CAUSES OF REPEATS IN PAEDIATRIC RADIOGRAPHY IN THREE TERTIARY HOSPITALS IN ENUGU METROPOLIS

Paediatric radiography comes with many challenges, unlike in adult’s radiography; children cannot always understand and comprehend a change of environment and cannot obey radiographer’s instruction which may result in repeat cases. Children are more radiosensitive than adults and have a longer life expectancy over which they may develop cancer from exposures to ionizing radiation due to high level of repeats. This is a cross sectional study aimed at determining: the factors that lead to repeat cases in paediatric radiography, the rates of repeats during paediatric radiography and to compare the causes of repeats in paediatric radiography in the hospitals studied. The target population for this study comprises paediatric radiography patients that came for radiography examination during the period of research in the study centres. The three tertiary hospital studied are University of Nigeria Teaching Hospital (UNTH), National Orthopaedic Hospital Enugu (NOHE), and Enugu State Teaching University hospital (ESUTH). Also practicing radiographers working in the three tertiary hospitals in Enugu metropolis where the research was carried out formed part of the study population and were used to elicit information about the factors that lead to paediatric repeat cases. A convenience sampling technique was used in this study. Questionnaire, observation and spy sheet were used as source of data collection. Result of this study showed that repeats in paediatric radiography occur due to patient’s movement, lack of specialised paediatric accessories, lack of dedicated unit, radiographer’s error, equipment error and processing error. The respondents in UNTH (18.5%) associated paediatric repeats mainly to patient’s movement and lack of dedicated paediatric immobilization devices. Most respondents in NOHE (66.7%) blamed paediatric repeats to lack of paediatric immobilization devices leading to patient movement and lack of dedicated unit, while most respondents (50%) in ESUTH blamed paediatric repeats on patient’s movement and lack of dedicated paediatric immobilization accessories. The study showed that majority of the respondents (70%) said that repeat rates occur intermittently. The overall repeat rates recorded is 43.8% (n=64).  The repeat rates in each hospital studied are, UNTH 45.3% (n=29), NOHE 29.7% (n=19), and ESUTH 25% (n=16). Examinations where the repeat rates occurred are; chest [39% n=25], extremities [26.6% n=17], skull is [20.3% n=13] and abdomen [14.1% n=9].Results suggest that hospitals should provide specialised paediatric accessories, and establish a paediatric dedicated unit to reduce paediatric repeats minimally because paediatric repeats can lead to increase in radiation dose, predisposing the paediatric to cancer and other effects of ionizing radiation in future.

Title page……..…………………………………………………………….i

Dedication …………..……………………………………………………..ii

Approval page……………..………………………………………………iii

Certification ……………………..……………………………………….. iv

Acknowledgement ……………………..…………………………………..v

Table of contents……….………………………………………………….vi

List of tables…………...…………………………………………………..vii

List of figures...................................................................................………..viii

Abstract ……………………………………………………………  ……. ix

CHAPTER ONE: INTRODUCTION

1.1 Background of study.………………………….…………………….1

1.2 Statement of problem..………………………………………………5

1.3 Purpose of study……………….……………………………….……5

1.3.1 Specific objective of study…..………………………….……............6

1.4 Significance of study…………………………………………………..6

1.5 Scope of study………….…….…………………………...……………6

1.6 Operational definition of terms…………………...……….……...........6

CHAPTERTWO: LITERATURE REVIEW

2.1 Evaluation of repeat rates in radiography…………………………….8

2.2 Causes of repeats in radiography…………………………………….18

2.3 Theoretical Background of Study……….………………...………….22

2.3.1 Paediatric radiography……………..…………..……..……………22

2.3.2 Environment………………………………………...…...………….23

2.3.3 Equipment…………………………………………….……..............25

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design………………………………………….….…….…27

3.2 Target Population…………………………………………...………..27

3.3 Sample size and sampling technique………………………..………28

3.4 Sources for data collection……………………………………..........28

3.5 Instrument for data collection………………………….………........28

3.6 Methods of data analysis……………………………………….…...29

CHAPTER FOUR: RESULTS

4.1 Data presentation…………………………………………….……...30

CHAPTER FIVE: DISCUSSION AND IMPLICATIONS OF RESULTS, CONCLUSION AND RECOMMENDATIONS

5.1 Discussion and Implications of Results…………….………….…...46

5. 1.1 Background characteristics of the respondents……….…….…...46

5.1.2 Objective 1 (Factors that lead to repeat cases in paediatric radiography)…………………………………………....47

5.1.3 Objective 2 (Evaluation of the rates of repeats during Paediatric radiography)………………………………………………...48

5.1.4 Objective 3 (Comparison of the causes of repeats in paediatric radiography in the hospital studied)………………………..49

5.2 Conclusion……………………………………………………..…..49

5.3 Recommendations………………………………………………....49

5.4 Limitations of the Study…………………………………………..50

5.5 Areas of further research………………………………………….50

References

Appendix 1

Appendix 11

Table 1:Physical characteristic of Radiographers studied……………..…30

Table 2: Comparison between Hospitals of employment and factors 

that Causes Repeats in Paediatric Radiography…..…………………..……38

Table 3: Comparison between Hospital of Employment and Occurrence of Repeats in Paediatric Radiography.………………………39

Table 4: Comparison between Hospital of Employment and Service of Equipment in the Departments…………..….……40

Table 5: Comparison between Hospital of Employment and Efforts 

made in the Department to Establish Dedicated Paediatric Unit……….......41

Table 6: Number of paediatric patients studied……………………………..42

Table 7: Different paediatric examinations carried out in hospital studied….43

Table 8:  Repeats rates in each hospital studied………………………..……44

Table 9: Distribution of repeat rates according to procedures………………..44

Figure 1: Shows the cases of repeats in paediatric radiography………………31

Figure 2: Shows the occurrence of repeats in paediatric radiography………..32

Figure 3: Shows factors causing repeats in paediatric radiography………….33

Figure 4: Shows the rate at which equipment is serviced…………………..34

Figure 5: Shows availability of specialized accessories for paediatric Radiography………………………………………………………35

Figure 6: Shows efforts made in the department to establish a dedicated paediatric unit………………………………………..36

Figure 7: Long term effects of repeats in paediatric radiography…………..37

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