Preparation of chldren undergoing nuclear medicine procedures.

OBJECTIVES: To re-evaluate implementation of standards developed for children undergoing nuclear medicine procedures and the effect of introducing cannulation by the day case coordinating nurse. METHODS: A prospective audit was undertaken of 177 children undergoing day case nuclear medicine procedures in a teaching hospital department used for paediatric and adult patients. Audit proformas were completed by both ward and nuclear medicine staff at the time of procedure over a 15 month period and the results compared to a previously published audit. RESULTS: Standards were met for providing families with relevant information and giving them sufficient notice about scan dates. Most children were offered surface analgesia for venepuncture and play preparation before the procedure. The day case coordinating nurse successfully performed 89 per cent of cannulations with the percentage performed by the SHOs falling from 71 per cent to six per cent between 2003 and 2006. Sixty-four per cent and 95 per cent of children were successfully cannulated after one and a total of three attempts respectively. Only two per cent of children were sedated. The percentage of children scanned within 0-20 minutes of the scheduled time improved over three years from 71 per cent to 97 per cent. CONCLUSIONS: The development of the day case coordinating nurse's role to include cannulation has had a positive effect on the efficiency of radionuclide procedures due to an increased success rate of cannulation and quicker transfer of the children from the ward to the nuclear medicine department. Improved standards have ensured that the patient pathway involving preparation, information and support for children and families has been enhanced. The audit standards could be used for comparison between units.

Preparing children for day case nuclear medicine procedures.

OBJECTIVES: To audit standards developed for children undergoing nuclear medicine procedures involving day case attendance on the renal unit. METHODS: A prospective audit was undertaken of 210 children (113 males) undergoing day case nuclear medicine procedures in a teaching hospital department catering for adult and paediatric patients. An audit sheet was completed by both ward and nuclear medicine staff at the time of the procedure over an 18-month period. RESULTS: The majority of families were given relevant information about the procedures and adequate notice before the scan date. Most patients were offered surface analgesia for the venepuncture and play preparation before the procedure. Fifty-eight per cent of patients were successfully cannulated at the first attempt and 88% after three attempts. Only 4% of children were sedated. The median delay between the scheduled and actual scan time was 15 min, with 71% of children being scanned within the standard of a 0-20-min delay. Most delays were due to logistic problems within the department (43%). Cannulation problems (35%) and patient-related factors (22%) accounted for further delays. CONCLUSIONS: The audit of these locally agreed standards has resulted in changes in practice, including nurse training for cannulation and better scheduling within the nuclear medicine department. We believe that play preparation is an essential component for all potentially painful procedures, with few patients requiring sedation. The standards could be used for comparative audits between units.