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05:55 CET
SS 214 - Professional issues in radiography
Radiographers Professional Issues Research
Wednesday, February 27, 10:30 - 12:00
Room: C
Type of session: Scientific Session
Topic: Radiographers, Professional Issues, Research
Moderators: V. Logager (Copenhagen/DK), B. Snaith (Bradford/GB)

Moving beyond the bookshelf: an investigation into the use of social media journal clubs in radiography practice
S. N. Mullen1, M. O'Connor2; 1Galway/IE 2Dublin/IE

Purpose: The introduction of mandatory continuous professional development (CPD) by CORU in October 2015, has increased demand on Radiographers to participate in CPD activities. Social media and digital communications have become prominent features of society and popular methods of communication and information sharing. Therefore, it is important to assess whether such technologies can contribute to CPD in Radiography.
Methods and Materials: A Facebook journal club was established to investigate the opinions of Radiographers regarding the use of social media facilitated journal clubs in contributing to CPD. Four teaching hospitals were chosen at random to participate. Six Radiographers from each centre were invited to participate. Two peer reviewed articles were discussed throughout the study. An online survey was used to establish the opinions of Radiographers.
Results: A response rate of 79% was obtained. Radiographers felt positive towards the use of social media as a tool in contributing to CPD. There was a slight disparity in opinion between newly qualified Radiographers and more senior members of the team, with newly qualified radiographers afraid of appearing “unprofessional” if found using social media in the department, and senior members being more open towards the use of social media for CPD purposes.
Conclusion: Respondents felt positive towards the use of social media facilitated journal clubs. Advantages of social media facilitated journal clubs are convenience and increased interaction with others. Limitations of social media facilitated journal club use in Radiography are a perceived poor professional reflection and the encroachment into an already compromised personal life.

Written patient information in radiology: an Irish perspective
S. S. Azman, E. McDermott, M.-L. Ryan; Dublin/IE

Purpose: Provision of information before patients attend their radiology examination plays an important role in enhancing patient experience and ensuring consent. Patient information leaflets (PIL) are used to support the verbal consultation between the patient and radiology team. This project aimed to ascertain whether public and private radiology services across Ireland use PILs for general, CT and ultrasound examinations, at what point PILs are given to patients and also to analyse the information included.
Methods and Materials: All radiology departments in Ireland were contacted (n=52). The manager of each participating department (n=23) was interviewed to understand at what point PILs are given to patients, and PILs were then collected from the participating departments. Analysis on 34 PILs across the three modalities was conducted under the following sub-headings- general content; radiology-related content; PIL design.
Results: 65% of the 23 participating facilities distribute PILs, with 35% being in the form of a written letter in advance of the examination. 74% send PILs by post while the remaining 26% use mixed methods depending on the modality and patient type. Each PIL varied in terms of the amount, depth and categorization of information. The most common information included is the nature of the procedure, the experience during the procedure and result availability after the examination.
Conclusion: There is a need to standardise PILs used in Irish radiology departments as both the method and timing of distribution and the information is not consistent, thus potentially impacting the knowledge imparted on the patient.

Influences on radiographers' choice of immobilisation methods in paediatric radiological examinations
S. Christie, C. Ng, C. Sá dos Reis; Perth/AU

Purpose: To identify the main influences on radiographers’ decisions about immobilisation methods in paediatric radiological examinations.
Methods and Materials: Australian and New Zealand radiographers were recruited to complete an online questionnaire identifying their use of different immobilisation methods and the influences on their choices. Follow-up interviews were conducted to further explore the findings. Institutional approval was obtained. Closed-end questions were analysed using frequencies and non-parametric tests (Fisher’s exact and Mann-Whitney U), while content analysis was applied to open-end questions and interview data.
Results: 65 completed questionnaires were received; 7 respondents also participated in interviews. Parental holding was the most likely method to be used (96.9%), but psychological methods (87.7%) were considered preferable as using less force and causing less distress to children and parents. Mechanical and chemical methods were not often used. Participants sought to adapt their immobilisation practice to each situation, often using the child’s age as a guide. Existing informal workplace training was perceived as adequate but not optimal. Opinions were divided over whether introducing written guidance would limit radiographers’ ability to adapt to different situations.
Conclusion: Immobilisation is a case-by-case activity which requires radiographers to seek a balance between different factors, consistently constrained by examination type and resource availability. Patient age was the most commonly considered factor, although this was acknowledged to be an imperfect guide. Short placements at paediatric institutions are recommended as a useful way of improving immobilisation education. Increased support from governing bodies is also required.

