Australian sonographers' perceptions of patient safety in ultrasound imaging: Part two - translation into practice.

Introduction: A lack of patient safety research hampers capacity to improve safety in healthcare.Ultrasound is often considered 'safe' as it does not use ionising radiation, a simplistic view of patient safety. Understanding sonographers' actions towards patient safety is crucial; however, self-reported measures cannot always predict behaviour. This study is part of a PhD exploring patient safety in medical diagnostic ultrasound. The aim of this paper is to explore sonographers' responses to the patient safety concerns identified in Part one of this study. The ultimate aim of the study is to inform the final phase of the doctoral study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. The Theory of Planned Behaviour (TPB) explained how sonographers respond to perceived patient safety risks in practice. Results: Thirty-one sonographers were interviewed. Based on the seven themes identified in Part one of the study, results showed that incongruences exist between identifying patient safety risks and the actions taken in practice to manage these risks. Conclusion: The TPB showed that behavioural, normative and control beliefs impact sonographers' responses to perceived patient safety risks in practice and can lead to risk avoidance. Lack of regulation in ultrasound creates a challenge in dealing with Fitness to Practice issues. Collective actions are required to support sonographers in taking appropriate actions to enhance patient safety from multiple stakeholders including accreditation bodies, regulatory authorities, educational institutions and employers.

Australian sonographers' perceptions of patient safety in ultrasound imaging: Part 1 - identifying the main safety concerns, a qualitative study.

Introduction: Patient safety has been an undervalued component of quality healthcare but is a challenging area of research.Ultrasound is the most common imaging modality in the world. Research on patient safety in ultrasound is generally focused on bioeffects and safe operation of ultrasound equipment. However, other safety issues exist in practice that warrant consideration.This paper forms the first part of a PhD study exploring patient safety in medical diagnostic ultrasound, beyond the notion of bioeffects.The ultimate aim of the study is to inform the final phase of the research study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. A thematic analysis categorised data into codes and generated final themes. Results: A heterogeneous mix of 31 sonographers, who reflected the profile of the profession in Australia, were interviewed between September 2019 and January 2020. Seven themes emerged from the analysis. These were bioeffects, physical safety, workload, reporting, professionalism, intimate examinations and infection control. Conclusion: This study presents a comprehensive analysis of sonographers' perceptions of patient safety in ultrasound imaging, not previously available in the literature. Consistent with the literature, patient safety in ultrasound tends to be viewed in technical terms through the potential for bioeffects of tissue damage or physical harm to the patient. However, other patient safety issues have emerged, and while not as well recognised, have the potential to negatively impact on patient safety.

Designing a breast support device for phase contrast tomographic imaging: getting ready for a clinical trial.

OBJECTIVE: To design a device that can support the breast during phase-contrast tomography, and characterise its fit parameterisation and comfort rating. METHODS: 27 participants were recruited to trial a system for breast support during simulated phase contrast imaging, including being positioned on a prone imaging table while wearing the device. Participants underwent a photogrammetry analysis to establish the geometric parameterisations. All participants trialled a single-cup design while 14 participants also trialled a double-cup with suction holder and all completed a series of questionnaires to understand subjective comfort. RESULTS: Photogrammetry revealed significant positive correlations between bra cup volume and measured prone volume (p < 0.001), and between "best fit" single-cup holder volume and measured prone volume (p < 0.005). Both holders were suitable devices in terms of subjective comfort and immobilisation while stationary. However, some re-engineering to allow for quick, easy fitting in future trials where rotation through the radiation beam will occur is necessary. Light suction was well-tolerated when required. CONCLUSION: All participants indicated the table and breast support devices were comfortable, and they would continue in the trial. ADVANCES IN KNOWLEDGE: Phase contrast tomography is an emerging breast imaging modality and clinical trials are commencing internationally. This paper describes the biomedical engineering designs, in parallel with optimal imaging, that are necessary to measure breast volume so that adequate breast support can be achieved. Breast support devices have implications for comfort, motion correction and maximising breast tissue visualisation.

The masked educator-innovative simulation in an Australian undergraduate Medical Sonography and Medical Imaging program.

INTRODUCTION: Clinical learning experiences for sonography and medical imaging students can sometimes involve the practice of technical procedures with less of a focus on developing communication skills with patients. Whilst patient-based simulation scenarios have been widely reported in other health education programmes, there is a paucity of research in sonography and medical imaging. The aim of this study was to explore the effectiveness of Mask-Ed™ (KRS Simulation) in the learning and teaching of clinical communication skills to undergraduate medical sonography and medical imaging students. Mask-Ed™ (KRS Simulation) is a simulation technique where the educator is hidden behind wearable realistic silicone body props including masks. METHODS: Focus group interviews were conducted with 11 undergraduate medical sonography and medical imaging students at CQUniversity, Australia. The number of participants was limited to the size of the cohort of students enrolled in the course. Prior to these interviews participants were engaged in learning activities that featured the use of the Mask-Ed™ (KRS Simulation) method. Thematic analysis was employed to explore how the introduction of Mask-Ed™ (KRS Simulation) contributed to students' learning in relation to clinical communication skills. RESULTS: Key themes included: benefits of interacting with someone real rather than another student, learning made fun, awareness of empathy, therapeutic communication skills, engaged problem solving and purposeful reflection. CONCLUSIONS: Mask-Ed™ (KRS Simulation) combined with interactive sessions with an expert facilitator, contributed positively to students' learning in relation to clinical communication skills. Participants believed that interacting with someone real, as in the Mask-Ed characters was beneficial. In addition to the learning being described as fun, participants gained an awareness of empathy, therapeutic communication skills, engaged problem solving and purposeful reflection.

Health human resources: consider the health technology professions.

Any analysis of health human resources must take into account the critical shortages in the health technology professions, such as medical laboratory technology, medical radiation technology, respiratory therapy and other allied health professions. These professions are often overlooked or invisible to patients, but they provide a vital role in diagnostic and therapeutic services. If projected shortages are not addressed, there will be a major impact on patient care. Accurate human resources information about these professionals must be collected; funding for additional spaces in educational institutions is essential; and a reconsideration of scopes of practice to allow more effective utilization of health technologists' knowledge and skills should be initiated as soon as possible.