AUDIT OF COMPLETION OF RADIOLOGY REQUEST FORM IN A NIGERIAN SPECIALIST HOSPITAL

O.A. Afolabi1, J.O. Fadare2 and E.M. Essien3

  1. Department of Surgery, Kogi State Specialist Hospital, Lokoja, Kogi State.
  2. Department of Internal Medicine, Kogi State Specialist Hospital, Lokoja, Kogi State.
  3. Department of Radiology, Kogi State Specialist Hospital, Lokoja, Kogi State.

Abstract

Background: Clinical audit is one approach to improve the quality of patient care, completion of request form inclusive. Radiology request forms are essential communication tools between the clinician and the radiologist. The aim of this study is to audit the adequacy of completion of X-ray request forms.

Methodology: A review of all consecutive request form received at the X-ray unit of the over a period of six weeks to assess the completeness of filling of the forms, details of biodata/clinical information, previous exposure and information about the requesting officer. The data was entered into a SPSS statistical software and analysed descriptively and results presented in tables/figures.

Result: Two hundred and two request forms were analysed. All the request had names on it however 89.1% had complete and adequate information while 10.9% have incomplete and inadequate information on names, one hundred and ninety-six (97%) had dates while, 6(3%) did not have information regarding date of request, space for the addresses were filled in 80 (39.6%) out of which only 24 (11.9%) had adequate and complete information. Clinical information were adequate and complete in 34.4%, only 6(8.3%) of those with previous x-rays
submitted their previous film with the new request.

Conclusion: We concluded that radiological investigation forms are still incompletely and inadequately filled. This will have effect on the quality and the overall service provided by both the radiographer and the
radiologist and may have effect sometimes on the clinical decision and outcome.

Keywords: audit, radiology, request form, medical education

Correspondence:

Dr. O.A. Afolabi
Kogi State Specialist Hospital,
Lokoja, Kogi State.
Nigeria.
Telephone: +2348035727069
Email: droaafolabi@yahoo.com

Introduction

Clinical audit is seen as one approach to improving the quality of all aspect of patient care completion of request form inclusive. Its development in the UK was linked to clinicians’ desire to improve medical care. It was thought that, by drawing attention to deficiencies of care, this would curb inefficient and ineffective practice1,2. Radiology request forms are essential communication tools between the clinician and the radiologist/radiographer it is a tool used in referring patients for radiological investigations. Its importance should not be underestimated. The Royal College of Radiologists clearly suggests that all request forms should be adequately and legibly completed to avoid any misunderstanding of the request3. According to the relevant articles of the Radiation Protection Regulations of European Union Nations4,5, the referring doctor has the responsibility for the collection of all diagnostic information that justifies the requested radiological examinations as well as information about previous exposures. The clinician is required to state the reason for referral as this helps radiologists to better understand the patient’s condition; so that the required expertise may be utilized to proffer the necessary information to aid proper patient management according to the relevant articles of the Radiation Protection Regulations of European Union Nations. However, no standardized format for radiology request forms is available. Different organizations adopt personalized versions. The standard is that all request forms received should contain the patient’s name, age, address, telephone number, ward, clinical background, the specific question to be answered, the name and signature of referring clinician and the name of the consultant responsible for patient’s care3.

Previous reports have shown that up to 20% of radiographic examinations are clinically unhelpful either due to inappropriate or wrong request6. Thus to improve the radiological support and utilization there is need for adequately and relevant details of the radiological request6.

The aim of this study is to audit X-ray request forms received at the radiology department of a Nigerian specialist hospital.

METHODOLOGY
This is a review of all consecutive request form received at the X-ray unit of the radiology department of Kogi State Specialist Hospital, Lokoja over a period of six weeks to assess the completeness of the forms, details of biodata, use of abbreviations and the usefulness of clinical information given to the radiologist, previous exposure and information about the requesting officer. The forms came from different departments, wards, outpatient clinics and specialists’ clinics as well as request from other health facility in the locality. A copy of the X-ray request form from which the data was extracted is attached as appendix A. The data was entered using SPSS version 13 statistical software and analyzed descriptively and results presented in tables and figures.