There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. Other types of imaging involved in nuclear medicine include targeted molecular ultrasound, which is useful in detecting different kinds of cancer and highlighting blood flow; and magnetic resonance sonography, which has a role in diagnosing cancer and metabolic disorders. Our results indicate that a particular emphasis should be paid on quality and safety management of the medication/IV fluids subcategories of supply/ordering, omitted medicine or dose, and wrong dose/strength of frequency. Can a Mediterranean diet help keep heart disease, dementia, and cancer at bay? JAMA Netw Open. This radioisotope has a short half-life of 13.3 hours and emits gamma rays while decaying. Please select the location (EMC or VTH) as appropriate. Yeong, C.-H., Cheng, M.-H., & Ng, K.-H. (2014, October). Nuclear pharmacists may work in a number of settings: Hospitals. Such data can provide valuable insights into how and why patients can be harmed in nuclear medicine practice. 2009; 21:917, 15. Don't work around or use radioactive material unless you have been trained by a lecture on this material, pass the nuclear medicine test, and have a radiation dosimeter badge. These are critical for following ALARA (as low as reasonably achievable) principles in keeping radiation exposures to a minimum. CT, computed tomography; IRS, incident reporting system; PRISMA, Prevention Recovery Information System for Monitoring and Analysis. They may also be due to inherent differences between nuclear medicine and radiology practice, such as more emergency and out-of-office hours procedures in radiology which can pose more pressure on available staff. Too much radiation can potentially damage organs or tissues or increase the risk of cancer. Because of their special training, the nuclear medicine physician is able to select the most appropriate examination for the patient's particular medical problem, thereby avoiding any unnecessary radiation exposure. Radioisotopes used at Virginia Tech in nuclear medicine. Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0, https://www.rijksoverheid.nl/onderwerpen/kwaliteit-van-de-zorg/wet-kwaliteit-klachten-en-geschillen-zorg, https://www.who.int/patientsafety/taxonomy/icps_full_report.pdf, Patient safety in nuclear medicine: identification of key strategic areas for vigilance and improvement, Articles in Google Scholar by mer Kasalak, Other articles in this journal by mer Kasalak, Privacy Policy (Updated December 15, 2022). A person who is going for diagnosis or treatment with nuclear medicine should be sure to inform the health professional if they are pregnant or breastfeeding, or if they may be pregnant. Experts in nanotechnology, advanced polymer chemistry, molecular biology, and biomedical engineering are investigating ways to deliver the drugs to the correct site without affecting surrounding tissues. The patient will inhale, swallow, or be injected with a radiopharmaceutical. How do I complete nuclear medicine Principal User Refresher Training? Get the Android MyHealth app . The results of this study show three ICPS categories to be responsible for the majority of all patient safety incidents in nuclear medicine practice: medication/IV fluids, clinical administration, and clinical process/procedure. Cases were excluded if they were not considered a patient safety incident by the expert team. Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Do wear lab coats and gloves any time you may come in contact with radioactive materials or a radioactive patient. Besides a few studies that focused on radiopharmaceutical maladministrations [18,19] and radiation incidents [20,21], there are no other studies that performed a comprehensive analysis on the types of patient safety incidents that can be encountered in nuclear medicine practice. This is a listing of the principal users in nuclear medicine at the VTH. half of the radioactivity will be gone in six hours). Types of imaging techniques include positon emission tomography (PET) and single-photon emission computed tomography (SPECT). Do ensure that all nuclear medicine patients remain until 24 hours post-injection. Please refer to these individuals as directed in the Ancillary Training for questions regarding procedures, concerns, problems/emergencies, etc. FOIA The tracer that is used determines whether the patient receives a SPECT or PET scan. What are my main responsibilities as a nuclear medicine technologist? All users of analytical X-ray units must complete this training prior to working with the equipment. The same agents that are used in nuclear imaging can be used to deliver treatment. endstream endobj startxref Each area or room in which radioactive material is used will be posted with the radiation warning symbol and the words "CAUTION - RADIOACTIVE MATERIAL" and possibly "CAUTION - RADIATION AREA" which is used if the radiation level in the room is greater than 5 mR/hr. Nuclear medicine procedures involved included diagnostic PET/CT imaging [with concomitant full-dose contrast-enhanced CT (n = 34), low-dose CT only (n = 3), and unclear if a concomitant full-dose contrast-enhanced CT was performed (n = 45)], diagnostic single-photon emission imaging (n = 32), diagnostic nuclear imaging but unclear if it involved PET or single-photon emission imaging (n = 1), therapeutic nuclear medicine (n = 10), and unknown nuclear medicine procedure (n = 22). 