**5.2. The interview data**

safe material, there was a poor appreciation, evident by the fact all the 28 respondents did

**Responses to MRI General Knowledge**

**agree**

(10.7% 4 (14.3%) 5 (17.9%) 28 (100.0%)

(3.6%) 4 (14.3%) 8 (28.6%) 28 (100.0%)

(14.3%) 0 (0.0 %) 28 (100.0 %)

(67.9%) 4 (14.3 %) 3 (10.7 %) 28 (100.0 %)

(21.4%) 13 (46.4%) 4 (14.3%) 4 (14.3%) 28 (100.0%)

4

(7.1 %) 20 (71.4 %) 2 (7.1 %) 4 (14.3 %) 28 (100.0%)

(7.1 %) 3 (10.7 %) 8 (28.6 %) 13 (46.4 %) 28 (100.0 %)

**Total**

**disagree Disagree Undecided Agree Strongly**

3

1

22 (78.6 %)

19

not know the existence of the colour identification of ferrous and MRI safe material.

68 Imaging and Radioanalytical Techniques in Interdisciplinary Research - Fundamentals and Cutting Edge Applications

2 (7.1%)

2 (7.1 %)

6

2 (7.1 %)

1 (3.6 %)

2

2

There was, however, high knowledge level in relation to how patients with implants and ferrous materials around the MRI suite were managed evident by the that fact 64.29% re‐

spondents could describe the correct steps that should be taken for such patients.

**Strongly**

14 (50.0%)

13 (46.4%)

1 (3.6%)

0 (0.0%)

1 (3.6 %)

0 (0.0%)

2 (7.1 %)

**QUESTIONS**

Q21.The magnet is only on during the working day

Q22.A strong magnetic field produces X-ray used for

Q23.A static magnetic field strength may be up to 100,000 times the magnetic field strength of the earth

Q24.5 Gauss line is the parameter around the MRI system where field strength is

Q25.At 5Gausspacemakers may be affected, ferrous items become potential flying projectiles and magnetic stripes

Q26.Below 5 Gaus is considered to be a safe level of magnetic field exposure to the public

Q27.Magnetic field strength is measured in Tesla (T) or Gauss

**Table 5.** Responses to general knowledge about MRI

over 5 Gauss

are erased

(G)

imaging

Thematic analysis was used to analyse the qualitative interview data. The predominant themes that emerged were the context for framework for operational safety at MRI unit, availability of departmental policy manual and training programmes for MRI. The areas identified included a maintenance programme for the MRI unit, structures in place for acci‐ dents and breakdown of the MRI unit and practical problems faced in ensuring safety at the MRI unit.

The context for framework for operational safety at MRI unit in this study represents a com‐ bination of organisational and operational methods that from the radiographers perspective, significantly affect the achievement of operational safety at MRI unit. It was noted that MRI was a relatively new modality in the country with the suite at the Korle Bu Teaching Hospi‐ tal which was in 2006 being the first in the country. It was further observed that there was no documented formal framework by either the hospital or the department and that prepa‐ rations were underway to produce one in accordance with best international standards. This observation was consistent with the findings from the survey questionnaire indicating the absence of a policy manual at the radiology department.

On the issue of continuous education and training of radiographers on MRI, it was noted that this was non-existent. As stated earlier, there was no MRI specialized radiographer in the department and any qualified radiographers who has basic knowledge in MRI could be assigned to the unit. The need to provide a platform to training and educate the practicing radiographers on MRI was identified.

On maintenance programme for the MRI unit, it was mentioned that the supplier of the equipment has a maintenance contract with the hospital to undertake routine maintenance of the MRI.

On measures that were being taken to prevent further accidents, it was indicated that the staff were required to report any incident or missed-incident to the appropriate authority. The ab‐ sence of zoning in the suite and the adjoining CT scan suite made it difficult to undertake any effective screening because both MRI and CT scan patients have to enter through the same en‐ trance. The absence of access codes for entrance into the MRI unit was also identified as a chal‐ lenge to restricting access and this was attributed to defect in MRI – suite.

Table 2 on page 13 also shows that equal numbers of the respondents were either diploma or degree holders (42.9% each) with the certificate holders being the least (14.3%). This is due to the fact that the certificate programme had been phased out long time ago and re‐ cently the diploma programme has also been stopped. The only radiography educational programme currently being offered in Ghana is the bachelor's programme. It was however observed that there was no respondent with a postgraduate degree hence the highest educa‐ tional qualification in the study setting was first degree holders. As a result the absence of post-graduate education in the country, only few radiographers have managed to acquire

Assessment of Safety Standards of Magnetic Resonance Imaging at the Korle Bu Teaching Hospital…

http://dx.doi.org/10.5772/52699

71

Figure 1 on page 13 shows that a good number of the respondents (47%) were into general radiography. The increased requests for general radiography examinations and the in‐ creased number of duty rooms may be responsible for this trend. Facilities for specialised imaging modalities are very limited and as has been stated earlier, there is only one MRI, a CT-scan and one mammogram in the department, hence the majority of the respondents in

In this study, majority of the respondent were of the view that access to the MRI suite should be restricted to everybody who enters the unit. Whilst majority of the respondents claimed that patients were screened before entry, the same could not be said about the staff members as only ten respondents reported to be screening staff members. However, this as‐ sertion could not be entirely true because close observation during the study revealed that not a single staff was made to undergo mandatory screening apart from taking out their metallic possessions on their own volition. This also goes to confirm the assertion that the personnel were unwilling to comply with safety and security protocols at the unit. This as‐ sertion was corroborated during the interview about the absence of coded access keys for staff in accordance with international best practices found in the literature (Kanal et al., 2007; Junk and Gilk, 2005; Shellock and Crues, 2004).It was also observed that patients were only made to change into gowns placed in the changing room of the MRI unit and all metallic opacities removed from them before entering the scanning room. A metal detector screening coupled with visual observation was the only form of screening that was done at the unit aside patients filling out an MRI screening form. There were no in - built detectors in the building to give off any alarm as an indication of the presence of a metallic substance (Gould, 2008). The study also showed that there were no lockers for both staff and patients to keep their valuables that may be ferrous in nature even though 57.1% of the respondents claimed that there were such facilities. The only available option for the staff was to keep their items in the rest room or bring them to the control panel area for safekeeping; which is not completely safety - assured. With regards to patients, their valuables were either kept in the changing rooms or brought to the control panel area. A positive observation made was the availability and use of an MR-compatible wheelchairs and trolleys. This development may be described as the reactive response by the management to the wheelchair incident that occurred at the unit as captured in the problem statement.The staff were also more vigi‐

post graduation abroad and they are mostly in the academia.

general radiography.

**6.3. MRI safety issues**

Other challenges identified include the attitude of some hospital personnel who were not will‐ ing to comply with safety and security measures in place. The need to undertake some structur‐ al adjustment to the unit was being considered to detach the CT suit from the MRI. Ensuring total commitment from both the management and staff of the hospital to safety and security is‐ sues was identified as one of the main means to prevent accidents at the MRI unit.
