Radiographers' areas of professional competence related to good nursing care

Radiographers' insights on the impact of their potential role in image interpretation within a low resource setting

INTRODUCTION

The global shortage of radiologists has led to a growing concern in medical imaging, prompting the exploration of strategies, such as including radiographers in image interpretation, to mitigate this challenge. However, in low-resource settings, progress in adopting similar approaches has been limited. This study aimed to explore radiographers' perceptions regarding the impact of their potential role in image interpretation within a low-resource setting.

METHODS

The study used a qualitative descriptive design and was conducted at two public referral hospitals. Radiographers with at least one year of experience were purposively sampled and interviewed using a semi-structured interview guide after consenting. Data saturation determined the sample size, and content analysis was applied for data analysis.

RESULTS

Two themes emerged from fourteen interviews conducted with two male and twelve female radiographers. Theme one revealed the potential for enhanced healthcare delivery through improved diagnostic support, bridging radiologist shortages, career development and fulfilment as positive outcomes of role extension. Theme two revealed possible implementation hurdles including radiographer resistance and reluctance, limited training, lack of professional trust, and legal and ethical challenges.

CONCLUSION

Radiographers perceived their potential participation positively, envisioning enhanced healthcare delivery, however, possible challenges like resistance and reluctance of radiographers, limited training, and legal/ethical issues pose hurdles. Addressing these challenges through tailored interventions, including formal education could facilitate successful implementation. Further studies are recommended to explore radiographers' competencies, providing empirical evidence for sustaining and expanding this role extension.

IMPLICATION FOR PRACTICE

The study further supports the integration of radiographers into image interpretation with the potential to enhance healthcare delivery, however, implementation challenges in low-resource settings require careful consideration.

Precision Workforce Management for Radiographers: Monitoring and Managing Competences with an Automatic Tool

Optimizing work shifts in healthcare is crucial for maintaining high standards of service delivery and fostering professional development. This study delves into the emerging field of skill-oriented work shift optimization, focusing specifically on radiographers within the healthcare sector. Through the development of Skills Retention Monitoring (SRH), this research aims to enhance skill monitoring, workload management, and organizational performance. In this study, several key highlights emerged: (a) Introduction of the SRH tool: The SRH tool represents a resource-efficient solution that harnesses existing software infrastructure. A preliminary version, focusing on the radiographers' professional profile, was released, and after several months of use, it demonstrated effectiveness in optimizing work based on competency monitoring. (b) The SRH tool has thus demonstrated the capacity to generate actionable insights in the organizational context of radiographers. By generating weekly reports, the SRH tool streamlines activity management and optimizes resource allocation within healthcare settings. (c) Application of a Computer-Assisted Web Interviewing (CAWI) tool for pre-release feedback during a training event. (d) Strategic importance of a maintenance and monitoring plan: This plan, rooted in a continuous quality improvement approach and key performance indicators, ensures the sustained effectiveness of the SRH tool. (e) Strategic importance of a transfer plan: Involving professional associations and employing targeted questionnaires, this plan ensures the customization of the tool from the perspective of each profession involved. This is a crucial point, as it will enable the release of tool versions tailored to various professions operating within the hospital sector. As a side result, the tool could allow for a more tailored and personalized medicine both by connecting the insights gathered through the SRH tool with the right competencies for healthcare professionals and with individual patient data. This integration could lead to better-informed decision making, optimizing treatment strategies based on both patient needs and the specific expertise of the healthcare provider. Future directions include deploying the SRH tool within the Pisa hospital network and exploring integration with AI algorithms for further optimization. Overall, this research contributes to advancing work shift optimization strategies and promoting excellence in healthcare service delivery.

Radiographers' perception of patient safety culture in radiology

INTRODUCTION

Radiographers play a central role in patient safety because of their knowledge of and responsibilities in relation to the imaging process. To maintain safe care, the workplace must create a safety culture that enables sustainable safety work.

AIM

This study aims to describe radiographers' perceptions of the patient safety culture in radiology units in Sweden.

METHODS

The Swedish Hospital Survey of Patients' Safety Culture (S-HSOPSC) was used to gather descriptive data from 171 Swedish registered radiographers working in five radiology clinics distributed across 15 units. Fifty-one questionnaire items and one open-ended question were analysed, comprising perceptions of the overall safety grade, the frequency of number of reported risks and events, and 14 composites regarding patient safety dimensions.

