Internal Audit to Monitor the Injected Activity in PET/CT Using Control Charts.

IF 1.2 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Quality Management in Health Care Pub Date : 2024-07-17 DOI:10.1097/QMH.0000000000000449

Sara Russo, Pedro Almeida, Teresa Lúcio, Luís Oliveira, Isabel Conde, Ana Aleixo, Ana Sofia Matos

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引用次数: 0

Abstract

Background and objective: In an effort to limit the risks associated with medical radiation exposure, the last century witnessed the development of dose control mechanisms, recommended by the International Commission on Radiological Protection. This organization recommends the optimization of radiation protection to provide the highest level of safety that may reasonably be achievable. Adhering to the "as low as reasonably achievable" principle, the purpose of this study was to monitor the 18F-FDG injected activity in PET and optimize the radiation protection through an internal audit process. This monitoring allows the identification of opportunities for improvement in patient care and safety, as well as to establish a periodic review of the medical unit reference levels.

Methods: The methodology is based on short run Quesenberry (Q) statistics and normalized nonconstant sample size (Z-chart) control charts. Anonymized data from 512 patients were selected from a set of 18F-FDG PET/CT (Siemens, Biograph 6) examinations performed during 10 months. The analyzed variable was the ratio between the 18F-FDG injected activity (MBq) and patient weight (kg).

Results: Mean injected 18F-FDG activity was 347.811 ± 64.967 MBq corresponding to a mean effective dose of 6.608 ± 1.234 mSv. The ratio between the 18F-FDG injected activity and the body mass of patients was reduced from 5.243 ± 0.716 to 5.171 ± 0.672 MBq/kg during the statistical data analysis. The study demonstrates that control charts can be a useful tool to signal situations where patients receive an activity significantly different from the standard practice in a medical unit.

Conclusion: The use of joint control charts is a suitable tool for detecting nonoptimized radiopharmaceutical administration. This analysis provides opportunities to evaluate and improve the quality of practice in nuclear medicine. This methodology constitutes an internal audit that may help health care professionals to make appropriate decisions to ensure all patients receive the safest and most appropriate care.

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使用控制图监控 PET/CT 注射活动的内部审计。

背景和目标：为了限制与医疗辐照相关的风险，上世纪在国际辐射防护委员会的建议下，建立了剂量控制机制。该组织建议优化辐射防护，以提供可合理实现的最高安全水平。根据 "在合理范围内尽可能低 "的原则，本研究的目的是监测 PET 中注射的 18F-FDG 活度，并通过内部审计流程优化辐射防护。通过这种监测，可以发现改善患者护理和安全的机会，并对医疗单位的参考水平进行定期审查：方法：该方法基于短期奎森伯里（Q）统计和归一化非恒定样本量（Z-图表）控制图。从 10 个月内进行的一组 18F-FDG PET/CT （西门子，Biograph 6）检查中选取了 512 名患者的匿名数据。分析变量为注射的 18F-FDG 活性（MBq）与患者体重（kg）之比：结果：18F-FDG 平均注射活性为 347.811 ± 64.967 MBq，平均有效剂量为 6.608 ± 1.234 mSv。在统计数据分析过程中，18F-FDG 注射活性与患者体重的比值从 5.243 ± 0.716 MBq/kg 降至 5.171 ± 0.672 MBq/kg。这项研究表明，控制图可以作为一种有用的工具，在患者接受的活动量与医疗单位的标准做法明显不同的情况下发出信号：结论：使用联合控制图是检测非优化放射性药物给药的合适工具。这种分析为评估和提高核医学实践质量提供了机会。这种方法是一种内部审计，可帮助医护人员做出适当的决定，确保所有患者都能得到最安全、最适当的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-

CiteScore

1.90

自引率

8.30%

发文量

108

期刊介绍： Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.