1554 An educational programme focusing on paediatric fracture identification maintains a low false-negative radiograph initial report rate in emergency medicine

Fox, T; Rowland, A

Abstract

Introduction: False negative radiograph reports constitute greater
than 80% of all diagnostic errors in Emergency Departments (EDs)
with reported levels of false negative initial reports around 1%.
Method: The records of all patients recalled to the Emergency
Department clinics for management of a possible false-negative initial radiograph report were examined (n=46), following which the junior emergency medicine doctors received three tutorials on fracture identification and management. A re-audit was completed.
Results: Between 1st September 2010 and 16th January 2010 a falsenegative radiograph report rate of 0.72% was identified. There were proportionally more false negatives in patients aged under 16. Between 16th January and 31st May 2011, after the educational intervention, the false negative radiograph report rate had dropped to 0.62%. The percentage reduction in false negative reports was 13.8% (p=0.53).
Conclusions: These results suggest that a well developed educational programme is an effective way of maintaining a low level of false negative initial reports in an Emergency Department.
False negative reports were most likely in fractures of the foot,
wrist, elbow and those in the paediatric population. Educational
sessions should focus on identification of these fractures. Mistakes
in diagnosis can occur when an inexperienced clinician dismisses a positive clinical examination after mis-interpreting an imaging
investigation. Encouraging senior review of paediatric radiographs
could help to maintain a low false-negative report rate.
This study indicates that educational interventions may have
the potential to improve patient care in the Emergency Department
setting. Further ways to reduce human error need to be explored.

Citation

Fox, T., & Rowland, A. (2012). 1554 An educational programme focusing on paediatric fracture identification maintains a low false-negative radiograph initial report rate in emergency medicine. Archives of Disease in Childhood, 97(Suppl), A440-A440. https://doi.org/10.1136/archdischild-2012-302724.1554

• Journal Article Type: Article
• Online Publication Date: Sep 6, 2014
• Publication Date: Oct 1, 2012
• Deposit Date: Apr 11, 2017
• Journal: Archives of Disease in Childhood
• Print ISSN: 0003-9888
• Publisher: BMJ Publishing Group
• Volume: 97
• Issue: Suppl
• Pages: A440-A440
• DOI: https://doi.org/10.1136/archdischild-2012-302724.1554
• Publisher URL: https://doi.org/10.1136/archdischild-2012-302724.1554
• Related Public URLs: http://adc.bmj.com/