ISQua's 39th International Conference 2023

Activities to improve the rate of patient evaluation before examination using radiographic contrast medium

J.A.Shin, RN1, J.Y.Lee, MD1, J.Y.jung, RN1, J.L.Kim, RN1

1QI team, INHA university Hospital, Incheon, South korea

Introduction & Objectives

With improvement and increased use of imaging technologies, The risk of adverse reactions to radiologic contrast medium has been increasing. Acute kidney injuries from nephrotoxic contrasts (sometimes requiring dialysis) could rise length of stay, and mortality could be effected by contrast medium use. However, there is no appropriate screening process before contrast administration and patient-care protocol during pre and post-administration in my hospital. Therefore, we aim to achieve the following:

1.Establish screening process before contrast medium administration and patient-care protocol during pre and post – administration in hopital

2.Increase the rate of renal function tests for outpatients before CT and MRI scan using contrast medium

3.Increase the rate of pretreatment for patients with a history of adverse reactions to contrast medium

4.Report all adverse reactions to contrast medium through the in-hospital reporting system.

Core indicator

1.Percentage of patients who receive renal function tests prior to contrast medium use

2. Pretreatment rate for patients with a history of adverse reactions to contrast medium

3. Rate of severe adverse reaction to contrast medium in patients who receive screening evaluation before contrast medium administration

Methods & Improvement activities

1. Establishment of protocol for contrast medium administration

2. Process for renal function test before contrast medium use

3. Pop-up message appears when doctors prescribe CT or MRI scan

4. Sharing information in EMR about patients with adverse reactions in the past.

5. Quarterly check of indicators and improvement activity plan according to result

6. Information sharing related to patient’s adverse reaction to contrast medium

7. Safety alert Education about reporting of adverse reactions to contrast medium

Results

1.The rate of renal function tests for patients evaluation prior to contrast

medium use increased from 47%(2017) to 97.8%(2022) after initiation of

proposed improvements.

2. The pretreatment rate for patients with a history of adverse reactions to

contrast increased to 79.3% from 71.6 % before implementation

3. Severe contrast agent adverse reaction rate was 0% in patient group that

received evaluation before using contrast..

conclusion

Through this QI activity, the rate of eGFR test for renal function evaluation before contrast medium use was significantly improved, and patients with a history of adverse reactions to contrast medium were registered in EMR and shared with medical staff. Our activities contributed to improving patient safety during imaging exams with contrast medium by offering appropriate pretreatment according to patient evaluation results when contrast medium prescription occurs.

ISQua's 39th International Conference 2023

ACTIVITIES TO IMPROVE THE RATE OF PATIENT EVALUATION BEFORE EXAMINATION USING CONTRAST MEDIA

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