Radiography最新文献

Introduction: Hearing loss is a widespread disability, and unfortunately, deaf and hard-of-hearing (DHH) patients often experience unequal healthcare and unmet needs. People with the condition are predisposed to anxiety, fatigue and depression. Communication barriers are a major issue, particularly during magnetic resonance imaging (MRI) scans where clear radiographer-patient communication is crucial for safety and quality imaging. This study aimed to understand the experiences of MRI Radiographers in providing care to DHH patients for MRI scans.

Methods: A qualitative descriptive phenomenological study design using purposive sampling to gain in-depth insights. The study comprised seven MRI radiographers working clinically at a public hospital in England. Data was collected through semi-structured face-to-face interviews. Audio recordings were transcribed using Microsoft 365 software. The transcripts were coded into categories and further on, into themes using the inductive approach of thematic analysis.

Results: The study revealed five key themes: communication barriers and consequences, current approaches to care, satisfaction of care provisions, prospects of technological advancements and training and professional development. The findings show that MRI radiographers encounter distinct and diverse communication difficulties while caring for DHH patients. Radiographers' experiences indicated the need for evidence-based strategies in addressing the communication challenges of DHH individuals. Some participants acknowledged that training and technological interventions could help with providing quality care for the patient group in MRI.

Conclusion: The study's findings advocate for inclusiveness in delivering MRI services. It presents compelling evidence for MRI service providers to support radiographers by encouraging training and implementing approaches that guarantee safe, quality, and consistent care for patients with hearing impairments. The diversity of the DHH population's communication needs and lack of comprehensive guidelines are recognised to contribute to the struggle to deliver good care.

Implications for practice: To mitigate DHH patients' communication challenges, MRI service providers should sufficiently train MRI radiographers, create a supportive environment and promote services that address their needs.

Introduction: Research strategies support professionals to create a shared vision and work towards common objectives which can enhance workforce satisfaction, retention and patient experience. Our research aimed to capture the current number of United Kingdom (UK) radiotherapy and diagnostic imaging departments that have a local discipline specific research strategy in place. We also sought to understand the contributing factors to their development, with the aim of generating models of support to enhance future local research strategies.

Methods: A discipline specific cross-sectional survey was co-developed by the research team, the College of Radiographers (CoR) and our patient and public involvement and engagement representative. Distribution was via the CoR to radiotherapy and imaging departments across the UK.

Results: Complete responses were received from 32 radiotherapy and 19 imaging departments, discipline specific strategy numbers were low with only 10 and 3 departments respectively having one in situ. Barriers and enablers to their development as well as disparate motivations and intentions to develop a strategy were evident within and across each discipline. The respondents identified a range of formats and topics to help the development of strategies.

Conclusion: Radiographers are keen to develop and implement their own research ideas, however this work is additional to clinical service demand. Removing barriers to research participation is a strategic priority, regional cooperation and coordination may play an increasing role in research engagement, scale and support. Opportunities to increase ownership and confidence in research strategy development should be pursued including template strategies and professional facilitation.

Implications for practice: A discipline specific strategy would support departments to navigate the complexities of research regulation and policy and overcome the challenges faced by competing priorities.

Introduction: Ankle injuries that present to the ED with instability of the joint due to multiple fractures/disruption of the mortise need to be re-aligned promptly to minimise complications. A protocol change was introduced whereby mobile radiographs would be performed in the ED resuscitation room during manipulation of a complex ankle injury. The aim of this study was to determine if the overall time to definitive reduction had reduced for these patients, improving patient flow.

Method: Data was collected from patients attending the ED with a complex or unstable ankle injury in a UK single-centre over 6-months periods, pre pathway introduction (2019), immediately post change (2021) and 2 years post implementation (2023).

Results: In excess of 3000 patients had ankle radiographs performed in each cohort of data collection with an average of 2.9 % of injuries categorised as complex or unstable and requiring manipulation, consistent across the cohorts (p = 0.246). Increasing compliance with the new pathway was evident over time with a significant time reduction demonstrated from initial ED presentation to final post manipulation imaging if mobile radiographs were obtained with the mean time 113 min quicker than those performed in the radiology department in 2023 (p = 0.00).

Conclusion: Although it takes time to embed new pathways and changes in practice, this study demonstrated that a simple change in imaging provision had a positive impact for patients with a complex ankle injury.

Implications for practice: Providing post manipulation radiographs in the ED resuscitation room allowed earlier confirmation of restored anatomical alignment for patients with a complex ankle injury and enabled clinicians to perform multiple manipulation attempts, if necessary, under the same sedation episode.

Introduction: Invasive fungal infections (IFI) in paediatric oncology patients are associated with significant morbidity and mortality. Abdominal ultrasonography is widely used for diagnosis, but its utility remains unclear.

Methods: We conducted a retrospective cohort study of paediatric oncology patients who were febrile and neutropaenic at Queensland Children's Hospital, Australia, from January 2018 to December 2019. We reviewed abdominal ultrasound (US) examinations requested for suspected IFI, analysing diagnostic yield and associations with clinical variables.

Results: There were 94 patients included, 21 of whom did not survive their underlying condition, seven (7.4 %) showed evidence of IFI on US. Infections did not demonstrate a predilection for a particular abdominal organ. Fourteen patients had a positive blood culture, with only three confirmed fungal pathogens. Chest computed tomography, performed in 41 of cases had findings suspicious for IFI in 52.3 % of these examinations.

Conclusion: Abdominal ultrasonography has a low diagnostic yield (7.4 %) for new IFI in paediatric oncology patients. However, given the mortality rate in this population, its use may be justified for monitoring known infections and as part of a comprehensive diagnostic approach.

Implications for practice: US is an effective method of screening for abdominal IFI in paediatric oncology patients who are febrile and neutropaenic. The low diagnostic yield is outweighed by the morbidity and mortality of IFI in this vulnerable patient cohort.