**6.3. MRI safety issues**

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‐

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

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‐

This research sought to investigate the availability of safety policies and guidelines and ad‐ herence to them by staff at the MRI suite of the Korle-Bu Teaching Hospital. It also investi‐ gated the design features of the MRI suite to ascertain whether it meets the acceptable international safety standards as these inevitably, affect patient care during MRI procedures. In this chapter, the findings are discussed and key issues which require immediate attention

Out of the 31 questionnaires administered, 28 were returned providing an appreciable re‐ sponse rate of 90.3% (n=28/31). The high response rate received could be due to the small population of radiographers in the department and their easy accessibility. It could also be due to the time and period that the data was collected; just after close of work. A response rate above 50% is an important part of a survey because it enables findings to be generalized (Burns and Grove, 2003). The survey undertaken can thus be generalized to the population

**6.2. Demographic profile of respondent: gender, professional qualification and working**

The demographic profile in table 2 on page 13 shows that the ratio of male to female respond‐ ents was 3:1 (75% - 25%). This observation may be associated to the general perception individ‐ uals have of radiation. As espoused by Maiorova et al (2008) most females prefer to work in other professions than to be in the radiography profession which is consistent with the Ghana‐ ian situation where high numbers of females are found in other professions, particularly, nurs‐ ing. As a result of the misconception people have about radiation in Ghana, some nurses even refuse to stay in the duty room at the radiography department to assist patients that they have accompanied. However, in other parts of the world, especially Australia, the radiography pro‐

fession is dominated by the female population (Merchant *et al.,* 2011).

lenge to restricting access and this was attributed to defect in MRI – suite.

**6. Discussion**

are identified.

**6.1. Response rate**

that was studied.

**area**

sues was identified as one of the main means to prevent accidents at the MRI unit.

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‐ lant and non ambulatory patients were thus transferred onto MRI safe wheelchairs and trol‐ ley before being sent to the scanning room.

**6.6. Summary**

and local rules.

**7. Conclusions**

nature or magnetic-sensitive.

Safety of patients and staff around the MRI unit is a critical issue in the practice of diagnos‐ tic radiology due to the high magnetic fields and radiofrequencies associated with the oper‐ ations of the MRI scanner. Magnetic field associated with the MRI scanner is 10,000 times higher than the earth's magnetic field; therefore a detection of the smallest amount of fer‐ rous in any material is essential. It is therefore essential that radiographers take practical steps to identify any unknown material in or on any patient or staff that may be ferrous in

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

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

73

The creation of an attitude of safety screening, however, requires a firm commitment of both senior management and staff of the hospital, which must be communicated through policies

**•** Safety screening was practiced to some extent but there were no written local rules or pol‐ icies that actually specify what a radiographer should do routinely. There was therefore

**•** The safety screening undertaken in the MRI unit was done primarily on patients, over‐ looking the risks posed by other individuals and co - workers who come to the MRI unit

**•** There was lack of an effective and efficient policy and guidelines in the hospital in general

**•** The inappropriate design feature of the MRI suite was also seen to be a hindrance to effec‐

**•** This research is the first of its kind to be conducted at the MRI unit of KBTH. It is our considered view that further work needs to be carried out to validate the assumption that the frequent accidents and breakdowns at the MRI unit is as a result of the lack of safety policies and operating guidelines at the unit. It would also me necessary to extend such a study to the other MRI units in the country to determine their safety and security levels,

This study was conducted exclusively in the Korle Bu Teaching Hospital with a study popu‐ lation of thirty one radiographers. Although KBTH is the leading referral hospital in Ghana, making generalizations about radiographers nationwide has to be done with caution since the sample may not be truly representative of the entire population. There are a very limited number of MRI scanners in the country with the one at Korle – Bu Teaching Hospital being

**7.1. Based on the findings of the study, the following conclusions are drawn;**

**•** Poor documentation of safety issues at the department was noted.

no standard of practice in the department.

and the radiography department in particular.

tive safety screening practices.

**7.2. Limitations of the study**

It was reported by 57.1% of the respondents that the MRI equipment was regularly checked by the hospital authorities. However, it was established that these checks were not regular according to the standardized quarterly quality checks and maintenance scheme. The irreg‐ ularity of the quality assurance checks could be a contributing factor to the frequent break‐ downs of the equipment a view held by the respondents as contained in Table 3 on page 14

It was observed that patients were asked to complete MRI history and assessment forms to determine if they have conditions that were contraindicated to MRI procedure. However, non- patients including referring clinicians entering the unit did not complete this form. With the exception of the screening forms, no other safety and security documentation for both patients and staff were available in contravention of standardised policies and guide‐ lines (Ferris *et al.,* 2007).

It was found that occasionally anaesthetists were assigned to the MRI unit for required pro‐ cedures. This could explain why majority of the respondents were unaware of the presence of anaesthetic services at the radiography department.
