Infection prevention and control in the CT suite: a qualitative study with Australian radiographers in intravenous contrast administration

Background: Within radiology departments, computed tomography (CT) has been identified as presenting a higher risk of infection compared to other imaging modalities. CT scanning often deploys contrast injectors to administer iodine contrast intravenously, which poses infection risks for patients and staff. The aim of this study was to explore the variations in practice and the enablers and barriers to infection prevention and control (IPC) practices in the CT suite in Australia. Methods: Semi-structured focus group discussions (FGD) were conducted over three sessions with thirteen registered radiographers, who had expressed interest in participating in FGDs after completing a survey on IPC knowledge and practice. The FGDs ran for one hour and questions focused on workplace surveillance, IPC education, risks associated with different components of contrast injectors, and variations between staff. FGDs were transcribed verbatim and coded using thematic analysis to identify key themes and concepts. Results: Three key themes arose from the focus group discussions: ‘Communication and Education in Radiology’, ‘Safety in CT’, and ‘Injection Technology’. Participants described general IPC modules, most of which did not relate to the CT environment. In hospital settings, IPC policies were often considered broad, and participants described having no written policies relating to IPC and the CT contrast injector. IPC safety was impacted by other staff members, particularly staff from other departments who assist with connecting the CT injector but were often not familiar with CT equipment. CT injectors have connection points that must remain sterile and poor adherence to IPC practices will increase the risk of infections. The number of connection points are less in multi-use injectors compared to single-use injectors, hence, there was a perceived advantage with multi-use injectors. However, single-use injectors were used for infectious patients if available for easier cleaning. Conclusion: The lack of CT-specific IPC training and policies led to variations in practice between staff in the CT suite. Training and resources focused on radiology settings and scenarios are needed and would benefit both radiology staff and other wards that require radiology services.