Assessment of Health Care Workers Knowledge, Attitude and Practices of Radiation Safety at A Specialist Hospital, Jos, Plateau State, Nigeria
Assessment of Health Care Workers Knowledge, Attitude and Practices of Radiation Safety at A Specialist Hospital, Jos, Plateau State, Nigeria
Assessment of Health Care Workers Knowledge, Attitude and Practices of Radiation Safety at A Specialist Hospital, Jos, Plateau State, Nigeria
Volume 6 Issue 6, September-October 2022 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
1. INTRODUCTION
The exposure of human beings to ionizing radiation causes genetic damage which is linked to cancer
from both natural and artificial sources is a continuing induction but this varies due to duration and the dose
and unavoidable part of life on earth. Today of exposure; Nowadays CT constitute 4% of medical
diagnostic imaging and interventional radiological examinations and it has the highest dose among all
techniques are increasingly used to diagnose varieties medical examinations. The typical exposure dose for
of injuries and diseases, and to provide lifesaving abdominal CT is 9mSv and one chest radiogragh is
treatment to many diseases. 0.02mSv. 15% of the average radiation dose (2.5mSv)
As a result the use of X-ray in imaging modalities received annually by the populace comes from related
such as mammography and Barium studies to medical exposures.
diagnose injuries in human system is the order of the The biological effect of ionizing radiation is rising a
day in modern medicine. To this effect, it contribute major concern, as such, the radiation dose given in
40% of collective dose of ionizing radiation that any diagnostic procedure should be enough to answer
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any clinical question, so that the dose given to 2.2 Questionnaire A self administered questionnaire
patients should be kept as low as reasonably was sent to 174 health care workers and ask to fill and
achievable. This can only be achieve if Doctors who return within three weeks (Appendix). They were
request for diagnostic imaging are well trained in asked about their duration of employment, training in
making such decisions, and have accurate knowledge radiation safety, exposure characteristics, knowledge,
of the associated risk. But it is quite pathetic that attitude and practices of radiation safety. The
research shows that there is a wide spread of questionnaire was tested on 12 health care workers in
underestimation of radiation dose among physicians. a pilot survey and we excluded these 12 respondents
The principle of radiation safety and their practical from the study.
application is critical to all health care workers and 2.3 Statistical analysis The analysis was perform
most be well understood. Misconceptions about using the Statistical Package for Social Sciences
radiation may cause fear and concern that will have version (SPSS 21), descriptive statistics including
negative impact on the patient. frequency distribution, mean, standard deviation and
The major concern may not be to address new percentages. Level of knowledge, attitude and
policies and procedures, but to improve the practices were calculated as percentages of correct
answers in each section. Levels above 50% were
understanding of frequency and causes of error,
especially those that are most likely harmful. Our considered good knowledge and safe practices.
goal is not to eradicate all faults; rather should we 3. RESULTS
focus our attention on conditions that can cause real One hundred and sixty nine questionnaires were duly
harvock. filled by participants (response rate, (97.1%). The
Similar surveys have been conducted in other parts of participants include: 8 Radiologist, 72 Nurses, 3
the world especially America and Europe, but on Oncologist, 49 Clinicians, 26 Technicians and 11
African doctors the awareness on radiation doses is Surgeons. Their ages ranged from 18-24, 25-30, 31-
not sufficient. It is therefore necessary to consider the 34, 35-40, 41-44, 45 years and above. The duration of
safety of both patients and those who deliver these workers at current employment among participants
services. The study aimed at assessing the health ranged from 1-10(68.6%) 11 and above (31.4%)
workers knowledge, attitude and practices regarding years. Male health workers account for 52.6% of the
radiation safety in a Specialist Hospital in Jos- participants compare to 47.4% females.
Nigeria. Table1 shows the distribution of health care workers
according to personal and work characteristics.
2. MATERIAL AND METHODS
This cross sectional study was conducted in a Table2 shows the distribution of the health care
Specialist Hospital in Jos Plateau State, Nigeria workers according to their exposure and practice.
