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MR safety during intrahospital transport of critically ill patients - An ethnographic study.

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Τίτλος: MR safety during intrahospital transport of critically ill patients - An ethnographic study.
Συγγραφείς: Martins MP; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Clinical Department of Radiology in Linköping, Region Östergötland, Linköping, Sweden; Center for Medical Imaging Science and Visualization (CMIV), Linköping University, Linköping, Sweden. Electronic address: marcelo.pereira.martins@liu.se., Silva VM; Clinical Department of Magnetic Resonance Imaging, ULS Hospital of St. John (CHSJ), Porto, Portugal., Tisell A; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging Science and Visualization (CMIV), Linköping University, Linköping, Sweden; Clinical Department of Medical Radiation Physics in Linköping, Region Östergötland, Linköping, Sweden., Zsigmond P; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Clinical Department of Neurosurgery in Linköping, Region Östergötland, Linköping, Sweden., Kihlberg J; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Clinical Department of Radiology in Linköping, Region Östergötland, Linköping, Sweden.
Πηγή: Radiography (London, England : 1995) [Radiography (Lond)] 2026 Sep; Vol. 32 (6), pp. 103487. Date of Electronic Publication: 2026 Jul 20.
Τύπος έκδοσης: Journal Article; Multicenter Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9604102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2831 (Electronic) Linking ISSN: 10788174 NLM ISO Abbreviation: Radiography (Lond) Subsets: MEDLINE
Imprint Name(s): Publication: 2003- : Amsterdam : Elsevier B.V.
Original Publication: London ; Philadelphia : W.B. Saunders Co., c1995-
Ιατρικοί όροι (MeSH): Magnetic Resonance Imaging*/adverse effects , Critical Illness* , Patient Safety* , Patient Transfer* , Transportation of Patients*, Humans ; Anthropology, Cultural ; Sweden ; Portugal ; Checklist
Περίληψη: Introduction: Intrahospital transport (IHT) of critically ill patients for magnetic resonance (MR) imaging is a high-risk procedure that combines physiological vulnerability with MR-specific hazards. While technical guidelines and checklists exist, less is known about how MR safety is accomplished in everyday clinical practice when critically ill patients undergo MR imaging. This study aimed to explore how MR safety is enacted during IHT.
Methods: A multisite focused ethnographic design was employed. Fourteen in-person observations were conducted across eight hospitals in Sweden and Portugal. Observations followed critically ill patients from ICU preparation through transport, MR scanning, and return to the ICU. Data consisted of field notes and analysis was conducted using inductive thematic analysis.
Results: MR safety emerged as a dynamic, context-dependent accomplishment rather than a fixed protocol. Three themes were identified: (1) the use of written, mental, and visual checklists and time-out procedures to coordinate safety work; (2) adaptation to spatial configurations and zoning practices shaping workflows and risk boundaries; and (3) managing uncertainty related to implants, devices, and incomplete information. Safety was continuously negotiated through interprofessional collaboration, experiential knowledge, and situational judgement, with gaps arising when communication, documentation, or MR-specific expertise were insufficient.
Conclusion: MR safety during IHT of critically ill patients is enacted through the integration of structured tools, tacit knowledge, team coordination, and spatial adaptation under conditions of uncertainty. Safety is achieved in action through collective, context-sensitive practices rather than sole reliance on protocols.
Implications for Practice: Radiographers play a central role in coordinating MR safety for critically ill patients. Strengthening layered safety strategies - combining checklists, time-outs, MR-specific education, and attention to spatial design - may reduce risk, support interprofessional collaboration, and enhance patient safety in MR practice.
(Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript.
Contributed Indexing: Keywords: Clinical workflow; Critically ill patients; Ethnography; Intrahospital transport; MR safety practices; Patient safety
Entry Date(s): Date Created: 20260721 Date Completed: 20260903 Latest Revision: 20260917
Update Code: 20260918
DOI: 10.1016/j.radi.2026.103487
PMID: 42480422
Βάση Δεδομένων: MEDLINE
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  Data: MR safety during intrahospital transport of critically ill patients - An ethnographic study.
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  Data: <searchLink fieldCode="AU" term="%22Martins+MP%22">Martins MP</searchLink>; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Clinical Department of Radiology in Linköping, Region Östergötland, Linköping, Sweden; Center for Medical Imaging Science and Visualization (CMIV), Linköping University, Linköping, Sweden. Electronic address: marcelo.pereira.martins@liu.se.<br /><searchLink fieldCode="AU" term="%22Silva+VM%22">Silva VM</searchLink>; Clinical Department of Magnetic Resonance Imaging, ULS Hospital of St. John (CHSJ), Porto, Portugal.<br /><searchLink fieldCode="AU" term="%22Tisell+A%22">Tisell A</searchLink>; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging Science and Visualization (CMIV), Linköping University, Linköping, Sweden; Clinical Department of Medical Radiation Physics in Linköping, Region Östergötland, Linköping, Sweden.<br /><searchLink fieldCode="AU" term="%22Zsigmond+P%22">Zsigmond P</searchLink>; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Clinical Department of Neurosurgery in Linköping, Region Östergötland, Linköping, Sweden.<br /><searchLink fieldCode="AU" term="%22Kihlberg+J%22">Kihlberg J</searchLink>; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Clinical Department of Radiology in Linköping, Region Östergötland, Linköping, Sweden.
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  Data: <searchLink fieldCode="JN" term="%229604102%22">Radiography (London, England : 1995)</searchLink> [Radiography (Lond)] 2026 Sep; Vol. 32 (6), pp. 103487. <i>Date of Electronic Publication: </i>2026 Jul 20.
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  Data: Introduction: Intrahospital transport (IHT) of critically ill patients for magnetic resonance (MR) imaging is a high-risk procedure that combines physiological vulnerability with MR-specific hazards. While technical guidelines and checklists exist, less is known about how MR safety is accomplished in everyday clinical practice when critically ill patients undergo MR imaging. This study aimed to explore how MR safety is enacted during IHT.<br />Methods: A multisite focused ethnographic design was employed. Fourteen in-person observations were conducted across eight hospitals in Sweden and Portugal. Observations followed critically ill patients from ICU preparation through transport, MR scanning, and return to the ICU. Data consisted of field notes and analysis was conducted using inductive thematic analysis.<br />Results: MR safety emerged as a dynamic, context-dependent accomplishment rather than a fixed protocol. Three themes were identified: (1) the use of written, mental, and visual checklists and time-out procedures to coordinate safety work; (2) adaptation to spatial configurations and zoning practices shaping workflows and risk boundaries; and (3) managing uncertainty related to implants, devices, and incomplete information. Safety was continuously negotiated through interprofessional collaboration, experiential knowledge, and situational judgement, with gaps arising when communication, documentation, or MR-specific expertise were insufficient.<br />Conclusion: MR safety during IHT of critically ill patients is enacted through the integration of structured tools, tacit knowledge, team coordination, and spatial adaptation under conditions of uncertainty. Safety is achieved in action through collective, context-sensitive practices rather than sole reliance on protocols.<br />Implications for Practice: Radiographers play a central role in coordinating MR safety for critically ill patients. Strengthening layered safety strategies - combining checklists, time-outs, MR-specific education, and attention to spatial design - may reduce risk, support interprofessional collaboration, and enhance patient safety in MR practice.<br /> (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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  Data: Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript.
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