A Dental Radiography Checklist as a Tool for Quality Improvement.

Purpose: A checklist intervention was applied to the dental radiographic acquisition process to determine its effectiveness in improving the diagnostic value of bitewing images and reducing patient exposure to unnecessary radiation. Methods: A mixed-method, nonrandomized research design using two dental hygiene program cohorts (n=33) as control and intervention groups was used to assess the effect of a radiographic checklist on the number and type of radiographic imaging errors. The relationship between perceived value of the checklist and willingness to continue its use was examined and analyzed using descriptive statistics. The effect of previous radiography experience, type and number of acquisition errors, and number of retake exposures were analyzed using Fisher's Exact test, chi-square analysis, Spearman's rho, ANOVA, Cronbach's alpha, Breslow-Day, and Pearson correlation coefficient test. Results: Checklist use did not contribute to an improvement in the diagnostic value of radiographs, nor did the intervention reduce patient exposure to unnecessary radiation. Additionally, analysis did not reveal a statistically significant difference between types of radiographic errors and previous radiography experience. A positive correlation was found between perceived value and willingness to continue checklist use. Conclusion: Similarities between the professions of medicine and dentistry suggest that dental procedures may also benefit from application of checklists. Although a positive association between checklist use and error and retake rate was not realized in this study, checklist use may help to improve the quality of radiographic exposures, thereby impacting patient safety by limiting unnecessary exposure to radiation. Additional research is needed to continue to evaluate the effects of checklist use on dental radiographs. As the body of knowledge related to checklist development and use continues to grow, dental hygienists can look for additional ways to incorporate checklists into practice.