Radiation safety knowledge, attitudes, and practices among nurses working in radiology departments: a qualitative study

Nurses working in radiological environments are frequently exposed to ionizing radiation and play an essential role in implementing radiation safety measures for both patients and healthcare professionals. Despite their close involvement in radiological procedures, evidence from several countries suggests that nurses may have inadequate knowledge of radiation protection principles and inconsistent safety practices. The objective of the study was to explore the knowledge, attitudes, and practices of nurses regarding radiation safety and identify educational needs among nursing staff working in the radiation related areas including wards, intensive care units, emergency departments, and operation theatres within a tertiary healthcare setting affiliated with Shri JJT University, Rajasthan, India. A qualitative descriptive study was conducted using semi-structured, in-depth interviews with seventeen female nurses employed in radiology-related departments. Participants were recruited through purposive sampling. Interview transcripts were analyzed using thematic analysis guided by the Knowledge, Attitudes, Practices (KAP) framework. Data coding and theme development were performed manually, and findings were interpreted through an iterative analytical process. Five major themes emerged: (1) limited understanding of radiation fundamentals, (2) inadequate awareness of radiation protection measures, (3) inconsistent patient education practices, (4) recognition of occupational risks, particularly during pregnancy, and (5) a strong desire for continuing education. Participants demonstrated confusion regarding ionizing and non-ionizing radiation and incomplete knowledge of imaging modalities. Although most nurses acknowledged that radiation exposure could be harmful, their detailed understanding of dose limits, justification of procedures, and protection strategies was limited. Participants consistently expressed the need for additional training and improved radiation content within nursing curricula. The findings indicate substantial gaps in radiation safety knowledge among nurses working in radiation-related clinical areas. Strengthening radiation protection education in undergraduate nursing programs and implementing regular continuing professional development initiatives may improve safety practices, patient education, and occupational protection for nursing staff.