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Sundland SL, Møller-Christensen B. The mobile X-ray service and hip fractures: The impact of the mobile X-ray service on the hip fast track. Radiography (Lond) 2024; 30:709-714. [PMID: 38428194 DOI: 10.1016/j.radi.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/29/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Hip fracture is a serious affliction that requires fast care and an X-ray examination, which are provided by an ambulance and a visit to the radiology department, respectively. If a well-functioning mobile X-ray service could be developed, by examining the patient in their own home, both the work strain of hospital workers and patient suffering could be reduced. The purpose of this study was to determine if the mobile X-ray service could be a supplement to the fast-track process that is utilised by the ambulance service. The study also examines other department's opinion of this implementation. METHODS A mixed method was used where data from a Swedish hospital's local RIS/PACS was collected from 706 patients for quantitative analysis, and six personnel working at the hospital were interviewed to obtain qualitative data. RESULTS The quantitative data demonstrates that the actual mobile X-ray service cannot act in such an acute manner as an ambulance service due to the staffing problems that the hospital is faced with, but with optimal staffing, radiographs with mobile X-ray service could be performed within an acute timeframe. The qualitative data shows that there is a strong wish for the mobile X-ray service to expand and be more active, but this requires a better staffing situation in the radiology department and better communication possibilities between other departments. CONCLUSION The mobile X-ray service is desirable in the investigated region, and it could benefit both the emergency ward and the ambulance service, and it could function as infection control for geriatric patients, but more radiographers on staff is required if the service should be functional as a complement to the hip-"fast track". More studies on the subject are required. IMPLICATION FOR PRACTICE A wide generalisation of the results is not applicable in this study, as mobile X-ray and the "hip fast track" is not a widespread service throughout Sweden. This means that this study only suggests trends, which needs to be studied further.
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Affiliation(s)
- S L Sundland
- Department of Radiology in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - B Møller-Christensen
- Jönköping University, Department of Natural Science and Biomedicine, Jönköping, Sweden
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Yu J, Huang J, Yang Q. Long-Term Adoption or Abandonment of Smart Technology in the Chinese Elderly Home Care Environment: A Qualitative Research Study. Healthcare (Basel) 2023; 11:2440. [PMID: 37685474 PMCID: PMC10486740 DOI: 10.3390/healthcare11172440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
China's rapidly aging population and shortage of care resources have made it difficult for its traditional model to meet the home care needs of the elderly. On this premise, China is implementing home digital health interventions based on smart technology. During implementation, instead of the expected explosion in long-term adoption, there has been a large amount of abandonment. But so far, the relationship between service experience and these behaviors has been ignored. This study aims to explore the reasons for the long-term adoption or abandonment behaviors of technology by elders in the home care environment. A qualitative study was conducted based on Golant's framework of smart technology adoption behaviors among elders. Semi-structured interviews were conducted with 26 elders who are long-term or former users of smart technology in a home care environment, and data from the interviews were analyzed using directed content analysis. This study identified three themes that influence elders' adoption behaviors of smart technology in the home care environment, including immediate effectiveness, long-term usability, and possible collateral damage. The findings indicated that the experience of the elders is the key point that affects long-term adoption behavior. For more elders to use smart technology in the home care environment, it is necessary for the government, technology developers, and nursing institutions to further reform the existing system.
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Affiliation(s)
- Jiahao Yu
- Population Research Institute, Hohai University, Nanjing 211100, China;
| | - Jianyuan Huang
- Population Research Institute, Hohai University, Nanjing 211100, China;
| | - Qi Yang
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
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Otomo K, Inaba Y, Abe K, Onodera M, Suzuki T, Sota M, Haga Y, Suzuki M, Zuguchi M, Chida K. Spatial Scattering Radiation to the Radiological Technologist during Medical Mobile Radiography. Bioengineering (Basel) 2023; 10:bioengineering10020259. [PMID: 36829753 PMCID: PMC9952711 DOI: 10.3390/bioengineering10020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Mobile radiography allows for the diagnostic imaging of patients who cannot move to the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have difficulty with movement. However, staff are exposed to scattered radiation from the patient, and they can receive potentially harmful radiation doses during radiography. We estimated occupational exposure during mobile radiography using phantom measurements. Scattered radiation distribution during mobile radiography was investigated using a radiation survey meter. The efficacy of radiation-reducing methods for mobile radiography was also evaluated. The dose decreased as the distance from the X-ray center increased. When the distance was more than 150 cm, the dose decreased to less than 1 μSv. It is extremely important for radiological technologists (RTs) to maintain a sufficient distance from the patient to reduce radiation exposure. The spatial dose at eye-lens height increases when the bed height is high, and when the RT is short in stature and abdominal imaging is performed. Maintaining sufficient distance from the patient is also particularly effective in limiting radiation exposure of the eye lens. Our results suggest that the doses of radiation received by staff during mobile radiography are not significant when appropriate radiation protection is used. To reduce exposure, it is important to maintain a sufficient distance from the patient. Therefore, RTs should bear this is mind during mobile radiography.
