Comprehensive Contrast Reaction Management Training: A Quality Improvement Initiative for Direct Patient Care in Radiology

Purpose: Severe or misidentified reactions to the various contrast agents used in daily imaging acquisition can have adverse patient outcomes, particularly when there is lack of awareness of contrast reactions and appropriate management. The purpose of this initiative was to ensure practical patient safety, to improve confidence and accuracy of the personnel involved in contrast reaction management, and to better prepare residents for current and future practice.

Methods/Materials: “Plan Do Study Act'' model was used as the American Board of Radiology’s (ABR) required process for radiology Practice Quality Improvement (PQI) projects. Pre- and post-intervention surveys were distributed via SurveyMonkey. Surveyed information included the participant’s training level, subjective and numerical confidence level related to various contrast agents, and objective knowledge assessment with multiple choice questions. Interventions included a radiology faculty-led lecture, small group simulation lab session, and distribution of American College of Radiology (ACR) standard reference badge buddies. Phase 1 included radiology residents. Phase 2 included radiology, internal medicine, and transitional year residents and rapid response nurses.

Results: The survey data was analysed with SPSS version 25 software using a p value < 0.05 for significance. T-test was used for analyzing subjective confidence level and objective knowledge assessment changes. Fisher’s exact test was used for comparing reference resources used in contrast reaction management.
Phase 1 had 12 participants and a 100% survey response rate, and phase 2 had 100 participants and a 66% survey response rate. Both phases demonstrated a statistically significant increase in confidence level and improvement in accuracy for both knowledge of contrast media and management of reactions.

Conclusions: Comprehensive, formalized contrast reaction management training improves both confidence and accuracy of contrast reaction management in radiology residents and other personnel involved in contrast reaction management. Simulation sessions, badge buddies, and faculty-led lectures are the top three most helpful components in participants’ subjective opinion.