Yaseen Muhammad, Nishtar Tahira, Ajaj Rahaf, Ali Amir
Muhammad Yaseen, MPhil. Department of Radiology, Lady Reading Hospital (LRH), Peshawar, Pakistan.
Tahira Nishtar, FCPS (Radiology). Department of Radiology, Lady Reading Hospital (LRH), Peshawar, Pakistan.
Pak J Med Sci. 2025 Jul;41(7):2052-2059. doi: 10.12669/pjms.41.7.11441.
Assessment of actual radiograph rejection was the primary goal of this investigation in the imaging facility of a public sector hospital, which was noticeably high during the pandemic as staff members were afraid of infection.
This retrospective study was carried out in the department of Radiology, LRH from July 2023 to March 2024 during which a total of 47,300 radiographic examinations were conducted. Analysis was performed for the rejected radiographs and their causes respectively.
Our rate of 11% is comparable to the global range of 3.4-14.1 % respectively. Of the total rejection, 46.1% rejection was observed in males and 53.9% in females while 69.5 % & 30.5 % rejection was noticed in adults and pediatric age group respectively. Artifacts (26.2%) was the prime cause of rejection followed by motion (18.8%), positioning (14%), improper collimation (11.7%), exposure errors (8.4 %), wrong labeling (6.6%), machine faults (5.7 %), detector errors (4.5%), PACS issues (2.5 %) and re-requests from referring physician (1.6%). The highest rejection with respect to anatomical body parts was observed in chest radiography (29.9%), followed by extremities (28.8%), spine (11.4%), KUB (9.9%), skull (8.4%), abdomen (5.5%), pelvis (4.4%), and neck (1.7%) respectively.
Radiograph rejection has reduced considerably but still is a common problem within the facility due to many contributing factors. Implementation of rejection analysis as an integral part of the quality assurance program as well as focusing on staff-centered skill and knowledge upliftment training programs can result in a significant reduction enhancing patient safety.
在一家公共部门医院的影像科，评估实际的X光片拒收情况是本次调查的主要目标，在疫情期间，由于工作人员担心感染，拒收率明显偏高。
本回顾性研究于2023年7月至2024年3月在拉瓦尔品第综合医院放射科进行，在此期间共进行了47300次X光检查。分别对被拒收的X光片及其原因进行了分析。
我们11%的拒收率分别与全球3.4%-14.1%的范围相当。在全部拒收情况中，男性的拒收率为46.1%，女性为53.9%，而成人和儿童年龄组的拒收率分别为69.5%和30.5%。伪影（26.2%）是拒收的主要原因，其次是移动（18.8%）、体位（14%）、准直不当（11.7%）、曝光错误（8.4%）、标记错误（6.6%）、机器故障（5.7%）、探测器错误（4.5%）、PACS问题（2.5%）以及转诊医生的再次申请（1.6%）。就解剖部位而言，胸部X光检查的拒收率最高（29.9%），其次是四肢（28.8%）、脊柱（11.4%）、泌尿系统平片（9.9%）、颅骨（8.4%）、腹部（5.5%）、骨盆（4.4%）和颈部（1.7%）。
X光片拒收情况已大幅减少，但由于多种因素，在该机构内仍是一个常见问题。将拒收分析作为质量保证计划的一个组成部分加以实施，以及专注于以工作人员为中心的技能和知识提升培训计划，可显著减少拒收情况，提高患者安全。
