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Radiographer role extension: a paradigm shift in practice.

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Presentation on theme: "Radiographer role extension: a paradigm shift in practice."— Presentation transcript:

1 Radiographer role extension: a paradigm shift in practice.
S Mathers*+, G McKenzie*, +The Health Services Research Group, The Robert Gordon University, *NHS Grampian Aberdeen, Scotland, UK.

2 Factors leading to radiographer role extension
Political NHS organisations are accountable for continuously improving the quality of the service New roles are encouraged to demonstrate innovations and (hopefully) improve quality A First-class Service, Quality in the NHS, 1998

3 Staff ‘The traditional demarcations between staff have held services
back ...the provision of health services should depend on the ability of the staff, not their job title.’ A Health Service for All Talents – Developing the NHS Workforce, Dept of Health, 2000

4 Radiology serious shortage of radiologists
increasing waiting lists for procedures year on year increase of examinations performed - additional demands on radiologist’s time

5 Guidance on delegation of tasks
Medical practitioners may delegate medical care to non-medical health care staff – but the MP must be sure that the staff are competent ... to carry out that task. Such health care workers must be accountable to a statutory body, i.e. state registered. GMC, Good Medical Practice, 1995


7 Main areas of role extension
In the areas of - GI, e.g. radiographer performed barium enemas - Ultrasound, e.g. general diagnostic US, O&G Intravenous injections of contrast media - IVU, CT, nuclear medicine Reporting of images - skeletal, US, GI, nuclear medicine, mammography, Angiography, e.g. peripheral angiograms

8 Training Initially hospital based Courses now University led
e.g. St James’ Leeds Barium Enema Course Courses now University led e.g. Salford University You must have a supportive and enthusiastic radiologist

9 Requirements between Dept and Hospital Management
Letter of agreement of radiographer role extension - task(s) delegated - to whom delegated - who is responsible - name(s) of radiographer(s) involved and training - name(s) of supervising radiologist(s) Signed by clinical manager and Hospital Manager Radiographer must be insured - Trust Indemnity Insurance AND - Personally (usually through SoR)

10 Radiographers experience of performing barium enemas
The main aims were to: determine characteristics of radiographers who performed BE establish current practices - ascertain benefits and drawbacks of performing BE

11 Study design Sample - convenience sample of 68 radiographers (GIRSIG members) Postal questionnaires - total of 20 questions (17 closed) - in 3 sections performing BE other duties personal information

12 Results 71% response rate (n=48/68)

13 Characteristics mean age 43 years (range 25-56 years)
76% (n=34) female 24% (n=11) male

14 Motivation

15 % of total BE performed by radiographers in their department
more than 80% 50% - 80% less than 50%

16 Reporting 16% (n= 7) reported own enemas without input from radiologists

17 Performing other fluoroscopy procedures

18 Main benefits of performing barium enemas
Increased job satisfaction Providing better service for patients Increased contact with other staff Raised profile of profession Increased knowledge and expertise

19 Main drawbacks of performing barium enemas
Radiologist attitude Lack of recognition of responsibilities Lack of radiography staff Lack of time for reporting Limitation of further CPD

20 Conclusions expectations have been fulfilled concerns do exist
implications for the expansion of the service

21 BUT there are obstacles
reluctance of radiologists to delegate tasks increasing shortage of radiographers reluctance of radiographers to embrace the use of assistant practitioners

22 - since 2003 training courses for technologists to
Experience outside UK USA - since 2003 training courses for technologists to perform BE, intravenous injections etc - they will be known as radiologist assistants - do not want to report New Zealand - radiographers performing BE

23 Conclusions radiographers role extension becoming the norm in UK
number of specialty area increasing increasing job satisfaction new career pathways for radiographers Assistant practitioner Practitioner Advanced practitioner Consultant

24 Paradigm shift? Radiographers should provide the utmost service for radiologists Furby, Radiography, 1944 Radiographers can distinguish between normal and abnormal Swinburne, Lancet, 1971 Radiographers can report fracture radiographs Loughran, BJR, 1994 Radiographer performed BE provide an excellent quality examination with results comparing favourably with published data (for radiologists) Law et al, Clin Rad, 2002

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