109 out of 177 (62%) units responded to the survey.
The vast majority of these units provide interventions in CT,
USS,
fluoroscopic,
breast and radiology intervention suites.
Patient information:
The proportion of units providing patient information sheets varies from 73% in intervention procedures to 65% in fluoroscopic interventions.
Uniformity of Checklist use (Fig 5):
48% provide procedural checklists for all invasive procedures.
50% use checklists for some procedures.
2% do not use checklists.
Departmental policy:
58% of trusts which use a checklist have a supporting written departmental protocol.
29% do not.
(Fig 6).
13% of responders were not aware of whether a supporting written protocol existed.
2 units have a policy excluding particular procedures from use of checklists.
These included USS FNA,
USS musculoskeletal injections,
breast FNA/core biopsy/localisation/stereotactic procedures.
Use of checklists for different procedures:
The use of a checklist varied with the procedure undertaken.
For example in the Intervention suite checklists were performed in 95% of units,
CT drainages 79% and breast FNA 49% (Fig 7).
Form of the checklist in the intervention suite:
74% use the modified WHO checklist,
22% a local modification and 1% the CIRSE checklist.
Anaesthesia:
84% use a checklist for procedures under general anaesthesia,
60% for local anaesthesia and 39% for procedures under local anaesthesia.
Form of the checklist for minor procedures:
53% of units have a modified checklist for minor interventions,
25% a modified WHO and 23% a simplified local modification.
Consent:
This varied widely with procedure (Fig 8).
Written consent was used for all procedures in the intervention suite in 92% of cases (other units verbal or written depending on procedure).
Oral consent is used in the majority of minor interventions eg FNA including thyroid (66%).
Documentation and preservation of the record:
The vast majority of departments use a handwritten record (87%),
some a combination fo handwritten and electronic forms (12%) and only 1% electronic only (Figure 9).
Only 26% of departments could confirm they have a RIS system enabling adding an electronic checklist and in only 11% did the RIS system no allow completion of the examination without completion of the checklist.
Handwritten records were scanned in 73% of cases and stored in paper form.
Audit:
72% of departments undertook audit of the checklist process.
Difficulties in implementation:
There was variable compliance with 67% of departments reporting uniformity of checklist completion by staff members.
Units were asked about a variety of obstacles to implementation.
The data suggests that the process is generally perceived as valuable but that the greatest problems are commitment of different individuals and the feeling the checklist is too lengthy and not all data are necessary.
Time pressure and resources to scan paper checklists are also factors (Table 1).
What are the essentials for a checklist in radiological procedures outside the intervention suite?
Respondents were asked for their views about the value of different components of a safety check.
The responses illustrate that the most important safety checks depend on the particular procedure (Fig 10).