RESULTS

The radiographers' concerns surrounding the patient safety culture in their workplaces related to weaknesses regarding the safety dimensions "Staffing", "Frequency of error reporting", "Organizational learning - continuous improvement" and "Executive management support for patient safety". They perceived "Teamwork within the unit" to be a strength.

CONCLUSION

Despite some weaknesses in the patient safety culture, the radiographers perceived that the overall patient safety level was good, in part because of their ability to spot risks in time. The executive management, however, needed to improve their feedback on safety measures; and another reason for some weaknesses in the patient safety culture could be staffing issues such as lack of time for meetings for continuous improvement. Managers and leaders have a great responsibility to establish a patient safety culture through support and good leadership.

IMPLICATIONS FOR PRACTICE

An understanding of what creates a safety culture is important to prevent patient safety incidents.

Diagnostic radiography students' perspectives on cultural competence and safety

INTRODUCTION

Cultural competency and safety are essential components to consider in the provision of person-centred equitable healthcare. Therefore, student radiographers' learning should include the necessary knowledge, skill sets and competence to recognise the patient's unique characteristics to enable culturally competent and safe medical imaging services. Therefore, this study explored undergraduate and postgraduate diagnostic radiography students' perspectives on cultural competency and safety.

METHODS

A qualitative phenomenological design with a hermeneutic phenomenological approach was followed to explore student perspectives. Student radiographers (second and third-year undergraduate and first and second-year postgraduate) from the study site were purposively and conveniently recruited to participate in focus group interviews. Fifteen focus group interviews were conducted, recorded and transcribed verbatim before undergoing thematic analysis.

RESULTS

Thematic analysis identified two themes. Theme one centred around the cultural competence and safety learnt by student radiographers at university and the second theme cultural competence and safety learnt in workplace learning.

CONCLUSION

This study demonstrated the importance of cultural competence and safe practice in examining patients of different cultures. It highlights the importance of creating awareness among students of their own abilities and capabilities of cultural sensitivity and safe practice as part of their learning. Future health professionals should be empowered to address and respond to patients' unique needs in a competent, safe and professional manner to reduce health disparities.

IMPLICATIONS FOR PRACTICE

Cultural competence and safety are integral to person-centred care. Including these concepts in radiography education is therefore vital to ensure optimal patient outcomes.

Radiographers' experience of preventing patient safety incidents in the context of radiological examinations

AIM

To describe factors that prevent patient safety incidents in connection with the radiological examination from the radiographer's perspective.

BACKGROUND

Radiology plays an important role in the care chain and involves diagnostic examinations and treatments using various radiation sources and different techniques. Risks for patient safety incidents exist in every phase of a radiological examination. Appropriate use of medical imaging requires a multidisciplinary approach involving staff of different categories to meet the medical objectives and the patient's care needs. In accordance with a Safety-II approach, it is therefore important to understand why things go right and ensure that they do by supporting the conditions for right things to happen.

DESIGN

A qualitative study with a descriptive design.

METHODS

Semi-structured interviews were conducted with 17 radiographers. The data were analysed using theoretical thematic analysis based on the Systems Engineering Initiative for Patient Safety model.

RESULTS

The analysis yielded 20 sub-themes, which describe different success factors contributing to patient safety.

CONCLUSION

Proactive work should focus on collaboration and sharing the necessary knowledge, internally and externally, for care in connection with the radiological examination. The radiological and peri-radiographic knowledge should include monitoring the patient's safety needs before, during and after the radiological examination. The referring clinician has a central role in writing relevant referrals and the radiographer's competence is crucial in monitoring the patient's safety needs. A good patient safety culture is required and working with standards is important.

South African radiographers' radiation protection practices, a qualitative study

INTRODUCTION

Radiation protection is multifarious, and consequently, a radiographers' application of radiation protection is multifaceted. Studies have shown varying radiation protection practices among radiographers. The first quantitative phase of this explanatory, sequential mixed-method study used the theory of planned behaviour to explore South African radiographers' radiation protection behaviour. Overall, South African radiographers' attitudes to radiation protection, subjective norm, perceived behavioural control, and radiation protection intention was high. This second phase of the study aimed to explore the reasons for South African radiographers' radiation protection practices.

METHODS

This study used an exploratory and descriptive qualitative approach. Data was collected through 13 in-depth semi-structured telephone interviews. Thematic analysis was used in order to uncover original phenomena. Data saturation was achieved and the study adhered to trustworthiness and ethical measures.

