Radiographer use of anatomical side markers and the latent conditions affecting their use in practice

BackgroundPatient safety is a primary concern within the NHS. It has been reported that anatomical side marker (ASM) use in radiography does not meet the ‘best practice’ standard. Case reports suggest this may be a contributing factor to adverse events in healthcare.PurposeThis study aimed to investigate the latent conditions contributing to poor ASM practice; communities of practice, time of image acquisition and competing priorities with collimation practice.MethodProxy variables of projection and laterality were used to measure communities of practice. ASM practice on 330 examinations (170 lumbar spine, 160 finger) was retrospectively observed using a data collection tool. Aggregate scores were calculated from the two images in each examination. Data was analysed using descriptive statistics, chi-square tests (projection) and Mann–Whitney U tests (laterality, time of acquisition and collimation practice).Results‘Best practice’ ASM use was met on one examination. Correct ASM were observed within the primary collimation in 32.0% images. Projection, laterality and collimation practice were associated with ASM use. Time of acquisition was not found to be associated.DiscussionCommunities of practice and competing priorities impact on ASM use. Logistic regression to determine a primary latent condition was not possible. However, comparison with previous research suggests this is likely to be specific to each radiography department.ConclusionLatent conditions are associated with poor ASM practice. These must be identified and addressed in each individual radiography department, to improve patient safety and uphold NHS Constitutional standards.