Radiography最新文献

{"title":"Occupational stress and wellbeing: A qualitative exploration of the perspectives and experiences of migrant sonographers practising in the United Kingdom","authors":"C.U. Ollawa ,&nbsp;O. Lawal ,&nbsp;E. Akpan ,&nbsp;E.R. Upeh ,&nbsp;M.N. Kwame Anudjo","doi":"10.1016/j.radi.2025.01.017","DOIUrl":"10.1016/j.radi.2025.01.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Occupational stress (OS) and burnout are prevalent in healthcare, including ultrasound. These challenges are exacerbated by staff shortages, increasing workload, and ageing population growth, leading to a growing reliance on ultrasound for diagnosis. In the UK, migrant sonographers fill critical staffing gaps but face unique work-related stressors that impact their well-being and mental health. This study explored the experiences and perspectives of migrant sonographers practising in the UK regarding OS and well-being.</div></div><div><h3>Methods</h3><div>Ethical approval was obtained from Health Sciences University, Bournemouth (HRS-2024-ECYBl). Semi-structured interviews were conducted with 12 HCPC-registered migrant sonographers across ten regions in the UK who had experienced OS. These interviews were conducted via Microsoft Teams, transcribed verbatim, and analysed thematically using NVivo software. A descriptive qualitative approach was employed.</div></div><div><h3>Results</h3><div>Five major themes were developed: workplace dynamics, socioeconomic factors, practice-related factors, personal issues and coping mechanisms. Primary sources of stress identified were workload, difficult patients, managerial/leadership challenges, immigration issues, and lack of awareness of the procedure for reporting repetitive stress injury (RSI) and work-related stress.</div></div><div><h3>Conclusion</h3><div>The findings highlight unique stressors associated with migrant sonographers that negatively impact their mental and physical well-being and performance. Thus, emphasising the need for inclusive managerial approaches and culturally tailored support systems. Customised onboarding, stress management training, and RSI reporting protocols can enhance well-being, job satisfaction, and retention.</div></div><div><h3>Implications for practice</h3><div>Healthcare institutions must address the unique needs of migrant practitioners. Culturally competent onboarding programs and ongoing support systems should be prioritised to foster a resilient and satisfied workforce.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102882"},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic, ethical and legal implications of evidence-based practice and continuing professional development in radiography: A narrative review","authors":"F. Ramazan ,&nbsp;Y. Graham","doi":"10.1016/j.radi.2025.102886","DOIUrl":"10.1016/j.radi.2025.102886","url":null,"abstract":"<div><h3>Objectives</h3><div>There is an increasing need to engage with evidence-based practice (EBP) and continuing professional development (CPD) to effectively respond to the current healthcare demands and challenges. This review highlights barriers to applying EBP and CPD, and synthesises the economic, ethical and legal implications of EBP and CPD in radiography.</div></div><div><h3>Key findings</h3><div>Inconsistent application of EBP and engagement in CPD may not only result in compromised professional development and gaps in knowledge in practice, but also affect patients, healthcare services and health organisations unfavourably from an economic, ethical and legal perspective. Leaders such as managers in radiology departments may play a key role in fostering an evidence-based culture.</div></div><div><h3>Conclusion</h3><div>Consistent application of EBP and CPD in daily practice is beneficial to patients, professionals and healthcare organisations from an economic, legal and intellectual perspectives. <em>Morally and ethically, although it has some conflicting views to EBP, applying an evidence-based approach may be considered a professional's responsibility to ensure the provision of prime quality care and treatment.</em></div></div><div><h3>Implications for practice</h3><div>The delay in translation of evidence-based interventions into everyday practice has several consequences and leads to possible missed opportunities including failure to provide best available care, reduction of unnecessary imaging procedures and cost. Hence, it is crucial for radiographers to regularly engage in EBP and CPD, and for healthcare organisations and radiology managers to educate themselves on EBP and CPD, and act as knowledgeable leaders for developing, enhancing, and sustaining EBP and CPD as the norm, create an environment that facilitates and empowers staff, and support staff to appreciate the rationale for any organisational changes associated with EBP.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102886"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative exploration of sonographers’ views toward transvaginal ultrasound in Zimbabwe: A barriers and solutions approach","authors":"B. Chinene ,&nbsp;W. Matika ,&nbsp;E.Y. Mushosho ,&nbsp;L.C. Mutandiro","doi":"10.1016/j.radi.2025.01.018","DOIUrl":"10.1016/j.radi.2025.01.