Enhancing safety in intravenous contrast practice: A multi-disciplinary initiative to improve oversight and patient management.

Abstract

Introduction: Historically, adverse reactions to intravenous contrast media at our service were documented via RiskMan only. However, this process lacked transparency and direct utility for radiology clinicians, limiting oversight, trend identification and safe planning for subsequent contrast studies. Method(s): In mid 2024, a Contrast Safety Committee was formed, comprising radiologists, radiographers, a quality manager and an allergist. Two baseline assessments were conducted: 1) an audit of all contrast reactions in 2023 revealed inconsistent, incomplete or poor-quality documentation; and 2) a staff survey found limited knowledge in recognising reactions and following safety protocols. A standardised signs and symptoms checklist was developed for immediate use when a reaction occurs. This checklist is scanned into the radiology information system and used by radiologists to guide contrast decisions for future imaging. Targeted continuing professional development sessions were delivered to radiographers, focussing on early recognition of reactions and patient deterioration. Patients experiencing a reaction now receive personalised information for subsequent providers Results: Post-implementation, documentation completeness and clarity have improved, and staff confidence in recognising reactions is increasing (via post-CPD feedback). Radiologists report better access to relevant reaction histories for improved decision support. Patients appreciate receiving tangible documentation of their event. Conclusion(s): This multi-disciplinary, governance driven initiative demonstrates that structured documentation, embedded into the radiology information system, combined with staff education and patient communication, can strengthen the safety framework for IV contrast in medical imaging. It provides a scalable model for other services aiming to improve contrast reaction management and patient continuity of care.