Medicolegal responsibilities for the administration of intravenous contrast media by radiographers : radiologists’ perspectives

• Date: 01 November 2018
• Published date: 01 November 2018
• Pages: 60-65
• Record Number: m_sajbl_v11_n2_a2
• DOI: 10.10520/EJC-14242dd6a3

November 2018, Vol. 11, No. 2 SAJBL 60

ARTICLE

Role extension can be defined as the adoption of a role or

responsibility that did not previously form part of one’s original

roles or responsibilities.[1] Global trends in the delivery of healthcare

services have warranted the need to revisit the job requirements and/

or scope of practice of cadres within professions, and to engage in

possible role extension.[2] The administration of intravenous contrast

media (IVCM), a fundamental area of expertise within the radiology

field, is an example of such a requirement. The administration of

IVCM is currently under consideration by the Professional Board

for Radiography and Clinical Technology (PBRCT) for inclusion as

an extension of the South African (SA) radiographer’s role.[1,3,4] In so

doing, it is important to identify the medicolegal responsibilities

that should become part of the radiographer’s scope of practice, and

those that should remain within the radiologists’ scope, to ensure

clarity and harmony between the two professions.

According to annexure 10 of the Ethical Rules of Conduct for

Practitioners registered under the Health Professions Act No. 56 of

1974, SA radiographers may not perform tasks outside the scope of

their training.[5] They are not permitted to administer IVCM, because

they have not received the necessary accredited training to do so.

Furthermore, it is not within the scope of the radiography profession.

However, in a recent study conducted by the PBRCT, 44.2% of

respondents (radiographers) indicated that they are currently

administering IVCM. This is a violation of the regulations defining the

scope of profession of radiography and can have serious professional

and medicolegal consequences.[6]

In a position statement published in 2011 by the Radiological

Society of SA (RSSA), radiologists in SA do support the idea of

radiographers administering IVCM, in principle, provided that the

necessary PBRCT-approved and accredited training is obtained.[7] This

is largely driven by: (i) the national shortage of radiologists, and the

subsequent service delivery constraints; and (ii) the gap between

SA and international trends.[1,7] Radiographers practising in the UK,

Ireland, USA, Europe, Canada and Australia have been able to extend

This open-access article is distributed under

Creative Commons licence CC-BY-NC 4.0.

Medicolegal responsibilities for the administration

of intravenous contrast media by radiographers:

Radiologists’perspectives

G G V Koch,1 MHSc Radiogr (Diagn), PGDip Tertiary Educ; L D Swindon,1 MEd (Higher Ed), BTech Radiogr (Diagn);

JDPillay,2PhDPhysiol,MPH

1 Department of Radiography, Faculty of Health Sciences, Durban University of Technology, South Africa

2 Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, South Africa

Corresponding author: G G V Koch (erhardkoch9@gmail.com)

Background. Global trends in the delivery of healthcare services have placed tremendous strain on resources, among them human and

capital. With this has emerged the need to revisit the job requirements and/or scope of practice of cadres within a profession, to ensure

adequate training where needed. The administration of intravenous contrast media (IVCM), a fundamental element of expertise within the

radiology field, is an example of such evolution in South Africa (SA). Currently falling within radiologists’ scope of practice, it has become

necessary for radiographers to extend their own scope to include this skill, owing to the national shortage of radiologists and subsequent

service delivery constraints, as well as the need to close the gap with international trends.

Objective. To provide a synopsis of the perspectives of radiologists on the medicolegal responsibilities related to the administration of IVCM

by radiographers.

Methods. A quantitative, descriptive, cross-sectional research design was conducted, targeting qualified radiologists in KwaZulu-Natal Province

(KZN). An online questionnaire was administered through SurveyMonkey that provided information on the medicolegal responsibilities associated

with the administration of IVCM.

Results. Of a total of 97 qualified radiologists in KZN, a response rate of 48.5% (n=47) was obtained. The majority of respondents felt that

radiographers should be responsible for obtaining informed patient consent (66.0%), and deciding on the site of IVCM administration

(72.3%). It was also felt that the radiologists should remain responsible for decisions regarding the type and dose of IVCM (87.2%) and

managing the possible complications and adverse reactions due to the administration of IVCM (78.7%).

Conclusion. Evidence-based research provides a contextualised approach towards addressing transformation in service delivery and

training needs. This study, in demonstrating the importance of appropriate medicolegal responsibilities in the extension of a professional

role, forms a basis for informing the future training of radiographers in SA.

S Afr J Bioethics Law 2018;11(2):60-65. DOI:10.7196/SAJBL.2018.v11i2.632