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Introduction: The radiology department plays an important role in healthcare settings, facilitating diagnoses using different imaging modalities, including ultrasound. However, this high-tech environment can pose various risks to patients. In this study, we aimed to describe the risk of patient safety incidents, and factors associated with the prevention of risks related to ultrasound examinations and the diagnostic work, from the perspective of Swedish radiographers.

Methods: We conducted a qualitative study, based on the written answers to three open-ended questions addressed to Swedish radiographers in ultrasound units of radiology departments, between March 2022 and May 2023. Data from the responses were analyzed using content analysis.

Results: A total of 22 radiographers participated in this study. The described risks were categorized into two groups: risk of tissue damage; and risk of missed, delayed, or incorrect diagnoses. Participants stated that patient safety relied on good organizational conditions—such as having enough time for ultrasound examinations and the diagnostic work, together with adequate technical equipment and new ultrasound devices not older than 5 years. As risk-prevention factors, the radiographers recommended ensuring adequate individual competence—for example, through recurrent mandatory education in ultrasound physics and safety performed by the hospital physicist, and by implementing a certificate with an identified level of expertise at every level of the ultrasound examination.

Conclusions: Within ultrasound units in Sweden, collaborative individual, organizational, and technical factors are important for reducing the risks of tissue damage and of missed, delayed, or incorrect diagnoses.

Implications for practice: In ultrasound diagnostics, risk-preventing factors include the use of adequate technical equipment and ultrasound devices not older than 5 years, sufficient time for ultrasound examinations and diagnostic work, thoroughly education in all ultrasound methods and recurrent mandatory education in ultrasound physics performed by hospital physicists.