RESULTS

Thematic analysis identified two themes. The participants had the appropriate radiation protection knowledge, but radiation protection compliance remained a personal choice. Impediments such as feeling rushed during imaging of trauma and challenging patients, patients knowledge of radiation protection, resources, imaging referrals, inadequate training when transitioning from analogue to digital radiography and managerial support contributed to radiation protection compliance. Strategies such as further education, research and a change in mindset were suggested to further foster radiation protection compliance.

CONCLUSION

Even though participants' knowledge of radiation protection aligned with the legislated guidelines, limited internalising of the knowledge resulted in compliance being a personal choice. Participants reflected on their insouciant attitude and observed a similar attitude in their radiographer colleagues. Patient and work-related impediments were identified to contribute to radiation protection compliance. Strategies to further foster compliance were suggested.

IMPLICATIONS FOR PRACTICE

Understanding the reasons for radiographers' choice in radiation protection will allow the development of strategies that foster optimum application of radiation protection practises. Developing a radiation protection culture that enhances personal compliance supported by education and evidence should be considered.

Does the introduction of a formal neutropenic sepsis protocol improve therapeutic radiographer confidence and competence at recognising sepsis within the radiotherapy department?

Aim:

The aim of this service review was to review whether implementing a formal training package increased therapeutic radiographer confidence and competence in recognising neutropenic sepsis in radiotherapy patients. In addition, authors also investigated whether the introduction of a weekly National Early Warning Score (NEWS) protocol had been successful in identifying cases of neutropenic sepsis.

Material and Methods:

Therapeutic radiographer (n = 13) views on the new protocol were collected through an online questionnaire. A review of the clinical observation sheets of patients who received chemo-radiotherapy (n = 49) between 18 April 2019 and 31 October 2019 was undertaken. Information on disease site, NEWS scores, number of patients who had become neutropenic and action taken by therapeutic radiographers was collected.

Results:

The majority of respondents to the questionnaire found that training benefitted both professionals and patients. Some challenges were highlighted relating to increased workload. For patients receiving regular observations, NEWS scores ranged from 0 to 4. When a patient scored on NEWS, the most common score was 1 across all treatment sites except cervix.

Findings:

Implementing a neutropenic sepsis protocol appears to be beneficial to therapeutic radiographers as professionals, increasing their confidence in patient assessment and monitoring. Regular observations may help to identify deteriorating patients alongside clinical judgement and symptom reviews.

Exploring radiographers' experience with mobile X-ray of patients in their homes

INTRODUCTION

To offer citizens with frailty or dementia living in nursing homes or other institutions a less stressful and anxious X-ray examination, a Danish hospital offers to perform the examination in the citizen's residence. This has changed the working procedure for the radiographers performing the examination. The aim of this study was to explore if the radiographers self-perceived competencies have changed whilst working in the mobile X-ray unit and if so, how these competencies are utilised within the department-based medical imaging team.

METHOD

This study had a qualitative design following a hermeneutic approach. Individual semi structured interviews included nine radiographers, four radiographers working in the mobile X-ray unit and five radiographers working exclusively in the medical imaging team.

RESULTS

Radiographers who worked in the mobile X-ray unit did acquire new competencies such as better communication and creative positioning skills. All nine participants recognised the advantage of sharing experiences and competencies with colleagues, and recommended a formal forum to do so. They sought opportunities for the use of the mobile X-ray unit to be more widespread within their own region, and within the profession.

CONCLUSION

This study indicates that radiographers working with mobile X-ray unit gained new competencies in communication and positioning, but without spread of new knowledge to colleagues in the medical imaging team.

IMPLICATION FOR PRACTICE

The use of home-based mobile X-ray is a new way to provide health care services and gain new competencies for the radiographers to focus on patient centred care.

