Radiographers perceptions of magnetic resonance imaging: a study of the causes that lead to the repetition of exams

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1 Radiographers perceptions of magnetic resonance imaging: a study of the causes that lead to the repetition of exams Poster No.: B-1020 Congress: ECR 2013 Type: Scientific Paper Authors: T. M. R. Filipe 1, L. P. V. Ribeiro 1, R. P. P. A. Almeida 1, S. Keywords: DOI: Rodrigues 1, K. B. Azevedo 1, C. A. Silva 2, A. F. Abrantes 1 ; 1 Faro/ PT, 2 Évora/PT Professional issues, MR, Health policy and practice, Education, Safety /ecr2013/B-1020 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Purpose 1. To know how often occur the repetitions of MRI exams and sequences in radiology departments. 2. Analyze the most common causes that lead to the repetition of MRI. 3. To determine which MRI exam has a higher frequency of repetitions. Methods and Materials A self-applied questionnaire was used as instrument and assigned to 57 diagnostic radiographers to determined which were the causes that lead to repeated MRI exams. The consent to participation was obtained from each diagnostic radiographer that filled the questionnaire and in accordance to institutional guidelines, the approval of this study was obtained from the review board. Sample: From March to July 2012 were selected 57 diagnostic radiographers by convenience sample that make MRI exams daily, 29 were women and 28 were men with a mean age of years ranging from 21 and 46 years old. Instruments: The questionnaire used in this study pretend to gather information about the causes that lead to the MRI exams repetition. The original questionnaire was developed by the author Fernanda Gonçalves (2009) who gave authorization to use her questionnaire. The questionnaire suffered some methodological modifications in order to gather more information, e.g. to know how often occur the repetitions of MRI exams and sequences in radiology departments. Procedures: The questionnaires filled by the radiographers were composed by five parts. The first part is about sociodemographic characterization, the second part is about the caracterization of the workplace of the radiographers. The third concerns about the work organisation of the radiographer, the fourth has to do with work accidents and errors and finally the fifth part is about patient safety. Page 2 of 8

3 Statistical analysis: The questionnaires were interpreted and statistically analyzed through descriptive statistics and Spearman's rho correlation using SPSS V.20 software. Results Work Conditions: At a 95% confidence interval, the results suggest that the radiographers consider that their work place has good conditions (illumination, protection equipment, temperature). On a five points likert scale (1 means poor conditions and 5 means excellent conditions), the radiographers consider that the illumination is good (M=3.74) as well as the temperature (M=3.46). The disposition of the equipment (M=3.84) and the equipment of personal protection (M=3.98) is considered good as well. Work Organisation: When asked about tiredness at the end of the shift, the majority of the radiographers said that sometimes they feel tiredness (80.7%). Some of the radiographers said that they were always tiredness (10.5%) and a few of them did not feel tiredness at the end of the service (8.8 %). Using Spearman's rho test (Table 1) we verify that there are some correlations between the radiographer's characteristics. To test the hypothesis "fatigue influences the frequency of repeated exams", the data indicate a weak negative correlation not significant (r=-.151; p=.263), therefore we reject the hypothesis that the fatigue influences the frequency of repeated exams. Table 1: Relationship between repeated MRI exams and Diagnostic Radiographers Fatigue. References: Department of Radiology, Health School - University of Algarve Workplace accidents and errors: Page 3 of 8

4 Concerning about the repetition of MRI exams, 91.2% of the diagnostic radiographers repeats MRI exams compared to 8.8% of the respondents that did not repeat those exams. To test the hypothesis "The frequency of repeat exams decreases with increasing years of experience of diagnostic radiographers" we use the spearman's rho test again (Table 2), in order to verify the linear association between the variables of time of service and the frequency repeat of MRI exams. We obtained a weak positive correlation (r =.141) not significant (p =.297), indicating that the longer time of service the largest frequency of repeated exams. Table 2: Relation between the repetition of MRI exams and the diagnostic radiographers years of experience. References: Department of Radiology, Health School - University of Algarve At a 95% confidence interval, the major results suggest that the patient's movement during de MRI exams is the main cause to repeat this exams (mean of 3.88 on a 5 points likert scale). However, there are causes related to the radiographer's and the results showed that the introduction of wrong imaging parameters by the performer are a major cause too (N=26). The MRI exams to the abdomen, thorax and pelvis are the most repeated. Patient Safety: To investigate the hypothesis "Patient safety is influenced by the frequency of repeat exams" we used the test of Spearman rho (Table 3). It was observed that there was a weak negative correlation (r = -.079) not significant (p =.564), indicating that the safety of the patient is not influenced by the repetition of MRI exams. Page 4 of 8

