Assessment of X-ray Film Reject Rate in Two Tertiary Healthcare Institutions in Northeastern Nigeria

Abstract

Background: Film reject analysis has been used as a quality indicator about the efficiency of radiology services and the basis for quality control and education for the radiographers. Furthermore, it gives an indication of the sources of radiographic errors thereby reducing unnecessary radiation dose to the patient population and also highlights areas where improvement can be made.

Objective: To establish the rate of reject films between two tertiary healthcare institutions in Northern Nigeria.

Methods: A Comparative, prospective and cross sectional study was conducted involving rejected x-ray films within a period of three months, from February to April, 2015. This was done in two tertiary Institutions; University of Maiduguri Teaching Hospital (UMTH) and Federal Neuro Psychiatric Hospital (FNPH) Maiduguri, Nigeria. Rejected films were retrieved weekly based on the criteria recommended by international Atomic Energy Agency (IAEA). This was recorded on a data capture form with the help of an experienced Radiographer. The rejected films were then classified according to different body regions/anatomical site and reasons for the rejection. Frequency and percentage were generated for each of these variables. This was done using SPSS software version 19.0. 

Results: The overall reject rate was 26.04% in 8476 exposed films. The reject rate for UMTH and FNPH were 29.89% in 5626 and 18.4% in 2841 exposed films respectively. Underexposure was the most common reason for reject in both hospitals amounting to 28.4% (n=463) and 38.7% (n=230) for hospital UMTH and FNPH respectively. With regards to the anatomical site, chest radiographs were the most commonly rejected radiographs in both hospital, UMTH (35.52, n=579) and FNPH (45%, n=268).

Conclusion: The overall reject rate is higher than the international acceptable limit. The reject rate for UMTH was higher than that of FNPH. The reject rates for the individual institutions were far above the international acceptable limits and also higher than the ones previously established in the respective institutions. Underexposure was the commonest reason for reject while chest radiograph was the most predominant anatomical site being rejected in both institutions.