A quality improvement project to reduce magnetic resonance imaging sedation in children.

IF 2.3 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-08-06 DOI:10.1007/s00247-025-06293-4

Juan Boriosi, Christina Bryndzia, Michael Lasarev, Justin Brucker, Susan Rebsamen, Teresa Chapman, Brianna Peterson, Megan Peters

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引用次数: 0

Abstract

Background: Our institution decided to implement an awake MRI scanning quality improvement project using audiovisual distraction (AVD) technology.

Objective: To reduce the utilization of minimal/moderate sedation by at least 20% in children 4 to 18 years, while maintaining comparable diagnostic quality and adhering to allotted exam times, through the implementation of an awake MRI program.

Materials and methods: This project was conducted at a pediatric sedation clinic between October 2021 and January 2024. We included patients 4 to 18 years of age, scheduled for an MRI at the pediatric hospital, and eligible for either minimal/moderate sedation or AVD. The outcome measure was the percentage of patients referred to our sedation clinic who completed an MRI with AVD and without sedation, analyzed on a statistical process control (SPC) P-Chart. Process measures were the number of children eligible for AVD per month, analyzed on an SPC C-Chart. Balance measures were the number of studies that exceeded allotted exam time or were non-diagnostic.

Results: Of 734 MRI referrals aged 4 to 18 years, 320 patients met inclusion criteria. Two hundred twenty-eight (71.3%) received minimal/moderate sedation (mean age [SD] 9.7 years [± 3.0]) and 92 (28.8%) underwent AVD (mean age 10.0 years [± 2.7]). The average monthly decrease in minimal/moderate sedation use was 28.8 percentage points. The average number of children considered eligible for AVD increased by special cause variation from 3.8 to 7 patients per month. All 92 MRI referrals triaged to AVD completed their MRI successfully without sedation; all studies were diagnostic, and 96% of studies were within the allotted exam time.

Conclusion: We implemented an awake MRI program with AVD that decreased monthly sedation needs by 28.8 percentage points while maintaining a high rate of diagnostic studies and no MRI delays.

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减少儿童核磁共振成像镇静的质量改进项目。

背景：我院决定实施一项使用视听分散（AVD）技术的清醒MRI扫描质量改善项目。目的：通过实施清醒MRI程序，将4 - 18岁儿童的轻度/中度镇静的使用率降低至少20%，同时保持相当的诊断质量并坚持分配的检查时间。材料与方法：本项目于2021年10月至2024年1月在某小儿镇静门诊进行。我们纳入了4至18岁的患者，计划在儿科医院进行MRI检查，并符合轻度/中度镇静或AVD的条件。结果测量是通过统计过程控制（SPC） p -图分析，在我们的镇静诊所完成有AVD和没有镇静的MRI检查的患者的百分比。过程测量是每月符合AVD条件的儿童数量，在SPC c图上进行分析。平衡指标是超过分配的检查时间或非诊断性研究的数量。结果：734例4 ~ 18岁的MRI转诊患者中，320例符合纳入标准。228例（71.3%）接受轻度/中度镇静治疗（平均年龄[SD] 9.7岁[±3.0]），92例（28.8%）接受AVD治疗（平均年龄10.0岁[±2.7]）。轻度/中度镇静使用的平均每月下降28.8个百分点。由于特殊原因的变化，被认为符合AVD条件的儿童的平均数量从每月3.8例增加到7例。所有92例被诊断为AVD的MRI转诊患者在没有镇静的情况下成功完成了MRI检查；所有的研究都是诊断性的，96%的研究在规定的检查时间内完成。结论：我们对AVD患者实施清醒MRI方案，在保持高诊断率和无MRI延迟的同时，每月镇静需求减少28.8个百分点。

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

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.