Table3 shows the distribution of health care workers
during October-November, 2017. Confidentiality and
anonymity was maintained in accordance with the knowledge regarding radiation dose. Table4 shows
health care workers knowledge on susceptibility of
regulations mandated by Research and Ethics
Committee of the hospital. organs to ionizing radiation. Table5 shows the
distribution of health care workers according to
2.1 Subjects Recruitment was done by convenience attitude regarding radiation safety and Table6 shows
sampling of all health workers exposed to ionizing the distribution of scores of health care workers
radiation on a voluntary basis. The participants were knowledge, attitude and practice regarding radiation
informed that the result would only be used for safety.
scientific study.
Table1: Distribution of health care workers according to personal and work characteristics (N=169)
Age (years)
Mean S.D 35 1.8
Range 22-47
Sex
Male 95 (56.2%)
Female 74 (43.8%)
Job Category
Clinicians 49 (29%)
Nurses 73 (43.2%)
Oncologists 3 (1.8%)
Radiologists 8 (4.7%)
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Surgeons 10 (5.9%)
Technicians 26 (15.4%)
Duration of current employment (years)
Range
1-10 116 (68.6%)
11 and above 53 (31.4%)
Receiving Radiation Safety Training (Yes) 39 (23.1%)
Reading Radiation Safety Publications
More than 5 articles 10 (5.9%)
1-5 articles 23 (13.6%)
1 article 33 (19.5%)
Never 103 (60.9%)
Table 2: Distribution of health care workers according to their exposure and practice (N=169)
Exposure Frequency (/Week) No.(%)
More than 3 times 32 (18.9)
1-3 times 23 (13.7)
Less than once 31 (18.3)
None 83 (49.)
Adherence to radiation protection policies, procedures and PPE
Adherent 3 (1.8)
Not Adherent 166 (98.2)
Applicability and convenience of radiation protection policies procedure and PPE
Lead aprons 22 (13.0)
Leaded gloves 3 (1.8)
Thyroid shields 4 (2.4)
Eye glasses 4 (2.4)
Distance from radiological device without protection during procedure
1 meter 10 (5.9)
2 meters 19 (11.2)
5 meters 73 (43.2)
I do not care 49 (29.0)
Table 3: Distribution of health care workers knowledge regarding radiation dose (N=169)
Radiation dose No. (%) of correct answers
Background radiation dose (mSv) 27 (16.0)
Chest X-ray radiation dose (mSv) 30 (17.8)
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Table 5: Distribution of health care workers according to attitude regarding radiation safety (N=169)
Assessment. No. (%) Agree respondents
1. The policies and procedures on radiation precautions are clear and easy to understand. 87 (51.5)
2. I feel confident about the steps I need to take when caring for patients needing radiation precautions.
77 (45.6)
3. I know whom to contact if I have questions about when radiation precautions are needed for a particular
patient. 93 (55.0)
4. I feel I can clearly explain the radiation precautions needed to any patients and their visitors. 74 (43.8)
5. I feel safe when caring for patients needing radiation precautions. 71 (42.0)
6. I feel the institutional policies and procedures are based in current regulations. 59 (34.9)
7. I am confident the institution is carefully monitoring my radiation exposure. 35 (20.7)
8. I feel that I will be called if I receive higher than normal exposure. 34 (20.1)
9. I feel that working with patients receiving radiation will not affect my ability to have a child. 32 (18.9)
Table 6: Distribution of score of health care workers knowledge, attitude and practices regarding
radiation safety (N=169)
Knowledge score No.(%) of respondents
Poor knowledge 83 (49.9)
Fair/Good knowledge 86 (50.1)
Attitude score
Negative attitude 96 (56.8)
Positive attitude 73 (43.2)
Perception
Good 46 (27.3)
Bad 123 (72.7)
Practices score
Safe 33 (19.5)
Unsafe 136 (85.5)
DISCUSSION
Since exposure to radiation from medical procedures a distance of 2 meters or less from source point
has become a topic of recent public and scientific without protection (Table2).
