A Scoping Review of Organisational Barriers and Facilitators to the Implementation of Best Practice within Forensic Radiographic Practice: This poster presents an overview of the scoping review process undertaken and its findings

Introduction:

Forensic radiography is a highly skilled subspecialty of diagnostic radiography. Its primary focus is the collection of medical imaging for medico-legal purposes rather than for diagnosis or as an aid to patient management. Forensic radiography requires radiographers to have a knowledge, awareness, and ability to be able to apply all applicable legislation, guidelines, and protocols to their practice setting. For this review, best practice is defined as comprising of relevant meaningful procedures, interventions, and techniques premised on high quality evidence. It is this evidence that informs the basis of the guidelines and protocols to be applied. Qualified radiographers are expected to acquire this knowledge through additional postgraduate training and maintenance of CPD. However, there are currently few national or internationally agreed guidelines implemented with forensic radiography practice, and where there is a consensus, these are not consistently being applied.

Aim:

To identify and evaluate from the literature identified, any organisational factors that may facilitate and or prevent the effective implementation of best practice guidelines within forensic radiographic practice.

Methods:

A scoping review was undertaken using the updated Joanna Briggs Institute guidelines and the Population, Concept and Context (PCC) mnemonic. Inclusion criteria required only professionals involved at any stage within the forensic radiography pathway, i.e., radiologists, diagnostic/forensic radiographers, consultants, pathologists, and coroners. The concepts included guidelines and protocols, knowledge and awareness of these, the workplace culture and multidisciplinary team working. International and UK settings together with all forms of settings that may apply within the forensic radiography remit as the context i.e., rural, urban, hospital, mortuary, and makeshift temporary sites.

The review was conducted through application of the PRISMA-ScR extension, demonstrating the selection strategy applied to the systematic search of 14 databases, encompassing peer-reviewed published papers and grey literature. Search terms were used reflecting specialised areas of forensic practice, paediatrics, post-mortem imaging, narcotics, and person identification. All papers were reviewed and selected independently by 2 reviewers throughout the selection process. A purposely designed data extraction template was used followed by Inductive Content Analysis (ICA) for the data analysis.

Results

1055 papers were identified through the databases with an additional 3 through handsearching. Of these 15 met the inclusion criteria for this review, reflecting an international scope of data sources. Through ICA, 5 conceptual categories were generated: ‘Ineffectual organisational governance’, ‘Education and the translation hurdle’, ‘System Brakes’, ‘Default practice’, and ‘Value-based judgement’. All papers selected related to paediatrics and suspected physical abuse (non-accidental injury), although 3 focussed on post-mortem imaging. This apparent weighting of papers towards paediatric forensic radiography is reflective of the volume of research in this speciality and scarcity in other specialist areas applicable to this research focus.

Conclusion:

The conceptual categories generated demonstrate that the issues underpinning the effective implementation of best practice within forensic radiography are complex and multi-faceted. A multi-disciplinary and wider departmental approach will be required to address these findings. Without this, implementation will continue to be ineffective.