Survey on the use of patient contact shielding during radiological practice: The European radiographers' perspective

Patient contact shielding (CS) has traditionally been used to protect radiosensitive organs during imaging, however recent European guidelines recommend against its routine use across all X-ray-based modalities, including computed tomography (CT) and interventional radiology (IR), due to advances in technology and updated evidence. Nevertheless, CS continues to be reported in several clinical settings. As radiographers are responsible for applying shielding, this study explores their adherence to current guidelines and the barriers they face in adopting non-shielding practices.

As part of the EFRS Research Hub at ECR 2024, an anonymous web-based survey was distributed targeting radiographers working in radiography, CT and IR. The questionnaire, delivered via Google Forms, consisted of 20 multiple-choice questions exploring professional practices and attitudes toward patient shielding.

A total of 246 radiographers from 20 European countries participated. While 70.7 % (174/246) reported that their institutions had formally discontinued shielding policies, 39.8 % (98/246) indicated that they still applied shielding in specific circumstances, despite existing departmental policies. Among those continuing its use, 61.2 % (60/98) believed it was effective in reducing unnecessary exposure to radiosensitive organs, and 44.9 % (44/98) felt it provided reassurance to patients and caregivers. Expectations from caregivers (61.2 %; 60/98) and patients (34.7 %; 34/98) were identified as the main barriers to implementation of non-shielding practices. Notably, 73.5 % (72/98) of radiographers reported continued shielding of paediatric patients.

Despite scientific recommendations, CS remains used in clinical practice across Europe. Ongoing efforts are required at both European and national levels to support radiographers through targeted education, communication strategies, and policy alignment, in adherence to guidelines to cease the routine use of shielding.

There is a need for training, policy alignment and communication strategies to support radiographers in adopting evidence-based non-shielding practices.