Obstetric sonography in Fiji: A review of the current practice at an urban public hospital

Abstract

This research employed a case study approach positioned in an interpretive paradigm to investigate the current obstetric sonography practice at an urban public hospital in Fiji. The primary aims of this research were firstly, to evaluate the current practices and procedures used for the mid-trimester obstetric sonography examinations at an urban public hospital in Fiji; and secondly, to examine the potential need for the development of a standard protocol for the mid-trimester obstetric sonography examinations at the hospital where this research was located. Multiple data collection methods were employed to collect predominantly qualitative data through observations, questionnaires and interviews. The participants, who were purposively selected, comprised six ‘on-the-job’ trained radiographers performing obstetric sonography and four sonography specialists (two radiologists and two obstetricians). While the quantitative data was obtained from the observations made on the scanning criteria used by the radiographers, most of the qualitative data was obtained from the radiographers’ questionnaires and the specialists’ interviews. The findings of this study revealed that there are obvious omissions in the current practice of obstetric sonography in Fiji. The evaluation of the radiographers’ guidelines for the mid-trimester obstetric sonography examinations at the host hospital showed inconsistencies in their current practice. Absence of a standard written protocol, insufficient expertise, training and supervision, excessive workload and lack of resources, have been identified as some of the major factors influencing the radiographers’ sonography practice at the host hospital. It is surmised that due to the identified limitations and constraints, the current obstetric sonography practice at the host hospital neither meets the international standards nor the expectations of the sonography specialists in their entirety. Hence, there is a genuine need for the implementation of standard obstetric sonography examination protocols at the host hospital and continuing professional development in medical sonography in Fiji.