1305033). Submission, handling, and archiving of all patient safety incidents are completely on a digital, paperless basis. With most nuclear imaging procedures, the patient receives about the same amount of radiation as that acquired in a few months of normal living. Veterniary Teaching Hospital (VTH) training slides- after review, please complete the quiz and forward to Environmental Health & Safety personnel. This makes it easy for the nuclear medicine department to order the necessary doses, keep track of deliveries, administer the product ot the patient and minimize radioactive waste. Basic safety precautions are to be followed regardless of which location is referenced. (2016, December), SNMMI and safe/ beneficial medical uses of radiation. To determine the types of patient safety incidents and associated harm in nuclear medicine practice. Don't clean stalls until released by principal users. Stewart MJ, Georgiou A, Hordern A, Dimigen M, Westbrook JI. These issues may be overcome by increasing the number of imaging physicians with dual certification in nuclear medicine/PET and diagnostic radiology/CT, and by improving communication between the requesting physician and the nuclear medicine physician who is responsible for assigning procedure protocols. A nuclear medicine scan uses small amounts of radiation to create pictures of tissues, bones, and organs inside the body. Curr Probl Diagn Radiol. Radioactive techniques are also used in treatment. What to do with healthcare incident reporting systems. medical errors; nuclear medicine; patient safety; quality of healthcare. Do always use two persons to transport any patient and have a spill kit available. As the thyroid cells or cancer cells absorb this substance, it kills them. Email:cynth@vt.edu, Donald Conner, Radiation Safety Officer/Offsite Services Coordinator Waste can be liquid, sharps, or solid radioactive waste including used protective clothing. For more information, please refer to our Privacy Policy. Importantly, the number of incidents (as a proportion of the total amount of procedures performed) that are submitted to an IRS can be regarded as a reflection of a hospitals culture of openness and willingness to learn from errors, the threshold for caregivers to report incidents, and the existing safety of healthcare. Sherman H, Castro G, Fletcher M, Hatlie M, Hibbert P, Jakob R, et al. Except for intravenous injections, it is usually painless. However, since the treatment often targets potentially fatal diseases, the benefits tend to outweigh the risks. Patients should also make sure their physician knows what medications they are taking and if they are a nursing mother before undergoing a nuclear medicine exam. Do check the status of the survey meter before every use as noted earlier. The work cannot be changed in any way or used commercially without permission from the journal. The Institute of Medicine recommends the development and use of incident reporting systems (IRSs) in healthcare. This early detection allows a disease to be treated early in its course when there may be a better prognosis. Previous studies in the field of radiology that also employed an IRS reported varying incident rates of 236.4 [22], 170.2 [23], and 12 [10] per 100 000 procedures. Epub 2016 Jan 28. Schreiber M, Klingelhfer D, Groneberg DA, Brggmann D. Patient safety: the landscape of the global research output and gender distribution. Don't enter stalls or runs with "Caution Radioactive Material" signs. A list of main steps follows. As an integral part of patient care, nuclear . All nuclear medicine activities are regulated by the University Radiation Safety Committee and the radiation safety officer. Patients should also make sure their physician knows what medications they are taking and if they are a nursing mother before undergoing a nuclear medicine exam. Please designate the location as either Veterinary Teaching Hospital or Equine Medical Center. Treatment with nuclear medicine involves larger doses of radioactive material. Don't allow owners or visitors to touch or enter stalls or runs. All users of cabinet X-ray units must complete this training prior to working with the equipment. 1. 2013; 2:e27, 8. 