Вы находитесь на странице: 1из 4

1

Erin Murdoch

DOS 516 Radiation Safety

Radiation Safety Paper

Public misconceptions about ionizing radiation can lead to unnecessary fears in patients
regarding radiation safety. Sometimes, these fears can cause an obstacle in signing consent forms
for a procedure, which can create a delay that further jeopardizes the patient’s well-being.1
Radiation oncology departments have methods and procedures in place to help increase patient
safety, however, explaining radiation safety to patients is an important aspect of care that is often
overlooked.2 The level of patient education necessary may depend on how concerned the patient
is with radiation exposure, however, several elements can be explained to help increase
understanding about safety.

Firstly, radiation is an ever-present part of our natural environment.1 According to


Roberts,1 most medical uses of radiation are comparable to exposure received naturally through
cosmic and terrestrial radiation. Reports about the increased use of radiation can be misleading to
patients, and it can be helpful to explain the role of natural radiation sources. Warner estimates
that, “Natural sources contribute approximately 50% of the annual radiation dose to the U.S.
public.”3

Additionally, it can be helpful to inform patients that diagnostic range radiation doses are
often too small to cause any deterministic side effects.1 Patients often fear potential stochastic
effects which have no dose threshold. According to Warner,3 we have no direct evidence that
small doses of radiation are harmful. Radiologic technologists operate under the assumption that
any exposure can cause biological damage.3 This assumption allows technologists to use
techniques that minimizes exposure, even when working with low doses.3 Patients should also be
informed that diagnostic range radiation damage can be repaired by healthy cells.1

When a patient better understands medical radiation exposure, it allows them to make
more accurate decisions when balancing the potential risks against the expected benefit of the
2

exam or treatment.2 Patient education can also include explaining the departmental procedures
that contribute to radiation safety.

Radiation oncology departments take many administrative steps to protecting patients


from unnecessary radiation exposure. Different roles within the radiation oncology team have
separate responsibilities that promote patient safety and quality assurance. Department directors
ensure that all employees are qualified, and often handle the implementation and continuation of
a departmental quality improvement program.4 Physicians are required to participate in chart
review, film review, and department quality improvement.4 Dosimetrists and physicists improve
patient safety with weekly and final reviews of treatment records, and the development of a
quality control program that follows national, state, and professionally mandated standards.4 As
the health care worker responsible for delivering the radiation to the patient, the therapist is often
responsible for a magnitude of quality assurance checks to promote safety. Some of these
responsibilities include warm up, quality assurance testing on the linac and simulator, verifying
consent forms, reviewing prescription and treatment plans, delivering accurate treatment
according to prescription, accurately documenting treatment record, taking initial and weekly
films, and participating in patient education.4 Therapists work in teams of two or more to help
review all activities both inside and outside of the treatment room to help promote accurate
treatments.5 Weekly chart checks are performed by all members of the radiation oncology team
to increase safety and efficiency for a radiation therapy treatment course.6

Radiation therapy departments are regulated by federal agencies and professional


organizations to ensure that patient safety is being upheld. The Nuclear Regulatory Commission
(NRC) is a major federal regulating agency that ensures the adequate protection of public safety
in the use of radioactive materials.4 The Joint Commission on the Accreditation of Healthcare
Organizations (JCAHO) is an independent organization that developed separate standards for
radiation oncology. A specified quality improvement plan is now required for each department.4
These agencies also mandate standards that qualify whether equipment is functional and that the
operators of the equipment are qualified individuals.4

In addition to set regulations, health workers often utilize a culture of safety within a
radiation therapy department to help protect patients.5 Therapy department leaders exhibit
qualities that uphold a culture of safety and empower employees to improve clinical processes.5
3

Part of this safety culture often includes an open work environment that allows employees to
comfortably report both errors and near misses.7 When employees report on incidents that could
lead to a treatment mistake, it allows departments to improve procedures and prevent errors in
the future.

While some patients hold misconceptions about the dangers of exposure, radiation in
medicine still has the potential for hazardous side effects if radiation safety procedures are not
developed and closely followed. The multifaceted efforts of the radiation oncology team provide
a triple-checked system so that no one individual is solely responsible for radiation safety. The
safety procedures utilized by radiation oncology departments are frequently changing, and
workers should continue to report errors and strive for patient safety in order to prevent future
mistakes.
4

References

1. Roberts BW. Patient-centered Radiation Safety. Radiologic Technology. 2017;88(5):499


516.
2. Ludwig RL, Turner LW. Effective patient education in medical imaging: public perceptions
of radiation exposure risk. Journal of Allied Health. 2002;31(3):159-164.
3. Warner R. OPEN FORUM. Radiation Perceptions and Practices...“U.S. Technologists’
Radiation Exposure Perceptions and Practices,” March/April 2011, Vol. 82/No. 4.
Radiologic Technology. 2011;82(6):576.
4. Washington CM, Leaver D. Principles and Practice of Radiation Therapy. 3rd ed. St. Louis,
MO: Mosby-Elsevier; 2010: 347-369
5. Legg JS, Dempsey MC, Aaron L. Patient Safety Perceptions Among U.S. Radiation
Therapists. Radiation Therapist. 2013;22(1):9-20.
6. Lewis SM, Heath AA. The Need for Radiation Therapist Weekly Chart Checks. Radiation
Therapist. 2018;27(2):188-190.
7. Garza Lozano R. Characterizing a Culture of Training and Safety: A Qualitative Case Study
in Radiation Oncology. Radiation Therapist. 2013;22(2):139-153.

Вам также может понравиться