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Alghamdi SA. Assessment of MRI Safety Practices in Saudi Arabia. Risk Manag Healthc Policy 2023; 16:199-208. [PMID: 36798619 PMCID: PMC9926921 DOI: 10.2147/rmhp.s398826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Aim The aim of this study is to investigate the safety practices used by MRI departments in Saudi Arabia. Methods A cross-sectional study across 113 private and public hospitals was conducted in Saudi Arabia. A survey questionnaire was designed and sent to 113 MRI units. The questionnaire consisted of 43 items under 14 sections for the assessment of MRI safety practices. These 14 sections are related to (i) MRI and its safety, (ii) MRI usage and its safety, and (iii) safety of the MRI technologists and reporting of adverse effects during the usage. The American College of Radiology (ACR) guidance document on MRI safety practices was used as a template for this survey. Data were analyzed using IBM SPSS Statistical software for Windows version 26.0 (IBM Corp., Armonk, NY, USA). Results Of the 43 items assessed, only 3 items' binary responses (Yes & No) did not differ much. A greater proportion of positive responses for 40 items (93%) regarding MRI safety practices. More than 50% of the participants claimed that their departments lacked a Magnetic Resonance Safety Officer (MRSO). Regarding regular safety training programs, less than 50% received training in MRI safety. Handheld metal detectors were found in only 39% of the MRI units. Conclusion The majority of MRI units in Saudi Arabia have demonstrated compliance with majority of ACR MRI safety recommendations; nonetheless, there are two main items for which the guidelines may not be attained: MRSO and regular MRI safety training programs. By taking into account the limitations of this study, it is strongly recommended to assign MRSO and implement annual MRI safety training to improve MRI safety practices for both patients and healthcare workers.
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Affiliation(s)
- Sami A Alghamdi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia,Correspondence: Sami A Alghamdi, Email
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Kawamura H, Komatsu Y, Tanaka K, Kanamoto M, Tobe M, Usami C, Hinohara H, Oshima K, Kitada Y, Tsuda K, Ogano T, Shimada H, Ohno T. Implementation of a rapid response system at an isolated radiotherapy facility through simulation training. BMJ Open Qual 2022; 11:bmjoq-2021-001578. [PMID: 35017175 PMCID: PMC8753419 DOI: 10.1136/bmjoq-2021-001578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022] Open
Abstract
A rapid response system is required in a radiotherapy department for patients experiencing a critical event when access to an emergency department is poor due to geographic location and the patient is immobilised with a fixation device. We, therefore, rebuilt the response system and tested it through onsite simulations. A multidisciplinary core group was created and onsite simulations were conducted using a Plan-Do-Study-Act cycle. We identified the important characteristics of our facility, including its distance from the emergency department; the presence of many staff with little direct contact with patients; the treatment room environment and patient fixation with radiotherapy equipment. We also examined processes in each phase of the emergency response: detecting an emergency, calling the medical emergency team (MET), MET transportation to the site and on-site response and patient transportation to the emergency department. The protocol was modified, and equipment was updated. On-site simulations were held with and without explanation of the protocol and training scenario in advance. The time for the MET to arrive at the site during a 2017 simulation prior to the present project was 7 min, whereas the time to arrive after the first simulation session was shortened to 5 min and was then shortened further to 4 min in the second session, despite no prior explanation of the situation. A multidisciplinary project for emergency response with on-site simulations was conducted at an isolated radiation facility. A carefully planned emergency response is important not only in heavy ion therapy facilities but also in other departments and facilities that do not have easy access to hospital emergency departments.