ASSESSMENT OF THE AWARENESS LEVEL OF RADIATION PROTECTION AMONG RADIOGRAPHERS WORKING IN THE MEDICAL IMAGING WARDS OF THE HOSPITALS IN ZANJAN, IRAN

X-ray usage in medical diagnosis could have hurtful effects for both patient and medical imaging wards' personnel as a result of failure to follow radiation protection (RP) principles (shielding, distance and time) by radiographers. This cross-sectional descriptive-analytical study was carried out by valid and reliable online questionnaire, which was completed by 103 radiographers. Data were analyzed by using descriptive statistics (mean, standard deviation and frequency) and analytical statistics (Pearson's correlation coefficient test, Student's independent t-test and analysis of variance test) in the Statistical Package for Social Sciences version 20 (sig: P < 0.05). The study's response rate was 67.32%. The mean scores of participants' total, RP and device knowledge were 42.76, 42.86 and 42.72 out of 100, respectively. Work experience and age of participants were significantly related to device and total knowledge (P < 0.01). Results revealed an undesirable level of participants' awareness, indicating the necessity of holding training courses, especially for less experienced radiographers.

Exploring the patient perspectives of mobile X-ray in nursing homes - A qualitative explorative pilot study

INTRODUCTION

For patients with dementia, behaviour and reactions to stimuli can change and an X-ray examination in the hospital can have be a frightening experience. The aim of this study was to identify the experiences and perspectives of patients with dementia and their caregivers on receiving a mobile x-ray examination in nursing homes.

METHODS

This study was designed as a qualitative study using patient observation and semi structured interviews, with a phenomenology-hermeneutic approach. In total, 23 patients were observed during X-ray examinations in nursing homes, and six semi structured interviews were conducted with the caregivers who participated in the examination.

RESULTS

The observations and interviews indicated that a known environment, a recognizable framework and calmness were central for a patient with dementia. The patients appeared calm and relaxed during the examination in their usual environment (nursing homes) where there are less stimuli and impressions based of the observations.

CONCLUSION

Mobile X-ray examinations for patients with dementia living in nursing homes had a positive impact on patients' reactions towards the X-ray examination. The examinations were performed in the patients' usual and safe environments, where impressions and stimuli were less disturbing for patients with dementia.

IMPLICATIONS FOR PRACTICE

The mobile x-ray unit can be of benefit for patients suffering from dementia and result in less impact. The patients living in nursing homes have the opportunity to be examined in their familiar environment, because of the mobile x-ray unit.

Cultural Diversity and the Importance of Communication, Cultural Competence, and Uncertainty in Radiography

Cultural diversity has been well-recognized as a challenge for health care providers in many countries, thereby stressing the importance of effective and sufficient communications between patients and health care staff. Culturally competent care is a key to day-to-day practice, and we must strive to provide optimum care despite personal differences. If the health care service is to provide culturally competent care, our radiographers are vulnerable and prone to errors because effective communication requires both cultural competence and knowledge of the language. An understanding in effective communication, cultural competence, and uncertainty is important in the profession of radiographers.

Patients' and radiographers' experiences of dose reducing abdominal compression in radiographic examinations-A qualitative study

Aim

To describe patients' and radiographers' experiences of abdominal compression using conventional and patient-controlled compression methods.

Design

Qualitative descriptive design.

Methods

Forty-five patients who had used both a conventional and a patient-controlled compression device answered questionnaires. Five radiographers were interviewed. The data-collection took place between September 2015 and February 2017. Data were analysed by qualitative content analysis.

Results

Patient-controlled compression was preferred by slightly more patients because of fear of pain due to excessively hard pressure, maintaining control over the pressure and shorter duration. It was more comfortable, and patients felt they could participate in the examinations. Conventional compression was preferred by some because of more stable pressure and uncertainty of own capacity to provide the optimal compression. Discomfort was more often mentioned concerning the conventional compression method. The radiographers experienced the patient-controlled method as less time-consuming and more comfortable, but uncertainty about correct compression technique and its effect on radiation dose and image quality was reported.

X-ray operators' self-perceived competence, barriers and facilitators in general radiography practice in Western Australia

INTRODUCTION

Australian X-ray operators (XROs) are health workers qualified with a limited radiography licence to perform basic radiography examinations in rural areas of Australia. However, no previous study explored Western Australian (WA) XROs' radiography practice. The purpose of this study was to investigate WA XROs' self-perceived competence in the general radiography practice, and barriers and facilitators to their competence for determination of appropriate strategies to improve quality and safety of the radiographic service provided by them.

METHODS

Institutional review board approval and informed consent from participants were obtained. Interviews were conducted with the WA XROs to obtain demographic information and identify their self-perceived competence in the general radiography practice, and the barriers and facilitators to their competence. A thematic analysis was used to analyse the interview data.

