Articles: checklist.
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Transition from film-screen to digital radiography requires changes in radiographic technique and workflow processes to ensure that the minimum radiation exposure is used while maintaining diagnostic image quality. Checklists have been demonstrated to be useful tools for decreasing errors and improving safety in several areas, including commercial aviation and surgical procedures. ⋯ The checklist and its accompanying implementation manual and practice quality improvement project are open source and downloadable at www.imagegently.org. The authors describe the process of developing and testing the checklist and offer suggestions for using the checklist to minimize radiation exposure to children during radiography.
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Acta medica Iranica · Jan 2014
Evaluation of emergency medicine residents competencies in electrocardiogram interpretation.
An electrocardiogram (ECG) leads physicians to diagnose many potentially life-threatening cardiac, metabolic, electrolyte, and toxicological conditions. This study was designed to evaluate the competency of emergency medicine residents (EMRs) in comparison with cardiologists in the interpretation of ECG when an interpretation checklist is used. This clinical trial was done in the emergency wards of the first grand general hospital of Iran. ⋯ In second-year EMRs, both ECG interpretation and ECG diagnosis scores improved significantly (P<0.05 and P<0.01, respectively). In third year EMRs, ECG interpretation was not improved but ECG diagnosis based on two methods improved significantly (P<0.05). The significant increase in accuracy of ECG interpretation and final diagnosis can be attributed to the utilization of a checklist by EMRs especially in the first year and second residents.
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AMIA Annu Symp Proc · Jan 2016
Checklist as a Memory Externalization Tool during a Critical Care Process.
We analyzed user interactions with a paper-based checklist in a regional trauma center to inform the design of digital cognitive aids for safety-critical medical teamwork. An initial review of paper checklists from actual trauma resuscitations revealed that trauma team leaders frequently wrote notes on the checklist. To understand this notetaking practice, we performed content analysis of 163 checklists collected over the period of four months. ⋯ An analysis of types and amount of notes written by leaders of different experience levels showed that more experienced leaders recorded more patient values and physical findings, while less experienced leaders recorded more notes about their activities and task completion status. These findings suggested that a checklist designed for a high-risk, fast-paced medical event has evolved into a dual function tool, serving both as a compliance and memory aid. Based on these findings, we derived requirements for designing digital cognitive aids to support safety-critical medical teamwork.
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The World Health Organization (WHO) Surgical Safety Checklist is a cost-effective tool that has been shown to improve patient safety. We explored the applicability and effectiveness of quality improvement methodology to implement the WHO checklist and surgical counts at Mbarara Regional Referral Hospital in Uganda between October 2012 and September 2013. Compliance rates were evaluated prospectively and monthly structured feedback sessions were held. ⋯ Use of the checklist was associated with performance of surgical counts (p value < 0.001; r(2) = 0.91). Pareto analysis showed that understaffing, malfunctioning and lack of equipment were the main challenges. A carefully designed quality improvement project, including stepwise incremental change and standardisation of practice, can be an effective way of improving clinical practice in low-income settings.
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Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. ⋯ Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.