Standardized Contrast Reaction Management Checklist Helps Reduce Errors

A standardized contrast reaction management checklist helps reduce treatment errors, according to a study published in the American Journal of Roentgenology.

Researchers from the University of Washington School of Medicine in Seattle assessed the performance of a contrast reaction management checklist for optimal management of a contrast reaction scenario created using a high-fidelity hands-on simulation.

Forty-three radiology residents participated in the study; 22 were assigned to the checklist group and 21 to the control group. The safety checklist was designed to present the five adverse events that most commonly occur after administration of IV contrast medium, as well as their step-by-step management.

Each participant took written tests two months before and immediately after participating in the high-fidelity simulation scenario, which was videotaped and independently evaluated by three graders.

The results showed that while both groups had similar scores on the multiple-choice question tests taken before and after participation in the simulation, after the simulation, the checklist group scored significantly higher than the control group with regard to their overall management of a severe contrast reaction, including individual scores for first-line treatment of bronchospasm and use of the correct route of administration and dose of epinephrine.

Checklist group/Control group
Overall management of severe contrast reaction 85.1% / 64.8%
Individual scores for first-line treatment of bronchospasm 97% / 91.3%
Use of correct route of administration and dose of epinephrine 77.3% / 45.2%

The researchers concluded that a standardized contrast reaction management checklist can reduce the number of treatment errors that occur during a simulated severe contrast reaction, particularly with regard to proper administration of epinephrine and treatment of bronchospasm. Such a checklist could be used by radiologists, technologists, and nurses to improve patient safety as a result of improved contrast reaction management and teamwork skills.