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Affiliation(s)
- Kazuki Otomo
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Keisuke Abe
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Mana Onodera
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Tomohiro Suzuki
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Masahiro Sota
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-22-717-7943
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Malathi A, Jasim K. Validating the relationship between service quality, patient sensitivity and experience towards medical applications using SERVQUAL. Int J Med Inform 2022; 168:104883. [DOI: 10.1016/j.ijmedinf.2022.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
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Zhao Y, Rokhani FZ, Sazlina SG, Devaraj NK, Su J, Chew BH. Defining the concepts of a smart nursing home and its potential technology utilities that integrate medical services and are acceptable to stakeholders: a scoping review. BMC Geriatr 2022; 22:787. [PMID: 36207705 PMCID: PMC9540152 DOI: 10.1186/s12877-022-03424-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/29/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Smart technology in nursing home settings has the potential to elevate an operation that manages more significant number of older residents. However, the concepts, definitions, and types of smart technology, integrated medical services, and stakeholders' acceptability of smart nursing homes are less clear. This scoping review aims to define a smart nursing home and examine the qualitative evidence on technological feasibility, integration of medical services, and acceptability of the stakeholders. METHODS Comprehensive searches were conducted on stakeholders' websites (Phase 1) and 11 electronic databases (Phase 2), for existing concepts of smart nursing home, on what and how technologies and medical services were implemented in nursing home settings, and acceptability assessment by the stakeholders. The publication year was inclusive from January 1999 to September 2021. The language was limited to English and Chinese. Included articles must report nursing home settings related to older adults ≥ 60 years old with or without medical demands but not bed-bound. Technology Readiness Levels were used to measure the readiness of new technologies and system designs. The analysis was guided by the Framework Method and the smart technology adoption behaviours of elder consumers theoretical model. The results were reported according to the PRISMA-ScR. RESULTS A total of 177 literature (13 website documents and 164 journal articles) were selected. Smart nursing homes are technology-assisted nursing homes that allow the life enjoyment of their residents. They used IoT, computing technologies, cloud computing, big data and AI, information management systems, and digital health to integrate medical services in monitoring abnormal events, assisting daily living, conducting teleconsultation, managing health information, and improving the interaction between providers and residents. Fifty-five percent of the new technologies were ready for use in nursing homes (levels 6-7), and the remaining were proven the technical feasibility (levels 1-5). Healthcare professionals with higher education, better tech-savviness, fewer years at work, and older adults with more severe illnesses were more acceptable to smart technologies. CONCLUSIONS Smart nursing homes with integrated medical services have great potential to improve the quality of care and ensure older residents' quality of life.
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Affiliation(s)
- Yuanyuan Zhao
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Global Century Science Group, Hong Kong, China
| | - Fakhrul Zaman Rokhani
- Faculty of Engineering, Universiti Putra Malaysia, Serdang, Malaysia
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang, Malaysia
| | - Shariff-Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang, Malaysia
| | - Jing Su
- College of Public Health, Hainan Medical University, Haikou, China
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Serdang, Malaysia
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Bazin D, Lucas IT, Rouzière S, Elkaim E, Mocuta C, Réguer S, Reid DG, Mathurin J, Dazzi A, Deniset-Besseau A, Petay M, Frochot V, Haymann JP, Letavernier E, Verpont MC, Foy E, Bouderlique E, Colboc H, Daudon M. Profile of an “at cutting edge” pathology laboratory for pathological human deposits: from nanometer to in vivo scale analysis on large scale facilities. CR CHIM 2022. [DOI: 10.5802/crchim.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Jabin MSR, Schultz T, Mandel C, Bessen T, Hibbert P, Wiles L, Runciman W. A Mixed-Methods Systematic Review of the Effectiveness and Experiences of Quality Improvement Interventions in Radiology. J Patient Saf 2022; 18:e97-e107. [PMID: 32433438 DOI: 10.1097/pts.0000000000000709] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to compile and synthesize evidence regarding the effectiveness of quality improvement interventions in radiology and the experiences and perspectives of staff and patients. METHODS Databases searched for both published and unpublished studies were as follows: EMBASE, MEDLINE, CINAHL, Joanna Briggs Institute, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, Web of Science, Mednar, Trove, Google Gray, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative studies of patients undergoing radiological examinations and/or medical imaging health care professionals; a broad range of quality improvement interventions including introduction of health information technology, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; context of radiological setting; a broad range of outcomes including patient safety; and a result-based convergent synthesis design. RESULTS Eighteen studies were selected from 4846 identified by a systematic literature search. Five groups of interventions were identified: health information technology (n = 6), training and education (n = 6), immediate and critical reporting (n = 3), safety programs (n = 2), and the introduction of mobile radiography (n = 1), with demonstrated improvements in outcomes, such as improved operational and workflow efficiency, report turnaround time, and teamwork and communication. CONCLUSIONS The findings were constrained by the limited range of interventions and outcome measures. Further research should be conducted with study designs that might produce findings that are more generalizable, examine the other dimensions of quality, and address the issues of cost and risk versus benefit.
