Exploring radiographers’ practice and decision-making relating to infection prevention and control in the CT environment: an observation study in a simulated environment

Background: Contrast media use is high in computed tomography (CT). This study aimed to explore radiographers’ decision-making process when using contrast media injectors in the CT environment, with a focus on infection prevention and control (IPC). Methods: A qualitative study using observation within a think-aloud methodology in a simulated environment was undertaken. Participants performed all the steps to undertake a contrast-enhanced CT scan, while verbalizing their actions and process. Results: CT radiographers (n = 20) participated in this study. Variations were observed across all stages of CT scanning. Gloves were used by a large proportion of participants while connecting the patient (n = 16, 80%), followed by disconnecting from the patient (n = 18, 90%). Discussion: To the best of our knowledge, this is the first study to map steps and explore radiographers’ decision-making relating to contrast-enhanced CT procedures. Justification of practice centered around patient care and self-protection factors, using routine IPC practice and awareness of IPC risks. Conclusions: There was inconsistency between participants in terms of workflow and order of steps setting up a patient in CT, along with variations in IPC practices. The lack of universal guidelines specific to IPC in CT has manifested as variations in practice across CT departments.