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the increasing reliance on pelvic imaging and the superior diagnostic quality of transvaginal ultrasound (TVUS), the British Medical Ultrasound Society emphasizes that all eligible patients should be offered this procedure to ensure the highest standard of care. However, in Zimbabwe, anecdotal evidence indicates a reluctance among sonographers to offer it to patients. This study aimed to understand sonographers' views on the barriers to adopting TVUS and to identify potential solutions.</div></div><div><h3>Methods</h3><div>This study employed a qualitative exploratory design using semi-structured interviews. Ten sonographers working in various healthcare institutions in Zimbabwe were recruited in this study. The interviews were transcribed and the qualitative data were managed in NVivo 13 and analyzed using thematic analysis based on the six steps outlined by Braun and Clarke<strong>.</strong></div></div><div><h3>Results</h3><div>The identified barriers to the adoption of TVUS included: i. Training and confidence ii. Patient and cultural-related factors iii. Resource constraints iv. Clinical Engagement v. Financial and Time Considerations. Proposed solutions encompassed 1. Training 2. Awareness 3. Invest in Equipment 4. Policy development.</div></div><div><h3>Conclusions</h3><div>The study highlights Zimbabwe's challenges in adopting TVUS, including financial constraints, limited training, and cultural attitudes. To improve TVUS utilization, simulation-based training, increased awareness, and supportive legislation are needed, ultimately improving women's access to high-quality diagnostic care.</div></div><div><h3>Implications for practice</h3><div>Addressing the identified barriers to TVUS adoption through targeted training, increased awareness, investment in resources, and supportive policies are essential for enhancing women's access to timely and effective diagnostic care.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102883"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User evaluation of clinical simulation-based learning developed by FORCE (Framework for Online Radiographer Clinical Education)","authors":"K. Matthews ,&nbsp;C. Kamp ,&nbsp;N. Dalen-Seime ,&nbsp;B. Kraus ,&nbsp;F. Zarb ,&nbsp;P. Sakariassen ,&nbsp;P.S. Costa ,&nbsp;G. Aarhu ,&nbsp;P. Bezzina ,&nbsp;M. Jaronen ,&nbsp;J. Huhtanen ,&nbsp;R. Strudwick","doi":"10.1016/j.radi.2025.01.005","DOIUrl":"10.1016/j.radi.2025.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The FORCE initiative, funded by the EU, was created in response to the COVID-19 pandemic's impact on radiography education. It offers a virtual learning environment (VLE) filled with clinical simulation scenarios targeting Diagnostic Imaging, Nuclear Medicine, and Radiotherapy. These scenarios are designed to provide open-access, simulation-based learning (SBL) resources that help radiography undergraduates engage in problem-based learning across relevant clinical knowledge and professional awareness. This study presents the results of an online survey aimed at evaluating the FORCE VLE and SBL resources to guide future development.</div></div><div><h3>Methods</h3><div>The survey targeted academic and clinical staff in Radiography and student Radiographers. It was based on the Course Experience Questionnaire (CEQ) and modified to include topics relevant to online learning, using a five-point Likert Scale (LS). The questionnaire consisted of four sections: research information and consent; socio-demographic data; LS-based questions on case structure, content, interactivity, technical aspects, multimedia quality, and overall experience; and open-text responses.</div></div><div><h3>Results</h3><div>Of the 407 invited participants, 109 (27 %) responded, with 77 % being students and 23 % clinical or academic radiographers from 13 countries. English proficiency was reported by 76 % of respondents. The median LS was consistently 4 across all categories, indicating high satisfaction. Content analysis of 159 open-text comments revealed 139 positive opinions on the SBL resources.</div></div><div><h3>Conclusion</h3><div>The FORCE VLE SBL resources were highly regarded for their interactivity, applicability, and support in consolidating knowledge and enhancing patient care. Suggestions for improvement were minor, mainly focusing on navigation and specific content preferences.</div></div><div><h3>Implications for practice</h3><div>Expanding the availability of online SBL cases could enhance Radiographer education and promote inclusivity across the field.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102870"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for the deaf and hard-of-hearing patients during magnetic resonance imaging (MRI): A phenomenological study of MRI radiographers' experiences.","authors":"F N Ogwudu, G M Akpaniwo","doi":"10.1016/j.radi.