Sustainability in radiography: Knowledge, practices, and barriers among radiographers in Zimbabwe and Zambia.

INTRODUCTION: As the global demand for radiography services increases, departments need to be aware of the environmental impact of their practices and strive to reduce their carbon footprint. However, sustainability in radiography, particularly in low-resource settings, remains underexplored. This study aimed to investigate the knowledge, practices, and barriers to sustainability in radiography practice among radiographers in Zimbabwe and Zambia. METHODS: A quantitative cross-sectional study involving 216 consecutively sampled radiographers who completed an online questionnaire was conducted. Data analysis was performed using descriptive statistics, the Chi-square test, and exploratory factor analysis using principal component analysis. RESULTS: Overall, 81.49 % of the radiographers had some familiarity with the concept of sustainability. The radiography educational curriculum was singled out as lacking sufficient content on sustainability (44.44 %). More than half of the radiographers reported the absence of deliberate sustainable practices in place in their respective departments (Zambia 51.02 %, Zimbabwe 54.69 %). The top reported barriers to sustainability include; a lack of priority for sustainability from leadership and organization (73.61 %), a lack of incentives for sustainability (75.46 %), and a lack of partnerships between suppliers and consumers on ways to improve diagnosis, patient safety and sustainability (82.4 %). CONCLUSION: This study offers valuable insights into the current state of sustainability in radiography in Zambia and Zimbabwe, highlighting the need for academic reforms, intentional departmental practices, and systemic changes to drive sustainable efforts in the field. Future research should aim to enhance the sustainability of radiographic examinations and procedures, thereby advancing the core practice of radiographers.

Exploring the perceptions of radiographers pertaining to the provision of quality radiological services in Zimbabwe.

INTRODUCTION: Radiology is part of the service industry; therefore, there is a need to understand quality and its associated factors. The cost of poor service quality is a loss of competitive advantage, increased litigation, misdiagnosis, unnecessary radiation exposure, and patient mortality. There has been little research into the factors influencing the quality of radiological services in Zimbabwe. This work, therefore, aimed to explore the radiographer's perceptions of the factors that affect the quality of radiological services at central hospitals in the Harare Metropolitan Province. METHODS: A qualitative, explorative study applying the SERVQUAL model was carried out. One-on-one interviews with 10 purposively sampled radiographers employed at central hospitals in the Harare Metropolitan Province were conducted. The data were managed by Nvivo 12 (QSR International) and analyzed by framework analysis. RESULTS: Radiographer's perceptions of the factors that affect the quality of radiological services were categorized by five themes namely; i. Tangibles - the physical appearance of the radiology department and facilities, ii. Reliability and dependability - the ability to perform the promised service dependably and accurately, iii. Responsiveness - the willingness to help patients and provide prompt service, iv. Assurance - the knowledge and courtesy of radiology staff and their ability to inspire trust and confidence, and v. Empathy - caring, the individualized attention the radiology department provides to its patients. CONCLUSION: Economically viable, well-designed national strategies are needed to prioritize and fund radiology in Zimbabwe and other resource-constrained settings. Recognition of acquired specialist skills by radiographers to halt the exodus and training of radiologists, radiology nurses, medical physicists, and biomedical engineers by local institutions will go a long way in improving the quality of radiological services.

Adequacy of completion of radiology request forms at St. Francis' Hospital of Katete District: A clinical audit in Zambia.

Background: Most imaging examinations use ionising radiation which causes biological effects on the body. For this reason, only justified examinations should be requested by adequately completing the radiology request form (RRF) by clinicians. The RRF allows radiographers and radiologists to assess if the benefit outweighs the risk associated with medical radiation exposure. Inadequately or incorrectly filled RRFs leads to unnecessary radiation exposures, imaging errors, and delays in performing the examination. Therefore, this study aimed at auditing the adequacy of completion of general RRFs at St. Francis' Hospital of Katete District in Zambia. Methods: This was a quantitative study in which RRFs for general radiography from January to December 2020 were audited. Data were collected retrospectively using a checklist from a total of 974 RRFs. The filled-in forms were assessed for completeness of information related to the patient, examination, and referring clinician. Data were analysed using descriptive statistics. The standard of completeness was based on the Royal College of Radiologists (RCR) guidelines requiring all the designated variables completed on the RRF. Results: Most N=881(90.5%), RRFs were incompletely filled. With regards to patient's identification, the findings revealed N=4(0.5%), N=597(61.3%), N=3(0.4%), and N=2(0.3%) RRFs devoid of patient's name, hospital number, age, and gender, respectively. Regarding the examination, the findings revealed N=3(0.4%), N=68(7%), N=449(46.2%), and N=336 (37%) RRFs devoid of requested examination, indication, clinical history, and level of urgency, respectively. Regarding the referrer, the findings revealed N=135(13.9%), N=173(17.8 %), N=472(48.5%), and N=31(3.2%) RRFs were devoid of information relating to the ward, clinicians' name, referring department, and signature, respectively. Conclusion: This audit reports that most of the RRFs were incompletely filled-in at St. Francis' Hospital. Furthermore, the hospital number, clinical history and level of urgency were the frequently unfilled variables. Overall, there were gaps in completion of RRFs requiring remedying.

Role development and extension for radiographers in computed tomography: Literature review findings and their application to Zimbabwe

Computed Tomography(CT) technology has evolved into avital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.

Roles of clinical supervisors in the clinical training of radiography students in Zambia: a qualitative study.

