Standardising infection control in CT intravenous contrast practice: an eDelphi study

Area of Science:

• Medical Imaging and Radiology
• Infection Prevention and Control
• Healthcare Policy

Background:

• Infection, prevention, and control (IPC) practices for intravenous (IV) contrast administration in computed tomography (CT) settings can vary.
• A lack of clear, relevant guidelines contributes to inconsistencies in CT IPC practices.
• Standardizing these practices is crucial for enhancing patient safety and reducing healthcare-associated infections.

Purpose of the Study:

• To develop consensus-based recommendations for IPC practices in CT.
• To establish guiding principles for Intravenous (IV) Contrast training and compliance.
• To define best practices for the use of IV contrast in CT environments.

Main Methods:

• A modified e-Delphi study was employed with a panel of experienced CT radiographers and nurses in Australia.
• Nineteen statements on IPC practices were evaluated using a 5-point Likert scale via online surveys.
• Consensus was defined as ≥75% agreement, with iterative modifications based on participant feedback over three rounds.

Main Results:

• Eighteen statements achieved consensus across three study rounds involving 24-34 participants.
• Consensus was reached on guiding principles, IV contrast sequencing, single- and multi-use systems, and general IPC considerations in CT.
• Statements regarding dripped contrast and tubing connections did not reach consensus or lost stability.

Conclusions:

• Eighteen IPC Guiding Principles and Best Practice statements for IV contrast administration in Australian CT departments were established.
• The findings highlight the need for standardized IPC training and clearer communication of policies.
• These recommendations can inform policy updates and guide future educational initiatives in diagnostic imaging.