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.radi.2025.01.010","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing loss is a widespread disability, and unfortunately, deaf and hard-of-hearing (DHH) patients often experience unequal healthcare and unmet needs. People with the condition are predisposed to anxiety, fatigue and depression. Communication barriers are a major issue, particularly during magnetic resonance imaging (MRI) scans where clear radiographer-patient communication is crucial for safety and quality imaging. This study aimed to understand the experiences of MRI Radiographers in providing care to DHH patients for MRI scans.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological study design using purposive sampling to gain in-depth insights. The study comprised seven MRI radiographers working clinically at a public hospital in England. Data was collected through semi-structured face-to-face interviews. Audio recordings were transcribed using Microsoft 365 software. The transcripts were coded into categories and further on, into themes using the inductive approach of thematic analysis.</p><p><strong>Results: </strong>The study revealed five key themes: communication barriers and consequences, current approaches to care, satisfaction of care provisions, prospects of technological advancements and training and professional development. The findings show that MRI radiographers encounter distinct and diverse communication difficulties while caring for DHH patients. Radiographers' experiences indicated the need for evidence-based strategies in addressing the communication challenges of DHH individuals. Some participants acknowledged that training and technological interventions could help with providing quality care for the patient group in MRI.</p><p><strong>Conclusion: </strong>The study's findings advocate for inclusiveness in delivering MRI services. It presents compelling evidence for MRI service providers to support radiographers by encouraging training and implementing approaches that guarantee safe, quality, and consistent care for patients with hearing impairments. The diversity of the DHH population's communication needs and lack of comprehensive guidelines are recognised to contribute to the struggle to deliver good care.</p><p><strong>Implications for practice: </strong>To mitigate DHH patients' communication challenges, MRI service providers should sufficiently train MRI radiographers, create a supportive environment and promote services that address their needs.</p>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential use of deep learning in performing autocorrection of setup errors in patients receiving radiotherapy","authors":"A. Muhammed,&nbsp;M. Hassan,&nbsp;W. Soliman,&nbsp;A. Ibrahim,&nbsp;SH. Abdelaal","doi":"10.1016/j.radi.2025.01.016","DOIUrl":"10.1016/j.radi.2025.01.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Modern radiotherapy practice relies on multiple approaches for verification of patient positioning. All of these techniques require experienced radiotherapists who understand the anatomical landmarks and the limitations of the used verification techniques. We explore the feasibility of using Artificial intelligence in assisted patient positions using acquired port images (PFIs) and digital reconstructed radiographs (DRRs).</div></div><div><h3>Methods</h3><div>A retrospective study was conducted on patients with brain and aerodigestive tract malignancy who were treated with radiotherapy between 2018 and 2023. A neural network was built to examine and perform auto-correction of the misaligned PFIs and DRRs images. The performance of the neural network was assessed quantitatively by mean-absolute errors (MAE) and mean-squared errors (MSE), and qualitatively by a survey which was sent to 30 experienced medical professionals in the field of radiation therapy.</div></div><div><h3>Results</h3><div>The total number of patients included in this study was 156 patients. 96 of the patients were treated for aerodigestive tract malignancy while the remaining were treated for brain tumours. The neural network achieved MAE of 27.430 and 27.437 for training and validation sets, respectively, and MSE of 0.5505, and 0.5565 for training and validation sets, respectively. Nineteen medical professionals responded to the survey. They reported a median accuracy score of 8 out of 10.</div></div><div><h3>Conclusion</h3><div>Our neural network is just one step further in the automation of modern radiotherapy services by using AI-assisted correction of setup errors.</div></div><div><h3>Implications for practice</h3><div>This study demonstrated the potential role of AI in assisting radiotherapists with patient positioning corrections during radiotherapy treatment. Further research is needed to validate the effectiveness of this approach in clinical practice.