Snaith, B, Raine, S, Fowler, L et al. (7 more authors) (2020) Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections. Hand Therapy, 25 (3). pp. 107-113. ISSN 1758-9983
Abstract
Introduction In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% ( n = 40/238), and this improved to 47.8% ( n = 77/161) post-intervention, but declined to 32.8% ( n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort ( p < 0.001) and the late post-intervention group ( p = 0.002) but not in the examinations performed two weeks after staff education ( p = 0.239). Conclusion Assessment of image quality is critical for diagnosis and treatment monitoring. Yet poor compliance with standard anatomical principles was evident. A simple educational intervention resulted in a transient improvement in wrist positioning, but the impact was not sustained over time.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | ©The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
Keywords: | Wrist, radiography, X-ray, quality improvement, education |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Specialist Science Education Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 22 Jul 2020 11:06 |
Last Modified: | 07 Aug 2022 08:44 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/1758998320935920 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:163537 |