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Affiliation(s)
| | - Tim Schultz
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia
| | - Catherine Mandel
- Swinburne Neuroimaging, Swinburne University of Technology, Melbourne, Victoria
| | - Taryn Bessen
- Royal Adelaide Hospital, South Australian Medical Imaging, Adelaide, South Australia
| | - Peter Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales
| | - Louise Wiles
- From the Australian Centre for Precision Health, University of South Australia
| | - William Runciman
- Australian Patient Safety Foundation, University of South Australia, Adelaide, South Australia, Australia
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Exploring radiographers' experience with mobile X-ray of patients in their homes. Radiography (Lond) 2021; 28:102-106. [PMID: 34481711 DOI: 10.1016/j.radi.2021.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/20/2022]
Abstract
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.
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Zhao Y, Sazlina SG, Rokhani FZ, Su J, Chew BH. The expectations and acceptability of a smart nursing home model among Chinese elderly people: A mixed methods study protocol. PLoS One 2021; 16:e0255865. [PMID: 34424931 PMCID: PMC8382194 DOI: 10.1371/journal.pone.0255865] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/26/2021] [Indexed: 02/05/2023] Open
Abstract
Nursing homes integrated with smart information such as the Internet of Things, cloud computing, artificial intelligence, and digital health could improve not only the quality of care but also benefit the residents and health professionals by providing effective care and efficient medical services. However, a clear concept of a smart nursing home, the expectations and acceptability from the perspectives of the elderly people and their family members are still unclear. In addition, instruments to measure the expectations and acceptability of a smart nursing home are also lacking. The study aims to explore and determine the levels of these expectations, acceptability and the associated sociodemographic factors. This exploratory sequential mixed methods study comprises a qualitative study which will be conducted through a semi-structured interview to explore the expectations and acceptability of a smart nursing home among Chinese elderly people and their family members (Phase I). Next, a questionnaire will be developed and validated based on the results of a qualitative study in Phase I and a preceding scoping review on smart nursing homes by the same authors (Phase II). Lastly, a nationwide survey will be carried out to examine the levels of expectations and acceptability, and the associated sociodemographic factors with the different categories of expectations and acceptability (Phase III). With a better understanding of the Chinese elderly people's expectations and acceptability of smart technologies in nursing homes, a feasible smart nursing home model that incorporates appropriate technologies, integrates needed medical services and business concepts could be formulated and tested as a solution for the rapidly ageing societies in many developed and developing countries.
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Affiliation(s)
- Yuanyuan Zhao
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Global Century Science Group, Shenyang, China
| | - Shariff-Ghazali Sazlina
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Persiaran MARDI - UPM, Serdang, Selangor, Malaysia
| | - Fakhrul Zaman Rokhani
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Persiaran MARDI - UPM, Serdang, Selangor, Malaysia
- Faculty of Engineering, Department of Computer and Communication Systems Engineering, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Jing Su
- College of Public Health, Hainan Medical University, Haikou, China
| | - Boon-How Chew
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Persiaran MARDI - UPM, Serdang, Selangor, Malaysia
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Kada S. Knowledge of CT exposure parameters among Norwegian student radiographers. BMC MEDICAL EDUCATION 2020; 20:302. [PMID: 32928205 PMCID: PMC7491127 DOI: 10.1186/s12909-020-02233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Improvements in the competency levels of student radiographers in computed tomography examinations (CT) are important due to the increasing number of these examinations being undertaken in imaging departments. The present study assesses the knowledge of student radiographers regarding CT exposure parameters. METHODS The level of knowledge related to CT exposure parameters was evaluated using a twenty-one-item questionnaire that was distributed to final-year student radiographers. The questionnaire consisted of questions around CT exposure parameters and either allowed respondents to answer "true," or "false" or choose a response from a range of responses where only one answer was correct. Correct answers were given one mark, while no mark was given for an incorrect answer. The score out of possible 21 was converted to a percentage, with a higher percentage signifying greater knowledge. RESULTS Seventy-two students completed and returned the questionnaire, resulting in a 71% response rate. The mean score was 53%. Only 33% of students correctly identified that kilovoltage peak (kVp) should be increased when patients have metallic implants, and milliampere seconds (mAs) should be increased as body part thickness increases. No one answered all the questions correctly. There was no significant knowledge difference between students who had CT facilities on campus and those that did not. CONCLUSION Overall, student radiographers' knowledge of CT exposure parameters was reported to be satisfactory.
