Quality improvement process in the adherence to gastric decontamination guidelines for poison exposures as recommended by a poison control center.

Abstract:

PURPOSE:Adherence to new guidelines for the use of ipecac syrup, gastric lavage, cathartics, and activated charcoal by a poison control center was studied with a quality improvement framework. METHODS:The rates of gastric decontamination were monitored through an electronic case record system. In February 2002, a revised guideline that narrowed the use of gastric decontamination was implemented with a performance improvement process. The rates of recommendation and utilization during 12 months following implementation of the new guidelines were compared with those during 12 previous months. RESULTS:Recommendations for the use of ipecac syrup declined from 1.50% to 0.02% (OR; 95% CI = 0.02; 0.01, 0.03), single-dose-activated charcoal declined from 5.39% to 1.38% (0.25; 0.22, 0.28), gastric lavage declined from 4.19% to 0.22% (0.05; 0.04, 0.06), and a cathartic declined from 1.48% to 0.13% (0.08; 0.06, 0.12). Declines in utilization were also significant (P < .001) for all forms of gastric decontamination. The proportions of patients managed at the scene of the poisoning were unchanged (1.04; 0.99, 1.09) before (67.64%) and after (68.50%) the new guidelines as were those for referral to a health care facility (20.57% and 21.42%, respectively, 1.05; 1.00, 1.11). CONCLUSION:Recommendations on gastric decontamination can be effectively modified with no detriment to patient outcome.

journal_name

Qual Manag Health Care

authors

Chyka PA,Winbery SL

doi

10.1097/00019514-200610000-00008

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

263-7

issue

4

eissn

1063-8628

issn

1550-5154

pii

00019514-200610000-00008

journal_volume

15

pub_type

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