上部消化管造影検査安全性への取り組み －検査前日に実施する合同カンファレンスの情報共有化の重要性－

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  • Actions to Ensure Safety in Upper Gastrointestinal Tract Contrast Examinations - Importance of Sharing Information in Joint Conferences on Day before Examinations -
  • ジョウブ ショウカカンゾウエイ ケンサ アンゼンセイ エ ノ トリクミ : ケンサ ゼンジツ ニ ジッシ スル ゴウドウ カンファレンス ノ ジョウホウ キョウユウカ ノ ジュウヨウセイ

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Objective: In our center, we determine the possibility of conducting upper gastrointestinal tract contrast examinations (hereafter MDL) after examining and interviewing examinees. In cases in which MDL is considered inapplicable at the time, the examination details are amended, either changing to endoscopy or conducting MDL at a later date. As it was considered important to have a system for ensuring the safety of examinations, we examined amendments that had been made to examination details in order to develop such a system.<br>Methods: From a list of examinees, we selected those in whom there had been amendments to MDL or it had been canceled, and classified the amendments according to 6 categories of reasons for amendment, by gender, age and number of examinations undertaken, and conducted a comparison.<br>Results: The examination was amended or canceled for 230 examinees, 0.9% of the total. Males accounted for 43% and females 57%; their average age was 55.6±11.8 years; by age group 72 were in their 50s (31.3%), 61 in their 60s (26.5%), 42 in their 40s (18.3%) and 24 in their 70s (10.5%). As reasons for amdendment or cancellation, there were 63 cases of poor physical condition (27.4%), 31 cases of postoperative adhesion (13.5%), 30 cases of severe constipation (13.0%), 17 cases of feeling of disgust, allergy, etc. (7.4%) and 82 cases of unspecified reason (35.7%). The number of examinations undertaken was 2-5 for 101 examinees (43.9%) and one for 73 (31.8%). The details of amendment were change to endoscopy in 125 cases (54.4%), MDL at later date in 61 cases (26.5%) and GI examination cancellation in 44 cases (19.1%).<br>Conclusion: Amendment was particularly frequent in women with poor physical condition, with constipation and feeling of disgust as major reasons. Important points in conducting MDL safely and efficiently were considered to be information collection procedures and capabilities, developing a system for sharing information, risk management and examinee education including instruction.

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