Efficacy of the implementation of the National Emergency X-Radiography Utilization Study II decision rule to clinical practice for paediatric head injury patients

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Hautala , M , Koskela , U , Pokka , T , Rantala , H , Uhari , M , Serlo , W & Mikkonen , K 2021 , ' Efficacy of the implementation of the National Emergency X-Radiography Utilization Study II decision rule to clinical practice for paediatric head injury patients ' , Acta Paediatrica , vol. 110 , no. 7 , pp. 2200-2205 . https://doi.org/10.1111/apa.15859

Title: Efficacy of the implementation of the National Emergency X-Radiography Utilization Study II decision rule to clinical practice for paediatric head injury patients
Author: Hautala, Maria; Koskela, Ulla; Pokka, Tytti; Rantala, Heikki; Uhari, Matti; Serlo, Willy; Mikkonen, Kirsi
Contributor organization: Lastenneurologian yksikkö
Children's Hospital
HUS Children and Adolescents
Helsinki University Hospital Area
University of Helsinki
Date: 2021-07
Language: eng
Number of pages: 6
Belongs to series: Acta Paediatrica
ISSN: 0803-5253
DOI: https://doi.org/10.1111/apa.15859
URI: http://hdl.handle.net/10138/340430
Abstract: Aim To investigate the usefulness of the National Emergency X-Radiography Utilization Study (NEXUS) II head trauma decision rule in clinical practice for paediatric patients in a tertiary university hospital serving as the only paediatric hospital in the area. Methods We compared how doctors evaluated and examined patients with head injury during two time periods, before and after the introduction of NEXUS II decision rule. Multiple implementation strategies were used as follows: education, tutoring and written instructions for the use of NEXUS II. Results Two hundred and forty-four head injury patients visited the hospital before and 385 after the introduction of the NEXUS II decision rule. The number of hospital admissions (56%) and the mean duration of hospitalisation (2.5 days) remained the same during the two periods. In the NEXUS II evaluated group, there was a decrease of 40% in the number of hospital admissions. NEXUS II was applied in only 62 (16%) cases. The number of head imaging procedures remained the same. No patients with a clinically significant head injury were missed with the NEXUS II evaluation. Conclusion NEXUS II was ineffective as our implementation failed. When used, NEXUS II reduced expenses in our study population by decreasing the number of hospital admissions.
Subject: brain injury
clinical decision rule
head trauma
implementation
National Emergency X&#8208
Radiography Utilization Study II
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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