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Affiliation(s)
- Sundaran Kada
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Post Box 7030, 5020, Bergen, Norway.
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Jensen JM, Andersen PAB, Kirkegaard L, Larsen N, Most W, Nielsen D, Precht H. Exploring the patient perspectives of mobile X-ray in nursing homes - A qualitative explorative pilot study. Radiography (Lond) 2020; 27:279-283. [PMID: 32919898 DOI: 10.1016/j.radi.2020.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- J M Jensen
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark.
| | - P A B Andersen
- Department of Radiology, Hospital Little Belt Kolding, Denmark
| | - L Kirkegaard
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark
| | - N Larsen
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark
| | - W Most
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark
| | - D Nielsen
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwsparken, 5000, Odense C, Denmark; Migrant Health Clinic, Odense University Hospital, Denmark
| | - H Precht
- Health Sciences Research Centre, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwsparken, 5000, Odense C, Denmark; Cardiology Research Department, Odense University Hospital, Baagøes Alle 15, 5700, Svendborg, Denmark
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Toppenberg MD, Christiansen TEM, Rasmussen F, Nielsen CP, Damsgaard EM. Mobile X-ray outside the hospital: a scoping review. BMC Health Serv Res 2020; 20:767. [PMID: 32814588 PMCID: PMC7439673 DOI: 10.1186/s12913-020-05564-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 07/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For several years mobile X-ray equipment has been routinely used for imaging in patients too unwell within the hospital, when transportation to the radiology department was inadvisable. Now, mobile X-ray examinations are also used outside the hospital. The literature describes that fragile patients may benefit from mobile X-ray, but we need to provide insights into the breadth, depth and gaps in a body of literature. METHODS The scoping review was performed by searching PubMed, Cinahl, Embase, EconLit and Health Technology Assessment. English-, Danish-, Norwegian-, German-, Italian-, French- and Swedish-language studies, published 1.1.2009-1.5.2020 about mobile X-ray outside the hospital were included. Participants were patients examined using mobile X-ray as the intervention. PRISMA was used when eligible to build up the review. To extract data from the selected articles, we used a structured summary table. RESULTS We included 12 studies in this scoping review. The results were divided into four topics:1. Target population 2. Population health 3. Experience of care and 4. Cost effectiveness. The main findings are that target population could be larger for instance including hospice patients for palliative care, group dwelling for people with intellectual disabilities, or psychiatric patients, population health may be improved, image quality seems to be good and mobile X-ray may be cost effective. Limitations of language, databases and grey literature may have resulted in studies being missed. CONCLUSIONS Mobile X-ray may be used outside hospital. There seems to be potential benefits to both patients and health care staff. Based on the published studies it is not possible to draw a final conclusion if mobile X-ray examination is a relevant diagnostic offer and for whom. Further studies are needed to assess the feasibility of use in fragile patients, also regarding staff, relatives and societal consequences and therefore the topic mobile X-ray needs more research.
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Affiliation(s)
- Maria Dietz Toppenberg
- The Department of Radiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | | | - Finn Rasmussen
- The Department of Radiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Camilla Palmhøj Nielsen
- DEFACTUM, Social and Health Services and Labour Market, Olof Palmes Allé 15, 8200, Aarhus N, Denmark
| | - Else Marie Damsgaard
- Department of Geriatrics, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
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Toppenberg M, Christiansen T, Rasmussen F, Nielsen C, Damsgaard EM. Mobile X-ray Outside the Hospital vs. X-ray at the Hospital Challenges Exposed in an Explorative RCT Study. Healthcare (Basel) 2020; 8:E118. [PMID: 32365932 PMCID: PMC7349166 DOI: 10.3390/healthcare8020118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND For frail patients, it may sometimes be preferable to carry out X-ray examinations at the patients' own home. The general state of such patients may worsen due to transport and change of environment when transported for examination at the hospital. OBJECTIVE The aim of the randomized controlled trial (RCT) was to investigate if mobile X-ray improves healthcare for fragile patients. The primary outcome was the number of hospitalizations. DATA SOURCES We collected all data using questionnaires and data from the Electronic Patient Record (ER). PARTICIPANTS Patients referred to a mobile X-ray examination living in nursing homes and homes for the elderly in the Aarhus Municipality (Denmark). INTERVENTION mobile X-ray examinations compared to those at the hospital. Study appraisal: Data were collected and stored using the computer programme Redcap. Stata was used for statistical calculations. One hundred and thirty-six patients were included in the RCT. We did not find significant differences between mobile X-ray (intervention) and X-ray at the hospital (control) concerning hospitalizations and number of hospital days. Challenges: We met several challenges when carrying out RCT in the planned study population. Doctors often withdraw the referral when they found out that their patient should go to the hospital instead of mobile X-ray. The nursing home staff often considered the patient too frail to allow the test person to ask questions post X-ray. We also met challenges in the randomization method resulting in bias in the first data collection, so we had to adjust the randomization method. CONCLUSIONS For the fragile patients in the present explorative study, mobile X-ray did not significantly reduce the number of hospitalizations compared to X-ray at the hospital. Yet, mobile X-ray may be a new important diagnostic tool for more precise treatment to the frailest patients for whom transportation to the hospital is too exhausting. We need studies with focus on this aspect. We also recommend future RCT studies in a population for which mobile X-ray has not yet been a possibility.
