title: New guidelines on the use of iodinated contrast media: a report on an implementation project.
abstract: OBJECTIVE
  The aim of this paper is to report on the implementation of new guidelines on the use of injectable iodinated contrast media (ICM) at our workplace and specific protocols for the preparation of patients at risk.
  
  
  METHODS
  Operators received training with continuing medical education (CME) credits. The new documentation (patient history/screening form and informed consent form) is available on the hospital Web site and requests serum creatinine determination with estimation of glomerular filtration rate (GFR) for every patient. Additional tests are required for high-risk patients only.
  
  
  RESULTS
  Attendance rates were 57.2% among referring physicians and 74.5% among Radiology Department personnel. The Cockcroft-Gault formula was used to estimate GFR in adults. The main problem encountered in the implementation process was that referring physicians failed to evaluate the GFR in 80% of patients, with low GFR being discovered in the Radiology Department on the day of examination in 20% of patients, resulting in a need to reschedule the examination.
  
  
  CONCLUSIONS
  Although not an easy task, implementation of the new guidelines for ICM use is both feasible and necessary. An additional refresher training course for personnel and GFR evaluation of the patient on referral are indispensable to ensure proper preparation of patients at increased risk of adverse reactions to ICM.
authors.affiliation: UOS Neuroradiologia, ASUR Marche - Zona Territoriale 11, 63023, Fermo, Italy. massimogiuliano.bonetti@tin.it
authors.forename: M G
authors.initials: MG
authors.lastname: Bonetti
authors.forename: A
authors.initials: A
authors.lastname: Vesprini
authors.forename: M
authors.initials: M
authors.lastname: Concetti
authors.forename: S
authors.initials: S
authors.lastname: Ventrella
authors.forename: M F
authors.initials: MF
authors.lastname: Spagna
authors.forename: S
authors.initials: S
authors.lastname: Mancinelli
authors.forename: M
authors.initials: M
authors.lastname: Santini
authors.forename: A
authors.initials: A
authors.lastname: Romanelli
authors.forename: P
authors.initials: P
authors.lastname: Pantanetti
authors.forename: C
authors.initials: C
authors.lastname: Cameli
authors.forename: L
authors.initials: L
authors.lastname: Bonanni
authors.forename: L
authors.initials: L
authors.lastname: Baffoni