scholarly journals Quality Initiatives MR Imaging in Patients at Risk for Developing Nephrogenic Systemic Fibrosis: Protocols, Practices, and Imaging Techniques to Maximize Patient Safety

Radiographics ◽  
2009 ◽  
Vol 29 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Krishna Juluru ◽  
Jens Vogel-Claussen ◽  
Katarzyna J. Macura ◽  
Ihab R. Kamel ◽  
Alexander Steever ◽  
...  
2009 ◽  
Vol 111 (1) ◽  
pp. 141-146 ◽  
Author(s):  
Taro Suzuki ◽  
Kuniaki Ogasawara ◽  
Ryonoshin Hirooka ◽  
Makoto Sasaki ◽  
Masakazu Kobayashi ◽  
...  

Object Preoperative impairment of cerebral hemodynamics predicts the development of new cerebral ischemic events after carotid endarterectomy (CEA), including neurological deficits and cerebral ischemic lesions on diffusion weighted MR imaging. Furthermore, the signal intensity of the middle cerebral artery (MCA) on single-slab 3D time-of-flight MR angiography (MRA) can assess hemodynamic impairment in the cerebral hemisphere. The purpose of the present study was to determine whether, on preoperative MR angiography, the signal intensity of the MCA can be used to identify patients at risk for development of cerebral ischemic events after CEA. Methods The signal intensity of the MCA ipsilateral to CEA on preoperative MR angiography was graded according to the ability to visualize the MCA in 106 patients with unilateral internal carotid artery stenosis (≥ 70%). Diffusion weighted MR imaging was performed within 3 days of and 24 hours after surgery. The presence or absence of new postoperative neurological deficits was also evaluated. Results Cerebral ischemic events after CEA were observed in 16 patients. Reduced signal intensity of the MCA on preoperative MR angiography was the only significant independent predictor of postoperative cerebral ischemic events. When the reduced MCA signal intensity on preoperative MR angiography was defined as an impairment in cerebral hemodynamics, MR angiography grading resulted in an 88% sensitivity and 63% specificity, with a 30% positive- and a 97% negative-predictive value for the development of postoperative cerebral ischemic events. Conclusions Signal intensity of the MCA on preoperative single-slab 3D time-of-flight MR angiography is useful for identifying patients at risk for cerebral ischemic events after CEA.


2018 ◽  
Vol 68 (669) ◽  
pp. e279-e285 ◽  
Author(s):  
Tom Margham ◽  
Natalie Symes ◽  
Sally A Hull

BackgroundIdentifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations.AimThis study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety.Design and settingMixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice.MethodThe project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians.ResultsTrigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs’ work is generally reactive and GPs welcomed an approach that identified patients who were ‘under the radar’ of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time.ConclusionElectronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks.


2016 ◽  
Vol 3 (2) ◽  
pp. 142-147
Author(s):  
Galuh Nilawati

Washing hands is a five moments act of hand washing which is done with water or handrub. Itis one kind of the infection prevention and as the control of patient safety. The purpose of this study wasto determine the implementation of the five moments for hand washing in Syuhada Haji Hospital BlitarCity. Method: This was a descriptive research by observation. The population in this study was nursesin the inpatient unit of Syuhada Haji Hospital. The sample was 37 respondents collected by totalsampling technique. The data collection was done on March 5 to April 9, 2015. Results: It showed thatfive moments of hand washing only moments 3 after touching body fluids of patients at risk and 4thmoments after touching the patient all the nurses wash their hands with more than 75% nurse handwashing is not appropriate standart operating procedures and the moment the most infrequent handwashing is the moment to-1 before touching the patient. Discussion: This is due to lack of knowledge ofnurses about the importance of washing their hands before touching patients can become a bad habit.Recommendations: the researchers were to observe the amount of washing hands nurses in one shift.


2009 ◽  
Vol 75 (5) ◽  
pp. 465-474 ◽  
Author(s):  
Edward A. Neuwelt ◽  
Bronwyn E. Hamilton ◽  
Csanad G. Varallyay ◽  
William R. Rooney ◽  
Robert D. Edelman ◽  
...  

2019 ◽  
Vol 24 (7) ◽  
pp. 310-314
Author(s):  
Emma Rickards ◽  
Dennis Wat ◽  
Carol Ann Kelly ◽  
Sarah Sibley

Despite the introduction of Oxygen Alert Cards, guidelines and audits, oxygen therapy remains overused in NHS practice, and this may lead to iatrogenic mortality. This pilot study aimed to examine the use of Oxygen Alert Wristbands (OxyBand) designed to alert health professionals who are delivering oxygen to patients to ensure that the oxygen is administered and titrated safely to the appropriate target saturations. Patients at risk of hypercapnic acidosis were asked to wear OxyBands while presenting to paramedics and health professionals in hospitals. Inappropriate prescription of oxygen reduced significantly after the OxyBands were used. A questionnaire-based assessment showed that the clinicians involved had a good understanding of the risks of uncontrolled oxygen. Forty-two patients found the wrist band comfortable to wear, and only two did not. OxyBands may have the potential to improve patient safety over Oxygen Alert Cards.


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