MR Safety in Sweden: Nationwide Survey Reveals False Sense of Security
A recently published Swedish survey has found that magnetic resonance imaging (MRI) personnel in Sweden express confidence in the nation’s MRI incident reporting mechanisms, despite a high number of severe MRI scanner-related safety incidents, near misses, and safety protocol breaches reported during a recent 12-month period.
“A false sense of security exists for MR” in Sweden, a multi-institutional team of researchers wrote in the study, published online in the Dec. 13, 2019 issue of European Radiology.1 The study also found that many respondents were unaware of incidents that occurred in their own departments and had been reported by their colleagues.
Sweden has no formal national registry for imaging-related safety incidents, but hospitals are encouraged to report them to the country’s health and social care inspectorate, according to the authors.
The study was conducted to survey MR safety incidents and their severity during a year-long period, as well as to evaluate MR personnel confidence in incident-reporting mechanisms.
It was part of a web-based questionnaire focusing on working conditions for MRI technologists and safety issues for patients compared to those in computed tomography (CT).
Some 620 MR personnel and 1,300 CT personnel at 92 imaging locations were surveyed. Among the 529 respondents were 345 full- or part-time technologists working with MR scanners in 81 hospitals, and 392 working full- or part-time with CT scanners in 86 hospitals. Thirty-nine percent reported working in both modalities, and nearly a third reported working at 12 hospitals affiliated with Sweden’s seven medical universities.
Survey questions for both modalities related to the reporting of injuries, material damage, or “close calls,” each of which was classified by researchers according to severity. Participants were also queried on their confidence in their facility’s incident-reporting policies and practices. Participants could also voluntarily complete a free-text description of incidents
Respondents reported 200 MR safety incidents and 156 CT safety incidents. MR-related incidents included 21 resulting in injury, 50 in material damage, and 129 considered to be close calls. CT-related incidents included 64 injuries, 39 cases of material damage, and 53 close calls.
The MR incidents and close calls related primarily to burns and projectiles, ranging from large items such as metal walkers, wheelchairs, and oxygen tanks, to smaller but still dangerous items such as scissors, knives, and cellphones. All these safety incidents were scored with a potential severity score ranging from 1 to 4, defined as the potential worst-case scenario outcome of a similar incident.
A score of 1 represented the potential for minor consequences, such as discomfort or insignificant injury, while 4 represented the potential for a catastrophic outcome, such as death or persistent major disability. Among all MRI incidents addressed by the survey, 16% received the highest potential severity score. The scores were assigned by a joint discussion by the MR safety physicist, the head of MR safety research radiographer, the responsible research radiographer, and the study’s principal investigator.
The survey also revealed that 82% of respondents were not aware of incidents that had occurred at their facilities.
“This finding suggests that the healthcare system lacks functioning local incident-reporting systems assuring feedback to employees,” wrote the researchers, led by principal investigator Isabella Björkman--Burtscher, MD, PhD, Professor of Neuroradiology, and lead author Boel Hansson, both of the Department of Medical Imaging and Physiology at Skåne University Hospital in Lund.
While the large number of close calls reflect “a considerable awareness of safety risks and that safety practices and routines are in place for MR accident prevention,” the authors concluded that feedback is not effectively communicated to radiology personnel and others who come in contact with MR imaging. Among other suggestions, they recommend that Sweden adopt international standards for MR safety and to design and implement MR educational programs, safety procedures, and screening forms for patients.
Reference
- Hansson B, Olsrud J, Wilén J, et al. Swedish national survey on MR safety compared with CT: a false sense of security? Eur Radiol. Published online December 13, 2019. doi: 10.1007/s00330-019-06465-5.