RESUMO
OBJECTIVE: To assess the effect of a multifaceted quality improvement intervention on variability of left ventricular dimensions as measured on pediatric echocardiograms. METHODS: Variability of measurements of left ventricular dimensions was assessed using percent error before a multifaceted educational intervention. Sonographers attended group sessions, used visual prompts and received individual feedback regarding the proper technique for measuring the left ventricle. Variability was reassessed following the intervention. RESULTS: Sonographers were more likely to use proper measurement technique (38% vs. 62%, P = .017) after the educational intervention. The percent error of the left ventricular end systolic measurement decreased significantly (12.4% to 8.8%, P = .002). The percent error of the left ventricular end diastolic measurement showed a trend toward a decrease (7.7% to 5.8%, P = .067). There was no significant improvement in percent error for other measurements. Use of correct technique and sonographer experience of less than 5 years predicted decreased percent error. CONCLUSION: A multifaceted educational intervention can be used to improve measurement variability in pediatric echocardiography laboratories.
Assuntos
Ecocardiografia , Educação Médica Continuada , Ventrículos do Coração/diagnóstico por imagem , Capacitação em Serviço , Pediatria/educação , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Adolescente , Criança , Pré-Escolar , Competência Clínica/normas , Ecocardiografia/normas , Feedback Formativo , Humanos , Lactente , Recém-Nascido , Pediatria/normas , Valor Preditivo dos Testes , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Reprodutibilidade dos TestesRESUMO
We performed a comparative analysis between Roche Amplicor HIV-1 DNA test and CAPTAQ assay for the detection of HIV in 830 dried blood spot (DBS) pediatric samples collected in Mozambique. Our results demonstrated no statistical difference between these assays. The CAPTAQ assay approached nearly 100% repeatability/accuracy. The increased throughput of testing with minimal operator interference in performing the CAPTAQ assay clearly demonstrated that this method is an improvement over the Roche Amplicor HIV-1 DNA test, version 1.5.