Knowledge and practices of radiographers in radiation protection during pediatric plain chest X-ray examinations at Mulago National Specialized Hospital

Abstract

Introduction: Medical chest x-ray imaging has led to improvements in the diagnosis and treatment of numerous medical conditions in Pediatric patients. Given the longer life expectancy in pediatrics than adults, predisposition to development of radiation induced malignant neoplasms is high. Radiographers are key players in minimizing radiation risk to pediatrics. Their knowledge on radiation protection, ability to communicate risk to patient and practices during chest x-rays are beneficial in ensuring as low as reasonably achievable principle is achieved. Methodology: The purpose of the study was to determine the knowledge and practices of radiographers in radiation protection during pediatric chest x-ray examinations at Mulago National Specialized Hospital. The study was non-interventional, cross sectional, descriptive, and quantitative. The study involved 18 participants and it was conducted for a period of one month at Mulago National Specialized Hospital in Kampala City, Central Region Uganda. An informed consent was obtained from the radiographers before collecting data and confidentiality was guaranteed and maintained throughout the study. Results: Majority of the respondents were male (83.3%), aged 30-34 years (38.9%). All respondents were Ugandan (100%). We found that 72.2% of the radiographers know what ALARA means and 27.8% do not appreciate the ALARA principle. 56.6% do not know the relationship between dose and cancer risk. All radiographers (100%) know about radiation protection referral guidelines. however only 61.1% use and refer to the guidelines as the rest (38.9%) do not use the guidelines. 83.3% know about justification during procedures and associated benefits. All radiographers (100%) attend courses on radiation protection. However, only 72.2% are consistent with attendance. It was found that 83.3% of radiographers justify pediatric plain chest x-ray examinations and only 16.7% do not justify the examination. Of all those that justify, 55.6% implement best optimization practices. Majority (61.1%) of radiographers do not use pediatric immobilization devices. 72.2% of radiographers communicated radiation protection to the patients. Most of the radiographers (88.9%) use alternative imaging modalities (lung ultrasound) where necessary.

Conclusions: Most radiographers at New Mulago National Specialized Hospital are knowledgeable about radiation protection during pediatric plain chest x-ray examinations. And the latter is attributed mainly to the high attendance of Continuous Medical Education (CME) sessions by all of the radiographers. Therefore, there is a significant backlog in regard to application of the acquired knowledge about radiation protection by the radiographers during pediatric chest x-ray examinations, as evidenced by their poor practices noted. Recommendations: Strong supervision schedule to ensure that radiographers at New Mulago Specialized Hospital effectively implement the standard radiation protection practices. The CMEs should be dominated by more practical sessions than theoretical sessions. New Mulago Specialized Hospital should be stocked with adequate and immobilization devices.