Clinical Audit of Radiographs Following Maxillofacial Injuries in Sultanah Nora Ismail Batu Pahat Hospital

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Clinical Audit of Radiographs Following Maxillofacial Injuries in Sultanah Nora Ismail Batu Pahat Hospital

Terk Hui Xin, Sathesh Balasundram: Clinical Audit of Radiographs Following Maxillofacial Injuries in Sultanah Nora Ismail Batu Pahat Hospital. Mal. J. Oral Maxillofac. Surg. 2013; 11: 6–11.

Abstract: Scope: Oral and maxillofacial surgery (OMFS) trauma cases seen from 04/ 2012- 07/2012 in Hospital Sultanah Nora Ismail Batu Pahat (HSNI).

Objectives: 1: To identify the appropriateness of the types of radiographs ordered. 2: To evaluate the quality of radiographs taken.

Materials and Methods: A clinical audit involving 221 skull radiographs from a consecutive series of 76 patients attending the Accident and Emergency Department and the OMFS Clinic with suspected facial injuries was performed. Patients’ records and radiographs were assessed and relevant data was collected and collated.

The quality of the radiographs was assessed according to the subjective quality rating system by Guidance Notes for Dental Practitioner on Safe Use of X-ray Equipment 2001. The appropriateness of radiograph type requested by the officers were compared against standards according to the recommendation in Oxford Handbook Dental Patient Care 2nd Edition (2005) and Dental Update (2006).

Results: The majority of skull radiograph requests were from the Department of Accident and Emergency (A&E) and the OMFS Department. A total of 66.1% of radiograph requests were from A&E house officers (HO) or medical officers (MO), and 26.7% of requests were from dental officers in OMFS, 3.6% from dental officers on-call and 2.3% from medical officers from other departments in HSNI. The requesting clinician for 1.3% of the radiographs could not be ascertained. From the 221 skull radiographs ordered, 151 of them were ordered inappropriately. 85.4% of inappropriate requests came from A&E department, 1.3% from dental officers on-call, 10% from dental officers in OMFS department, and 3.3% from other departments’ medical officers. Based on the quality rating, only 26.7% was of good quality, 36.2% was categorized as acceptable, and the remaining 37.1% was classified as poor.

Conclusion: The importance of radiographs cannot be underestimated and they are extremely crucial in the assessment and diagnosis of patients. This audit is aimed to further enhance the management of our patients by evaluating our current maxillofacial radiography practice and to continually improve in our patient care.