discussion, it is important that physicians should be Regarding health workers knowledge, this study
knowledgeable on radiation protection properly so revealed that 16.0% of Health workers correctly
that they can protect themselves, patients and others identify the background radiation equivalent dose and
around the patients. 4.1% of the hospital workers correctly identify the
The result showed that only a few of the respondents radiation equivalent dose in a chest X-ray. However
(23.1%) had attended an educational program in the only 24.3%, 2.4%, 3.6% and 17.8% of the health
country about radiation safety and the attendance was workers correctly identified the equivalent number of
highest among radiologists The majority of the health chest X-ray, CT, MRI and ultra sound respectively in
workers (76.9%) didn’t receive any radiation safety different radiological investigations (Table3). Under
training, and 60.9% of them don’t used to read estimation of radiation dose means that physicians are
radiation safety magazine (Table1). As regard not aware of the radiation risk and therefore are less
exposure frequency 18.9% of the participants cautious in offering radiation related investigations to
recorded more than three times exposure per week. their patients, which in turn may increase their
Fifty five health workers (32.6%) were exposed to unnecessary exposure. Also there are physicians who
ionizing radiation once per week or while only 18.3% fail to recognized MRI and ultrasound as radiation –
are exposed to ionizing radiation less than once per free modalities, these alternatives to X-ray and CT
week. Only three of the hospital workers (1.8%) were may not be frequently utilized in their practice.
adherent to radiation protection policies, procedures According to this study, physicians used lead apron
and personal protection equipment (PPE). At least more than the did other PPE and only 1.8% used lead
19.6% of the participants thought that radiation gloves. The used of other measures such as thyroid
protection policies and procedures and PPE were shields and eye glasses were less frequent (Table2).
applicable and convenient while working. However
twenty nine health workers (17.1%) were standing at
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The mean knowledge score was 56.5 15.2. About Awareness of Radiation Exposures Associated
49.9% of health workers were classified as having with Diagnostic Imaging Investigations.
poor knowledge, while only 50.1% were classified as Insights into Imaging, 1, 86-92.
having fair to good knowledge (Table 6) among http://dx.doi.org/10.1007/s13244-010-0009-8
which physicians score only 23.7% fair to good. The [5] Yurt, A., Çavuşoğlu, B. and Günay, T. (2014)
mean attitude and practice score were 46.9 8.6 and Evaluation of Awareness on Radiation
59.3 3.0 respectively and 85.5% was classified as Protection and Knowledge about Radiological
having unsafe practice (Table 6). Examinations in Healthcare Professionals Who
Many factors would have contributed to the unsafe Use Ionized Radiation at Work. Molecular
practice of the health workers and in particular the Imaging and Radionuclide therapy, 23, 48-53.
poor knowledge of the physicians amongst which is http://dx.doi.org/10.4274/mirt.00719
the undergraduate never having formal training on [6] Arslanoğlu, A., Bilgin, S., Kubal, Z., Ceyhan,
this topic. The deficit of knowledge of basic scientific M.N., Ilhan, M.N. and Maral, I. (2007)
principles in post graduate education and lack of Doctors’ and Intern Doctors’ Knowledge about
organized continuous education in hospitals on Patients’ Ionizing Radiation Exposure Doses
radiation safety and protection is also a factor. In during Common Radiological Examinations.
addition, there were inadequate availability of Diagnostic and Interventional Radiology, 13,
radiation safety equipment such as radiation dose 53-55.
badges and this may be one of the major reasons for
[7] Wong, C.S., Huang, B., Sin, H., Wong, W.,
not using them. There was no regular monitoring of
Yiu, K. and Chu, Y. (2012) A Questionnaire
radiation exposure per year and therefore, it is
Study Assessing Local Physicians, Radiologists
difficult to assess the average radiation exposure in
and Interns’ Knowledge and Practice Pertaining
the hospital.
to Radiation Exposure Related to Radiological
CONCLUSION Imaging. European Journal of Radiology, 81,
At the Specialist Hospital, health workers knowledge 264-268.
and practices towards radiation safety related to http://dx.doi.org/10.1016/j.ejrad.2011.02.022
radiological imaging are fair.
[8] Keijzers, G.B. and Britton, C.J. (2010) Doctors’
ACKNOWLEDGEMENT Knowledge of Patient Radiation Exposure from
We would like to express our sincere appreciation and Diagnostic Imaging Requested in the
deepest gratitude for the cooperation and generous Emergency Department. Medical Journal of
help of the participants and the responsible authorities Australia, 193, 450-453.
of the Specialist Hospital.
[9] Moifo, B., Edzimbi, A., Tebere, H., Tambe, J.,
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