Prevention and management of allergic-like reactions to iodine contrast media: a best practice implementation project

ABSTRACT Introduction: With the wide application of iodine contrast media (ICM), the occurrence of allergic-like reactions to iodine contrast media (ALR-ICM) has increased. Strategies for the prevention and management of ALR-ICM need to be identified to provide quality care to patients undergoing enhanced computed tomography. Aim: The overarching aim of this project was to improve the prevention and management of ALR-ICM at a medical imaging center of a nearly 5,000-bed tertiary hospital in China. Methods: This project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted to measure current practices against recommended best practices. Feedback from the audit was used to identify barriers and design strategies to improve practice. A follow-up audit was conducted to measure changes in compliance with best practices. Results: The results revealed a positive change in compliance with best practices. More than 60% compliance with the four audit criteria was observed. The overall ALR-ICM rate decreased from 0.56% to 0.19%, while emergency equipment management dramatically increased from 37.50% to 100%. The smallest improvement was observed for pre-procedure prophylactic treatment of high-risk patients (27.66%). Conclusions: Most audit criteria showed moderate improvements in compliance with best practices. Further testing of this program in more hospitals is needed. Spanish abstract: http://links.lww.com/IJEBH/A269