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Affiliation(s)
| | - Yasuhiro Komatsu
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazumi Tanaka
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Maebashi, Japan
| | | | - Masaru Tobe
- Intensive Care Unit, Gunma University Hospital, Meabashi, Japan
| | - Chisato Usami
- Intensive Care Unit, Gunma University Hospital, Meabashi, Japan
| | | | - Kiyohiro Oshima
- Emergency Medical Center, Gunma University Hospital, Meabashi, Japan
| | - Yoko Kitada
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Kazuhisa Tsuda
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tomoaki Ogano
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
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Evans RS, Kuttler KG, Simpson KJ, Howe S, Crossno PF, Johnson KV, Schreiner MN, Lloyd JF, Tettelbach WH, Keddington RK, Tanner A, Wilde C, Clemmer TP. Automated detection of physiologic deterioration in hospitalized patients. J Am Med Inform Assoc 2015; 22:350-60. [PMID: 25164256 PMCID: PMC5566187 DOI: 10.1136/amiajnl-2014-002816] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 06/23/2014] [Accepted: 07/15/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. MATERIALS AND METHODS A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. RESULTS Nurses reported the positive predictive value of alerts was 91-100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. CONCLUSIONS We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before-after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help.
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Affiliation(s)
- R Scott Evans
- Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, Utah, USA
- Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kathryn G Kuttler
- Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, Utah, USA
- Pulmonary and Critical Care, Intermountain Medical Center, Murray, Utah, USA
| | - Kathy J Simpson
- Shock Trauma Intensive Care, Intermountain Medical Center, Murray, Utah, USA
| | - Stephen Howe
- Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Peter F Crossno
- Pulmonary and Critical Care, Intermountain Medical Center, Murray, Utah, USA
| | - Kyle V Johnson
- Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Misty N Schreiner
- Shock Trauma Intensive Care, Intermountain Medical Center, Murray, Utah, USA
| | - James F Lloyd
- Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - William H Tettelbach
- Hyperbaric Medicine, Wound Care & Infectious Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Roger K Keddington
- Intensive Medicine/Emergency Services, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Alden Tanner
- Shock Trauma Intensive Care, Intermountain Medical Center, Murray, Utah, USA
| | - Chelbi Wilde
- Shock Trauma Intensive Care, Intermountain Medical Center, Murray, Utah, USA
| | - Terry P Clemmer
- Critical Care Medicine, LDS Hospital, Salt Lake City, Utah, USA
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Ott LK, Pinsky MR, Hoffman LA, Clarke SP, Clark S, Ren D, Hravnak M. Patients in the radiology department may be at increased risk of developing critical instability. ACTA ACUST UNITED AC 2015; 34:29-34. [PMID: 25821413 DOI: 10.1016/j.jradnu.2014.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to calculate the event rate for in-patients in the Radiology Department (RD) developing instability leading to calls for Medical Emergency Team assistance (MET-RD) compared to general ward (MET-W) patients. A retrospective comparison was done of MET-RD and MET-W calls in 2009 in a U.S. tertiary hospital with a well-established MET system. MET-RD and MET-W event rates represented as MET calls/hour/1000 admissions, adjusted for length of stay (LOS); rates also calculated for RD modalities. There were 31,320 hospital ward admissions had 1,230 MET-W, and among 149,569 radiology admissions there were 56 MET-RD. When adjusted for LOS, the MET-RD event rate was 2 times higher than the MET-W rate (0.48 vs. 0.24 events/hour/1000 admissions). Event rates differed by procedure: computed tomography (CT) had 38% of MET-RDs (event rate 0.89); magnetic resonance imaging (MRI) accounted for 27% (event rate 1.56). Nuclear medicine had 1% of RD admissions but these patients accounted for 5% of MET-RD (event rate 1.53). Interventional radiology (IR) had 6% of RD admissions but 16% of MET-RD (event rate 0.61). While general x-ray comprised 63% of RD admissions, only 11% of MET-RD involved their care (event rate 0.09). In conclusion, the overall MET-RD event rate was twice the MET-W event rate; CT, MRI and IR rates were 3.7-6.5 times higher than on wards. RD patients are at increased risk for a MET call compared to ward patients when the time at risk is considered. Increased surveillance of RD patients is warranted.
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Affiliation(s)
- Lora K Ott
- Department of Tertiary Care, School of Nursing, University of Pittsburgh
| | | | - Leslie A Hoffman
- Department of Tertiary Care, School of Nursing, University of Pittsburgh
| | | | - Sunday Clark
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh
| | - Dianxu Ren
- Department of Tertiary Care, School of Nursing, University of Pittsburgh
| | - Marilyn Hravnak
- Department of Tertiary Care, School of Nursing, University of Pittsburgh
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