RESULTS

A total of nine interviews were conducted (eight nurses and one paramedic). Participants indicated that they felt highly competent in patient care in radiography and adequately competent in the production of diagnostically acceptable images. The self-perceived barriers include overload of responsibilities, a lack of continuing professional development, and inadequacy of communication, support and XRO courses. The facilitators, post-qualification/course training, support in undertaking examinations, primary professional roles and a small population of the rural and remote areas were identified.

CONCLUSION

Based on interview data from nine WA XROs, the perception is that they have competence adequate for providing an acceptable quality radiographic service.

IMPLICATIONS FOR PRACTICE

A continuous XRO course review, and provision of a video conference support channel, an online XRO networking forum and additional XROs and/or radiographers working with XROs undertaking the radiography examinations were perceived as the appropriate strategies to improve the WA XROs' radiography practice. However, these require financial and/or managerial support from governments.

Oncology patients' experience of a routine surveillance CT examination: Relationships and communication

INTRODUCTION

The question of radiographers' capacity to establish short time relationships as well as decoding patients' needs and expectations simultaneously with performing high technological examination frequently arises in the clinical practice. Additionally, the constant focus on technology and the fact that radiographers work in high productive departments accentuates the issue. Patients' experiences with radiology seem to be a neglected area of research and may help to identify areas for improvement in this highly technological and productive field. The purpose of the study was to explore oncology patients' experiences of a routine surveillance CT examination and their need for relationships and communication with the radiographer as part of the CT examination.

METHODS

The study included patients diagnosed with cancer and in need of a CT examination as part of their course of treatment, and 21 semi-structured interviews were conducted. The interviews were analysed using qualitative content analysis. Themes were constructed and narratively reported. To increase validity, the themes were identified, discussed and formulated by the author group.

RESULTS

Four themes were constructed based on the analysis: 1: The professional radiographer, 2. Disease and treatment, 3. The examination environment and 4: While waiting.

CONCLUSION

The lack of focus on radiographers' capacity to establish relations, to consider each patient as an individual human being and being able to show sincere interest and empathy were highlighted. Findings illuminated the patient's need for relationship and communication with the radiographer as part of a CT examination.

Radiographers' experience of risks for patient safety incidents in the radiology department

AIMS AND OBJECTIVES

To describe potential risks for patient safety incidents in the radiology department from a radiographer's perspective.

BACKGROUND

A radiology department is a high-tech environment with high communication activity between different healthcare systems in combination with a large patient flow. Risks for patient safety incidents exist in every phase of a radiological examination. Due to the nature of the activity, a radiology department needs to have its own range of measures to prevent risks linked to radiology.

DESIGN

A qualitative descriptive design.

METHODS

Semi-structured interviews were carried out with 17 radiographers during the period September 2015 to February 2016. The data were analysed using conventional content analysis. This study followed the COREQ checklist criteria for the reporting of qualitative research.

RESULTS

The analysis yielded 20 different patient safety incidents that could result in the following six types of healthcare-associated harm: Patients could be exposed to unnecessary radiation; patients could receive an inaccurate diagnosis; patients could incur drug-induced damage; patients could suffer direct physical injury; or, their examination and treatment could be delayed or not carried out; or, their general health condition could deteriorate.

CONCLUSION

Lack of communication and knowledge, both internally and externally, can increase risks for patient safety incidents. The study describes a complex chain of activities that represent risks in the radiology department. It needs to be pointed out that it is not always the activities in the radiology department that cause the harm.

RELEVANCE TO CLINICAL PRACTICE

To carry out preventive patient safety work, a comprehensive analysis of the entire care chain is required. Patient safety work should also focus on improvement in communication both internally, within the radiology department, and externally. Standardised methodological guidelines, consistent prescriptions of method from the radiologist and a good working environment are internal success factors for patient safety at the radiology department.

Assessment of radiographers' competences from the perspectives of radiographers and radiologists: a cross-sectional survey in Lithuania

BACKGROUND

Assessing radiographers' clinical competence is of major importance in all medical imaging departments, and is a fundamental prerequisite for guaranteeing professional standards in both nursing care and radiography. Despite the fact that self-assessment has been reported to be the most common form of competence evaluation only several studies defining the radiographers' self-assessment of clinical competencies were identified. The aim of the study was to evaluate radiographers' professional competence from the perspectives of radiographers and radiologists by applying the Radiographers' Competence Scale (RCS).