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102881"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"If there was a quick and easy way to participate\": The engagement of United Kingdom radiotherapy and diagnostic imaging departments in research strategy.","authors":"A Hancock, D Hutton, I Powell Brown, T Murphy, B Stride, M A Mallinson","doi":"10.1016/j.radi.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.radi.2025.01.009","url":null,"abstract":"<p><strong>Introduction: </strong>Research strategies support professionals to create a shared vision and work towards common objectives which can enhance workforce satisfaction, retention and patient experience. Our research aimed to capture the current number of United Kingdom (UK) radiotherapy and diagnostic imaging departments that have a local discipline specific research strategy in place. We also sought to understand the contributing factors to their development, with the aim of generating models of support to enhance future local research strategies.</p><p><strong>Methods: </strong>A discipline specific cross-sectional survey was co-developed by the research team, the College of Radiographers (CoR) and our patient and public involvement and engagement representative. Distribution was via the CoR to radiotherapy and imaging departments across the UK.</p><p><strong>Results: </strong>Complete responses were received from 32 radiotherapy and 19 imaging departments, discipline specific strategy numbers were low with only 10 and 3 departments respectively having one in situ. Barriers and enablers to their development as well as disparate motivations and intentions to develop a strategy were evident within and across each discipline. The respondents identified a range of formats and topics to help the development of strategies.</p><p><strong>Conclusion: </strong>Radiographers are keen to develop and implement their own research ideas, however this work is additional to clinical service demand. Removing barriers to research participation is a strategic priority, regional cooperation and coordination may play an increasing role in research engagement, scale and support. Opportunities to increase ownership and confidence in research strategy development should be pursued including template strategies and professional facilitation.</p><p><strong>Implications for practice: </strong>A discipline specific strategy would support departments to navigate the complexities of research regulation and policy and overcome the challenges faced by competing priorities.</p>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":" ","pages":"102874"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of automatic and semi-automatic MRI segmentation in human brain imaging","authors":"M. Chau ,&nbsp;H. Vu ,&nbsp;T. Debnath ,&nbsp;M.G. Rahman","doi":"10.1016/j.radi.2025.01.013","DOIUrl":"10.1016/j.radi.2025.01.013","url":null,"abstract":"<div><h3>Introduction</h3><div>AI-based segmentation techniques in brain MRI have revolutionized neuroimaging by enhancing the accuracy and efficiency of brain structure analysis. These techniques are pivotal for diagnosing neurodegenerative diseases, classifying psychiatric conditions, and predicting brain age. This scoping review synthesizes current methodologies, identifies key trends, and highlights gaps in the use of automatic and semi-automatic segmentation tools in brain MRI, particularly focusing on their application to healthy populations and clinical utility.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following Arksey and O'Malley's framework and PRISMA-ScR guidelines. A comprehensive search was performed across six databases for studies published between 2014 and 2024. Studies focused on AI-based brain segmentation in healthy populations, and patients with neurodegenerative diseases, and psychiatric disorders were included, while reviews, case series, and studies without human participants were excluded.</div></div><div><h3>Results</h3><div>Thirty-two studies were included, employing various segmentation tools and AI models such as convolutional neural networks for segmenting gray matter, white matter, cerebrospinal fluid, and pathological regions. FreeSurfer, which utilizes algorithmic techniques, are also commonly used for automated segmentation. AI models demonstrated high accuracy in brain age prediction, neurodegenerative disease classification, and psychiatric disorder subtyping. Longitudinal studies tracked disease progression, while multimodal approaches integrating MRI with fMRI and PET enhanced diagnostic precision.</div></div><div><h3>Conclusion</h3><div>AI-based segmentation techniques provide scalable solutions for neuroimaging, advancing personalized brain health strategies and supporting early diagnosis of neurological and psychiatric conditions. However, challenges related to standardization, generalizability, and ethical considerations remain.</div></div><div><h3>Implications for Practice</h3><div>The integration of AI tools and algorithm-based methods into clinical workflows can enhance diagnostic accuracy and efficiency, but greater focus on model interpretability, standardization of imaging protocols, and patient consent processes is needed to ensure responsible adoption in practice.