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Emergency head injury imaging: implementing NICE 2007 in a tertiary neurosciences centre and a busy district general hospital

BackgroundHead injuries are a common emergency department (ED) presentation. The National Institute for Health and Clinical Excellence (NICE) updated its guidance in September 2007 regarding imaging required for patients with head injuries.MethodsA two-centre observational ED study was carried out,... Full description

Journal Title: Emergency medicine journal : EMJ 2011-09, Vol.28 (9), p.778-782
Main Author: Mooney, J S
Other Authors: Yates, A , Sellar, L , Shipway, T , Roberts, C , Parris, R , Hassan, Z , Thomas, M , Smith, M , Lecky, F
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: England: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
ID: ISSN: 1472-0205
Link: https://www.ncbi.nlm.nih.gov/pubmed/21030548
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title: Emergency head injury imaging: implementing NICE 2007 in a tertiary neurosciences centre and a busy district general hospital
format: Article
creator:
  • Mooney, J S
  • Yates, A
  • Sellar, L
  • Shipway, T
  • Roberts, C
  • Parris, R
  • Hassan, Z
  • Thomas, M
  • Smith, M
  • Lecky, F
subjects:
  • Adult
  • Adults
  • Age
  • Child
  • Child, Preschool
  • Children & youth
  • Clinical medicine
  • Coma
  • Compliance
  • Consciousness
  • Craniocerebral Trauma - diagnostic imaging
  • Data collection
  • Diagnosis
  • Emergency Service, Hospital - standards
  • Female
  • Fractures
  • Guideline Adherence - standards
  • head
  • Head injuries
  • Hospitals, District - standards
  • Hospitals, General - standards
  • Humans
  • Imaging
  • Infant
  • Male
  • Medical imaging
  • Neurosciences
  • Practice guidelines (Medicine)
  • Practice Guidelines as Topic
  • Signs
  • Studies
  • Tomography, X-Ray Computed - utilization
  • trauma
  • Vehicles
ispartof: Emergency medicine journal : EMJ, 2011-09, Vol.28 (9), p.778-782
description: BackgroundHead injuries are a common emergency department (ED) presentation. The National Institute for Health and Clinical Excellence (NICE) updated its guidance in September 2007 regarding imaging required for patients with head injuries.MethodsA two-centre observational ED study was carried out, examining imaging practice in adults and children with head injuries attending pre-guideline and post-guideline implementation. Guideline implementation occurred through a formal implementation programme at the teaching hospital, and informally at the district general hospital (DGH). Retrospective extraction took place of prospectively recorded data case records and radiology department imaging registers. Pre-implementation data were collected from Salford Royal Foundation NHS Trust (SRFT) from January and February 2008 and post-implementation data in May 2008. Post-implementation data was collated from Royal Bolton Hospital Foundation NHS Trust (RBFT) from September to November 2007. Compliance with NICE 2007 was the primary outcome assessed.ResultsWith the implementation of NICE 2007 guidelines at SRFT, a significant increase in compliance from 94.2% (92.9–95.5) to 98.8% (98.2–99.3) was observed for adults requiring head CTs, with an overall trend to improved clinical practice in the adult patient populations. However, a significant number of children (SRFT 68.7% and RBFT 77.1%) did not receive the indicated head CT scan following a head injury, after implementation of the guidelines.ConclusionsThe SRFT implementation strategy employed was successful for adults, with the overall trend to increased clinical compliance post-guideline introduction. Evidence of a reluctance to adhere to the NICE recommendations for children indicated for CT head scan after a head injury was observed.
language: eng
source:
identifier: ISSN: 1472-0205
fulltext: no_fulltext
issn:
  • 1472-0205
  • 1472-0213
url: Link


