ABSTRACT
This study presented a model applied for potential risk assessment in an interventional radiology setting. The model of potential risk assessment (MARP) consisted of the creation of a scale of indicators ranging from 0 to 5. The radiation levels were categorized according to gender, kind of procedure, value of kerma air product (Pka), and accumulated radiation dose (mGy). The MARP model was applied in 121 institutions over 8 y. A total of 201 656 patient radiation doses (Dose-area product and accumulated kerma) data were launched into the system over time, with an average of 22 406 doses per year. In the context of the workers (cardiologists, radiographers, and nurses) monitored during the MARP application, 8007 cases (with an average of 890 per year) of occupational radiation doses were recorded. This study showed a strategy for quality evaluation in fluoroscopy using a model with a compulsory information system for monitoring safety.
Subject(s)
Occupational Exposure , Radiation Dosage , Humans , Fluoroscopy/methods , Risk Assessment/methods , Occupational Exposure/analysis , Occupational Exposure/prevention & control , Female , Male , Radiography, Interventional/adverse effects , Radiation Monitoring/methods , Radiation Protection/standards , Radiation Protection/methods , Radiology, Interventional/methods , Radiology, Interventional/standards , Radiation Exposure/analysisABSTRACT
Resumo: Introdução: A utilização de protocolos de ultrassonografia revolucionou o atendimento na medicina de emergência e pode auxiliar no diagnóstico de insuficiência respiratória no pronto atendimento. Assim, torna-se importante o treinamento médico para a utilização desses protocolos. Já foi demonstrado também que os aplicativos de smartphone médico têm resultados positivos na prática diária, além de serem uma ferramenta educacional potencialmente valiosa. Objetivo: Dessa forma, o objetivo deste estudo foi desenvolver um aplicativo em ultrassonografia pulmonar de emergência. O BLUE SIM é um aplicativo de celular que simula atendimentos de casos clínicos utilizando o protocolo Bedside Lung Ultrasound in Emergency, o qual pode auxiliar alunos e profissionais da área da saúde a usar a ultrassonografia pulmonar no atendimento da insuficiência respiratória aguda. A hipótese é que o BLUE SIM será um aplicativo usável e aceitável entre os usuários. Método: Após desenvolvido, avaliou-se o aplicativo com 36 voluntários: 18 fisioterapeutas, um médico, sete enfermeiros e dez acadêmicos de Medicina. Analisaram-se a usabilidade e a utilidade de uma aplicação móvel para o sistema iOS, utilizando como referências a escala de usabilidade System Utility Score (SUS) e o modelo de aceitação Technology Acceptance Model (TAM). Os dados obtidos foram tabulados e analisados pelo teste exato de Fisher ou Mann-Whitney. Resultado: Pela aplicação do questionário SUS (usabilidade), o aplicativo obteve um escore de 76,8%. Exclusivamente entre os fisioterapeutas, obteve-se um escore de 75%, não havendo diferença estatística entre o grupo geral de todos os profissionais emergencistas e o grupo somente de fisioterapeutas (p = 0,239). Segundo a análise de percepção de utilidade, 93,9% dos profissionais emergencistas responderam positivamente, enquanto, entre os fisioterapeutas, obteve-se um escore de 88,9% (p = 0,04). Conclusão: O aplicativo desenvolvido foi classificado de utilidade na aprendizagem do diagnóstico de insuficiência respiratória entre os profissionais, contudo eles consideraram que é necessário um treinamento para o uso da ferramenta.
Abstract: Introduction: The use of ultrasound protocols has revolutionized care in emergency medicine and can help in the diagnosis of respiratory failure in emergency care; therefore, medical training for the use of these protocols has become important. It has also been demonstrated that medical smartphone apps have positive results in daily practice, in addition to being a potentially valuable educational tool. Objective: Thus, the objective was to develop an emergency pulmonary ultrasound application. The "BLUE SIM" is a cell phone application that simulates clinical cases using the "Bedside Lung Ultrasound in Emergency" protocol, which can help students and health professionals regarding the use of pulmonary ultrasound in the care of acute respiratory failure. The hypothesis is that the "BLUE SIM" will be a usable and acceptable application among users. Method: After the development, the application was evaluated with a group of 36 volunteers, which included 18 physical therapists and 18 other professionals consisting of physicians, nurses and medical students. The usability and usefulness of a mobile application for the iOS system was analyzed, using the System Utility Score (SUS) usability scale and the Technology Acceptance Model (TAM) as references. The obtained data were tabulated and analyzed using Fisher's exact test or Mann-Whitney test. Result: When applying the SUS questionnaire (usability), the application obtained a score of 76.8%. A score of 75% was obtained exclusively among physical therapists, with no statistical difference between the general group of all emergency professionals and the group of physical therapists only (p=0.239). According to the usefulness perception analysis, 93.9% of the emergency professionals had a positive response, while a score of 88.9% was obtained among physical therapists (p=0.04). Conclusion: It was concluded that the developed application was classified as useful in learning the diagnosis of respiratory failure among health professionals; however, they considered that training is necessary for its use.