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Affiliation(s)
- Maria Toppenberg
- The Department of Radiology, Aarhus University Hospital, 8200 Aarhus, Denmark; (T.C.); (F.R.)
| | - Thomas Christiansen
- The Department of Radiology, Aarhus University Hospital, 8200 Aarhus, Denmark; (T.C.); (F.R.)
| | - Finn Rasmussen
- The Department of Radiology, Aarhus University Hospital, 8200 Aarhus, Denmark; (T.C.); (F.R.)
| | - Camilla Nielsen
- DEFACTUM, Social and Health Services and Labour Market, 8200 Aarhus, Denmark;
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Impact of mobile radiography services in nursing homes on the utilisation of diagnostic imaging procedures. BMC Health Serv Res 2019; 19:428. [PMID: 31242914 PMCID: PMC6595684 DOI: 10.1186/s12913-019-4276-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/18/2019] [Indexed: 11/23/2022] Open
Abstract
Background In the last decade, mobile radiography services have been introduced in nursing homes in several countries. Earlier research found an underutilisation of diagnostic imaging among nursing home residents. However, the effects of introducing mobile radiography services on the use of diagnostic imaging are unknown. The purpose of this study was to determine the utilisation of diagnostic imaging among nursing home residents and if there are any differences between hospitals with and without a mobile radiography service. Methods Data for 2015 were collected from the radiological information systems of 11 hospitals. The data included information on the anatomical region/organ/organ system, modality, and information on where the examination took place. Using nursing home beds as a proxy for nursing home residents’ differences in the use of diagnostic imaging in areas with hospitals with and without mobile radiography services were analysed. The chi-squared test was used to compare the areas. Results From 11,066 examinations of nursing home residents, 87% were plain radiographs, 8% were CT scans, and 4% were ultrasound examinations. In areas with mobile radiography services, there was a significantly higher proportion of diagnostic imaging used per nursing home bed, 50% per bed compared to 36% per bed in areas without; p = < 0.001. Furthermore, in areas with mobile radiography services, there was a significantly lower proportion of CT and ultrasound used per nursing home bed, 2.5 and 1.4% respectively per bed compared to 4.7 and 2.2% respectively per bed in areas without; p = < 0.001. Conclusions This study demonstrate a lower use of radiology by nursing home residents compared to the general population, and indicates that mobile radiography services increase the level closer to the user rate in the general population. The proportions of plain radiographs are significantly higher in areas with a mobile radiography service, while the proportion of more advanced imaging techniques such as CT and ultrasound are lower. The higher use of diagnostic imaging is most likely appropriate because of higher morbidity and lower use of diagnostic imaging among nursing home residents, compared to the general population. Further research is necessary on how to improve diagnostic imaging services for nursing home residents.
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Omori K, Yanagawa Y, Muramatsu KI, Nagasawa H, Takeuchi I, Madokoro S, Jitsuiki K, Yatsu S, Ohsaka H, Ishikawa K. Experience using a portable X-ray system at the scene transported by a physician-staffed helicopter. Acute Med Surg 2019; 6:396-399. [PMID: 31592083 PMCID: PMC6773656 DOI: 10.1002/ams2.431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/25/2019] [Indexed: 11/18/2022] Open
Abstract
Background Fujifilm (Tokyo, Japan) developed a portable X‐ray system called the CALNEO Xair, which can be carried by a physician. The X‐ray radiation machine weighs 3.5 kg. The dimensions are: height, 144 mm; length, 148 mm; width, 258 mm. Case Presentation When a 33‐year‐old woman driving a car made a right turn at a crossroad, her car hit another car, causing her vehicle to tip onto its side. Staff of the doctor helicopter checked her at the scene, and the findings of chest and pelvic X‐ray were all negative. She received a diagnosis of cervical sprain and pelvic contusion and was transferred to a local hospital by ambulance. Conclusion This is the first report of a case evaluated by a portable X‐ray system at the scene, under transportation by a doctor helicopter. This system could be useful for undertaking prehospital assessment and medical treatment.
