Presenting my QI poster at a national conference

by Clarissa Hjalmarsson on 29 January 2019

I was invited to present my poster, entitled, ‘Audit of Paediatric MRI Under Oral Sedation at West Suffolk Hospital’, at the British Paediatric Neurology Association (BPNA) Annual Conference held from 23rd- 25th January 2019, in Liverpool. The conference provided a fantastic opportunity to present an audit project that I assisted on during my summer placement in Bury St Edmunds, to learn more about neurology, and to meet other students and researchers. 

During my placement at West Suffolk Hospital this summer, I worked on several service evaluation and improvement projects under one of the paediatric consultants, Dr Arun Saraswatula, who has a special interest in paediatric neurology and migraine. I compiled a dataset of children treated for migraine with Greater Occipital Nerve Injection, and analysed outcomes of the 2018 cases of paediatric oral sedation for MRI. In addition, I assisted FY2 Dr Soltani in data extraction and analysis for the 2016 and 2017 cycles of a long-running audit of oral sedation for paediatric MRI and CT imaging. These projects provided an opportunity to integrate the statistics teaching I received in the IA course with my clinical knowledge, and to learn more about quality improvement initiatives.

Based on a similar protocol at Great Ormond Street Hospital in London, Dr Saraswatula’s team developed in-house sedation guidelines for paediatric oral sedation for MRI and CT scans. This allows West Suffolk Hospital to undertake scans on children using oral sedation at the hospital, rather than referring them to Addenbrooke’s for a general anesthetic. This protocol has been regularly audited since 2012 in order to meet documentation requirements, reduce the incidence of adverse events, and reduce the need for repeated imaging or referral to Addenbrookes. This pathway has become more pertinent in light of the recent guidelines that aim to phase out direct referrals for paediatric MRI to Addenbrookes in favour of oral sedation for MRI in the relevant district general hospitals. The carefully-refined protocol developed at WSH provides an excellent model for other district general hospitals in the region to draw on or emulate.

This was my first opportunity to work on an audit, and to convert it into a presentation and poster. It was highly rewarding to help to bring the team’s important work to a wider audience, particularly as the audit data evidences the high quality of the service provided at West Suffolk, and demonstrates the importance of a specialist nurse for paediatric MRI sedation.  It was also a great opportunity to get to know the paediatrics team at the hospital, including nurses, junior doctors, and consultants. I also had the pleasure of presenting the data from this audit at the Eastern Paediatrics Epilepsy Network (EPEN) Autumn 2018 Meeting earlier this term, held at Wolfson College, Cambridge. 

I had a wonderful time at the BPNA conference. I travelled to Liverpool after my pre-clinical lectures on Tuesday, and arrived the night before. I was fortunate enough to stay in a very friendly and welcoming hostel, from which I was able to walk to the conference through the city in the morning.

The poster and the results of our audit received positive feedback, and it was a pleasure to talk to other students and clinicians about their own research. I attended fascinating talks by a diverse range of academics, including Professor Helen Cross and Professor Tom Solomon. Specific talks on Fetal Acetylcholine Receptor Inactivation Syndrome (by Dr M O’Rahelly) and a keynote lecture by Professor Yanick Crow on interferonopathies were directly relevant to one of my MVST IB courses, Biology of Disease. I was grateful to have studied the pathways recently for the mock exams – I learnt a lot from the session and finally appreciated the rigorous scientific teaching in the pre-clinical medicine course! There were several presentations describing clinical trials of promising new drugs for the treatment of the most severe forms of epilepsy, and spinal muscular atrophy, which may well be used in clinical practice by the time I hope to qualify.

I am hugely grateful to Dr Saraswatula and Dr Soltani for giving me the opportunity to work with them, and for teaching me about QI initiatives and the specifics of the work. It is always a delight to work with clinicians who are passionate about improving services for patients, and I hope to continue working with Dr Saraswatula and his team during the summer.

The abstract and poster can be found in the BPNA 2019 Conference App, and will be published in the upcoming issue of Developmental Medicine and Child Neurology.

Thank you to Lucy for providing the funding to make exciting academic events like this happen!

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