5 Table 3: Relation between the repetition of MRI exams and the safety of the patients. References: Department of Radiology, Health School - University of Algarve Conclusion In accordance with the frequency values, we can conclude that the repetition of MRI exams is not very frequent. In the same way, the most common causes that lead to the repetition of MRI exams are the patients movement and the use of incorrect technical parameters by the diagnostic radiographers. The MRI of abdomen is the most repeated exam due to the patients movement, because this is an exam that requires the maximium cooperation of the patient. The patients' movement may disrupt the examination or degrade the images with artifacts. The level of experience doesn't influence the repetitions of MRI exams, it seems that seniors radiographers don't have improvements in performance as it should be expected. It's recommendable to do training courses regularly to improve the performance and systematically evaluate. Several features will need to be identified which would decrease the MRI exams repetitions. References 1. Amado, C. (2009). Taxa de repetição por causa: avaliação de radiogramas em radiologia de urgência. Escola superior de tecnologia da Saúde de Lisboa. Acedido em 23 de Maio, 2012, em radiologia0509.files.wordpress.com/2010/03/artigo-de-investigacaochristelle-amado2.pdf 2. Bell, A. (2006). Improving Patient Safety within a Radiology Department. Consultado em 27 de Abril, 2012 através de site/article.cfm?id=7 3. Busel, D. & Silva, C. (2004). Radiologia baseada en la evidência: Estrategia conceptual focalizada para la pratica de la imagenologia. Consultado em 13 de Dezembro, 2010 através de art04.pdf 4. Correira, E. & Pardal, L. (1995). Metodologia. Consultado em 3 de Janeiro, 2011 através de 5. De Keyser, V. (2005). O Erro Humano. In J. J. Castillo & J. Villena (Eds.), Page 5 of 8

6 6. Ergonomia - Conceitos e Métodos (1ª ed., A. Reis & V. Rodrigues, Trad., pp ): Dinalivro. (Capítulo original publicado em Mundo Científico, Vol. 99, 1990) 7. Department of Radiology, McMaster University (2001). Evidence-based Radiology: A new Approach to the practice of Radiology. Consultado a 13 de Dezembro, 2010 através de documents/general_radiology/articles/evidence%20based%20radiology %20-%20A%20New%20Approach%20To%20Practicing%20Radiology.pdf 8. Dickerson, J., Donnelly, L., Goodfriend, M., & Muething, S., (2010). Improving patient safety in radiology. Consultado em 27 de Abril, 2012 através de 9. Fortin, M.F. (2009). Fundamentos e Etapas do Processo de Investigação. Loures: Lusodidacta. 10. Gonçalves, F. (2009). Análise do erro durante a realização de radiografias digitais em situação de urgência: estudo comparativo entre dois hospitais. Consultado em 7 de Dezembro, 2010 através de bitstream/ /1755/1/documento%20definitivo%20da%20tese.pdf 11. Hayrton (2009). Erro Humano. Consultado em 15 de Dezembro, 2010 através de Rodrigues, A. (2010). Introdução aos métodos de investigação. Consultado em 3 de Janeiro, 2011 através de Introducao-aos-Metodos-de-Investigacao 13. Santos, M. (2010). Ressonância Magnética. Consultado a 12 de Dezembro, 2010 através de Secca, M. F. (2003). Bases físicas das diferentes técnicas. In J. M. Pisco (Ed.), 15. Imagiologia Básica: Texto e Atlas (pp. 3-8): LIDEL. 16. Serviço de bioestatística e informática médica (s.d.). Metodologia Científica. Consultado em 3 de Janeiro, 2011 através demedicina.med.up.pt/im/ im2004/teoricas/tq3.ppt Personal Information T. M. R. Filipe, Department of Radiology, Health School - University of Algarve, Portugal. Tel: Fax: Page 6 of 8

7 L. P. V. Ribeiro, PhD, Department of Radiology, Health School - University of Algarve, Member of Cdaf (Research Center of Sports and Physical Activity), Portugal. lpribeiro@ualg.pt R. P. P. Almeida, Department of Radiology, Health School - University of Algarve, PhD student at Faculty of Health Sciences - University of Beira Interior, Portugal. rpalmeida@ualg.pt S. Rodrigues, Master, Department of Radiology, Health School - University of Algarve. srodrigues@ualg.pt K. B. Azevedo, Department of Radiology, Health School - University of Algarve, Portugal; PhD student at Cranfield University, UK. kbazevedo@ualg.pt C. A. Silva, PhD, Department of Radiology, Health School - University of Algarve, Member of CESNOVA (Sociology Studies Center of New University of Lisbon), Portugal, Sociology Department - University of Evora. casilva@uevora.pt A. F. Abrantes, PhD, Department of Radiology, Health School - University of Algarve, Member of CESNOVA (Sociology Studies Center of New University of Lisbon), Portugal. aabrantes@ualg.pt Page 7 of 8

8 Fig. 1 References: Department of Radiology, Health School - University of Algarve Page 8 of 8