Reducing unnecessary CT scan of the head for minor paediatric head injuries at the emergency department

被引:5
作者
Elmoheen, Amr [1 ]
Salem, Waleed [1 ]
Bashir, Khalid [1 ]
机构
[1] Hamad Med Corp, Emergency Med, Doha, Qatar
关键词
emergency department; paediatrics; evidence-based practice; PDSA; quality improvement;
D O I
10.1136/bmjoq-2020-000973
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The CT scan is a determining imaging study in the diagnosis and treatment of head trauma; however, its indiscriminate application can have serious consequences for patients and the health system. More than 45% of CT scans of the head requested for minor head injuries in the paediatric age group in the emergency department were not correctly indicated according to international guidelines. The root of such a high percentage was misinformation and lack of knowledge about the ideal parameters for requesting a CT scan for minor head injuries. To achieve this, survey-based interventions and educational programmes were conducted to improve understanding of international guidelines and access to this information, which was the most important parameter during this project. A decreasing rate of CT scans for paediatric minor head injuries was demonstrated at the rate of 17%, achieving a reduction by more than 47% after the implementation of the interventions. Besides, misinformation and documentation deficits improved by more than 30%. Quality improvement methods decreased misinformation and improved access to information, which reduced errors in the indication of CT scans of the head in the paediatric age group and increased efficiency of patient care.
引用
收藏
页数:6
相关论文
共 8 条
  • [1] [Anonymous], 2014, CG176 NICE CG176 NICE
  • [2] Adherence to Guidelines in Adult Patients with Traumatic Brain Injury: A Living Systematic Review
    Cnossen, Maryse C.
    Scholten, Annemieke C.
    Lingsma, Hester F.
    Synnot, Anneliese
    Tavender, Emma
    Gantner, Dashiell
    Lecky, Fiona
    Steyerberg, Ewout W.
    Polinder, Suzanne
    [J]. JOURNAL OF NEUROTRAUMA, 2021, 38 (08) : 1072 - 1085
  • [3] Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children
    Dunning, J.
    Daly, J. Patrick
    Lomas, J-P
    Lecky, F.
    Batchelor, J.
    Mackway-Jones, K.
    [J]. ARCHIVES OF DISEASE IN CHILDHOOD, 2006, 91 (11) : 885 - 891
  • [4] Comparison of PECARN, CATCH, and CHALICE Rules for Children With Minor Head Injury: A Prospective Cohort Study
    Easter, Joshua S.
    Bakes, Katherine
    Dhaliwal, Jasmeet
    Miller, Michael
    Caruso, Emily
    Haukoos, Jason S.
    [J]. ANNALS OF EMERGENCY MEDICINE, 2014, 64 (02) : 145 - 152
  • [5] Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study
    Kuppermann, Nathan
    Holmes, James F.
    Dayan, Peter S.
    Hoyle, John D., Jr.
    Atabaki, Shireen M.
    Holubkov, Richard
    Nadel, Frances M.
    Monroe, David
    Stanley, Rachel M.
    Borgialli, Dominic A.
    Badawy, Mohamed K.
    Schunk, Jeff E.
    Quayle, Kimberly S.
    Mahajan, Prashant
    Lichenstein, Richard
    Lillis, Kathleen A.
    Tunik, Michael G.
    Jacobs, Elizabeth S.
    Callahan, James M.
    Gorelick, Marc H.
    Glass, Todd F.
    Lee, Lois K.
    Bachman, Michael C.
    Cooper, Arthur
    Powell, Elizabeth C.
    Gerardi, Michael J.
    Melville, Kraig A.
    Muizelaar, J. Paul
    Wisner, David H.
    Zuspan, Sally Jo
    Dean, J. Michael
    Wootton-Gorges, Sandra L.
    [J]. LANCET, 2009, 374 (9696) : 1160 - 1170
  • [6] Comparison of PECARN, CATCH, and CHALICE clinical decision rules for pediatric head injury in the emergency department
    McGraw, Mark
    Way, Todd
    [J]. CANADIAN JOURNAL OF EMERGENCY MEDICINE, 2019, 21 (01) : 120 - 124
  • [7] CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury
    Osmond, Martin H.
    Klassen, Terry P.
    Wells, George A.
    Correll, Rhonda
    Jarvis, Anna
    Joubert, Gary
    Bailey, Benoit
    Chauvin-Kimoff, Laurel
    Pusic, Martin
    McConnell, Don
    Nijssen-Jordan, Cheri
    Silver, Norm
    Taylor, Brett
    Stiell, Ian G.
    [J]. CANADIAN MEDICAL ASSOCIATION JOURNAL, 2010, 182 (04) : 341 - 348
  • [8] Clinical decision rules for children with minor head injury: a systematic review
    Pickering, Alastair
    Harnan, Susan
    Fitzgerald, Patrick
    Pandor, Abdullah
    Goodacre, Steve
    [J]. ARCHIVES OF DISEASE IN CHILDHOOD, 2011, 96 (05) : 414 - 421