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Affiliation(s)
- Kazuhiko Omori
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Youichi Yanagawa
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Ken-Ichi Muramatsu
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Shunsuke Madokoro
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Shoichiro Yatsu
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Shizuoka Japan
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Kjelle E, Kleven L, Olerud HM, Melberg HO. Cost analysis of mobile radiography services for nursing home residents in Southeast Norway. J Eval Clin Pract 2019; 25:275-281. [PMID: 30362207 DOI: 10.1111/jep.13058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/09/2018] [Indexed: 12/01/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVE Telemedicine applications, such as a mobile radiography service, provide a new way of organizing healthcare services. In order to provide safe and personalised care for nursing home residents during X-ray examinations, mobile radiography services have been implemented. The objective of this study was to analyse the costs of X-ray examinations and treatments for nursing home residents when comparing hospital-based imaging with a combination of hospital-based imaging and a mobile radiography service in Southeast Norway. METHODS A decision model was developed using the software TreeAge Pro. The model included two alternatives: the mobile radiography service in combination with hospital-based imaging and hospital-based imaging alone. The treatment needed based on the examination results could be given either in the nursing home or at the hospital. Probabilities and costs in the model were derived from previous research, various reports, and hospital data from the Southeast region of Norway. Monte Carlo simulations of 1000 residents were run through the model, and statistical analyses were applied. RESULTS The analysis showed a mean cost of €2790 per resident for the hospital-based service alone. For mobile and hospital-based services combined, the mean cost was €1946 per resident, including examinations and the immediate treatment given. This difference in costs was significant (p < 0.001). CONCLUSION A mobile radiography service in nursing homes provides a safe, high quality health care service. The result of this study showed there was a 30% cost-reduction by implementing the mobile radiography service.
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Affiliation(s)
- Elin Kjelle
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Linn Kleven
- Department of Clinical Research Support, Oslo University Hospital, Oslo, Norway
| | - Hilde Merete Olerud
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hans Olav Melberg
- Department of Clinical Research Support, Oslo University Hospital, Oslo, Norway.,Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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Kjelle E, Lysdahl KB, Olerud HM, Myklebust AM. Managers' experience of success criteria and barriers to implementing mobile radiography services in nursing homes in Norway: a qualitative study. BMC Health Serv Res 2018; 18:301. [PMID: 29699547 PMCID: PMC5921415 DOI: 10.1186/s12913-018-3115-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 04/12/2018] [Indexed: 11/25/2022] Open
Abstract
Background In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Methods Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Results Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. Conclusions The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly facilitated by the intuitive appeal of mobile radiography. Changes in healthcare management and in the financial system might facilitate services across healthcare levels. In addition, compatible information systems across healthcare levels are needed in order to facilitate the use of new technology and mobile services. Electronic supplementary material The online version of this article (10.1186/s12913-018-3115-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elin Kjelle
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University College of Southeast Norway, Postboks 235, 3603, Kongsberg, Norway.
| | - Kristin Bakke Lysdahl
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University College of Southeast Norway, Postboks 235, 3603, Kongsberg, Norway.,Institute of Radiography and Dental technology, Department of Life Sciences and Health, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 4, St. Olavs plass, 0130, Oslo, Norway
| | - Hilde Merete Olerud
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University College of Southeast Norway, Postboks 235, 3603, Kongsberg, Norway
| | - Aud Mette Myklebust
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University College of Southeast Norway, Postboks 235, 3603, Kongsberg, Norway
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Sasaki M, Uto Y, Yoshida T, Iwaanakuchi T, Muranaga F, Saigo Y, Kumamoto I. Secondary use of hospital information system data for safe bedside radiography in terms of patient factors. Health Inf Manag 2018; 48:24-32. [PMID: 29359587 DOI: 10.1177/1833358317749162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE: The purpose of this study was to use patient data gathered by a hospital information system (HIS) to improve the safe performance of bedside radiography. METHOD: Hierarchical cluster analysis was used to investigate the factors of hospitalised patients who had undergone radiography in the X-ray room or at the bedside. Logistic regression analysis was then performed to quantify patient factors and calculate the probability of undergoing general radiography or bedside radiography. RESULTS: Patients were grouped into six clusters by hierarchical cluster analysis on the basis of their factors. We found a remarkable difference between clusters for the ratio of bedside radiography. Results indicated that "types of transportation" and "level of mobility" related to the ratio of bedside radiography. Logistic regression analysis of the associations between the probability of undergoing bedside radiography and patient factors indicated that type of transportation and level of mobility were highly correlated with bedside radiography or general radiography. CONCLUSION: Our results suggested that the secondary use of HIS data for the quantitative evaluation of patient factors and implementation of those quantitative values in medical records may be useful for the safe performance of bedside radiography as well as providing a method of decision support for doctors to order bedside radiography.
