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Radiographers' perspectives on immobilisation and restraint mechanisms in paediatric radiography
Melissa Breen1, Rena Young1, Helle Precht2
1Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland.
Insights
Irish radiographers frequently use immobilization and restraint in pediatric radiography, despite lacking formal training and clear guidelines. Most prefer alternative methods, highlighting a need for updated best practices and education.
Area of Science:
- Radiological Sciences
- Pediatric Imaging
- Medical Ethics
Background:
- Immobilization and restraint in pediatric radiography present legal and ethical challenges.
- A significant gap exists in current professional best-practice guidance for radiographers.
- This study addresses the need for updated perspectives on pediatric immobilization and restraint practices in Europe.
Purpose of the Study:
- To investigate Irish radiographers' perspectives on using immobilization or restraint methods in pediatric radiography.
- To identify factors influencing the choice of immobilization or restraint techniques.
- To contribute to the global discourse on pediatric radiography practices.
Main Methods:
- An anonymous online survey was distributed to hospital radiology departments in Southern Ireland.
- A supplementary survey audited the availability of immobilization and/or restraint devices.
- Descriptive statistics, including frequencies and percentages, were used for analysis.
Main Results:
- Over 100 radiographers responded, with 95% using immobilization and 89% using restraint techniques.
- 70% acknowledged a lack of training in restraint techniques, yet 93% attempted alternatives like distraction.
- 80% of respondents deemed further guidance and training as essential or beneficial.
Conclusions:
- Ambiguity persists regarding the distinction between 'restraint' and 'immobilization' in pediatric radiography.
- Factors influencing choices include child's age, distress, radiation safety, and cooperation.
- Updated guidelines and training are recommended to clarify terminology and promote safe practices.
Introduction:
The utilisation of immobilisation or restraint during paediatric radiography is a multifactorial issue with associated legal and ethical considerations. Current practice regularly presents challenges for radiographers, with a notable absence of any professional best-practice guidance. This study investigated radiographers' perspectives in Ireland on the use of immobilisation or restraint methods and the factors influencing these choices and aimed to fill the 20-year gap in European radiographers' perspectives gaining an up-to-date understanding and contribute to the global conversation in this regard.
Methods:
An anonymous online survey design was constructed using the Google Forms platform and distributed to hospital radiology departments across the Southern region of Ireland. Additionally, a short survey was send to the head of the nine radiology departments to audit the existing availability of immobilisation and/or restraint devices for paediatric radiography. Descriptive statistics (frequencies and percentages) were undertaken. Bar charts were utilised where appropriate to display trends.
Results:
One hundered and three responses were received. The majority of radiographers reported using immobilisation (95 %) or restraint (89 %) techniques during paediatric radiography, although 70 % acknowledged the lack of training regarding restraint techniques. However, 93 % reported trying alternative techniques such as distraction and negotiation to avoid immobilisation or restraint. A desire for further guidance and training was reported, with 80 % of respondents noting training as essential or potentially beneficial.
Conclusions:
Ambiguity remains surrounding the distinction between the terms "restraint" and "immobilisation" in paediatric radiography. Radiographers' use of restraint and immobilisation during paediatric radiography is influenced by the child's age, distress level, radiation protection and safety, and the ability of the child to understand instructions. Appropriate up-to-date guidelines and training would be recommended to clarify terminology and promote the safe practice of restraint and immobilisation during paediatric radiography.
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