Radiographer workforce role expansion to improve patient safety related to nasogastric tube placement for feeding in adults.

AIM: To determine whether the active involvement of radiographers in nasogastric tube (NGT) management at a large multisite healthcare institution can contribute to risk reduction regarding feeding through misplaced NGTs. MATERIALS AND METHODS: Despite national guidance in the National Health Service advising on safe practice to confirm NGT position, a number of "never events" (feeding through misplaced NGT) continue to occur due to misinterpretation of the check radiograph. Practice change was introduced, including all plain film radiographers providing contemporaneous comments on NGT position on the check radiograph. The success of the system was assessed to determine the accuracy of radiographer comments against the reference standard of the radiologist report to see whether the system has helped reduce the number of "never events". RESULTS: During the first 27 months post-implementation, 4,675 check NGT radiography examinations were analysed. Two hundred and twenty-seven examinations were excluded due to absent or incomplete radiographer comments. The accuracy of the radiographer comments was 98.5% (95% confidence interval [CI]: 97.7-99.5%), sensitivity 97.4% (95% CI: 96.3-98.3%), specificity 98.9% (95% CI: 98.5-99.2%), positive predictive value 96.8% (95% CI: 95.6-97.7%), and negative predictive value 99.1% (95% CI: 98.8-99.4%). CONCLUSION: After focused training, radiographer comments are a safe, sustainable, and workable solution offering an effective solution for image misinterpretation issues relating to NGT "never events". This should be considered for wider implementation in healthcare.

Preparing for consultant interviews in clinical radiology.

This article will specifically deal with preparing for consultant interviews in clinical radiology by providing a list of carefully selected resources comprising of training courses and internet sites available for trainee radiologists nearing the end of their training. It will also be of use to established consultant radiologists seeking a new post, those applying for consultant positions in other specialties, and doctors applying for more junior positions in radiology. Hyperlinks are available in the electronic version of this article.

Evolution of idiopathic fibrosing pancreatitis--MRI features.

Here, the clinical and imaging features of idiopathic fibrosing pancreatitis are described, including a description of the evolution of MRI features in a patient treated successfully with biliary stenting alone. Thus, not all masses of the pancreatic head in the paediatric population need to be managed surgically.

Precautions to be taken by radiologists and radiographers when prescribing hyoscine-N-butylbromide.

Hyoscine-N-butylbromide (Buscopan, Boehringer Ingelheim) is a widely used antispasmodic in radiological practice. There seems to be no consensus as to best practice within radiology regarding the precautions that need to be taken when prescribing Buscopan. We have performed a thorough review of the available literature and make the following recommendations to those administering Buscopan: (1) enquire whether there is an allergic history; (2) ensure patient literature warns that "in the rare event that following the examination you develop painful, blurred vision in one or both eyes, you must attend hospital immediately for assessment"; (3) warn patients to expect blurred vision and not to drive until this has worn off; (4) remind clinicians that special consideration needs to be given as to the method of investigating patients with cardiac instability, such as those recently admitted with acute coronary syndrome, recurrent cardiac pain at rest, uncontrolled left ventricular failure and recent ventricular arrhythmias.

Optimization of CT colonography technique: a practical guide.

In this article we provide practical advice for optimizing computed tomography colonography (CTC) technique to help ensure that reproducible, high-quality examinations are achieved. Relevant literature is reviewed and specific attention is paid to patient information, bowel cleansing, insufflation, anti-spasmodics, patient positioning, CT technique, post-procedure care and complications, as well as practical problem-solving advice. There are many different approaches to performing CTC; our aim is to not to provide a comprehensive review of the literature, but rather to present a practical and robust protocol, providing guidance, particularly to those clinicians with little prior experience of the technique.