The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK.
The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK; The Institute of Cancer Research, UK.
Radiography (Lond). 2024 May;30(3):843-855. doi: 10.1016/j.radi.2024.03.009. Epub 2024 Apr 4.
Strict safety practices are essential to ensure the safety of patients and staff in Magnetic Resonance Imaging (MRI). Training regarding the fundamentals of MRI safety is well-established and commonly agreed upon. However, more complex aspect of screening patients, such as image review or screening of unconscious patients/patients with communication difficulties is less well discussed. The current UK and USA guidelines do not suggest the use of communication training for MRI staff nor indicate any training to encourage reviewing images in the screening process. This review aims to map the current guidance regarding safety and patient screening training for MRI diagnostic and therapeutic radiographers.
A systematic search of PubMed, Trip Medical database and Radiography journal was conducted. Studies were chosen based on the review objectives and pre-determined inclusion/exclusion criteria using the PRISMA-ScR framework.
Twenty-four studies were included in the review, which identified some key concepts including MRI safety training and delivery methods, screening and communication, screening of unconscious or non-ambulatory patients and the use of imaging.
Training gaps lie within the more complex elements of screening such as the inclusiveness of question phrasing, particularly to the neurodivergent population, how we teach radiographers to screen unconscious/unresponsive patients and using imaging to detect implants.
The consequences of incomplete or inaccurate pre-MRI safety screening could be the introduction of unexpected implants into the scanner or forgoing MRI for a less desirable modality. The development of enhanced training programs in implant recognition using imaging and communication could complement existing training.
严格的安全措施对于确保磁共振成像(MRI)中的患者和工作人员的安全至关重要。关于 MRI 安全基础的培训已经得到充分确立并得到广泛认可。然而,对于更复杂的患者筛查方面,如图像审查或对无意识患者/有沟通困难的患者的筛查,讨论得较少。目前英国和美国的指南并未建议对 MRI 工作人员进行沟通培训,也未指示进行任何培训以鼓励在筛查过程中审查图像。本综述旨在绘制目前关于 MRI 诊断和治疗放射技师的安全和患者筛查培训的指南。
对 PubMed、Trip Medical 数据库和 Radiography 杂志进行了系统搜索。根据综述目标和使用 PRISMA-ScR 框架预先确定的纳入/排除标准选择研究。
综述共纳入了 24 项研究,这些研究确定了一些关键概念,包括 MRI 安全培训和交付方法、筛查和沟通、无意识或非活动患者的筛查以及影像学的应用。
培训中的差距在于筛查的更复杂方面,例如问题措辞的包容性,特别是针对神经多样性人群;我们如何教导放射技师筛查无意识/无反应的患者;以及使用影像学来检测植入物。
不完全或不准确的 MRI 安全筛查可能会导致意外的植入物进入扫描仪,或者放弃 MRI 而选择不太理想的方式。使用影像学和沟通来增强植入物识别的培训计划的开发可以补充现有的培训。