shows that using a safety checklist significantly improves contrast reaction management, as shown by resident performance in a simulated contrast reaction scenario resulting in fewer preventable human errors, which could potentially decrease real-life mortality and morbidity,” the authors wrote.
Parsian and colleagues also noted that using safety checklists may help providers challenge incorrect recommendations made by individuals in leadership positions.
“Another source of error in health care is intimidation by superiors, which often occurs as a result of an established or perceived hierarchy,” the authors wrote. “Many instances of harmful errors in medication administration that affect patients share a common factor: at least one member of the health care team thought that something was wrong with the order before the medication was dispensed and administered but was too intimidated to voice concern.”
This American Journal of Roentgenology study was based on research presented at the RSNA 2017 annual meeting in Chicago.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.