[The Knowledge Gained from Questionnaire Survey of the Patients Fall in the Radiological Examinations -Focus on the Severity Due to Fall Accidents].

PURPOSE: The purpose of this study is to analyze the factors of patient's fall that causes serious injury in the radiological examinations. METHODS: We conducted a questionnaire survey on cases of medical accidents occurring in the radiological examination department in medical institutions. The number of responses to the questionnaire surveys was 372. Among them, 197 cases were related to fall. The incident influence classification divided into eight clusters (0, 0H, 1, 2, 3a, 3b, 4, 5) was divided into three clusters (tiny, moderate, serious injury) depending on severity. We analyzed the factors that cause serious injury. RESULTS: In the case of patient's fall, several factors have been found to cause serious injury. The factors were general radiography, standing position, outside working hours. CONCLUSION: All falls can cause serious injury. To reduce falls, it is important to analyze what kind of patient and in what situation tend to fall, and prevent falls in advance.

[The Actual Condition of Fall Accident and Suggestion of Improvement for Accident Prevention in the Department of Radiology].

We conducted a questionnaire survey (situation, patient factor, environmental factor, operator factor, degree of disability, countermeasure etc.) on cases that occurred up to the present to investigate the actual situation of the medical accidents that occur in the radiological examination department of medical institutions. There were 373 questionnaires collected. Among them, there were 197 cases of falls. In this study, we examined the age of patients who fell, the background of the accident, and factors. As for the accident, 11.7% of accidents with risk impact level 3b or higher occurred including the fatal accident. Of the accidents, 44.2% were foreseeable and 55.8% were unforeseeable. The most accident-prone age was elderly in their 60s to 80s. As the causative factor for the accident, the patient factor was the largest at 63.5%. We can prevent about 30% of the accident by improving the operator factor and the environmental factor which are parts other than patient factor. It is important for us to understand what kind of people tend to fall. Among foreseeable accidents, the causes of patient factors can be reduced.

[The Prevention of the Root Accident in the Department of Radiological Examination Room -Analysis of the Results of Questionnaire Survey about Medical Accident to Many Hospital].

PURPOSE: The purpose of this paper is to analyze the characteristics of incidents related to routes and drains that occur in the radiological examination room for the prevention of these incidents. METHODS: We conducted a questionnaire survey on incident cases that occurred in the radiological examination room. There were 373 responses, of which 76 responses were related to routes and drains. The question contents were the number of hospital beds, radiology department of occurrence, time of occurrence, patient's situation, method of visiting, years of experience of the radiological technologists, and countermeasures, and so on. Based on these answers to these questions, we analyzed which factors were involved in the occurrence of the incidents. RESULTS: Incidents related to routes and drains often occur when moving examination table or transferring the patients to the examination table using the slider. On the other hand, the years of experience of the radiological technologists hardly participated in the factor of these incidents. From these answers to questions, 75% of incidents might predictable, and these incidents could be prevented by improvement of human factors accounted for the majority rather than that of physical factors. CONCLUSION: The number of incidents related to routes and drains may reduce by that all staff involved in the radiological examination recognizing the characteristic of these incidents.

[Analysis of the Environmental Factor of a Patient Falls in Department of Radiology-Proposal of Scientific Analysis Method in Patient Safety].

We analyzed 197 fall incidents in the questionnaire survey about the incident that occurred in Department of Radiology. In the past paper about the patient safety, there is no report that evaluated incident data directly. The purpose of this paper is to analyze the factor of the medical incidents using statistical technique scientifically. In this paper, we do not suggest concrete precaution. At first, we found the number of patients (each gender, modality, generation) in the five facilities of the coworker of one week. We found an incident rate from this patient total number, and we normalized data. As a result, we were able to do each risk evaluation because a risk ratio and relative risk degree was found. And, we were able to identify modality and the generation with the significant difference using the testing for differences in population rate. By our analyses, we revealed the chapter which must strengthen safety management.

Usefulness of real-time three-dimensional echocardiography in evaluating aortic root diameters during a cardiac cycle.

BACKGROUND: The preoperative evaluation of aortic root diameters is important for determining the surgical strategy in patients with aortic valve disease. The purpose of this study was to evaluate the usefulness of real-time three-dimensional echocardiography (3D-echo) for the evaluation of aortic root diameters compared with two-dimensional echocardiography (2D-echo) and to evaluate aortic root dynamics. METHODS: We prospectively investigated 23 patients with aortic stenosis (AS) and 37 normal controls. With 2D-echo, aortic root diameters were measured from the parasternal long-axis view. With 3D-echo, long-axis and short-axis views of the aortic root were reconstructed from the full-volume image, and aortic root diameters were measured at mid-systole, end-systole, mid-diastole, and end-diastole. These aortic root diameters were compared between 2D and 3D measurements, regarding intraoperative and computed tomographic measurements as the gold standard. In addition, dynamic changes of aortic root diameters during a cardiac cycle were evaluated. RESULTS: Aortic root diameters measured by 3D-echo were larger than those measured by 2D-echo (annular diameter 19.6 ± 2.1 vs. 21.2 ± 2.2 mm, p < 0.0001), and 3D measurements were closer to intraoperative and computed tomographic measurements than 2D measurements. The diameter of the aortic annulus increased during diastole, but the changes during a cardiac cycle were significantly smaller in patients with AS than in normal controls (2.0 ± 2.2 vs. 7.8 ± 3.4%, p < 0.0001). CONCLUSIONS: Aortic root diameters can be more accurately measured by 3D-echo than 2D-echo. Dynamic change of the aortic annulus during a cardiac cycle was smaller in patients with AS. 3D-echo is useful for the quantitative evaluation of the aortic root, including dynamics during a cardiac cycle.