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Feasibility Check: Renal Colic Management in Oman Hospitals

   

Added on  2019-09-16

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Outline/Proposal FormEvaluation of a healthcare innovation in practice (clinical audit with pre- and post-change evaluation)Student’s Name andProfessionWorking Title(Maximum 30 words) Plain CT KUB as a First Diagnostic Option for Renal Colic PatientsIn Sohar HospitalAudit areaGive the topic and professional/clinical area for your research.Plain CT KUB as a First Diagnostic Option for Acute Renal ColicPatients in Sohar HospitalRadiology Department Audit question Must be accurate, succinct and answerableCan Plain KUB CT scan be used as the first diagnostic option for acute renal colic patients at Sohar Hospital? Aims/ObjectivesConsider primary and secondary aims/objectives for your audit. 1)Establish new imaging protocol for acute renal colic patients.2)Minimise renal colic patient`s radiology waiting list.3)Reduce renal colic patient’s treatment pathway. A new Lithotripsy Unit has been recently introduced in Sohar Hospital. This study aims to establish new imaging protocol in order to help renal colic patients in terms of diagnosis and treatment pathway as the current imaging protocol is complicated.Brief justification for work Brief review of the key literature, demonstrating ‘need’ for the research and possible clinical relevance or implications(Maximum 250 words)Computed tomography of the kidneys, ureter and bladder (CT KUB) has become the reference technique in medical imaging for renal colic patients, to diagnose, plan treatment and explore differential diagnosis. Despite the limitations and the radiation risk of CT scan; CT KUB is the accepted gold standard investigation forsuspected renal colic and it replaces intravenous urography (IVU) in many hospitals because it is a diagnostically superior (sensitivity 97-98 %, specificity 96 – 100 %), contrast-free, quicker, safer and more cost effective investigation for acute renal colic (Bariol et al., 2005; Chowdhury et al., 2007; Kennish et al., 2008; Yong, 2009; CML June2015
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Patatas et al., 2012).Sohar Hospital in Oman is a 400 bed hospital which serves a population of over half a million people, and it has only one CT machine and two ultrasound machines which are used for eight hours every day a week. In fact, with reference to the statistics of Radiology Department at Sohar Hospital; there were about 1420 CT KUB examinations donein the period between January 2013 and July 2016, all those patients definitely have done some radiological examination as initial investigation such as: US, IVU or plain KUB x-ray (Sohar Hospital, 2016). This means that patient radiological investigation was delayed (appointments after 3 months), increased risk of patient radiation dose, increased risk of contrast reaction and unnecessary waste of radiological facilities which of course end with complicated patient management and treatment pathway.Early and accurate diagnosis of renal colic which is crucial as it plays a major role in the early management of the condition as well as post treatment planning (Ripolles et al., 2004; Rucker et al., 2004).Feasibility CheckDetail where and how you have checked for existing research in this area, and show how your question will add to any existing research (Include key references you have found)Two ways of search were conducted in order to check how this issue is manged with other institutions.1)A survey of clinical protocols being used in Oman hospitals will becarried out to find out how each hospital manages renal colic patients. This will be a telephone interview with the Head of Radiology Department of individual hospitals. 2)Initial literature review of radiology journals, which was conducted via Hertfordshire University study net library through research engines such as: PubMed, Science Direct, CINHAL Plus.(see appendix 1 for a list of references)Proposed methodology Detail your approach and audit design. eg proposed change/s and their measurement and evaluation,data collection methods, sample, recruitment, etcType of analysis: detail how you The initial methodology of this study was a mixed method design for data collection. Mixed method is used to combine qualitative and quantitative data in order to maximise the strengths of each, CML June2015
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