scholarly journals A clinical audit of anatomical side marker use in a pediatric medical imaging department: A quantitative and qualitative investigation

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242594
Author(s):  
Lilian Chung ◽  
Saravana Kumar ◽  
Joanne Oldfield ◽  
Maureen Phillips ◽  
Megan Stratfold
Keyword(s):  
Clinical Practice ◽  
Medical Imaging ◽  
Best Practice ◽  
Clinical Audit ◽  
Diagnostic Feature ◽  
Structured Interviews ◽  
Quantitative And Qualitative Research ◽  
Imaging Department ◽  
Practice Standards ◽  
Stage 1

Background The presence of a radiopaque or digital anatomical side marker (ASM) is an important diagnostic feature on radiographs and should be a routine feature on every radiographic image. Despite its importance, research has indicated numerous instances where ASMs were absent which have the potential to lead to adverse events. To date, few studies have systematically examined the use of ASMs in clinical practice and explored medical imaging professionals’ perspectives on ASM use. This research aimed to address this knowledge gap. Methods This investigation was conducted in two stages. Stage 1 involved a retrospective clinical audit of 421 randomly selected radiographs within 12-months at a pediatric medical imaging department. The data were analyzed for overall presence and type of marker use. Stage 2 comprised of semi-structured interviews with 11 radiographers to garner their perspectives on ASM use, and barriers and enablers to their use in clinical practice. The interviews were transcribed verbatim and thematically analyzed. Results The overall presence of ASMs (radiopaque and digital) was observed on 99 per cent of radiographs. There was a noticeable shift towards the use of digital (78.8 per cent) compared to radiopaque ASMs (20.2 per cent), highlighting the growing trend towards using ASM in post-processing. A handful of images (N = 4) did not include any ASMs. Semi-structured interviews revealed multifaceted barriers (time, infection precautions, and patient factors) and few enablers (professionalism, legal requirement) for ASM use. Conclusion This investigation, informed by quantitative and qualitative research paradigms, has shed new light on an important area of radiography practice. While missing ASMs were a small feature, there continue to remain opportunities where best practice standards can be improved. The increasing use of digital ASMs potentially highlights a shift in clinical practice standards.

scholarly journals Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandra Rekha Makanjee ◽  
Anne-Marie Bergh ◽  
Deon Xu ◽  
Drishti Sarswat
Keyword(s):  
Medical Imaging ◽  
Medical Practitioner ◽  
Well Being ◽  
Structured Interviews ◽  
Patient Journey ◽  
Personal Lives ◽  
Healthcare Transition ◽  
Imaging Department ◽  
Patient Cooperation

Abstract Background There is emerging interest in person-centred care within a short-lived yet complex medical imaging encounter. This study explored this event from the viewpoint of patients referred for an imaging examination, with a focus on the person and their person-al space. Methods We used convenience sampling to conduct semi-structured interviews with 21 patients in a private medical imaging practice in Australia. The first phase of data analysis was conducted deductively, using the six elements of the person-centred, patient-journey framework of the Australian Commission on Safety and Quality in Healthcare: transition in; engagement; decisions; well-being; experience; and transition out. This was followed by inductive content analysis to identify overarching themes that span a patient’s journey into, through and out of an imaging encounter. Results The transition-in phase began with an appointment and the first point of contact with the imaging department at reception. Engagement focused on patient-radiographer interactions and explanations to the patient on what was going to happen. Decisions related primarily to radiographers’ decisions on how to conduct a particular examination and how to get patient cooperation. Participants’ well-being related to their appreciation of gentle treatment; they also referred to past negative experiences that had made a lasting impression. Transitioning out of the imaging encounter included the sending of the results to the referring medical practitioner. Person-al vulnerabilities emerged as a cross-cutting theme. Patients’ vulnerability, for which they needed reassurance, pertained to uncertainties about the investigation and the possible results. Healthcare professionals were vulnerable because of patient expectations of a certain demeanour and of pressure to perform optimal quality investigations. Lastly, patients’ personal lives, concerns and pressures – their person-al ‘baggage’ – shaped their experience of the imaging encounter. Conclusion To add value to the quality of the service they deliver, radiography practitioners should endeavour to create a person-al space for clients. Creating these spaces is complex as patients are not in a position to judge the procedures required by technical imaging protocols and the quality control of equipment. A reflective tool is proposed for radiographers to use in discussions with their team and its leaders on improving person-centred care and the quality of services in their practice.

scholarly journals Barriers Perceived by Managers and Clinical Professionals Related to the Implementation of Clinical Practice Guidelines for Breastfeeding through the Best Practice Spotlight Organization Program

