QUALITATIVE STUDY OF IMPLEMENTATION OF RADIATION SAFETY PROTOCOL IN PRIVATE RADIOLOGY CLINICS IN MEDAN

Abstract

The escalating reliance on diagnostic and interventional radiology services globally necessitates stringent adherence to radiation safety protocols to mitigate potential health risks to both patients and healthcare professionals. Despite established guidelines from international bodies such as the International Commission on Radiological Protection (ICRP) and national regulatory agencies, the practical implementation of these protocols can present significant challenges, particularly within the diverse landscape of private radiology clinics. Recent trends highlight an increasing utilization of advanced imaging technologies, which, while enhancing diagnostic accuracy, also amplify the potential for radiation exposure if not meticulously managed. A critical gap persists in understanding the granular realities of radiation safety protocol implementation in private healthcare settings within rapidly developing urban centers like Medan, Indonesia, where specific contextual factors, including resource availability, staff training levels, and prevailing organizational cultures, may substantially influence compliance and effectiveness. This qualitative study addresses this void by exploring the lived experiences and perceptions surrounding radiation safety protocol implementation within this specific geographical and institutional context, aiming to illuminate the practical challenges and facilitators that shape its success. The research specifically aimed to comprehensively explore and describe the multifaceted aspects of radiation safety protocol implementation in private radiology clinics in Medan, focusing on identifying perceived barriers and enablers to effective protocol adherence, understanding the influence of organizational factors and professional practices, and uncovering the lived experiences of healthcare professionals involved in radiological procedures, underpinned by the Health Belief Model and the Theory of Planned Behavior. A phenomenological qualitative research design was employed to delve deeply into the subjective experiences and meanings attributed to radiation safety protocol implementation by healthcare professionals, involving a purposive sample of twenty-five participants from five private radiology clinics in Medan, comprising radiologists, radiographers, and radiology nurses. Data were collected through in-depth, semi-structured interviews, and thematic analysis was utilized to identify emergent patterns, revealing that a predominant theme identified was the "Perceived Dichotomy between Policy and Practice," highlighting a significant gap between written protocols and their daily execution. Participants frequently cited "Resource Constraints" as a major barrier, including insufficient availability of personal protective equipment (PPE) and outdated monitoring devices, which often led to workarounds and compromises in safety measures. Another prominent theme was the "Variability in Training and Awareness," indicating that the level of understanding and commitment to radiation safety practices differed significantly among staff, influenced by the frequency and quality of training received. Furthermore, the "Influence of Patient Throughput and Time Pressure" emerged as a significant factor, where the drive to see more patients within limited timeframes sometimes led to hurried procedures and a diminished focus on meticulous safety checks. In conclusion, this study demonstrates that the implementation of radiation safety protocols in private radiology clinics in Medan faces substantial challenges stemming from resource limitations, inconsistent training, and operational pressures, leading to a notable disparity between policy and practice. These findings underscore the critical need for targeted interventions that address these practical barriers, including the provision of adequate resources, standardized and continuous staff training programs, and the fostering of a robust safety culture, theoretically contributing to the empirical validation and extension of the applicability of the Health Belief Model and Theory of Planned Behavior within the context of healthcare safety protocols in a developing country setting, and practically informing policy development and guiding the design of more effective, contextually relevant strategies for improving radiation safety practices, ultimately enhancing patient and staff well-being.