Informed consent in diagnostic imaging: an evaluation of current practice
A. Ramlaul; Hatfield/GB

Purpose: It is normally assumed that all attending patients have given their informed consent for imaging investigations, although variations may exist in the form in which this is provided. The purpose of this study was to conduct an audit of current practice regarding gaining informed consent within NHS diagnostic imaging departments throughout the United Kingdom.
Methods and Materials: A cross-sectional survey was conducted involving lead superintendent radiographers within NHS sites in Scotland, Wales, England and Northern Ireland. The survey explored methods in which information on radiological examinations and procedures was disseminated to patients; radiographer practices with regard to gaining informed consent; and staff knowledge of consent policies. Responses were analysed using descriptive statistics and outcomes were matched according to guidelines provided by the Health and Care Professions Council (HCPC) and College of Radiographers (CoR).
Results: The survey yielded a response rate of 46% (220/478). The findings demonstrated mixed awareness of policy documents, together with variations in the methods used for disseminating information to patients and gaining informed consent.
Conclusion: Some radiographers appear to have a cursory knowledge of consent policies. There is a lack of standardisation regarding practices for disseminating information to patients as well as for gaining informed consent from patients. The study highlights a possible need for more explicit guidance for gaining informed consent, to enhance patients’ clinical outcomes and reduce the likelihood of litigation.

Perceptions about the practice of seeking informed consent in paediatric imaging
J. Portelli1, J. McNulty2, P. Bezzina1, L. Rainford2; 1Msida/MT 2Dublin/IE

Purpose: To investigate health professionals’ and parents’ perceptions about the practice of seeking informed consent for paediatric imaging examinations.
Methods and Materials: This research is part of a larger multi-phase study performed at a large general hospital in Malta, which also serves as a primary paediatric referral centre. Following institutional board approval, a purposive sample of radiographers, radiologists, paediatricians, emergency physicians and parents were invited to attend for an audio-recorded semi-structured interview with the primary author. Participants were asked questions about different aspects related to the imaging of paediatric patients, including their thoughts and opinion about the practice of seeking informed consent for such examinations.
Results: Nineteen health professionals and seven parents willingly took part in the study. Following thematic analysis of the transcribed interview data, one of the dominant themes that emerged highlighted a general misconception that informed consent was primarily sought in paediatric imaging so as to provide a legal safeguard to the respective health professionals against any possible future medical liability issues that could arise. Furthermore, parents generally expressed feelings of heightened anxiety and concern when referring physicians and/or radiographers asked them to provide their written consent, with many interpreting this to mean that the imaging examination would involve higher risks for their child.
Conclusion: The findings highlight a need for relevant authorities to address the noted misconceptions and raise awareness about the true purpose of informed consent, which is to ensure that patients and/or their representatives are provided with relevant information that empowers their health decisions.

Radiographers and scientific research: the Italian experience
M. Zanardo1, A. Capaldo1, M. Codari1, D. Catania1, P. Cornacchione2, S. Durante3; 1Milan/IT 2Rome/IT 3Bologna/IT

Purpose: Research plays a fundamental role in the development and growth of radiographers’ skills. The aim of this study was to investigate how radiographers are currently involved in scientific research and how to increase their involvement in this field.
Methods and Materials: The Italian Federation of Scientific Radiographers Societies (FASTeR) proposed a national online survey. The questionnaire was composed of multiple-choice questions, using a 5-point Likert scale to identify radiographers’ involvement (1 no involvement, 5 active participation) and skill level (1 no formation, 5 adequate formation).
Results: We obtained 315 participants (159 male), mean age of 40±12, 51 (16%) with a master’s degree and 293 (93%) workers. Only 13 (4%) radiographers feel themselves adequately trained on research methodology during their qualification, with a mean evaluation of 2.6±1.0. Only 26 (8%) were actively involved in research activities 2.4±1.3. Only 10 (3%) radiographers did not consider research important for their work and professional growth 4.1±1.0, and 23 (7%) affirmed they did not have time for research, while 194 (62%) radiographers were fascinated by participating in research projects. Most of radiographers lack basic knowledge about Evidence-Based Medicine and scientific database (Pubmed/Medline or EMBASE). Continuing Medical Education (CME) courses were the most desirable instrument to improve research methodology, with both theoretical and practical sections 4.2±1.0. Limitations in conducting research projects were a poor knowledge of English and limited involvement by other professional figures.
Conclusion: To improve radiographers’ involvement and skills in research, research methodology CME courses with theoretical and practical section should be activated.