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Affiliation(s)
| | - Yumiko Uto
- 2 Department of Medical Information Sciences, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan
| | - Takuma Yoshida
- 3 Mathematics and Computer Science, Graduate School of Science and Engineering, Kagoshima University, Japan
| | | | | | | | - Ichiro Kumamoto
- 2 Department of Medical Information Sciences, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan
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Kjelle E, Lysdahl KB. Mobile radiography services in nursing homes: a systematic review of residents' and societal outcomes. BMC Health Serv Res 2017; 17:231. [PMID: 28335759 PMCID: PMC5364720 DOI: 10.1186/s12913-017-2173-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 03/18/2017] [Indexed: 11/23/2022] Open
Abstract
Background Demographic changes are leading to an ageing population in Europe, and predict an increase in the number of nursing home residents over the next 30 years. Nursing home residents need specialised healthcare services such as radiology due to both chronic and acute illnesses. Mobile radiography, x-ray examinations performed in the nursing homes, may be a good way of providing services to this population. The aim of this systematic review was to identify the outcomes of mobile radiography services for nursing home residents and society. Methods A systematic review based on searches in the Medline, Cochrane, PubMed, Embase and Svemed + databases was performed. Titles and abstracts were screened according to a predefined set of inclusion criteria: empirical studies in the geriatric population, and reports of mobile radiography services in a clinical setting. All publications were quality appraised using MMAT or CASP appraisal tools. Data were extracted using a summary table and results were narratively synthesised. Results Ten publications were included. Three overarching outcomes were identified: 1) reduced number of hospitalisations and outpatient examinations or treatments, 2) reduced number of transfers between nursing homes and hospitals and 3) increased access to x-ray examinations. These outcomes were interlinked with the more specific outcomes for residents and society reported in the literature. For residents there was a reduction in burdensome transfers and waiting time and adequate treatment and care increased. For society, released resources could be used more efficiently, and overall costs were reduced substantially. Conclusions This review indicates that mobile radiography services for nursing home residents in the western world are of comparable quality to hospital-based examinations and have clear potential benefits. Mobile radiography reduced transfers to and from hospital, increased the number of examinations carried out and facilitated timely diagnosis and access to treatments. Further research is needed to formally evaluate potential improvements in care quality and cost-effectiveness. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2173-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elin Kjelle
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University College of Southeast Norway, Postboks 235, 3603, Kongsberg, Norway.
| | - Kristin Bakke Lysdahl
- Institute of radiography and dental technology, Department of Life Sciences and Health, Faculty of health sciences, Oslo and Akershus University College of Applied Sciences, Postboks 4, St. Olavs plass, 0130, Oslo, Norway
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PP102 Perceived Quality By Patients Hospitalized At Home Undergoing Domicillary Radiography. Int J Technol Assess Health Care 2017. [DOI: 10.1017/s0266462317002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION:Europe currently has the highest proportion of older people in the world and is expected to maintain this leading position for the next 50 years. A teleradiology service for frail patients living at home or in nursing-homes (R@dhome), funded by the Italian Ministry of Health, has been operating from June 2013 to May 2015 (1). The goal was to offer, within the path of home care patients, radiologic care for fragile elderly patients (2). In this report of the study a secondary outcome was evaluated; the perceived quality for patients and caregivers undergoing home radiology.METHODS:The study was a randomized controlled trial (RCT) with 136 patients; 71 cases and 65 controls. The perceived quality assessment was only performed among home inpatient group cases, at home or in nursing homes and not in the control group patients (who had treatment in a hospital). The assessment instrument was a semi-structured interview based on the benchmark system SERQUAL®. The identified dimensions of quality were: tangible aspects, reliability, responsiveness and empathy in a subpopulation of non-dementia patients. Eligible subjects were interviewed between May 2014 and May 2015.RESULTS:The percentage of satisfied patients, evaluated on the dimensions of perceived quality, was 97.7 percent. The main reasons given were: short waiting time, best comfort and safety, efficiency, operator's kindness and less need to travel for the treatment.CONCLUSIONS:R@dhome benefits are not limited to clinical or financial aspects but ethical, social and relational advantages have also been shown in this study (3). Given the fragility of the patients, positive results were mostly achieved by reducing the risk of trauma in transport between their home and the hospital.
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Dozet A, Ivarsson B, Eklund K, Klefsgård R, Geijer M. Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden. J Eval Clin Pract 2016; 22:990-997. [PMID: 27412082 DOI: 10.1111/jep.12590] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations. METHODS This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skåne, Sweden. RESULTS From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography. CONCLUSION Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.