METHODS

The study was conducted in university hospitals of Lithuania. We used the original instrument designed by Swedish researchers - the Radiographers' Competence Scale (RCS) consisting of two domains: A "Nurse-initiated care" and B "Technical and radiographic processes". The study involved in all 397 respondents; radiographers (250) and radiologists (147) working in departments of diagnostic radiology. Each competence was evaluated twice - the level on a 10-point scale, and the frequency of practical application on a 6-point scale.

RESULTS

The overall level of the radiographers' competence and the frequency of its use in practice were evaluated high or very high by both respondent groups. The radiographers attributed the highest evaluations to such competences as "Encouraging and supporting the patient" and "Collaborating with other radiographers", while the lowest evaluations were attributed to "Guiding the patient's relatives" and "Empowering the patient by involving him/her in the examination and treatment" competences. The radiologists attributed the highest evaluations to such competences as "Collaborating with radiologists" and "Independent carrying out of the radiologist's prescriptions", while the lowest evaluations - to the same competences as the radiographers did. Irrespectively of the work experience and age, the radiographers gave significantly higher ratings to all competences that the radiologists did (p < 0.001).

CONCLUSIONS

Both groups of the respondents attributed high or very high evaluations to the competences in both the "Nurse-initiated care" and the "Technical and radiographic processes" domains.

Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden

OBJECTIVE

This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process.

METHOD

A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics.

RESULTS

In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD.

CONCLUSION

It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.

Radiographers' perceptions of their professional rights in diagnostic radiography: a qualitative interview study

BACKGROUND

Considering the ethics of each profession is important as inter-professional collaboration increases. Professional ethics creates a basis for radiographers' work, as it includes values and principles, together with rights and duties that guide and support professionals. However, little is known about radiographers' rights when it comes to professional ethics.

THE AIM

The aim of this study was to describe radiographers' perceptions and experiences of their professional rights. The ultimate aim was to increase the understanding of professional ethics in this context and support radiographers' ethical pondering in diagnostic radiography.

METHODOLOGY

A qualitative method was used. Semistructured group interviews with 15 radiographers were conducted in spring 2013 at two publicly provided diagnostic imaging departments in Finland. Data were analysed by inductive content analysis. All the participants were women, and they had worked as radiographers for an average of 18 years.

FINDINGS

Based on our analysis, radiographers' professional rights consisted of rights related to their expertise in radiography and the rights related to working conditions that ensured their wellbeing. Expertise-based rights included rights to plan, conduct and assess radiological care with patient advocacy. Radiographers have the right to contribute to a culture of safe radiation in their organisation and to use their professional knowledge to achieve their main target, which is the safe imaging of patients. Radiographers also have right to work in conditions that support their well-being, including the legal rights stated in their employment contract, as well as their rights concerning resources at work.

CONCLUSIONS

Radiographers' professional rights are an elementary and multidimensional part of their clinical practice. In future, more theoretical and empirical research is needed to deepen the understanding of their rights in the clinical practice and support radiographers on issues related to this aspect of their work.

Radiographers' professional knowledge regarding parameters and safety issues in plain radiography: a questionnaire survey

OBJECTIVE

To review the knowledge of radiographers and examine the possible sociodemographic and situational contributors to this knowledge.

METHODS

A questionnaire survey was devised and distributed to a cohort of 120 radiographers. Each questionnaire contained two sections. In the first section, background data, including sex, age, highest academic level, grade point average (GPA), length of time from graduation, work experience as a radiographer and the status of previous refresher course(s), were collected. The second section contained 17 multiple-choice questions concerning radiographic imaging parameters and safety issues.

RESULTS

The response rate was 63.8%. In univariate analytic model, higher academic degree (p < 0.001), higher GPA (r(2) = 0.11; p = 0.001), academic workplace (p = 0.04) and taking previous refresher course(s) (p = 0.01) were significantly associated with higher knowledge score. In multivariate analytic model, however, higher academic degree (B = 1.62; p = 0.01), higher GPA (B = 0.50; p = 0.01) and taking previous refresher course(s) (B = -1.26; p = 0.03) were independently associated with higher level of knowledge. Age, sex, length of time from graduation and work experience were not associated with the respondents' knowledge score.

CONCLUSION

Academic background is a robust indicator of a radiographer's professional knowledge. Refresher courses and regular knowledge assessments are highly recommended.