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102878"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and fellowship funding perspectives: A collective NIHR experience of a community of pre- and post-doctoral radiographers","authors":"T.N. Akudjedu ,&nbsp;R. Reeve ,&nbsp;J. Eaton ,&nbsp;C. Costigan ,&nbsp;C. Burnett ,&nbsp;H. Barnsley ,&nbsp;H. McNair ,&nbsp;I.C. Simcock","doi":"10.1016/j.radi.2025.01.015","DOIUrl":"10.1016/j.radi.2025.01.015","url":null,"abstract":"<div><h3>Objectives</h3><div>This paper harnesses a comprehensive overview and the collective experience of a community of pre- and post-doctoral Radiographers in successfully securing grants to demonstrate what is required as part of an NIHR fellowship application.</div></div><div><h3>Key findings</h3><div>Developing a research fellowship application requires individuals to expose themselves to critique to improve the content, design and structure of the proposed piece of work. The scale of the project should be carefully considered when developing applications, with the research plan accurately and realistically proposing a suitable amount of work to be undertaken within the timeframe.</div><div>All fellowship applications comprise several key elements which must be meticulously crafted to address the requirements of the specific call. This is critical because every section of the application undergoes scrutiny by review panels to ensure the funding achieves its maximum impact.</div><div>The key elements requiring detailed information are themed around <em>Project, Person, Place, Patient and public involvement and engagement (PPIE), the surrounding People, and a training plan.</em> However, a golden thread highlighting inclusive research that is people-centred is required to run through the entire application.</div></div><div><h3>Conclusion</h3><div>NIHR fellowships are an important pathway to enable dedicated clinically relevant research projects for patient/family benefit to be combined with the advancement of an individual's clinical and academic skills. These dedicated funding streams are tailor-made to enable a wide range of healthcare professionals, including Radiographers, to develop into research leaders of the future.</div></div><div><h3>Implications for practice</h3><div>Maximising research training opportunities, including research fellowships for the Radiography profession, will offer the completion of clinically relevant research projects alongside the development of the research leaders of the future.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 2","pages":"Article 102880"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of imaging protocols on complex ankle fracture manipulation in the ED: A before and after study.","authors":"S Holt, B Snaith, C Bolan, C Chadwick, A Crede","doi":"10.1016/j.radi.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.radi.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle injuries that present to the ED with instability of the joint due to multiple fractures/disruption of the mortise need to be re-aligned promptly to minimise complications. A protocol change was introduced whereby mobile radiographs would be performed in the ED resuscitation room during manipulation of a complex ankle injury. The aim of this study was to determine if the overall time to definitive reduction had reduced for these patients, improving patient flow.</p><p><strong>Method: </strong>Data was collected from patients attending the ED with a complex or unstable ankle injury in a UK single-centre over 6-months periods, pre pathway introduction (2019), immediately post change (2021) and 2 years post implementation (2023).</p><p><strong>Results: </strong>In excess of 3000 patients had ankle radiographs performed in each cohort of data collection with an average of 2.9 % of injuries categorised as complex or unstable and requiring manipulation, consistent across the cohorts (p = 0.246). Increasing compliance with the new pathway was evident over time with a significant time reduction demonstrated from initial ED presentation to final post manipulation imaging if mobile radiographs were obtained with the mean time 113 min quicker than those performed in the radiology department in 2023 (p = 0.00).</p><p><strong>Conclusion: </strong>Although it takes time to embed new pathways and changes in practice, this study demonstrated that a simple change in imaging provision had a positive impact for patients with a complex ankle injury.</p><p><strong>Implications for practice: </strong>Providing post manipulation radiographs in the ED resuscitation room allowed earlier confirmation of restored anatomical alignment for patients with a complex ankle injury and enabled clinicians to perform multiple manipulation attempts, if necessary, under the same sedation episode.</p>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}