The construction of care in CT
R. K. Forton1, M. Hardy2, A. Sargeant2; 1Norwich/GB 2Bradford/GB

Purpose: Patient-centred care and the ‘patient voice’ are core components of UK healthcare policy and practice guidance. This study explored how care is perceived and experienced within the high-technology environment of CT.
Methods and Materials: A grounded theory (GT) methodology using semi-structured interviews obtained primary data from CT radiographers and patients. Recruitment was performed at a 1200-bed teaching hospital over a 6-month period.
Results: The patient-radiographer relationship and the radiographer’s role in providing care within CT are complex and multifaceted. Both patients and radiographers perceive CT imaging as an integral part of the overall patient care and treatment pathway. As such, the act of being imaged is perceived as a care process. While image acquisition is recognised as a task-orientated and technical process, the human element of providing care is cognitive, dynamic and responsive to individual need. Importantly, patient confidence in the care received was influenced by the radiographer’s ability to build a trusting relationship and display technical competence. This in turn facilitated active compliance resulting in a technically accurate examination. Despite previous literature suggesting that technical environments create a barrier to care, patients within this study confirmed that radiographers provide care commensurate to the nursing ideals represented by the 6Cs (care; compassion; competence; communication; courage; commitment).
Conclusion: A new model of care encompassing both technical components and patient centeredness has been constructed and will be presented. This model promotes a new vision of patient-centred care based on care perceptions within high-technology environments.

Mobile radiography services can improve the utilisation of diagnostic imaging among nursing home residents
E. Kjelle, K. B. Lysdahl, H. M. Olerud; Kongsberg/NO

Purpose: To determine utilisation of diagnostic imaging among nursing home residents and the impact of mobile radiography services on utilisation rates.
Methods and Materials: The number of examinations made on nursing home residents in 11 hospitals in Norway was collected for the year 2015, which involved five hospitals with mobile service facilities and six without. The data included anatomical region/organ/organ system, modality, and place of examination (hospital or nursing home). Using the 24,805 nursing home beds in the included areas as a proxy for residents, the utilization rates were compared in areas with and without mobile radiography services, using the chi-squared test.
Results: A total of 11,066 examinations, 0.45 per nursing home bed, was carried out. Of these, 87% were plain radiographs, 8% were CT scans and 4% were ultrasound examinations. In areas with mobile radiography services, the proportion was 50% per bed, compared to 36% in areas without, χ2 (df=1, n=11,066)=470.39, p+<0.001.
Conclusion: Mobile radiography services increase the overall utilization of examinations among nursing home residents significantly. Nonetheless, the rates of diagnostic imaging are still low compared to the rates for the Norwegian population in general, which is 0.9 examinations per person per year. This study clearly indicates an under-utilisation of diagnostic imaging among nursing home residents and suggests extended use of mobile services to be one possible remedy. This study has been submitted to BMC Geriatrics in 2018.

