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Luke VanLanen
Fundamentals of Radiation Safety
Radiation Safety Paper
Radiation Treatment Patient Safety
One of the fastest growing fields in medicine is the use of radiation in the medical setting.
This may appear worrisome to the public as radiation at times can bring with it a negative
connotation. This can cause the patient to have an uneasy feeling about radiation treatment
before they are even exposed to it. The truth is that radiation is an incredible tool used for
imaging and treating people with difficult cancers. Like all procedures there are risks that come
with it, however radiation and its effects on humans has been extensively studied. These studies
result in treatment recommendations and protocols that allow a patient to have safe radiation
treatment.
The journal article ​Patient-centered Radiation Safety​ looks at why patients feel uneasy about
radiation treatment and why they actually should have confidence in radiation treatment.
Following the nuclear bombings of Hiroshima and Nagasaki, radiation and the biological effects
on humans has been a focal point of science. The Radiation Effects Research Foundation is still
currently collect data for about 280,000 people who were exposed to doses ranging from just
above background radiation to several gray.[1] For the purpose of science this is a massive
sample size which equates to sound research on the effects of radiation on humans. There is also
another study called the United States Radiologic Technologists Study and it is the largest and
most comprehensive study of occupationally exposed medical personnel. The research done in
this study includes data from 146,022 registered radiologic technologists. [1] The result is that
the risks associated with radiation has been monitored and studied by thousands of professions,
and the risks have been looked at in massive sample sizes. The availability of research to create a
safe and effective protocol is available. Trained professionals in charge of assuring the general
safety of medical radiation can then implement these requirements to create a sound and
effective radiation treatment. What all this means to the public is that if a healthcare provider
follows correct safety protocol there is little need to worry about the safety risks. The protocols
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and procedures implemented at accredited clinics are there to guarantee the patient with the best
possible treatment while keeping them as safe as they can be.
There are many different aspects needed to keep patients safe at an accredited radiation
oncology clinic. ​Patient Safety Perceptions Among U.S. Radiation Therapists ​looks at the
different safety aspects involved in treating with radiation, and the perceptions the public has on
radiation treatment. The first aspect the article looks at is quality assurance of imaging and
treatment machines. One of the main aspects of maintaining equipment accuracy is the
publications used to guide physicians doing quality assurance. The American College of
Radiology has published, ​A Technologist’s Guide to Quality Assurance​. For some time this was
the only text used to guide quality assurance in the radiation treatment field. However more
recently, Pawlicki et al published a comprehensive textbook with a portion of it dedicated to
patient safety and error management. [3] The new Pawlicki text incorporated aspects of quality
assurance that was not in previously published texts. This text has helped advance the safety of
machines in the medical oncology field. Traditional quality assurance was done on charts and
logged manually. However, with growing technology quality assurance is typically done
electronically. This may include integrating the many different computer systems involved in
today's quality assurance. The last aspect of quality assurance is having work double checked
through peer review. This does not mean delegating the work amongst individuals. Instead it
means that a second physician or therapist is needed in order to review the activities done inside
and outside of the treatment room[3].
The next aspect of safety ​Patient Safety Perceptions Among U.S. Radiation Therapists​ refers
to is the technical side of safety. Organizations like The Joint Commission of American Hospital
Association have the goal of patient safety in mind. They aim for “safe and proper use of
additional imaging and treatment delivery systems”[3]. One way The Joint Commission aims to
create a safer environment for patients is by enhancing technical performance. Technical
performance refers to detecting and reporting mechanical and dosimetric parameters that are not
within specified tolerances.[3] The technical side of safety is constantly being studied and
researched. There are maximum dosing limits and requirements in place currently, and every
year they become more and more effective. Although enhancing the technical side will create a
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safer environment, the past decade there has been a shift in patient safety. This shift is toward
what is called patient safety culture.
Patient safety culture is “the values, beliefs, and norms about what is important in an
organization and what attitudes and behaviors related to patient safety are supported, rewarded,
and expected.”[3] This encompasses a hospitals attitude toward stressing patient safety in all
aspects of health care. Some examples of good safety culture would be, employees taking action
as soon as a problem arises, making safety the responsibility of all employees no matter what
level the employee is, a sense of teamwork and communication driving the institution, and lastly
employees being unafraid to report adverse events. Incorporating a culture of safety in a clinic is
inherently beneficial for the safety of the patient. On top of the obvious advantages having a
culture of safety provides it can also help a hospital identify weak points in patient safety. One
way it does this is through communication. Fluid communication allows for gaps in quality
assurance, safety procedures, and medical events to quickly be addressed and solved. Overall,
having a patient safety culture throughout an organization will lead to a safe and comfortable
experience for each individual involved.
Throughout my research it was stated many times the general concern regarding radiation in
the medical field. It has been reported that the public has an assumption that radiation is risky
and dangerous. These assumptions can be caused by many factors, but the most likely factors are
education and patient safety culture. Educating patients on radiation treatment could be one way
to help ease their fears. Radiation is an extensively studied treatment approach and the protocols,
regulations, and restrictions put in place are there to keep the patient safe. The more important
factor in helping the patient feel comfortable is the patient safety culture. The more aware a
hospital is of their actions involving safety the more at ease a patient will feel. In the future I feel
that culture around safety will continue to be stressed, and in turn this will change the public’s
attitude to be more positive regarding radiation treatment.
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References

1. Roberts BW. Patient-centered Radiation Safety. ​ASRT​. May 2017:499-511.

https://web-a-ebscohost-com.libweb.uwlax.edu/ehost/pdfviewer/pdfviewer?vid=6&sid=d374fc5
d-e508-4e48-ad5f-7bc407f527e9@sessionmgr4006. Accessed October 18, 2018.

2. Legg, JS, Dempsey MC, Aaron L. Patient Safety Perceptions Among U.S. Radiation
Therapists.​ASRT.​ August 2015:9-20.
https://web-b-ebscohost-com.libweb.uwlax.edu/ehost/pdfviewer/pdfviewer?vid=8&sid=a43d301
5-93ff-4080-a4f6-315a9788b74c@pdc-v-sessmgr03. Accessed October 18, 2018.