Optimising x-ray referral systems to ensure patient safety during ionising radiographic examination in Nelson Mandela Bay Health District
- Authors: Munnick, Derna Camille
- Date: 2018
- Subjects: X-rays -- Diffraction -- Safety measures , Radiography, Medical , Medical personnel and patients
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/22824 , vital:30105
- Description: X-ray request forms are used at hospitals and primary health care centres (PHCC) by health care professionals (HCP) to communicate with radiologists and radiographers when referring patients for ionising radiographic (x-rays) examinations. The x-ray request form and the radiological report are medico-legal documents. However, the importance of adequately completed x-ray request forms, appear to be underestimated. The HCP must write a brief clinical history on the x-ray request form that justifies the ionising radiographic (x-ray) examination referral, enabling radiographers and radiologists to have a better understanding of the patient’s clinical condition. An adequately completed x-ray request form assist the radiographer to make decisions regarding patient safety techniques and standard operating protocols that need to be applied. The radiologist will also have a better understanding of the patient’s clinical condition when reporting on the x-ray projections based on the clinical information supplied on the x-ray request form. The primary objective of this study was to explore and describe the adequacy of completion of x-ray request forms in order to optimise ionising radiographic referrals (x-ray requests) to ensure patient safety during ionising radiographic examinations at PHCC’s in NMBHD. A quantitative research design with an explorative, descriptive, and contextual approach was undertaken. The data was collected using an evaluation form checklist that the radiographer responsible for the requested x-ray examination completed. Data was gathered at all five PHCC’s, offering x-ray services, in the NMBHD by qualified radiographers evaluating the adequacy of completion of the x-ray request forms using an evaluation form checklist with an online program QuestionPro. Strategies to ensure validity and reliability in the study were undertaken. Ethical principles adhered to included informed consent, privacy, anonymity and confidentiality, gaining ethical permission to do the study and approval to enter the research site. The results of the study revealed that none of the 582 x-ray request forms evaluated were adequately completed. The fields on the x-ray request forms that were most frequently completed were the surname, clinical history, examination requested and the referring HCP details all had a total percentage correct completion of 90% and above. The fields most frequently omitted were last menstrual period (LMP) of females of child-bearing age and an indication of previous x-rays. The patient’s age and how to address the patient were also frequently incomplete. The researcher made recommendations to the NMBHD on how the x-ray referral system by means of the x-ray request form could be optimised of in order to increase patient safety during ionising radiographic (x-ray) examinations. Recommendations made to the Nelson Mandela Bay Health District (NMBHD) was based on the findings of the research study to ensure optimisation of x-ray requests concerning the completion of the x-ray request forms to ensure patient safety during x-ray examination procedures. Recommendations to the NMBHD were as follows:Education and training, Distribution of guidelines, Keeping a record of HCP’s qualifications, Consent form must be completed for all female patients of child-bearing age, Redesign the current x-ray request form. The researcher also made recommendations for possible future studies which could also increase patient safety during x-ray examinations and were as follows. The researcher suggested that this research could be applied at both public and private hospitals as well as in other health districts in the Eastern Cape to evaluate the adequacy of the completion of the x-ray request forms in the Eastern Cape. The researcher suggested a research study be done at PHCC’s in NMBHD, on the justification and the dose levels used for the frequently requested x-rays. The researcher recommended an accessible health information exchange system for radiography in Port Elizabeth and surrounding health institutions to reduce repeated x-ray requests for patients who visit different health institutions for the same clinical problem. The researcher concluded from the results of the statistical analyses of the study that generally the adequacy of completion of the x-ray request forms at the PHCC’s in NMBHD was average. Improperly or incomplete fields on the x-ray request forms were observed from the results. Indicating that referring HCP’s at the PHCC’s of NMBHD could optimise the x-ray referral system by means of correct, accurate and comprehensive completion of the x-ray request form to ensure patient safety during ionising radiographic examinations.
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- Date Issued: 2018
Knowledge and understanding of radiographers regarding supraspinatus outlet projection for shoulder impingement syndrome
- Authors: Willians, Razana
- Date: 2015
- Subjects: Radiography, Medical , Diagnosis, Radioscopic , Shoulder , Diagnostic imaging
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/4456 , vital:20602
- Description: The shoulder is a complex anatomical structure and imaging plays an important role in the diagnosis and management of shoulder conditions. The complexity of the shoulder’s anatomy has led to the development of multiple radiographic projections and techniques within plain film imaging with each projection intended to demonstrate specific aspects of the anatomy of the shoulder. However, reproducing the required projections can be difficult especially if radiographers are not familiar with the projections and their evaluation criteria. Literature has revealed the importance of a comprehensive knowledge and understanding of anatomy, patient positioning, beam direction and centring point, and evaluation criteria to ensure a quality projection for accurate diagnoses. The aim of the study was to determine the knowledge and understanding of radiographers with regard to the supraspinatus outlet projection (SOP) for shoulder impingement syndrome (SIS) and its evaluation criteria. The inferences derived from the research findings were used to develop guidelines for a structured in-service training programme for practising radiographers to optimise their knowledge and understanding of the supraspinatus outlet projection in shoulder impingement syndrome. The proposed study followed a quantitative approach. Furthermore, a descriptive, exploratory, contextual design was employed. The research population consisted of practising radiographers working in the public and private hospitals of the Nelson Mandela Bay Municipality. The data were collected by means of a structured self-administered questionnaire. The questionnaire comprised of three sections. The first section requested demographic information from the participants. The second section assessed their knowledge and understanding regarding the scapular ‘Y’ and the supraspinatus outlet projections and shoulder impingement syndrome. The third section assessed their knowledge and understanding of anatomy and image evaluation/critiquing. The reliability and validity of the data collection instrument was ensured by conducting a pilot study and comparing the results with those of the main study. In addition, the expertise and guidance of a radiographer experienced in the clinical training of radiographers, the supervisor (who has twenty years’ experience in the teaching of radiographers) and a statistician was obtained. Descriptive and inferential statistical analyses were performed by means of a statistical programme and with the guidance of a statistician. The researcher ensured that the study was conducted in an ethical manner by adhering to the ethical principles of beneficence, justice and respect for persons.
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- Date Issued: 2015