Hospital-Level Factors Associated with Use of Pediatric Radiation Dose-Reduction Protocols for Head CT: Results from a National Survey

Details

• Personal Author:
  Applegate KE ; Graves JM ; Jarvik JG ; Kanal KM ; Rivara FP ; Vavilala MS ; Applegate KE ; Graves JM ; Jarvik JG ; Kanal KM ; Rivara FP ; Vavilala MS
• Description:
  Objectives: To examine hospital-level factors associated with the use of a dedicated pediatric dose-reduction protocol and protective shielding for head CT in a national sample of hospitals. Methods: A mixed-mode (online and paper) survey was administered to a stratified random sample of US community hospitals (N = 751). Respondents provided information on pediatric head CT scanning practices, including use of a dose-reduction protocol. Modified Poisson regression analyses describe the relative risk (RR) of not reporting the use of a pediatric dose-reduction protocol or protective shielding; multivariable analyses adjust for census region, trauma level, children's hospital status, and bed size. Results: Of hospitals that were contacted, 38 were ineligible (no CT scanner, hospital closed, do not scan infants), 1 refused, and 253 responded (35.5% response rate). Across all hospitals, 92.6% reported using a pediatric dose-reduction protocol. Modified Poisson regression showed that small hospitals (0-50 beds) were 20% less likely to report using a protocol than large hospitals (>150 beds) (RR: 0.80, 95% confidence interval [CI]: 0.65-0.99; adjusted for covariates). Teaching hospitals were more likely to report using a protocol (RR: 1.10, 95% CI: 1.02-1.19; adjusted for covariates). After adjusting for covariates, children's hospitals were significantly less likely to report using protective shielding than nonchildren's hospitals (RR: 0.64, 95% CI: 0.56-0.73), though this may be due to more advanced scanner type. Conclusion: Results from this study provide guidance for tailored educational campaigns and quality improvement interventions to increase the adoption of pediatric dose-reduction efforts. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Hospitals Occupational Health Safety
• Keywords:
  Author Keywords: CT Imaging Protocols Children Hospital Equipment Imaging Techniques Medical Care National Survey Pediatric Head CT Radiation Control Radiation Dose Radiation Exposure Trauma Center

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• ISSN:
  1546-1440
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  Georgia ; OSHA Region 10 ; OSHA Region 4 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Volume:
  11
• Issue:
  7
• NIOSHTIC Number:
  nn:20055298
• Citation:
  J Am Coll Radiol 2014 Jul; 11(7):717-724.e1
• Contact Point Address:
  Janessa M. Graves, PhD, MPH, Washington State University College of Nursing-Spokane, P.O. Box 1495, Spokane, WA 99210-1495
• Email:
  janessa.graves@wsu.edu
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of the American College of Radiology
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2ae8163c344827c94759160cf30bca8e7a3a94a3afdbfa30913ad53ced5762df7fecc0ce48d352b57a5858ab1d3ea3beb0376173a1aa9b5947fa3ce17fcffaf0
• Download URL:
  https://stacks.cdc.gov/view/cdc/217636/cdc_217636_DS1.pdf
• File Type:
  [PDF - 353.62 KB ]