Mixed methods study on the use of and attitudes towards safety checklists in interventional radiology

Communication during children's X-ray procedures and children's experiences of the procedure: A scoping review

INTRODUCTION

Communication is a central part of radiological procedures and influences children's experiences. Previous research concentrates on communication and experiences during complex radiological procedures such as magnetic resonance imaging (MRI). Less is known about the communication that occurs with children undergoing procedures, such as non-urgent X-ray procedures, or the impact communication has on a child's experience.

OBJECTIVES

This scoping review examined evidence relating to the communication which occurs between children, parents and radiographers during children's X-ray procedures and how children experience undergoing X-ray procedures.

KEY FINDINGS

The comprehensive search identified eight papers. Evidence shows that radiographers dominate communication during X-ray procedures, with their communication in many cases being instructional, closed and limiting the opportunities for children to be involved. Evidence indicates that radiographers have a role in facilitating children in actively engaging in communication during their procedure. The papers that sought children's first-hand experiences highlight children's mainly positive experiences of having an X-ray, and the importance of informing children about their X-ray before and during the procedure.

CONCLUSIONS

The scarcity of literature highlights a need for research exploring communication during children's radiological procedures and children's first-hand experiences of undergoing these procedures. Findings highlight a need for an approach that recognises the importance of dyadic (radiographer and child), and triadic (radiographer, parent and child) communication opportunities during an X-ray procedure.

IMPLICATIONS FOR PRACTICE

This review highlights a need for an inclusive and participatory approach to communication that recognises children's voice and agency in X-ray procedures.

Improving Healthcare Workers' Adherence to Surgical Safety Checklist: The Impact of a Short Training

Background

Although surgery is essential in healthcare, a significant number of patients suffer unfair harm while undergoing surgery. Many of these originate from failures in non-technical aspects, especially communication among operators. A surgical safety checklist is a simple tool that helps to reduce surgical adverse events, but even if it is fast to fill out, its compilation is often neglected by the healthcare workers because of unprepared cultural background. The present study aims to value the efficacy of a free intervention, such as a short training about risk management and safety checklist, to improve checklist adherence.

Methods

In March 2019, the medical and nursing staff of the General Surgical Unit attended a two-lesson theoretical training concerning surgical safety and risk management tools such as the surgical safety checklist. The authors compared the completeness of the surgical checklists after and before the training, considering the same period (2 months) for both groups.

Result

The surgical safety checklists were present in 198 cases (70.97%) before the intervention and 231 cases (96.25%) after that. After the training, the compilation adherence increased for every different type of healthcare worker of the unit (surgeons, nurses, anesthetists, and scrab nurses). Furthermore, a longer hospitalization was associated with a higher surgical checklist adherence by the operators.

Conclusions

The results showed that a free and simple intervention, such as a two-lesson training, significantly stimulated the correct use of the surgical safety checklist. Moreover, the checklist adherence increased even for the operators who did not attend the training, maybe because of the positive influence of the colleagues' positive behaviors. As the results were promising with only two theoretical lessons, much more can be done to build a new safety culture in healthcare.

Validation of a patient safety checklist for radiological procedures in hemodynamics

ABSTRACT Objectives: to carry out cultural adaptation and validation of WHO Surgical Safety Checklist: for Radiological Interventions ONLY to Brazilian Portuguese. Methods: a methodological research with the following stages of the cultural adaptation process: translation of the instrument, achievement of a consensus in Portuguese, evaluation by a committee of judges, back-translation, achievement of a consensus in English, comparison with the original version, and a pre-test. The psychometric properties of the adapted version were evaluated through interobserver reliability. Results: the values of the kappa coefficient ranged from moderate to almost perfect in most instrument items, demonstrating that the instrument items were understandable and reliable when applied to the observed context. Conclusions: the cultural adaptation and validation of face and content of the instrument met the criteria of equivalence between the original and the translated instrument. The tool proved to be understandable and feasible and can be applied in invasive radiological procedures in Brazil.

Checklists for image-guided interventions: a systematic review

OBJECTIVES

Safety checklists have improved safety in patients undergoing surgery. Checklists have been designed specifically for use in image-guided interventions. This systematic review aimed to identify checklists designed for use in radiological interventions and to evaluate their efficacy for improving patient safety. Secondary aims were to evaluate attitudes toward checklists and barriers to their use.

METHODS

OVID, MEDLINE, CENTRAL and CINAHL were searched using terms for "interventional radiology" and "checklist". Studies were included if they described pre-procedural checklist use in vascular/body interventional radiology (IR), paediatric IR or interventional neuro-radiology (INR). Data on checklist design, implementation and outcomes were extracted.

RESULTS

Sixteen studies were included. Most studies (n = 14, 87.5%) focused on body IR. Two studies (12.5%) measured perioperative outcome after checklist implementation, but both had important limitations. Checklist use varied between 54 and 100% and completion of items on the checklists varied between 28 and 100%. Several barriers to checklist use were identified, including a lack of leadership and education and cultural challenges unique to radiology.

CONCLUSIONS

We found few reports of the use of checklists in image-guided interventions. Approaches to checklist implementation varied, and several barriers to their use were identified. Evaluation has been limited. There seems to be considerable potential to improve the effective use of checklists in radiological procedures.

ADVANCES IN KNOWLEDGE

There are few reports of the use of checklists in radiological interventions, those identified reported significant barriers to the effective use of checklists.

Patient safety is everyone's business

This editorial addresses the importance of incident reporting, checklists and a just culture to patient safety.