Literature DB >> 17599499

Elimination of daily routine chest radiographs does not change on-demand radiography practice in post-cardiothoracic surgery patients.

Onno Mets1, Peter E Spronk, Jan Binnekade, Jaap Stoker, Bas A J M de Mol, Marcus J Schultz.   

Abstract

OBJECTIVE: We sought to determine the effect of elimination of daily routine chest radiographs on chest radiographic practice in cardiothoracic surgery patients in the intensive care unit and the post-intensive care unit ward.
METHODS: We used a prospective, comparative study design with an intervention in a 28-bed intensive care unit/post-intensive care unit ward (including a 4-bed medium-care unit) in a university hospital. Cardiothoracic surgery patients were admitted to the intensive care unit during a period of 6 months (3 months before intervention and 3 months after intervention). Daily routine chest radiographs in the intensive care unit were eliminated; all chest radiographs required a clinical indication. Routine chest radiographs were not performed in the post-intensive care unit ward, both before and after the intervention.
RESULTS: Before intervention, in the intensive care unit 353 daily routine chest radiographs and 261 on-demand chest radiographs were obtained in 175 patients; after intervention, 275 on-demand chest radiographs were obtained in 163 patients. Before intervention, in the post-intensive care unit ward 413 on-demand chest radiographs were obtained in 167 patients; after intervention, 445 on-demand chest radiographs were obtained in 161 patients. In the intensive care unit the number of chest radiographs per patient day decreased from 1.8 +/- 0.6 to 1.1 +/- 0.6. In the post-intensive care unit ward the number of chest radiographs per patient per day was 0.4 +/- 0.2, both before and after the intervention. Slightly more unexpected abnormalities were found in the on-demand chest radiographs after the intervention. No negative influence on chest radiography timing, length of stay in the intensive care unit and hospital, and readmission rate was seen.
CONCLUSIONS: Elimination of daily routine chest radiographs led to a decrease of the total number of chest radiographs obtained per patient per day in the intensive care unit and did not change chest radiography practice in the post-intensive care unit ward.

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Year:  2007        PMID: 17599499     DOI: 10.1016/j.jtcvs.2007.02.029

Source DB:  PubMed          Journal:  J Thorac Cardiovasc Surg        ISSN: 0022-5223            Impact factor:   5.209


  10 in total

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Review 6.  Routine chest x-rays in intensive care units: a systematic review and meta-analysis.

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8.  Significant changes in the practice of chest radiography in Dutch intensive care units: a web-based survey.

Authors:  Martijn Tolsma; Tom A Rijpstra; Marcus J Schultz; Paul Gh Mulder; Nardo Jm van der Meer
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9.  Daily routine versus on-demand chest radiograph policy and practice in adult ICU patients- clinicians' perspective.

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10.  Trends in Use of Daily Chest Radiographs Among US Adults Receiving Mechanical Ventilation.

Authors:  Hayley B Gershengorn; Hannah Wunsch; Damon C Scales; Gordon D Rubenfeld
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  10 in total

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