Investigating the initial effect of COVID-19 on the functioning of outpatient diagnostic imaging facilities

Pandemic preparedness of diagnostic radiographers during COVID-19: A scoping review

INTRODUCTION

As chest imaging is a tool for detecting coronavirus disease 2019 (COVID-19), diagnostic radiographers are a key component of the frontline workforce. Due to its unforeseen nature, COVID-19 has challenged radiographers' preparedness in combating its effects. Despite its importance, literature specifically investigating radiographers' readiness is limited. However, the documented experiences are prognostic of pandemic preparedness. Hence, this study aimed to map this literature by addressing the question: 'what does the existing literature reveal about the pandemic preparedness of diagnostic radiographers during COVID-19?'.

METHODS

Using Arksey and O'Malley's framework, this scoping review searched for empirical studies in MEDLINE, Embase, Scopus, and CINAHL. Consequently, 970 studies were yielded and underwent processes of deduplication, title and abstract screening, full-text screening, and backward citation searching. Forty-four articles were deemed eligible for data extraction and analysis.

RESULTS

Four themes that reflected pandemic preparedness were extrapolated: infection control and prevention, knowledge and education, clinical workflow, and mental health. Notably, the findings highlighted pronounced trends in adaptation of infection protocols, adequate infection knowledge, and pandemic-related fears. However, inconsistencies in the provision of personal protective equipment, training, and psychological support were revealed.

CONCLUSION

Literature suggests that radiographers are equipped with infection knowledge, but the changing work arrangements and varied availability of training and protective equipment weakens their preparedness. The disparate access to resources facilitated uncertainty, affecting radiographers' mental health.

IMPLICATIONS FOR PRACTICE

By reiterating the current strengths and weaknesses in pandemic preparedness, the findings can guide clinical practice and future research to correct inadequacies in infrastructure, education, and mental health support for radiographers in the current and future disease outbreaks.

Utilization of a rapid diagnostic centre during the COVID-19 pandemic reduced diagnostic delays in breast cancer

BACKGROUND

Access to breast imaging was restricted during the first wave of the COVID-19 pandemic. We assessed the impact of healthcare restrictions on the Gattuso Rapid Diagnostic Centre (GRDC) at the Princess Margaret Cancer Centre.

METHODS

A retrospective review of patients seen at the GRDC between March 12 - August 31, 2020 and the corresponding period from 2019 was performed.

RESULTS

There was an 18.6% decrease in patients seen at the GRDC (n = 429 in 2020 vs. 527 in 2019). Time from the first abnormal breast image to diagnosis was significantly shorter (17.4 days [IQR 13.0-21.8] in 2020 vs. 25.9 days [21.0-30.8] in 2019; p = 0.020) with no appreciable difference in time from diagnosis to consult or from consult to surgery.

CONCLUSION

The GRDC enabled patients with concerning breast symptoms to access breast imaging, which helped to ensure timely treatment during the first wave of the pandemic.

The impact of the SARS-CoV-2 pandemic on the management of chronic limb-threatening ischemia and wound care

In the wake of the coronavirus pandemic, the critical limb ischemia (CLI) Global Society aims to develop improved clinical guidance that will inform better care standards to reduce tissue loss and amputations during and following the new SARS‐CoV‐2 era. This will include developing standards of practice, improve gaps in care, and design improved research protocols to study new chronic limb‐threatening ischemia treatment and diagnostic options. Following a round table discussion that identified hypotheses and suppositions the wound care community had during the SARS‐CoV‐2 pandemic, the CLI Global Society undertook a critical review of literature using PubMed to confirm or rebut these hypotheses, identify knowledge gaps, and analyse the findings in terms of what in wound care has changed due to the pandemic and what wound care providers need to do differently as a result of these changes. Evidence was graded using the Oxford Centre for Evidence‐Based Medicine scheme. The majority of hypotheses and related suppositions were confirmed, but there is noticeable heterogeneity, so the experiences reported herein are not universal for wound care providers and centres. Moreover, the effects of the dynamic pandemic vary over time in geographic areas. Wound care will unlikely return to prepandemic practices. Importantly, Levels 2–5 evidence reveals a paradigm shift in wound care towards a hybrid telemedicine and home healthcare model to keep patients at home to minimize the number of in‐person visits at clinics and hospitalizations, with the exception of severe cases such as chronic limb‐threatening ischemia. The use of telemedicine and home care will likely continue and improve in the postpandemic era.

Coronavirus-related anxiety and fear among South African diagnostic radiographers working in the clinical setting during the pandemic

Introduction

The current coronavirus pandemic has impacted the healthcare sector significantly. Policies and practices had to be amended to ensure maximum safety for both patients and healthcare professionals, including radiographers. This led to negative impacts on the occupational wellbeing and mental health of radiographers.

Purpose

The aim of this study was to fill the gap in knowledge about coronavirus-related anxiety and fear among diagnostic radiographers across South Africa in order to inform policy and practice so as to mitigate the negative influence the coronavirus pandemic conditions has on the occupational wellbeing of diagnostic radiographers working on the frontline.

Methodology

A quantitative, descriptive research design, using a cross-sectional approach, was employed. Two-hundred and forty-eight (n=248) South African diagnostic radiographers working in the clinical setting during the current coronavirus pandemic were recruited through social media. Data pertaining to their coronavirus-related anxiety and fear were collected through a digital questionnaire comprising three parts: demographics, coronavirus anxiety scale (CAS), and fear of coronavirus-19 scale (FCV-19S).

Results

Most of the participants’ coronavirus anxiety scale scores are indicative of probable dysfunctional anxiety (69.8%). The participants had higher levels of coronavirus-related fear compared to anxiety. Anxiety levels were dependent on biological sex. For all other demographic variables anxiety and fear levels were independent.

Conclusion

Support strategies should be implemented to mitigate the negative impacts of a pandemic such as the coronavirus pandemic on the occupational wellbeing and mental health of diagnostic radiographers. More research in this area is recommended to inform future policy and workforce development as well as practice amendments.

Computed tomography during the COVID-19 pandemic: A survey of changes to service delivery, working practices and decision-making role of radiographers

INTRODUCTION

During the COVID-19 pandemic, Computed Tomography (CT) departments have established additional acute capacity whilst maintaining essential services. The purpose of this study was to investigate the changes in service delivery, working practices and decision-making role of diagnostic radiographers during the pandemic.

METHODS

We conducted an electronic cross-sectional survey of diagnostic radiographers working in CT during the COVID-19 pandemic. The survey was open for 6-weeks, with radiographers from all geographical regions encouraged to respond. The questionnaire explored social distancing, patient scheduling and departmental organisation; PPE usage; recognition and escalation of COVID-19 changes, patient management pathways and any training. Additionally, we sought the personal perspectives of radiographers through free text comments.

RESULTS

Following exclusions, 180 responses were analysed. Service delivery changes included social distancing (59.4%; n= 107), restriction of referrals to those considered time-critical (63.3%; n=114) and dedicated COVID-19 scanners (66.1%; n=119). Working practices were impacted by a need to implement PPE, although variation in PPE worn for different scenarios was seen. Half of the radiographers were routinely reviewing asymptomatic outpatient images for common COVID-19 signs, despite 63.5% of respondents not receiving formal training. Ad hoc patient pathways were in place in 90.5% of cases with 35% indicating that this was radiographer-led. CT staff had experienced anxiety, fatigue, and low morale, but praised teamwork.

CONCLUSIONS

Radiographers were able to reduce the risk of transmission through social distancing, designated scanners, and PPE. This study has demonstrated that despite variance in practice, radiographers play a key role in identifying and triaging high-risk patients.