Health Care : Current Reviews

An audit to evaluate Abdominal XR requests in surgical patients

Webinar on 12^th World Congress on Healthcare

February 17, 2022 | WEBINAR

Amy Bryce*, Dr Marwa Al-Azzawi, Mr David Watt

NHS Ayrshire & Arran trust, Crosshouse hospital, Kilmarnock, Glasgow, UK

Scientific Tracks Abstracts: Health Care Current Reviews

Abstract:

Abdominal x-rays (AXR) are a useful tool in investigating a number of pathologies. However they expose the patient to up to 7 times more radiation than a standard chest x-ray1. AXR’s that are requested without appropriate indication are not an efficient use of resources. Our aim was to evaluate if requests for AXR’s being made are in line with Royal College of Radiologists (RCR) refer guidelines2. AXR requests made by surgical staff at Crosshouse hospital between January and February 2021 were gathered. Clinical history of the patients and indications in the request for the AXR were compared with guideline recommendations. In total 52 requests for AXR’s were made during this period, of which 32 (62%) were made appropriately. 20 (38%) did not match guidelines, as the patient’s presenting complaint and clinical history did not match one of the recommended indications to perform AXR. Of the AXR’s performed, 38% went on to receive a CT AP as an inpatient. The main documented indication in the request was to rule out obstruction. 10 (19%) had other reasoning for AXR being requested. AXR’s requested during this time period were not all made in line with guidelines. The most commonly noted error was the AXR being requested to rule out obstruction, when the clinical history was not suspicious of obstruction. We hope to improve the number of appropriate AXR requests. AXR requests will be re-audited after quality improvement interventions have been made, such as educational posters and circulation of guidelines to staff email.
References:
1. Mettler FA, et al. "Effective Doses in Radiology and Diagnostic Nuclear Medicine: A Catalogue," Radiology (July 2008), Vol. 248, pp. 254–63.
2. Soin, S. (2018). Indications for Plain Abdominal films from the Emergency Department. Available: https://www.rcr.ac.uk/audit/indications-plain-abdominal-films-emergency-department. Last accessed 22/04/2021.

Biography :

Main author, Dr Amy Bryce, is a junior doctor at Crosshouse hospital in Glasgow. She graduated her MBChB medical degree from Glasgow University in 2021 a few months early, in order to join the workforce in the fight against COVID-19. Prior to this she completed a BSci (Hons) in Anatomy, also at Glasgow University. She is currently working towards applying for surgical training, and has a keen interest in ENT.