2020 ◽  
Vol 17 (17) ◽  
pp. 6248
Author(s):  
Antonio Jesús Ramos-Morcillo ◽  
David Harillo-Acevedo ◽  
David Armero-Barranco ◽  
César Leal-Costa ◽  
José Enrique Moral-García ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Health Professionals ◽  
Best Practice ◽  
Research Study ◽  
Structured Interviews ◽  
Qualitative Research Study ◽  
Implementation Program

International institutions facilitate the contact of health professionals to evidence-based recommendations for promoting exclusive breast feeding (BF). However, the achievement of good rates of exclusive BF is still far from the optimum. The intention of the present work is to determine the barriers identified by managers and health professionals involved in the implementation and sustainability of Clinical Practice Guidelines (CPG) for breastfeeding under the auspices of the Best Practice Spotlight Organization program. A qualitative research study was carried out. The participants were managers, healthcare assistants, nurses, midwives, pediatricians and gynecologists. Semi-structured interviews were conducted which were transcribed and analyzed using the six steps of thematic analysis. Twenty interviews were conducted, which defined four major themes: (1) Lack of resources and their adaptation; (2) Where, Who and How; (3) Dissemination and reach of the project to the professionals; and (4) The mother and her surroundings. This research identifies the barriers perceived by the health professionals involved in the implementation, with the addition of the managers as well. Novel barriers appeared such as the ambivalent role of the midwives and the fact that this CPG is about promoting health. The efforts for promoting the implementation program should be continuous, and the services should be extended to primary care.

scholarly journals A clinical audit of anatomical side marker use in a paediatric medical imaging department

2016 ◽  
Vol 63 (3) ◽  
pp. 148-154 ◽  
Author(s):  
Kate Barry ◽  
Saravana Kumar ◽  
Rebecca Linke ◽  
Emma Dawes
Keyword(s):  
Medical Imaging ◽  
Clinical Audit ◽  
Imaging Department

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

scholarly journals A Qualitative Analysis of the Needs and Experiences of Hospital-based Clinicians when Accessing Medical Imaging

2021 ◽  
Author(s):  
Séan Cronin ◽  
Bridget Kane ◽  
Gavin Doherty
Keyword(s):  
Medical Imaging ◽  
Digital Imaging ◽  
Data Privacy ◽  
General Purpose ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Desktop Computers ◽  
Single Voice ◽  
Safety Officer ◽  
Basic Features

AbstractAs digital imaging is now a common and essential tool in the clinical workflow, it is important to understand the experiences of clinicians with medical imaging systems in order to guide future development. The objective of this paper was to explore health professionals’ experiences, practices and preferences when using Picture Archiving and Communications Systems (PACS), to identify shortcomings in the existing technology and inform future developments. Semi-structured interviews are reported with 35 hospital-based healthcare professionals (3 interns, 11 senior health officers, 6 specialist registrars, 6 consultants, 2 clinical specialists, 5 radiographers, 1 sonographer, 1 radiation safety officer). Data collection took place between February 2019 and December 2020 and all data are analyzed thematically. A majority of clinicians report using PACS frequently (6+ times per day), both through dedicated PACS workstations, and through general-purpose desktop computers. Most clinicians report using basic features of PACS to view imaging and reports, and also to compare current with previous imaging, noting that they rarely use more advanced features, such as measuring. Usability is seen as a problem, including issues related to data privacy. More sustained training would help clinicians gain more value from PACS, particularly less experienced users. While the majority of clinicians report being unconcerned about sterility when accessing digital imaging, clinicians were open to the possibility of touchless operation using voice, and the ability to execute multiple commands with a single voice command would be welcomed.

scholarly journals Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Samantha Chakraborty ◽  
Bianca Brijnath ◽  
Jacinta Dermentzis ◽  
Danielle Mazza
Keyword(s):  
Qualitative Research ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
International Guideline ◽  
Novel Approach ◽  
Clinical Questions ◽  
Key Questions

Abstract Background There is no standardised protocol for developing clinically relevant guideline questions. We aimed to create such a protocol and to apply it to developing a new guideline. Methods We reviewed international guideline manuals and, through consensus, combined steps for developing clinical questions to produce a best-practice protocol that incorporated qualitative research. The protocol was applied to develop clinical questions for a guideline for general practitioners. Results A best-practice protocol incorporating qualitative research was created. Using the protocol, we developed 10 clinical questions that spanned diagnosis, management and follow-up. Conclusions Guideline developers can apply this protocol to develop clinically relevant guideline questions.

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