Navigating the Contrast Shortage: Enhancing CT Scan Decision-Making with Nursing

Table of Contents

1. Introduction
2. The Impact of the Contrast Shortage on Hospital Operations
3. The Role of Nursing in the Decision-Making Process for CT Scans
4. The Importance of Including Nursing in Stroke Alerts
5. Addressing the Challenge of Ordering CT Perfusion Scans
6. The Influence of State Stroke Work Groups and Medical Directors
7. Prioritizing CT Scans with Contrast: Urgent vs. Routine Cases
8. Leveraging Technology to Support Decision Making
9. The Power of Collaboration: Engaging Multidisciplinary Teams
10. Conclusion

The Impact of the Contrast Shortage on Hospital Operations

🔍 Introduction

The scarcity of contrast in medical imaging has had a significant impact on hospital operations, particularly in the ordering and prioritization of CT scans. This article explores the challenges faced by Healthcare institutions due to the shortage of contrast, with a specific focus on the role of nursing in the decision-making process. By including nursing in stroke alerts and leveraging the expertise of multidisciplinary teams, hospitals can navigate this challenge effectively and ensure optimal patient care.

💡 The Role of Nursing in the Decision-Making Process for CT Scans

Nursing leaders play a crucial role in the decision-making process for ordering CT scans. Traditionally, the responsibility of choosing whether to proceed with CT scans fell solely on the providers. However, including nursing in this process has proven to be valuable. Nursing involvement empowers those at the bedside to advocate for the patient and contributes to informed decision-making.

⚙️ The Importance of Including Nursing in Stroke Alerts

One area where the inclusion of nursing in the decision-making process has been particularly beneficial is stroke alerts. In cases where patients Present with stroke symptoms but the diagnosis is not clear-cut, the provider may opt to order a CT perfusion scan. However, with the contrast shortage, it is no longer feasible to perform CT perfusions on every patient based solely on intuition or a "gut feeling." Nursing's inclusion allows for a more thorough evaluation of the need for a CT perfusion, ensuring the appropriate use of resources and the best possible care for the patient.

🔎 Addressing the Challenge of Ordering CT Perfusion Scans

The contrast shortage has necessitated a reevaluation of the criteria for ordering CT perfusion scans. Nursing professionals, in collaboration with the healthcare team, must determine whether a CT perfusion is truly necessary based on the patient's condition and symptoms. This calls for critical thinking, effective communication, and shared decision-making. By carefully assessing the urgency and need, nursing professionals can optimize the use of contrast resources, avoiding unnecessary scans and prioritizing those who truly require them.

🌐 The Influence of State Stroke Work Groups and Medical Directors

In Louisiana, the presence of a robust state stroke work group facilitated by the Louisiana Emergency Response Network has been instrumental in guiding healthcare facilities through the challenges posed by the contrast shortage. The state stroke medical director provides direction to facilities lacking certain capabilities, such as MRI or specific CT scans. These directives serve as a valuable resource, helping healthcare professionals make informed decisions and prioritize imaging studies based on patients' last known well and screening for large vessel occlusions.

⏳ Prioritizing CT Scans with Contrast: Urgent vs. Routine Cases

Given the limited availability of contrast, healthcare institutions must establish designated tiers for prioritization of CT scans. Urgent or emergent cases, such as trauma or stroke alerts, naturally receive higher priority. Routine follow-up or non-urgent cases fall lower on the tier. Effective communication with providers is essential in managing expectations and determining if less urgent cases can wait until the contrast shortage is resolved.

🖥️ Leveraging Technology to Support Decision Making

While electronic medical records (EMRs) do not currently incorporate best practice advisories for CT scan decision making, healthcare institutions with engaged multidisciplinary teams can utilize technology to support decision making. Implementing a call center with direct access to radiologists enables providers to Seek guidance for urgent or emergent cases. This integration of technology and expert advice ensures that healthcare providers can make informed decisions when facing uncertainty regarding the necessity of CT scans.

🤝 The Power of Collaboration: Engaging Multidisciplinary Teams

Navigating the challenges posed by the contrast shortage requires a collaborative approach. Nursing professionals should not work in isolation, but rather tap into the expertise of various stakeholders, including radiologists, interventional radiologists, CT and MRI technicians, pharmacy staff, and emergency room teams. By harnessing the collective knowledge and experience of the multidisciplinary team, nursing professionals can make well-informed decisions that prioritize patient care while managing resource limitations.

✅ Conclusion

The shortage of contrast in medical imaging has created a significant challenge for hospitals, impacting the way CT scans are ordered and prioritized. However, by involving nursing professionals in the decision-making process, leveraging guidance from state stroke work groups and medical directors, and promoting collaboration among multidisciplinary teams, healthcare institutions can mitigate the effects of the contrast shortage and ensure that patients receive the appropriate care. By maximizing the use of available resources and engaging all stakeholders, hospitals can navigate this challenging situation and continue to provide high-quality healthcare services.

Highlights

• The scarcity of contrast in medical imaging has greatly affected hospital operations.
• Including nursing in the decision-making process for CT scans enhances patient care.
• Nursing's involvement in stroke alerts empowers bedside advocates and optimizes resource utilization.
• Assessing the need for CT perfusion scans is crucial due to the shortage of contrast.
• State stroke work groups and medical directors provide valuable guidance for facilities.
• Prioritization of CT scans is essential, with urgent cases given higher priority.
• Utilizing technology and expert advice supports decision-making in uncertain cases.
• Collaboration among multidisciplinary teams is crucial in overcoming the contrast shortage.
• Nursing professionals should not work in isolation, but instead, utilize the expertise of various stakeholders.
• By involving all stakeholders and maximizing resource utilization, hospitals can mitigate the impact of the contrast shortage and provide quality care.

FAQ

Q: How is the shortage of contrast impacting hospitals? A: The contrast shortage has disrupted the ordering and prioritization of CT scans, requiring hospitals to carefully manage the use of available resources.

Q: What is the role of nursing in the decision-making process for CT scans? A: Nursing professionals play a valuable role in advocating for patients and contributing to informed decision-making regarding CT scans.

Q: How has the shortage affected the ordering of CT perfusion scans in stroke alerts? A: The contrast shortage has prompted a reevaluation of the criteria for ordering CT perfusions, ensuring they are performed only when necessary.

Q: What guidance is available for healthcare facilities dealing with the contrast shortage? A: State stroke work groups and medical directors provide valuable guidance for facilities lacking certain imaging capabilities.

Q: How are CT scans with contrast prioritized in hospitals? A: CT scans are prioritized based on the urgency of the case, with trauma or stroke alerts receiving higher priority.

Q: Is technology being utilized to support decision-making in CT scan ordering? A: While electronic medical records currently do not incorporate best practice advisories, call centers with direct access to radiologists support decision-making in uncertain cases.

Q: How can nursing professionals navigate the contrast shortage effectively? A: Nursing professionals should engage with multidisciplinary teams and leverage the collective expertise of various stakeholders in order to make informed decisions.

Q: How can hospitals continue to provide quality care during the contrast shortage? A: By maximizing resource utilization, involving all stakeholders, and prioritizing patient care, hospitals can navigate the contrast shortage successfully.