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Affiliation(s)
- Alexander Dozet
- Department of Healthcare Governance, Region Skåne, Malmö, Sweden
| | - Bodil Ivarsson
- Medicine Service University Trust, Region Skåne, Department of Cardiothoracic Surgery, Skåne University Hospital and Lund University, Lund, Sweden
| | - Karin Eklund
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | | | - Mats Geijer
- Department of Radiology, Örebro University, Örebro, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
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Hollaar V, van der Maarel-Wierink C, van der Putten GJ, van der Sanden W, de Swart B, de Baat C. Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi Method. BMC Geriatr 2016; 16:60. [PMID: 26951645 PMCID: PMC4782327 DOI: 10.1186/s12877-016-0231-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In nursing home residents, it is not possible to distinguish pneumonia and aspiration pneumonia clinically. International literature reveals no consensus on which and how many characteristics and risk indicators must be present to diagnose (nursing home-acquired) pneumonia and aspiration pneumonia. The aim of this survey was to reach consensus among a panel of clinical medical experts in geriatrics and pulmonology about the characteristics required for diagnosing pneumonia, and about the risk indicators needed to consider the diagnosis aspiration pneumonia in nursing home residents with pneumonia. METHODS Literature review and three expert-rating iterations using the electronically-modified Delphi Method were carried out. After each expert rating iteration, data analysis was performed. Qualitative responses and additional (nursing home-acquired) pneumonia characteristics which were mentioned in reply to structured open-ended questions were summarised, whilst similar responses were combined and these combinations were ordered by frequency in order to use them in the next iteration. Characteristics which failed to reach consensus were considered as inconclusive and eliminated. Consensus was reached when at least 70 % of the participants agreed. RESULTS Literature review revealed 16 currently used common characteristics for diagnosing (nursing home-acquired) pneumonia. No consensus was reached about characteristics and the number of characteristics required for diagnosing (nursing home-acquired) pneumonia. However, 57 % agreed that dyspnea, fever, deterioration of general functioning, tachypnea and crepitation with auscultation are the most important characteristics and the responses by the participants suggested that two or three characteristics should be present. Subsequently, 80 % of the participants agreed on the risk indicators dysphagia, choking incident, (history of) tube feeding, neurological disease and cognitive impairment for considering the diagnosis aspiration pneumonia in nursing home residents with pneumonia. CONCLUSIONS No final consensus could be reached about which and how many characteristics are required for diagnosing pneumonia in nursing home residents. However, the results indicated that dyspnea, fever, deterioration of general functioning, tachypnea and crepitation with auscultation are characteristics of some importance and that at least two or three characteristics should be present. With regard to considering aspiration pneumonia in nursing home residents with pneumonia, final consensus was reached about the risk indicators dysphagia, choking incident, (history of) tube feeding, neurological disease and cognitive impairment.
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Affiliation(s)
- Vanessa Hollaar
- Department of Neurorehabilitation, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, The Netherlands. .,BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium. .,BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands. .,Department of Oral Function and Prosthetic Dentistry, Radboud university medical center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Claar van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium. .,BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands. .,Center for Special Care in Dentistry, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands.
| | - Gert-Jan van der Putten
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium. .,Center for Special Care in Dentistry, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands. .,Department of Oral Function and Prosthetic Dentistry, Radboud university medical center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands. .,Amaris Gooizicht, Paulus van Loolaan 21, 1217, SH, Hilversum, The Netherlands.
| | - Wil van der Sanden
- Department of Oral Function and Prosthetic Dentistry, Radboud university medical center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Bert de Swart
- Department of Neurorehabilitation, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, The Netherlands. .,Department of Rehabilitation, division Speech Therapy, Radboud university medical center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Cees de Baat
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium. .,BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands. .,Department of Oral Function and Prosthetic Dentistry, Radboud university medical center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
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Farajollahi AR, Fouladi DF, Ghojazadeh M, Movafaghi A. Radiographers' professional knowledge regarding parameters and safety issues in plain radiography: a questionnaire survey. Br J Radiol 2014; 87:20140090. [PMID: 24827380 DOI: 10.1259/bjr.20140090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- A R Farajollahi
- 1 Medical Education Research Center and the Department of Medical Physics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Andersson BT, Christensson L, Jakobsson U, Fridlund B, Broström A. Radiographers' self-assessed level and use of competencies-a national survey. Insights Imaging 2012; 3:635-45. [PMID: 23079730 PMCID: PMC3505567 DOI: 10.1007/s13244-012-0194-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 09/11/2012] [Accepted: 09/13/2012] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Bodil T Andersson
- Department of Nursing Science, School of Health Sciences, Jönköping University, Box 1026, SE-551 11, Jönköping, Sweden,
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