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titleEmergency head injury imaging: implementing NICE 2007 in a tertiary neurosciences centre and a busy district general hospital
creatorMooney, J S ; Yates, A ; Sellar, L ; Shipway, T ; Roberts, C ; Parris, R ; Hassan, Z ; Thomas, M ; Smith, M ; Lecky, F
creatorcontribMooney, J S ; Yates, A ; Sellar, L ; Shipway, T ; Roberts, C ; Parris, R ; Hassan, Z ; Thomas, M ; Smith, M ; Lecky, F
descriptionBackgroundHead injuries are a common emergency department (ED) presentation. The National Institute for Health and Clinical Excellence (NICE) updated its guidance in September 2007 regarding imaging required for patients with head injuries.MethodsA two-centre observational ED study was carried out, examining imaging practice in adults and children with head injuries attending pre-guideline and post-guideline implementation. Guideline implementation occurred through a formal implementation programme at the teaching hospital, and informally at the district general hospital (DGH). Retrospective extraction took place of prospectively recorded data case records and radiology department imaging registers. Pre-implementation data were collected from Salford Royal Foundation NHS Trust (SRFT) from January and February 2008 and post-implementation data in May 2008. Post-implementation data was collated from Royal Bolton Hospital Foundation NHS Trust (RBFT) from September to November 2007. Compliance with NICE 2007 was the primary outcome assessed.ResultsWith the implementation of NICE 2007 guidelines at SRFT, a significant increase in compliance from 94.2% (92.9–95.5) to 98.8% (98.2–99.3) was observed for adults requiring head CTs, with an overall trend to improved clinical practice in the adult patient populations. However, a significant number of children (SRFT 68.7% and RBFT 77.1%) did not receive the indicated head CT scan following a head injury, after implementation of the guidelines.ConclusionsThe SRFT implementation strategy employed was successful for adults, with the overall trend to increased clinical compliance post-guideline introduction. Evidence of a reluctance to adhere to the NICE recommendations for children indicated for CT head scan after a head injury was observed.
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subjectAdult ; Adults ; Age ; Child ; Child, Preschool ; Children & youth ; Clinical medicine ; Coma ; Compliance ; Consciousness ; Craniocerebral Trauma - diagnostic imaging ; Data collection ; Diagnosis ; Emergency Service, Hospital - standards ; Female ; Fractures ; Guideline Adherence - standards ; head ; Head injuries ; Hospitals, District - standards ; Hospitals, General - standards ; Humans ; Imaging ; Infant ; Male ; Medical imaging ; Neurosciences ; Practice guidelines (Medicine) ; Practice Guidelines as Topic ; Signs ; Studies ; Tomography, X-Ray Computed - utilization ; trauma ; Vehicles
ispartofEmergency medicine journal : EMJ, 2011-09, Vol.28 (9), p.778-782
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descriptionBackgroundHead injuries are a common emergency department (ED) presentation. The National Institute for Health and Clinical Excellence (NICE) updated its guidance in September 2007 regarding imaging required for patients with head injuries.MethodsA two-centre observational ED study was carried out, examining imaging practice in adults and children with head injuries attending pre-guideline and post-guideline implementation. Guideline implementation occurred through a formal implementation programme at the teaching hospital, and informally at the district general hospital (DGH). Retrospective extraction took place of prospectively recorded data case records and radiology department imaging registers. Pre-implementation data were collected from Salford Royal Foundation NHS Trust (SRFT) from January and February 2008 and post-implementation data in May 2008. Post-implementation data was collated from Royal Bolton Hospital Foundation NHS Trust (RBFT) from September to November 2007. Compliance with NICE 2007 was the primary outcome assessed.ResultsWith the implementation of NICE 2007 guidelines at SRFT, a significant increase in compliance from 94.2% (92.9–95.5) to 98.8% (98.2–99.3) was observed for adults requiring head CTs, with an overall trend to improved clinical practice in the adult patient populations. However, a significant number of children (SRFT 68.7% and RBFT 77.1%) did not receive the indicated head CT scan following a head injury, after implementation of the guidelines.ConclusionsThe SRFT implementation strategy employed was successful for adults, with the overall trend to increased clinical compliance post-guideline introduction. Evidence of a reluctance to adhere to the NICE recommendations for children indicated for CT head scan after a head injury was observed.
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atitleEmergency head injury imaging: implementing NICE 2007 in a tertiary neurosciences centre and a busy district general hospital
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abstractBackgroundHead injuries are a common emergency department (ED) presentation. The National Institute for Health and Clinical Excellence (NICE) updated its guidance in September 2007 regarding imaging required for patients with head injuries.MethodsA two-centre observational ED study was carried out, examining imaging practice in adults and children with head injuries attending pre-guideline and post-guideline implementation. Guideline implementation occurred through a formal implementation programme at the teaching hospital, and informally at the district general hospital (DGH). Retrospective extraction took place of prospectively recorded data case records and radiology department imaging registers. Pre-implementation data were collected from Salford Royal Foundation NHS Trust (SRFT) from January and February 2008 and post-implementation data in May 2008. Post-implementation data was collated from Royal Bolton Hospital Foundation NHS Trust (RBFT) from September to November 2007. Compliance with NICE 2007 was the primary outcome assessed.ResultsWith the implementation of NICE 2007 guidelines at SRFT, a significant increase in compliance from 94.2% (92.9–95.5) to 98.8% (98.2–99.3) was observed for adults requiring head CTs, with an overall trend to improved clinical practice in the adult patient populations. However, a significant number of children (SRFT 68.7% and RBFT 77.1%) did not receive the indicated head CT scan following a head injury, after implementation of the guidelines.ConclusionsThe SRFT implementation strategy employed was successful for adults, with the overall trend to increased clinical compliance post-guideline introduction. Evidence of a reluctance to adhere to the NICE recommendations for children indicated for CT head scan after a head injury was observed.
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pmid21030548
doi10.1136/emj.2009.083360