Angiographic Patient's safety

1

• Angiographic Patient's safety

2

• ??????? Angiogram ?????????????????????
  ????????? ?????????????????????? ??????? ???????
  semi-invasive ????????????????????????????????????
  ?????????????????????????????? ?????
  ??????????????????????????????

3
???????????

• ?????????? angiography ???????????? 100
• ???????????????????????????????????????????
• ????????????????????????????

4
Arteriographic complications

• Puncture site
• Hematoma / Dissection/Thrombosis
• Pseudoaneurysm/AVF
• Infection
• Systemic
• Allergic contrast reaction
• Nausea ,vomiting, vasovagal syncope
• Catheter induced
• Subintimal tear

5
Classification of Complications by Outcome

• Minor complications
• No therapy, no consequence
• Nominal therapy, overnight admission for
  observation only
• Major complications
• Require therapy,hospitalization lt48 hrs.
• Require major therapy, unplanned increase in
  level of care,prolonged hospitalization gt48 hrs.
• Permanent adverse sequelae
• Death

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ANALYSIS of QUALITY IMPROVEMENT

• Important processes of care
• Patient selection
• Performance of procedure
• Monitoring the patient
• Management of material utility
• Reused materials
• Sterile procedure

7
????????????

• ????????????????????? complication
  ??????????????? review literature
• ?????????????????????????????????????????
• ??????????????????????
• ??????????? ??????????? ??????????????????
• ??????????? ??????????????? ?????????????????
  (Interdepartmental and MM
• conferences)

8
?????????????

• ????? Assessment ?????????????????????????????????
  ?????? ????????/?????????????????????
  ???????????? ?????????????? check list
  ???????????
• ????????????? Nursing recording form
  ????????????????????/????? ???????????????????????
  ???????????????????? ???????????????????
  interventional record ???????? ???????????????????
  ????????????????????????
• ?????????? ??????????????????????????????????
  Unit cost
• ????????????????????????????? ?????????????

9
????????????? (???)

• ?????????? ??????????????? ?????????????????????
• ????? follow up ??????? 24 ??????????????????
• ????????????????????????????????????????????????
  ?????????? ????????????????? ?????????????????
• ???????????????? conference ?????????????? major
  complication
• ???????????????????????????????????
  ??????????????? ?????????? ????? ???????????
  ?????????

10
Check list ?????????????????????????patient
grading

• ??????? ??????? ??????????????????
  ???-?????????????
• ????????????????????????????????? ????????????
  ???-?????????????
• ?????????????????????????????????????
  ????????????????? ???????????????????
• ???????????? ??????????????????????????????
  ?????????????????? ?????? ??????????????-?????????
  ???????? ????????????

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Universal standard Indicators

• ???????????? Major Complication lt 1
• ???????????? Minor Complication lt 10
• ????????????????????? follow up 24
  ?????????????????? gt80

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Perfected VIR care team

• Multidisciplinary team agreement
• CPG
• Patient counseling system
• Perfect data recording and analysis

13
REFERENCES

• ACR STANDARDS Diagnostic Arteriography
• Standard of Practice Committee of the Society of
  Interventional Radiology.Standard for diagnostic
  arteriography in adults.J Vasc Interv Radiol 2002

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Thank you