RESUMEN
INTRODUCTION: This study investigates instances of elevated radiation dose on a radiation tracking system to determine their aetiologies. It aimed to investigate the impact of radiographer feedback on these alerts. METHODS: Over two six-month periods 11,298 CT examinations were assessed using DoseWatch. Red alerts (dose length products twice the median) were identified and two independent reviewers established whether alerts were true (unjustifiable) or false (justifiable). During the second time period radiographers used a feedback tool to state the cause of the alert. A Chi-Square test was used to assess whether red alert incidence decreased following the implementation of radiographer feedback. RESULTS: There were 206 and 357 alerts during the first and second time periods, respectively. These occurred commonly with CT pulmonary angiography, brain, and body examinations. Procedural documentation errors and patient size accounted for 57% and 43% of false alerts, respectively. Radiographer feedback was provided for 17% of studies; this was not associated with a significant change in the number of alerts, but the number of true alerts declined (from 7 to 3) (χ2 = 4.14; p = 0.04). CONCLUSION: Procedural documentation errors as well as patient-related factors are associated with false alerts in DoseWatch. Implementation of a radiographer feedback tool reduced true alerts. IMPLICATIONS FOR PRACTICE: The implementation of a radiographer feedback tool reduced the rate of true dose alerts. Low uptake with dose alert systems is an issue; the workflow needs to be considered to address this.
Asunto(s)
Sistemas de Entrada de Órdenes Médicas , Documentación , Retroalimentación , Humanos , Dosis de Radiación , Tomografía Computarizada por Rayos XRESUMEN
An unusual case of discitis and vertebral osteomyelitis due to Haemophilus aphrophilus is described. Infections due to this organism have usually responded to treatment with beta-lactam antibiotics. However, our isolate was resistant to third-generation cephalosporins which has not been reported previously in the world literature. The patient made a good clinical response to ciprofloxacin treatment.
Asunto(s)
Discitis/microbiología , Infecciones por Haemophilus/complicaciones , Osteomielitis/microbiología , Enfermedades de la Columna Vertebral/microbiología , Absceso/tratamiento farmacológico , Absceso/microbiología , Antiinfecciosos/uso terapéutico , Resistencia a las Cefalosporinas , Ciprofloxacina/uso terapéutico , Discitis/tratamiento farmacológico , Haemophilus/efectos de los fármacos , Haemophilus/aislamiento & purificación , Infecciones por Haemophilus/tratamiento farmacológico , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Osteomielitis/tratamiento farmacológico , Enfermedades de la Columna Vertebral/tratamiento farmacológicoRESUMEN
A fatal case of penicillin resistant Staphylococcus lugdunensis endocarditis on a native valve damaged by rheumatic fever is described. A retrospective examination of 978 tube coagulase negative staphylococcal blood culture isolates was also performed to determine how often this species is isolated. None of the 978 isolates was identified as S lugdunensis. It is concluded that ornithine decarboxylase production is the only reliable method of identifying this species.
