The appropriateness of abdominal X-ray requests in the acute medical initial admissions unit.

Abdominal X-rays Acute medicine Education Graded assertive communication Guidelines

Journal

British journal of hospital medicine (London, England : 2005)
ISSN: 1750-8460
Titre abrégé: Br J Hosp Med (Lond)
Pays: England
ID NLM: 101257109

Informations de publication

Date de publication:
02 May 2022
Historique:
entrez: 2 6 2022
pubmed: 3 6 2022
medline: 7 6 2022
Statut: ppublish

Résumé

Abdominal X-rays are frequently requested by clinicians in the Aberdeen Royal Infirmary acute medical initial assessment unit. The proportion of indicated abdominal X-rays requested within 24 hours of admission was retrospectively examined. This process was repeated after displaying an educational poster with the Royal College of Radiologists guidelines (cycle 2) and a graded assertive communication poster (cycles 3 and 4); a tool to enable junior doctors to challenge inappropriate requests for abdominal X-rays from seniors. Only 47.2% of abdominal X-ray requests were deemed appropriate in cycle 1. A 1.54% reduction in abdominal X-ray requests and an 11.5% increase in indicated abdominal X-rays were noted after cycle 2. Cycle 3 led to a statistically significant improvement with 2.6% fewer patients undergoing an abdominal X-ray and a 24.6% increase in indicated abdominal X-rays. This improvement was sustained in cycle 4. Promoting graded assertive communication is an effective means of helping junior doctors to challenge seniors requesting non-indicated abdominal X-rays.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Abdominal X-rays are frequently requested by clinicians in the Aberdeen Royal Infirmary acute medical initial assessment unit.
METHOD METHODS
The proportion of indicated abdominal X-rays requested within 24 hours of admission was retrospectively examined. This process was repeated after displaying an educational poster with the Royal College of Radiologists guidelines (cycle 2) and a graded assertive communication poster (cycles 3 and 4); a tool to enable junior doctors to challenge inappropriate requests for abdominal X-rays from seniors.
RESULTS RESULTS
Only 47.2% of abdominal X-ray requests were deemed appropriate in cycle 1. A 1.54% reduction in abdominal X-ray requests and an 11.5% increase in indicated abdominal X-rays were noted after cycle 2. Cycle 3 led to a statistically significant improvement with 2.6% fewer patients undergoing an abdominal X-ray and a 24.6% increase in indicated abdominal X-rays. This improvement was sustained in cycle 4.
CONCLUSIONS CONCLUSIONS
Promoting graded assertive communication is an effective means of helping junior doctors to challenge seniors requesting non-indicated abdominal X-rays.

Identifiants

pubmed: 35653316
doi: 10.12968/hmed.2021.0603
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-10

Auteurs

Kiruthika Ananthan (K)

Department of Otolaryngology, Raigmore Hospital, NHS Highlands, Inverness, UK.

Jonathan P Whitfield (JP)

Department of Acute Medicine, Aberdeen Royal Infirmary, NHS Grampian, Foresterhill, Aberdeen, UK.

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Classifications MeSH