Barium Swallow Examination: Radiographer and radiologist compliance to National Diagnostic Reference Levels

Abstract

ObjectivesCompliance to the National Diagnostic Reference Levels (NDRLs) ensures the radiation dose to patients is maintained at an acceptable level thereby reducing the element of risk and should not be exceeded wherever possible. The aim of the audit was to determine compliance to NDRLs for Dose Area Product (DAP) and fluoroscopy screening time in patients having Barium Swallow Examinations (BSE) between a specialist radiographer (SR) and radiologists. Methods157 BSEs DAP and screening time values were collected retrospectively over a five-month period. 34 specialist radiographer (SR)-led, 65 trainee radiologist (TR)-led and 52 consultant radiologist (CR)-led were included in the analysis. Six were excluded. These values were compared to the NDRL; both by individual and group mean value. Statistical analysis was mean, standard deviation and Mann–Whitney U to assess for significant differences between the operator groups. Results129 of 151 BSEs were below the NDRL for either DAP, screening time or both, equating to 85.4% compliance. For the three operator group BSE mean DAP values were <9 Gycm2 and mean screening time values <2.3 min. CR-led produced the lowest mean DAP value (2.69 Gycm2) and SR-led produced the highest mean DAP value (5.56 Gycm2). DAP values: no significant difference between SR-led and TR-led (p > 0.05); a significant difference was noted between SR-led and CR-led and TR-led and CR-led (p < 0.05). Screening time: no significant difference between screening time for TR-led and CR-led (p > 0.05) was shown; a significant difference was noted between SR-led and TR-led, and SR-led and CR-led (p < 0.05). ConclusionsThis audit shows good compliance with the NDRLs for both DAP and screening time.Differences were demonstrated for both DAP values and screening time between the different operator groups. The highest mean values for both DAP and screening time were produced by examinations performed by the newly introduced specialist radiographer-led service.