ADVANCES IN KNOWLEDGE

This is the first study in the literature that examines professional knowledge of radiographers in terms of technical and safety issues in plain radiography. Academic degree, GPA and refresher courses are independent predictors of this knowledge. Regular radiographer professional knowledge checks may be recommended.

Will it hurt? Verbal interaction between child and radiographer during radiographic examination

This study investigated the nature of verbal interactions between child, parent and radiographer and the extent to which it varied as a function of the child's age. The participants were 20 female radiographers and 32 children (3-15 years) examined for acute injuries. The verbal interactions during the examination were video recorded and analyzed using the Roter Interaction Analysis System (RIAS). Results indicated that 80% of the verbal interaction was accounted for by the radiographer, 17% by the child and 3% by the parent. The distribution of utterances varied with regard to children's age.

[Critical incident technique and its nursing use: an integrative literature review]

Integrative literature review conducted in the databases LILACS, MEDLINE and SciELO from 2000 to 2010 to synthesize knowledge produced in nursing studies using the critical incident technique and identify the use and applicability of this technique as methodological framework. A total of 17 papers were found and Brazil stood out with 76.5% of the studies. Analysis and characterization according to the three elements of the technique were identified in 76.0% of the papers. The category 'analysis of iatrogenic events' caused by health workers stood out in the use of the critical incident technique. The integrative review enabled to synthesize scientific knowledge on this subject and revealed its large contribution to the improvement of health and nursing care.

Radiographers' self-assessed level and use of competencies-a national survey

Objectives

To describe radiographers’ self-assessed level and use of competencies as well as how sociodemographic and situational factors are associated with these competencies, particularly related to work experience.

Methods

A cross-sectional design was employed. Radiographers (n = 406) completed the self-administered 28-item questionnaire encompassing two dimensions: ‘Nurse-initiated care’ and ‘Technical and radiographic processes’. The level of competencies was rated on a 10-point scale and the frequency of use on a 6-point scale.

Results

Most competencies received high ratings both in terms of level and frequency of use. In ‘Nurse-initiated care’ the competency ‘Adequately informing the patient’ was rated the highest, while ‘Identifying and encountering the patient in a state of shock’ and ‘Participating in quality improvement regarding patient safety and care’ received the lowest ratings. In ‘Technical and radiographic processes’ the highest rated competencies were ‘Adapting the examination to the patient’s prerequisites and needs’ and ‘Producing accurate and correct images’. The lowest frequency of use was ‘Preliminary assessment of images’.

Conclusion

The main findings underline the radiographers’ high competency in both ‘Nurse-initiated care’ and ‘Technical and radiographic processes’. The lower rated competencies emphasise the importance of continuous professional education and quality improvement.

Main Messages

• Assessing radiographers’ clinical competencies is fundamental for ensuring professional standards.

• Most competencies received high ratings both in the nursing and in the radiographic dimensions.

• The highest rated competencies focussed on information and adaptability to the patients needs.

• The lowest rated competencies focussed on encountering the patient in shock and image assessments.

• Age, years in present position and work place only explained a relatively small part of competency.

What actions promote a positive ethical climate? A critical incident study of nurses' perceptions

Few qualitative studies explore the phenomenon of positive ethical climate and what actions are perceived as promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate way, as well as receiving and giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research should investigate other conditions that might also promote a positive ethical climate.

Positive experience of a mobile radiography service in nursing homes

BACKGROUND

For elderly people living in nursing homes, a transport to hospital for a radiological examination can lead to increased anxiety, disorientation and other problems related to the new environment.

OBJECTIVE

To investigate the usefulness of a mobile radiography service for radiological assessment of patients in nursing homes from the patient and staff perspectives.

METHODS

Lightweight equipment with a digital flat-panel detector was used for mobile radiography on nursing home patients in their own rooms. Data on patient and staff experiences from the service were collected using a questionnaire with closed and open-ended questions. Image quality was evaluated by the radiographer and a radiologist.

RESULTS

The majority of 241 radiography examinations were of the musculoskeletal system (94%). Twelve of 123 patients had pathology that required hospital treatment, while 22 patients with radiographic pathology could be treated locally. The main beneficial factors were security and comfort, acceptance from the patients, no need for transportation, no need for staff to be absent from the nursing homes.

CONCLUSION

Mobile radiography in nursing homes is technically feasible, with good image quality. The most beneficial results were that patients avoided unnecessary transport back and forth to the hospital, and that the majority of patients could be treated locally.