Quality of care: identification and quantification of the process of care among children undergoing nuclear medicine studies.
The aim of this study was to define indices which could be used to assess the quality of care of children undergoing an examination requiring intravenous (i.v.) access in an integrated department of radiology and to see if these indices could be quantified. A prospective study of all patients requiring an i.v. injection for a nuclear medicine examination (NME) over a period of 8 weeks was undertaken. The following indices were assessed: the waiting time of the patients in the department for a NME, the use of EMLA (a local anaesthetic cream), use of sedation, and number of attempts to achieve i.v. access. The 219 males and 174 females had a median age of 46 months. EMLA was applied to 298 children. The median times from arrival to the application of EMLA was 5 min, between EMLA to the injection 59 min, and between arrival to injection 65 min. Seventeen children had sedation. Intravenous access was achieved on the first attempt in 76.7% of cases and three or more attempts were made in 8.5% of cases. Successful injections were made in 91.5% of the children; 8.2% had partial extravasation of the radio-isotope at the injection site and in one patient the examination was abandoned due to an inability of gaining i.v. access. This study has identified and quantified indices to measure the quality of care for children undergoing an i.v. injection in an imaging department. Baseline values have been established for i.v. access, sedation and waiting times in the radiology department for various NMEs. Undertaking multiple imaging procedures on the same day requires careful scheduling and complex organization.
Sherazi
Z
Z
Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
Gordon
I
I
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D009683:Nuclear Medicine / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D011868:Radioisotopes / Q000008:administration & dosage*; D011877:Radionuclide Imaging / Q000592:standards; D014055:Tomography, Emission-Computed / Q000592:standards; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D011868:Radioisotopes