RESUMEN
INTRODUCTION: Medical imaging examinations that make use of ionising radiation provide valuable information towards patient management. Literature suggests that there is a significant rise in the number of patient referrals for such examinations. The concept "individual patient radiation dose tracking" (IPRDT) is introduced to optimise radiation monitoring. Many countries across the globe explored and implemented methods to enhance and promote the justification and optimisation principles essential for patient radiation safety. In South Africa (SA), however, attention to IPRDT is limited. METHODS: A qualitative research design was employed. Radiographers in the Western Cape Province of SA were purposefully sampled for participation in one-on-one, semi-structured interviews. Thematic analysis was applied to the transcribed interview data. RESULTS: This paper presents a theme developed from the radiographer cohort of ten (10) participants. The theme: the need for creating awareness and implementing legislative support structures, was developed from the data, with the following supporting subthemes: 1) stakeholder awareness and 'buy-in' 2) continuous professional development and 3) mandated practice. CONCLUSION: This study provides findings that are of value for patient radiation safety in SA by giving a voice to local stakeholders. Other countries that are conducting similar research investigations toward the integration of an IPRDT model, method, or framework, may also benefit from these findings. IMPLICATIONS FOR PRACTICE: The effective integration of IPRDT into the clinical environment requires unison amongst the relevant stakeholders and clarity on the various professionals' roles and responsibilities. The findings of this study furthermore suggest the involvement of regulatory organisations for the provision of a mandated form of practice at national and international levels.
Asunto(s)
Investigación Cualitativa , Dosis de Radiación , Humanos , Sudáfrica , Seguridad del Paciente , Entrevistas como Asunto , Masculino , Femenino , Monitoreo de Radiación/métodos , Actitud del Personal de Salud , Protección RadiológicaRESUMEN
INTRODUCTION: Simulation based learning (SBL) has been used in diagnostic radiography for teaching and learning purposes. However, the method of offering the SBL opportunities has not been placed in the context of whether the experiences provide the student with a real life simulation. Moreover, in the light of the current staff shortages and healthcare issues in South Africa, placing students into the clinical practice without sound grounding in the application of theory into practice would be unfair to the student and patients. Thus, SBL could provide the opportunity for the student to learn in a safe teaching and learning environment. METHODS: A qualitative, meta- synthesis was undertaken using systematic literature searches. The existing literature in English was retrieved from databases (Medline, CINAHL and ScienceDirect). The keywords used were simulation based learning, simulation, radiography and diagnostic radiography. RESULTS: Themes and categories were developed from the literature. Theme 1: An authentic and realistic situation, which is relevant to the development of a professional in the context of the profession. Theme 2: Building confidence in a safe, reliable and nurturing environment. Theme 3: Active participation in a collaborative process. CONCLUSION: The meta synthesis revealed three major themes that can be used as a framework to motivate for the use of SBL in a diagnostic radiography programme. IMPLICATIONS FOR PRACTICE: The implementation of SBL that could prepare students for the workplace. SBL focused on specific competencies for clinical readiness.
Asunto(s)
Competencia Clínica , Aprendizaje , Atención a la Salud , Humanos , Radiografía , EstudiantesRESUMEN
INTRODUCTION: The focus on paediatric radiation dose reduction supports reevaluation of paediatric imaging protocols. This is particularly important in the neonates where chest radiographs are frequently requested to assess respiratory illness and line placement. This study aims to assess the impact of neonatal chest radiographic protocols on patient dose in four hospitals in different countries. METHODS: Exposure parameters, collimation, focus to skin distance (FSD) and radiation dose from 200 neonatal chest radiographs were registered prospectively. Inclusion criteria consisted of both premature and full-term neonates weighing between 1000 and 5000 g. Only data from the examinations meeting diagnostic criteria and approved for the clinical use were included. Radiation dose was assessed using dose area product (DAP). RESULTS: The lowest DAP value (4.58 mGy cm2) was recorded in the Norwegian hospital, employing a high kVp, low mAs protocol using a DR system. The Canadian hospital recorded the highest DAP (9.48), using lower kVp and higher mAs with a CR system, including the addition of a lateral projection. The difference in the mean DAP, weight, field of view (FOV) and kVp between the hospitals is statistically significant (p < 0.001). CONCLUSION: Use of non-standardised imaging protocols in neonatal chest radiography results in differences in patient dose across hospitals included in the study. Using higher kVp, lower mAs and reducing the number of lateral projections to clinically relevant indications result in a lower DAP measured in the infant sample studied. Further studies to examine image quality based on exposure factors and added filtration are recommended. IMPLICATIONS FOR PRACTICE: Reevaluation of paediatric imaging protocols presents an opportunity to reduce patient dose in a population with increased sensitivity to ionising radiation.