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Publication Type: Safety Information
Single or Multiple Incident: Multiple
Date: 1/13/2020 12:00:00 AM
Country: Australia
This alert discusses the potential for clinical errors and compromised patient outcomes when blue synthetic blankets are used during radiological procedures. The use of blue synthetic blankets during x-ray procedures, including mobile x-ray, general x-ray, fluoroscopy and angiography as they may result in artefacts presenting in the image. These artefacts may be interpreted as pathology and may impact patient clinical assessment and outcomes. It was identified that the RFID tags in some patient gowns, pillow cases, and sheets also have the potential to result in artefact during imaging. The alert provides recommendations to avoid artefacts from linen used during radiological procedures.

Additional Details

Device:
blue synthetic blankets

Rules / Policies / Procedures
  1. Blue synthetic blankets will be removed as an order item for all imaging departments across NSW Health. White cotton blankets will be offered as an alternative interim solution to be used in imaging departments as required.
  2. As blue synthetic blankets are used and returned to HealthShare NSW Linen Services from radiology departments, these will be replaced with white cotton blankets through the normal ordering processes via Linenweb.
  3. Where possible, remove or minimise linen from imaging field during any radiological procedure, including mobile x-ray, general x-ray, fluoroscopy and angiography
  4. If blankets or covers are required, do not use blue blankets and ensure minimal folds, bunching or creasing of the covering to reduce artefact

Use of linen in radiological procedures - potential artefact