Eze K C, Omodia N, Okegbunam B, Adewonyi T, Nzotta C C
Department of Radiology, Irrua Specialist Teaching Hospital P.M.B 08 Irrua, Edo State, Nigeria.
Niger J Clin Pract. 2008 Dec;11(4):355-8.
To find out the causes, number, percentage and sizes of rejected radiographic films with a view of adopting measures that will reduce the rate and number of rejected films.
Radiology Department of a University Teaching Hospital.
Over a two-year period (1st April 2002 to 31st March 2004), the total number of x-ray films utilized for radiographic examinations, rejected films and sizes of rejected films were collected retrospectively from the medical record of radiology department. All the rejected films were viewed by a radiologist and three radiographers for the causes of the rejects which was arrived at by consensus. The data was analysed.
A total of 15,095 films were used in the study period and 1,338 films (8.86%) were rejected or wasted. The rate of rejected films varied from 7.69% to 13.82% with average of 8.86%. The greatest cause of film rejects was radiographers' faults 547 (40.88%), followed by equipments faults 255 (19.06%), and patients' faults 250 (18.90%). The highest reject rate (13.82%) was for films used for examination of the spine (15 x 30) cm size. This is followed by 9.92% for skull (18 x 24) cm films and 8.83% for small sized films (24 x 30) cm used for paediatric patients. Of a total of 1,338 rejected films, 1276 (95.37%) additional exposure were done to obtain the basic desired diagnostic information involving 1151 patients; 885 (76.89%) of these patients needed at least one additional hospital visit to take the repeat exposure.
Rejected films are not billable; patients receive additional radiation and may even come to hospital in another day for the repeat. Radiographer's work is increased as well as that of the support staff. The waiting room may be congested and waiting time increased. The cost of processing chemical and films are increased, thus if work is quantified in monetary terms, the cost of repeats is high. Rejected-repeated film analysis is cheap, simple, practicable, easy to interpret and an effective indictor of quality assurance of radiology departments.
找出被拒收的X光片的原因、数量、百分比及尺寸，以便采取措施降低X光片的拒收率和数量。
某大学教学医院放射科。
在两年期间（2002年4月1日至2004年3月31日），从放射科病历中回顾性收集用于X光检查的X光片总数、被拒收的X光片及被拒收X光片的尺寸。所有被拒收的X光片由一名放射科医生和三名放射技师查看，共同确定拒收原因，并对数据进行分析。
研究期间共使用了15095张X光片，其中1338张（8.86%）被拒收或浪费。X光片的拒收率在7.69%至13.82%之间，平均为8.86%。X光片被拒收的最大原因是放射技师的失误，共547例（40.88%），其次是设备故障255例（19.06%），以及患者因素250例（18.90%）。拒收率最高的是用于脊柱检查的（15×30）厘米尺寸的X光片，为13.82%。其次是用于颅骨检查的（18×24）厘米尺寸的X光片，拒收率为9.92%，用于儿科患者的（24×30）厘米尺寸的小尺寸X光片拒收率为8.83%。在总共1338张被拒收的X光片中，为获取基本的所需诊断信息，对1276例（95.37%）进行了额外曝光，涉及1151名患者；其中885例（76.89%）患者至少需要再次到医院进行重复曝光。
被拒收的X光片无法计费；患者接受了额外的辐射，甚至可能需要改天再来医院进行重复检查。放射技师以及辅助人员的工作量增加。候诊室可能会拥挤，等待时间会延长。冲洗化学药剂和X光片的成本增加，因此如果从货币角度量化工作，重复检查的成本很高。对被拒收-重复使用的X光片进行分析成本低廉、简单可行、易于解读，是放射科质量保证的有效指标。
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