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Computer Tomography (CT) for head injury: adherence to the National Institute for Health and Care Excellence (NICE) criteria

Harris, L; Axinte, L; Campbell, P; Amin, N; (2019) Computer Tomography (CT) for head injury: adherence to the National Institute for Health and Care Excellence (NICE) criteria. Brain Injury , 33 (12) pp. 1539-1544. 10.1080/02699052.2019.1658130. Green open access

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Abstract

Objective Head injury is a common presentation to the emergency department yet adherence to guidelines for management is suboptimal. Our study assesses adherence to National Institute for Health and Care Excellence (NICE) computed tomography (CT) head guidelines at a teaching hospital in the United Kingdom. It critically evaluates the efficacy of interventions. Methods We performed a quality improvement project to improve adherence to NICE CT head scan guidelines following head injury. Data was collected over one-month in 2014, and 2017. Interventions included education of the multidisciplinary team, information sheets, team engagement and tri-annual education sessions for junior doctors. The success of these interventions in the adult population was assessed objectively during the second cycle and subjectively via a junior doctor survey. Results 171 patients were included in the study. Following interventions, there was a statistically significant decrease of 23% in the number of CT heads requested with no clear indication (P = 0.00027). The mean time to scan for the one-hour indications decreased from 73 to 55 minutes. The mean time to report all scans decreased from 89 to 57 minutes. The survey results were encouraging. Conclusion Adherence to NICE guidelines for head injury is inadequate but can be improved by interventions.

Type: Article
Title: Computer Tomography (CT) for head injury: adherence to the National Institute for Health and Care Excellence (NICE) criteria
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/02699052.2019.1658130
Publisher version: https://doi.org/10.1080/02699052.2019.1658130
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Neurosciences, Rehabilitation, Neurosciences & Neurology, Head injury, guidelines, quality improvement, interventions, CT scans
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10089261
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