Exploring the implementation of evidence-based optimisation strategies: A qualitative study of the experience of diagnostic radiographers.

INTRODUCTION: Radiographers are responsible for ensuring safe and effective use of ionising radiation. Through evidence-based practice (EBP), valuable optimisation strategies can be implemented to fulfil these responsibilities. This study aimed to explore radiographers' attitudes, perceptions, and experience of using evidence-based optimisation strategies. METHODS: A Grounded Theory approach using in-depth interviews. UK-based radiographers were recruited. Discussions focused on (1) the role of evidence-based optimisation strategies in daily practice, (2) assistance in implementing evidence-based optimisation strategies, and (3) the role of EBP and optimisation strategies in the future. Interviews were transcribed verbatim and analysed using open and axial coding. RESULTS: Participants (n = 13) stated that EBP is not frequently used to implement optimisation strategies. Participants relied on the knowledge taught in education settings and their professional skills to optimise in daily practice, alongside departmental protocols. Barriers identified as affecting the implementation of optimisation strategies related to reluctance to change, a lack of support from superiors, and a lack of resources to engage with EBP. Some participants expected the use of optimisation strategies to become unnecessary due to technology advancements. CONCLUSION: The results indicate that effective operationalisation of EBP is not part of daily practice among radiographers to implement valuable optimisation strategies in daily practice. IMPLICATIONS FOR PRACTICE: The potential barriers to implementing evidence-based optimisation strategies highlighted in this study suggest that improving access to resources and empowerment of individual radiographers is required to enable radiographers to implement optimisation strategies.

Chest CT in patients with shortness of breath: Comparing high pitch CT and conventional CT on respiratory artefacts and dose.

INTRODUCTION: To investigate chest respiratory artefact reduction using High Pitch Dual Source Computed Tomography (HPCT) compared to conventional CT (CCT) in symptomatic patients with shortness of breath. METHODS: Forty patients were prospectively examined on a second-generation Dual Source scanner. They were randomly divided into two groups: twenty patients underwent an experimental HPCT protocol and twenty control cases CCT protocol. Respiratory artefacts were evaluated using an ordinal score (0, 1 and 2) assigned by two readers with five and thirty years of experience. A qualitative assessment was performed using two categorical groups, group 1 = acceptable and group 2 = unacceptable. Dose Length Product (DLP) was compared. RESULTS: The two groups showed a statistical difference in artefacts reduction (p < 0.0001). HPCT demonstrated no artefacts in 82% of cases, while CCT showed no artefacts in 39% of cases. DLP showed no statistical differences (p = 0.6) with mean = 266.9 for HPCT and mean = 282.65 for CCT. HPCT provides high table speed in the z-direction allowing a high temporal resolution, which reduces respiratory artefacts during free-breathing acquisition. Despite the use of two x-ray tubes, the HPCT did not increase the dose to the patient but provided the highest images quality. CONCLUSIONS: In the emergency setting, HPCTs have been critical for achieving good image quality in uncooperative patients. IMPLICATIONS FOR PRACTICE: Acute respiratory failure is a common emergency department presentation, and the choice of high-speed acquisition CT may increase image quality.

Evaluation of distraction techniques for patients aged 4-10 years undergoing magnetic resonance imaging examinations.

OBJECTIVES: The main aim of the review is to identify potentially effective distraction techniques for the 4 to 10 age range whilst reducing the need for sedation. Objectives also included assessment of the applicability of distraction for the 4-10 age range and, where appropriate, to identify potential cost implications and assess the interventions' impact on image quality. KEY FINDINGS: A priori search terms, inclusion and exclusion criteria were developed and two independent reviewers were employed to assess study quality. Five studies fitted the criteria of the systematic search strategy. The studies implemented a range of distraction and preparatory techniques resulting in paediatric patients being able to complete an MRI scan to a diagnostic level in the 4 to 10-year-old age category with a sedation rate of 5-20%. All interventions included in the review required time with the patient prior to the scan. CONCLUSION: There are a range of efficacious techniques that can be employed to reduce the sedation rates in children aged 4-10 years, whilst allowing diagnostic images to be acquired. The introduction of play and the engagement with the patient prior to the scan appear to be indicators of intervention effectiveness. The efficacy of these interventions does not appear to be linked with proprietary equipment. IMPLICATIONS FOR PRACTICE: Age appropriate interventions are necessary for children of different ages and these distraction interventions may be implemented within departments, for little cost, with notable benefits in terms of sedation.