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    Knowledge, clinical competencies and medico legal responsibilities required by diagnostic radiographers for the interpretation of radiographs
    (2022-09-29) Budhu, Reshel; Nkosi, Pauline Busisiwe; Khoza, Thandokuhle Emmanuel
    In SA, image interpretation and reporting by diagnostic radiographers have yet to be validated. Currently, the only training exposure and formalized education that diagnostic radiography students get in the four-year undergraduate degree relates to pattern recognition and pathological conditions However, a review of the regulations on the scope of practice of radiographers is currently being undertaken by the Health Professions Council of South Africa (HPCSA) to include formal reporting in South Africa. Aim The aim of the study was to explore the knowledge, clinical competencies and medico-legal responsibilities required by diagnostic radiographers for the interpretation of radiographs and ultimately, to recommend training guidelines for radiographers in the interpretation of radiographic images. Methodology A qualitative descriptive study employing criterion sampling of qualified radiologists practicing within the eThekwini district of KZN province was conducted. Ethics approval to perform this study was obtained from the Durban University of Technology’s (DUT’s) Institutional Research Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool used for this study was face-to-face, one-on-one, semi-structured and in-depth interviews, which included various questions related to radiographic image interpretation. The data from the interviews were analysed by the researcher using Tesch’s eight steps for analysing qualitative data. Moreover, all the data obtained from this research study was kept confidential and under password protection by the researcher. Findings Findings reveal that Radiologists support the interpretation of radiographic images by radiographers in rural settings, and for the radiographer’s scope of practice to be restructured to include the chest and the musculoskeletal system. Extension in the scope of practice would result in increased job satisfaction, as the overall costs, rates and turnaround time will be affected if radiographers interpret images. Moreover, image interpretation training should begin 3-5 years post degree. An in-depth knowledge of anatomy, radiological anatomy and pathophysiology is required to understand pattern recognition during image interpretation. The training would be between 6 months and 5 years. Findings also indicated that there should be continuous monitoring and accreditation for image interpretation courses, with accreditation being in the form of a diploma for each system, a degree or a certificate of competence. Assessments for image interpretation should be carried out by radiologists. The participants of this study found that clinical competency for radiographers who are performing image interpretation has to do with the assessment of the patient, with assessment determining the history, the background, the past medical history of relevance and the current presenting symptoms. The study also suggested that apart from having stringent criteria for radiographers entering the image interpretation course, radiographers must be able to triage patients and all assessments should be done by a radiologist. The findings also indicated that no harm is to be done to the patient; patient information must not be disclosed to others; radiographers should be covered in the event of adverse outcomes when interpreting images; there should be decision-making regarding the radiologic/radiographic report; and the rights of a healthcare provider are to be protected.
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    Knowledge, clinical competencies and medico legal responsibilities required for the administration of intravenous contrast media by radiographers
    (2017) Koch, Gerhardus George Visser; Swindon, Lynda; Pillay, Julian David
    Background The current scope of practice for diagnostic radiographers, does not allow them to administer intravenous contrast media (IVCM) since there are no formal training guidelines accredited by the Health Professions Council of South Africa (HPCSA) (Koch 2014: 26). In selected countries abroad, radiographers are allowed to administer IVCM and have thus received the necessary and accredited training to do so. In view of this, the South African radiographer’s scope of practice is not on par with the selected countries. The radiologists in South Africa (SA) who are currently responsible for the administration of IVCM have issued a position statement which supports, in principle, the idea of radiographers administering IVCM should they receive the necessary and appropriate training to do so (RSSA 2011: 1-2). The aim of this research study was, therefore, to investigate the radiologists’ perspectives regarding the theoretical knowledge, clinical competencies and medico legal responsibilities required by radiographers in order to effectively administer IVCM. This research study provides input for the development of national training guidelines for radiographers to administer IVCM. Research Methodology A quantitative, descriptive study was conducted by targeting qualified radiologists residing and practicing within the province of KwaZulu Natal (KZN). Ethical approval was obtained from the Durban University of Technology’s (DUT) Institutional Research and Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool was an online survey administered through SurveyMonkey which included questions and statements relating to the administration of IVCM and was structured so as to meet the study objectives. The research tool was evaluated and amended by an expert focus group to ensure reliability and validity. Confidentiality was maintained and all the data obtained during this research study was password protected. Results and discussion Fifty-nine radiologists (60.8 percent) participated in this study. Twelve respondents, however, were excluded due to incomplete surveys. The final response rate, therefore, was 48.5 percent (n=47) of which 72.3 percent of the respondents were from the private sector. Results illustrated the radiologists’ agreement regarding the theoretical, clinical/practical and medico legal training components for inclusion in the further training of radiographers to administer IVCM. Most respondents supported the inclusion of three assessments: theoretical (87.2 percent), clinical (93.6 percent) and a record of clinical competencies (95.7 percent). The assessments were considered equally important in terms of percentage weighting. The overall results compared favorably to the current international trends and practice standards of radiographers administering IVCM. Conclusion and Recommendations The study, in providing key data for the development of training guidelines for radiographers to administer IVCM, has demonstrated the importance of higher education (HE) and training in addressing transformation in health services with particular reference to professional scopes of practice. Furthermore, it reinforces the need for local research that will inform HE and training and hence a scope of practice that meets local needs. It was recommended that future studies should include those HE institutions offering training in Radiography as well as their stakeholders for the design and transformation of a national curriculum for radiographers to administer IVCM.
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    A survey of South African Radiographers’ and Radiologists’ opinions on role extension for radiographers
    (AFAHPER-SD, 2015-12) Kekana, R.M.; Mathobisa, J.M.; Swindon, Lynda
    Role extension for radiographers in South Africa is driven by the need to improve service delivery challenges and the radiographers’ need for professional recognition. The two areas earmarked for role extension are injection of contrast media and reporting on radiographs. This study was conducted to determine the willingness of diagnostic radiographers to extend their roles and gather the opinions of radiologists regarding this role extension. A quantitative, descriptive, exploratory and cross-sectional study was conducted. A sample of 300 radiographers and 30 radiologists was taken from a population of 7771 radiographers and 885 radiologists as per the Health Professions Council of South Africa register (HPCSA). Survey Monkey was used for making questionnaires accessible to all participants. The level of significance was fixed at 5%. Sixty-eight percent of radiographers agreed in principle to injection of contrast media and only 25.5% agreed to provide a written report on the interpretation of radiographs. Eighty percent of radiologists agreed in principle to radiographers injecting contrast media and only 11.6% agreed to radiographers providing a written report on the interpretation of radiographs. The participants gave an average response of 74.4% on the need for radiologists to take responsibility for the adverse reactions that may results from injecting contrast media. Radiographers and radiologists supported the need for further education and training and role extension for injecting contrast media. There is concern over the ‘no one’ response as to who performs radiologists’ work and how this impacted on service delivery.