Burnout level of personnel working in radiology departments in Hungary
D. Sipos1, A. Pandur2, A. Kedves1, V. Varga2, M. Csima1, I. Repa1, Á. Kovács1; 1Kaposvár/HU 2Pécs/HU

Purpose: Burnout phenomenon among healthcare professionals is the current problem. Burnout may have wide negative impact that can undermine personal and professional life of the individual, also the quality and the effectiveness of the healthcare system.
Methods and Materials: Radiology department workers who were members of the Hungarian Society of Radiographers were invited to participate in our online survey during June to September 2018. Maslach Burnout Inventory (MBI) and SF 36 survey was used to measure burnout levels and participants health status. Self-made questionnaire was made to determine demographic attributes. All data were analysed using SPSS V 24.0. Descriptive statistics, independent samples t test, ANOVA, Kruskal Wallis analysis were performed to examine the relationship between given demographic characteristics and the three dimensions of burnout at the significance level of p<0.05.
Results: Total of 404 radiology department workers participated in the survey with the average age of 40.08 years (SD12.18; 22-70). The sample had high mean burnout score for emotional exhaustion (34.28; SD 12.98) and depersonalisation (12.81; SD 6.62) compared to MBI norms. Personal achievement mean (41.03; SD 8.70) showed higher mean compared to MBI norms. Educational level, years spent in health care system, current financial situation had significant influence for all three dimensions of burnout (p<0.05). Type of workplace had significant impact on emotional exhaustion (p=0.001).
Conclusion: Our study indicates that high number of radiology department workers are experiencing occupational burnout at emotional exhaustion and depersonalisation dimension. These results vary according to demographic and work-related factors.

VERTIM: pilot study evaluating influence of adding nature images in imaging departments' waiting rooms, according to different aesthetic approaches, on patients' perceived anxiety
M. P. Loiseau Audirac, C. Bader, C. Castermans, I. Quintana; Bordeaux/FR

Purpose: Study about influence of physical environment of imaging departments' waiting rooms on pre-examination patients' perceived anxiety. The main objective is to estimate the difference in state anxiety, perceived by patients in 3 types of waiting room environment "Nature GREEN", "Nature SEA", "Nature ZEN" compared to a reference environment "Standard waiting room" and to evaluate emotional perception and satisfaction of patients for each environment.
Methods and Materials: 400 patients' anxiety score was measured by STAI-Y trait and state scales after 12 minutes' immersion time. Emotional perception for environment was evaluated by "Scale of the perceived attractiveness" of Sophie Rieunier and satisfaction of patient with digital analog scale.
Results: The "Nature GREEN" environment is the only one where it is observed a significant 10% decrease in state anxiety score compared to the reference group "Standard waiting room". This is also where patients' satisfaction score is the highest. Affective perception scores for environment are better in "Nature GREEN" and "Nature SEA".
Conclusion: "Nature GREEN" environment has proven its effectiveness in reducing patients' pre-examination anxiety in imaging department. A multi-centre study would be needed to establish evidence-based recommendations for care space design.

Value-based practice (VBP) training for radiographers
R. M. Strudwick1, A. Newton-Hughes2, S. Gibson3, J. Harris4, M. Gradwell3, E. Hyde5, J. Harvey-Lloyd1, T. J. O'Regan6, J. Hendry7; 1Ipswich/GB 2Salford/GB 3Canterbury/GB 4Guildford/GB 5Derby/GB 6Lancashire/GB 7Kingston/GB

Purpose: Value-based practice (VBP) is the consideration of a patient’s values in decision-making. VBP takes into account and highlights what matters to the patient. By patient values we mean the unique preferences, concerns and expectations each patient brings to a practice encounter which must be integrated into clinical decisions for the patient1.
Methods and Materials: A small team made up of radiography educators have adapted materials from a VBP handbook, originally developed for medicine. The handbook, conceived by Professor Bill Fulford and Dr. Ashok Handa2, has been adapted for use by diagnostic and therapeutic radiographers. The scenarios included in the text have been piloted with radiographers and undergraduates at study days and in teaching sessions. We are grateful to the participants for their input. Raising the awareness of values is essential to enable contemporary person-centred care. Sustainable implementation, however, depends on a whole-systems approach where patients are put at the centre of service delivery. The handbook introduces the concept and provides examples of individual values.
Results: We have facilitated two successful study days focused on VBP in radiography and teaching sessions with student radiographers.
Conclusion: Our aim has always been to share this material; we advocate that all radiographers must gain an understanding of VBP and adopt the approach in practice. The handbook acts as a method of raising awareness. The result is the beginning of VBP conversations in radiography; when embedded, VBP will provide assurance that we put the patient as the centre of everything we do.

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