Improving the Quality of Radiographs in Neonatal Intensive Care Unit Utilizing Educational Interventions.
OBJECTIVE
We aimed to develop an educational tool to improve the radiograph quality, sustain this improvement overtime, and reduce the number of repeat radiographs.


METHODS
A three phase quality control study was conducted at a tertiary care NICU. A retrospective data collection (phase1) revealed suboptimal radiograph quality and led to an educational intervention and development of X-ray preparation checklist (primary intervention), followed by a prospective data collection for 4 months (phase 2). At the end of phase 2, interim analysis revealed a gradual decline in radiograph quality, which prompted a more comprehensive educational session with constructive feedback to the NICU staff (secondary intervention), followed by another data collection for 6 months (phase 3).


RESULTS
There was a significant improvement in the quality of radiographs obtained after primary educational intervention (phase 2) compared with phase 1 (p < 0.001). During interim analysis after phase 2, radiograph quality declined but still remained significantly better than phase 1. Secondary intervention resulted in significant improvement in radiograph quality to > 95% in all domains of image quality. No radiographs were repeated in phase 3, compared with 5.8% (16/277) in phase 1.


CONCLUSIONS
A structured, collaborated educational intervention successfully improves the radiograph quality and decreases the need for repeat radiographs and radiation exposure in the neonates.
Division of Neonatology, Al DuPont Hospital for Children, Wilmington, Delaware.
Ashish O
AO
Gupta
Division of Neonatal-Perinatal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia.
Jeanne
J
Rorke
Division of Neonatal-Perinatal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia.
Kabir
K
Abubakar
D000488:Allied Health Personnel / Q000193:education*; D057189:Checklist; D000068156:Formative Feedback; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008505:Medical Staff, Hospital / Q000193:education*; D009741:Nursing Staff, Hospital / Q000193:education*; D011446:Prospective Studies; D058996:Quality Improvement; D013902:Radiography, Thoracic / Q000592:standards*; D012189:Retrospective Studies