Providing patient-centred care as Medical Radiation Practitioners to children and young persons in out of home care.

Modern healthcare focuses on patient-centred care where patients' needs, beliefs, choices and preferences are valued and lead to better health outcomes. Children and young persons in out of home care (OOHC) require more health care services compared with children from similar social and economic backgrounds. Each state and territory government are responsible for statutory child protection in Australia. If a child is unsafe in their current environment, they may be removed and placed into OOHC where they have ongoing case management with either a government or non-government agency. Complex trauma is the prolonged and uncontrolled exposure to traumatic events, like those experienced by maltreated children. Complex trauma can create a toxic stress response that produces biological alteration to the developing brain and affects the lives of the child, other family members and their descendants. Children with complex trauma often do not have the ability to regulate their responses to stimuli, reacting to minor triggers with disproportionate reactions. Many of these children will present with challenging behaviours. Trauma-informed care is a method of service delivery that seeks to actively minimise re-traumatisation. Creating a safe space is an essential element of trauma-informed care. Children with a history of complex trauma have life experiences that may be re-lived in a healthcare setting. There are ethical and legal considerations like privacy, consent and mandatory reporting when dealing with children in OOHC. By practising trauma-informed care Medical Radiation Practitioners can minimise further trauma to one of the most vulnerable population groups in Australia.

Exploring the evidence-practice gap in the use of plain radiography for acute abdominal pain and intestinal obstruction: a systematic review and meta-analysis.

AIM: Previous studies, some dating back several decades, have recommended that the use of plain abdominal radiography should be curbed, particularly with the growth of more accurate imaging modalities. However, evidence from referral data suggests that plain abdominal radiography continues to be a commonly requested examination. The aim of this review was to explore the gap between evidence and practice by re-examining the evidence using a robust methodology, investigating the diagnostic accuracy of plain abdominal radiography. METHODS: Studies were identified from electronic databases and reference lists. Eligible studies provided data as to the sensitivity and specificity of plain abdominal radiography for either acute abdominal pain (Group A) or suspected intestinal obstruction (Group B). Version 2 of the Quality Assessment of Diagnostic Accuracy Studies was used to assess the quality of studies and hierarchical summary receiver operator characteristic curves and coupled forest plots were generated. RESULTS: Four studies evaluated plain abdominal radiography for acute abdominal pain (Group A) and 10 for suspected intestinal obstruction (Group B). Two studies investigated both presentations and were included in both groups. Methodological quality of studies was moderately high, though incorporation bias was a common limitation. Sensitivity for Group A studies ranged from 30 to 46%, with specificity from 75 to 88%. For Group B, the range of sensitivity was 48 to 96% and specificity from 50 to 100%. CONCLUSION: The results suggest that use of plain abdominal radiography could be substantially reduced, particularly for patients with undifferentiated acute abdominal pain. While some guidelines exist, there is sound argument for clinical decision rules for abdominal imaging to inform evidence-based clinical decision-making and radiology referrals.

Recommendations for radiographers and radiation therapists drawn from an analysis of errors on Australian Radiation Incident Registers.

INTRODUCTION: The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) collect reported incidents for inclusion in the Australian Radiation Incident Register (ARIR), a database of radiation incident reports that occur within Australia. While the information on previous radiation incidents is available, there is little information on the lessons that can be learned from those past incidents to help prevent the same errors reoccurring. The aims of the study were to investigate what radiation incident registers are publicly available in Australia and to utilise the information contained within the ARIR and any other state or territory radiation protection authority registers to make recommendations for radiographers and radiation therapists to prevent future adverse events. METHODS: A search was conducted to locate what radiation incident registers within Australia were available to the public. All adverse events from 2003 to 2014 were compiled into a spreadsheet for analysis. An error-type classification taxonomy was used to classify the adverse events. Conclusions were drawn from the determined causes to make recommendations to change work practices in an attempt to prevent similar adverse events reoccurring. RESULTS: Incident registers were located from New South Wales, South Australia, Tasmania, Victoria and Western Australia. Radiography represented 76% (243) of the adverse events. A vast majority of the incidents were a failure to comply with time-out protocols (77%, 248). CONCLUSION: There are several radiation adverse event registers publicly available to utilise in Australia. All departments need to adopt and strictly adhere to time-out protocols. This in conjunction with the other recommendations in this article has the potential to dramatically reduce radiation adverse events.

Recommendations for Nuclear Medicine Technologists Drawn from an Analysis of Errors Reported in Australian Radiation Incident Registers.

When a radiation incident occurs in nuclear medicine in Australia, the incident is reported to the relevant state or territory authority, which performs an investigation and sends its findings to the Australian Radiation Protection and Nuclear Safety Agency. The agency then includes these data in its Australian Radiation Incident Register and makes them available to the public as an annual summary report on its website. The aim of this study was to analyze the radiation incidents included in these annual reports and in the publically available state and territory registers, identify any recurring themes, and make recommendations to minimize future incidents. METHODS: A multidisciplinary team comprising a nuclear medicine technologist, a radiation therapist, and a diagnostic radiographer analyzed all nuclear medicine technology-, radiation therapy-, and diagnostic radiography-related incidents recorded in the Australian Radiation Incident Register and in the registers of New South Wales, Western Australia, Victoria, South Australia, and Tasmania between 2003 and 2015. Each incident was placed into 1 of 18 categories, and each category was examined to determine any recurring causes of the incidents. RESULTS: We analyzed 209 nuclear medicine incidents. Their primary cause was failure to comply with time-out protocols (85.6%). By analyzing both the causes and the rates of radiation incidents, we were able to recommend ways to help prevent them from being repeated. CONCLUSION: Information drawn from the Australian Radiation Incident Register and 5 state registers has revealed steps that can be taken by any nuclear medicine department to prevent repetition of the incidents that have already occurred.

International collaboration in medical radiation science.

INTRODUCTION: International collaboration is recognised for enhancing the ability to approach complex problems from a variety of perspectives, increasing development of a wider range of research skills and techniques and improving publication and acceptance rates. The aim of this paper is to describe the current status of international collaboration in medical radiation science and compare this to other allied health occupations. METHODS: This study utilised a content analysis approach where co-authorship of a journal article was used as a proxy for research collaboration and the papers were assigned to countries based on the corporate address given in the by-line of the publication. A convenience sample method was employed and articles published in the professional medical radiation science journals in the countries represented within our research team - Australia, the United Kingdom (UK) and the United States of America (USA) were sampled. Physiotherapy, speech pathology, occupational therapy and nursing were chosen for comparison. RESULTS: Rates of international collaboration in medical radiation science journals from Australia, the UK and the USA have steadily increased over the 3-year period sampled. Medical radiation science demonstrated lower average rates of international collaboration than the other allied health occupations sampled. The average rate of international collaboration in nursing was far below that of the allied health occupations sampled. Overall, the UK had the highest average rate of international collaboration, followed by Australia and the USA, the lowest. CONCLUSION: Overall, medical radiation science is lagging in international collaboration in comparison to other allied health fields.