小儿医学影像科解剖侧标使用的临床审核：定量与定性研究。
A clinical audit of anatomical side marker use in a pediatric medical imaging department: A quantitative and qualitative investigation.
机构信息
UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
SA Medical Imaging, Women's and Children's Hospital, Adelaide, South Australia, Australia.
出版信息
PLoS One. 2020 Nov 24;15(11):e0242594. doi: 10.1371/journal.pone.0242594. eCollection 2020.
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.
背景
放射状或数字解剖侧标记物（ASM）的存在是 X 光片上的一个重要诊断特征，应该成为每个 X 光图像的常规特征。尽管它很重要，但研究表明，存在许多 ASM 缺失的情况，这有可能导致不良事件。迄今为止，很少有研究系统地检查 ASM 在临床实践中的使用情况，并探讨医学影像专业人员对 ASM 使用的看法。这项研究旨在弥补这一知识空白。
方法
本研究分两个阶段进行。第一阶段对儿科医学影像科 12 个月内随机抽取的 421 张 X 光片进行回顾性临床审核。对整体标记物使用情况和类型进行了数据分析。第二阶段包括对 11 名放射技师进行半结构化访谈，以了解他们对 ASM 使用的看法，以及在临床实践中使用 ASM 的障碍和促进因素。访谈内容逐字转录，并进行主题分析。
结果
99%的 X 光片中都存在 ASM（放射状和数字）。与放射状 ASM（20.2%）相比，数字 ASM（78.8%）的使用明显增加，这突出了在图像处理中使用 ASM 的趋势。少数图像（N=4）未包含任何 ASM。半结构化访谈揭示了 ASM 使用的多方面障碍（时间、感染预防和患者因素）和很少的促进因素（专业精神、法律要求）。
结论
本研究结合了定量和定性研究范式，为放射学实践的一个重要领域提供了新的视角。虽然缺失 ASM 是一个小问题，但仍有机会改进最佳实践标准。数字 ASM 的使用越来越多，这可能凸显了临床实践标准的转变。
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