Introduction: Clinical supervisors are responsible for the facilitation of practice-based learning for radiography students. However, literature is scarce on the roles of clinical supervisors in the clinical training of students in Zambia. Objective: This study was aimed at identifying and exploring the roles of clinical supervisors in the clinical training of radiography students in Zambia. Methods: A qualitative design with unstructured interviews was used in this study. Ten individual interviews were conducted in July 2018 with clinical supervisors of radiography students working at the main clinical training and placement sites of the Lusaka and Copperbelt provinces of Zambia, respectively. All digital interview recordings were transcribed verbatim and analysed thematically. Results: Three main roles of a clinical supervisor emerged: managerial, educational, and supportive. The managerial role deals with organising and managing clinical training resources. The educational role involves imparting knowledge and skills to students. The supportive role involves supporting students with social and learning problems. Findings show the inter-relationship of these roles to each other. Conclusion: Clinical supervisors need to understand their roles in order to develop and maintain their competences in the facilitation of practice-based learning. This could also help stakeholders to provide appropriate support to clinical supervisors.

Intravenous cannulation and administration of contrast media by radiographers: a literature review to guide the training and practice in Zambia.

Background: There has been a demand for radiographers in Zambia to perform intravenous (IV) cannulation and administration of contrast media, a role which, traditionally, was radiologists'. This demand is due to a shortage of radiologists and an increase in demand for imaging examinations. This review aimed at synthesising relevant literature related to IV cannulation and administration of contrast media by radiographers to guide the training and practice in Zambia. Methods: A structured literature search was conducted in three online databases (PubMed/MEDLINE, CINAHL, and ScienceDirect), radiography journals, and cited references to identify research studies on IV cannulation and administration of contrast media by radiographers. Results: Seven studies were identified and included in this review. The findings are summarised under six themes: benefits and challenges, adoption of the extended role, infection control, safety and complications, medico-legal issues, and education and training. Our findings revealed that radiographer-led IV cannulation and administration of contrast media contribute positively to the management of imaging patients. Conclusion: The themes identified in this review could provide a template of where to base the establishment of the training programme and local guidelines. Before extending the role of radiographers, the scope of practice should be extended, and accredited training programme and local guidelines should be put in place.

Experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom.

OBJECTIVE: The objective of the study was to explore the experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom (UK). METHODS: The study used a qualitative research design. Data were collected using semi-structured interviews from eight purposively selected consultant breast radiographers across the UK. Interviews were recorded, transcribed, and analyzed by themes. RESULTS: Four themes emerged: Reasons for the introduction of breast consultancy role in radiography, education and training, domain of practice, and autonomy and support. This study found that participants were carrying out roles similar to those performed by consultant breast radiologists and that they had been performing such roles even before they were appointed. The study further revealed that the creation of consultancy posts came because of an increase in demand for breast imaging services and the shortage of radiologists. Four domains of practice were clinical expert, professional leadership, research and evaluation, and education and training. Participants worked independently with adequate support from fellow consultants and non-radiology staff. CONCLUSION: Consultant breast radiographers are performing most of the consultancy roles stated in their scope of practice, except for research and evaluation, which they are mainly unable to do due to clinical workload. Therefore, there is a need to provide protected time for research and evaluation activities so that consultant breast radiographers can utilize their full potential. The findings have provided baseline information for countries planning to extend the scope of practice of radiographers in breast imaging.

What nurses need to know about mobile radiography.

Nurses have a vital role in providing nursing care to patients requiring mobile radiography. Mobile radiography is requested when a patient's condition makes it impossible for them to be transported to the radiology department. All health professionals involved in mobile radiography, such as nurses, medical doctors and radiographers should be knowledgeable in this area. This is even more important in current practice, where nurse consultants and nurse advanced practitioners are assessing and referring patients for limited radiological examinations. However, there is little literature to equip nurses with knowledge about mobile radiography. The aim of this article is to raise awareness of this subject at a time when the number of patients requiring mobile radiography has increased globally, due to the outbreak of coronavirus. Critically ill patients with COVID-19 require portable chest X-rays to diagnose complications of the disease, such as pneumonia.

Developing a Framework Strategy for Supporting Radiographers in the Clinical Supervision of Radiography Students in Zambia: A Mixed Methods Study.

BACKGROUND: Clinical supervisors of radiography students play a key role in the facilitation of practice-based learning. However, there is a scarcity of evidence-based strategies to support clinical supervisors. This study aimed at exploring the level of support required by radiographers in order to develop a framework strategy for supporting clinical supervisors of radiography students in Zambia. METHODS: This study used an exploratory sequential mixedmethods approach. The qualitative phase was conducted first, and the findings were used to develop the questionnaire for the quantitative phase. The study population was radiographers working in the Lusaka and Copperbelt provinces of Zambia. For the first phase, data were collected from a purposive sample of 10 clinical supervisors of radiography students. For the survey, data were collected from 120 radiographers using a questionnaire. In the third phase, a group of experts validated the proposed framework using an online questionnaire. Qualitative data were analysed thematically and quantitative data using statistics. RESULTS: Four support areas were identified: training and education in clinical supervision, clinical training resources, human resources and relationships, and quality assurance programmes related to clinical supervision. These findings informed the development of a support framework strategy for clinical supervisors. CONCLUSION: This study has revealed that clinical supervision of radiography students requires coordinated support from stakeholders: schools of radiography, professional body, and radiology and hospital management. It is anticipated that the developed framework, when implemented, will enhance the experiences of clinical supervisors and improve the quality of clinical education.