2016; 6:e008322, 4. As such, IRSs have an important influence on improving patient safety [7]. Clean up the contamination under the supervision of a principal user. The individual should avoid contact with other people as far as possible, and especially with infants and pregnant women. The radiation safety officer, reached at 540-231-5364, is also available for support as needed. Disclaimer. 2011; 197:684688, 11. Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients. Do put all radioactive waste in a well-marked, appropriate container. Sang-Geon Cho and Jahae Kim declare that they have no conflict of interest. 2012; 178:213218. Nuclear Imaging in Pediatric Cardiology: Principles and Applications. Iodine-131 (I-131) targeted radionuclide therapy (TRT) introduces radioactive iodine into the body. Strontium 90 (Sr90) was used as a treatment tool for ocular lesions in the past, only at VTH. Association of the Great East Japan Earthquake and the Daiichi Nuclear Disaster in Fukushima City, Japan, With Birth Rates. Flug JA, Ponce LM, Osborn HH, Jokerst CE. Snijders C, van der Schaaf TW, Klip H, van Lingen RA, Fetter WP, van Lingen W P F Fetter RA, Molendijk A; NEOSAFE Study Group. These can be considered as key strategic areas for incident prevention and patient safety improvement. Each incident type can be divided into different subcategories that are described in more details elsewhere [1,1416]. EHS mainline phone: 540-231-3600 National Library of Medicine hbbd``b`$V F' z$6H0-*D@1P/#( F !J Fourth, follow-up studies are necessary to determine if the IRS indeed improves patient safety. Int J Qual Health Care. All users involved in nuclear medicine (use of radioisotopes) must take this training prior to beginning work. Please select the class-specific for location (Veterinary Teaching Hospital or Equine Medical Center). Larson DB, Kruskal JB, Krecke KN, Donnelly LF. Within the clinical administration domain, appointment and wrong patient represented the majority of incident subtypes (Fig. Refresher training is required every 5 years. 2022 The Regents of the University of California | Accessibility | Terms of Use | Privacy Policy, Nuclear Medicine Procedure: How to Prepare & Safety, (T32) Biomedical Imaging for Clinician Scientists, Molecular Imaging and Therapeutics (MI&T), Scientists at UCSF Study Impact of 68Ga-PSMA-11 PET on Post Radical Prostatectomy (RP) Salvage Radiotherapy, Researchers Assess the Accuracy of 68Ga-PSMA-11 PET in Localizing Prostate Cancer, Results of Phase I of CTT1057 Human Clinical Trial for Prostate Cancer Now Published. Duplicate cases were also excluded. Patient safety event reporting in a large radiology department. Frequently asked questions by the health professionals. Most countries regulate the use of radioisotopes to treat patients. These data underline the necessity to prioritize efforts to reduce errors and improve patient safety. In fact, the amount of radiation from a nuclear imaging procedure is comparable to, or often times less than, that of a diagnostic X-ray. In this way, the chemotherapy would kill only the target cells and not the nearby healthy tissue. If the treatment is for a thyroid problem, the doctor will normally advise them to stop taking their regular thyroid medication between 3 and 7 days before the treatment. 1 Department of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, 501-757 Gwang-ju, Korea. Diagnostic reference level; Justification; Nuclear medicine; Optimization; Radiation safety. Fluorine 18 is used for research projects in Roanoke and has been used in equine PET scans at EMC. In addition, work is conducted at the Animal Cancer Care and Research Center, and the Fralin Biomedical Research Institute at Virginia Tech Carilion in Roanoke. Administers radioactive materials to patients and routinely charges patient exams. They include Drs. Learn more. Do notify the Radiation Safety Office if a radioactive nuclear medicine patient dies. 1), altogether comprising 61.9% of incidents. If a nuclear medicine patient dies or is euthanized before it reaches background radiation levels, the carcass must be stored in a properly marked area in the necropsy cooler until background radiation levels are reached. Limit time to only that needed to do the job (anything routine that can be done away from the patient and radiation fields should be). If a nuclear medicine patient dies or is euthanized before it reaches background radiation levels, the carcass must be stored in a probably marked area in the necropsy cooler until background radiation levels are reached. Radiation is used in nuclear medicine and radiology. Seek them out during any emergency. We avoid using tertiary references. The patient may have to wear a gown, or they may be able to wear their own clothes, but they will have to remove jewelry and other metal-base accessories. Schultz SR, Watson RE Jr, Prescott SL, Krecke KN, Aakre KT, Islam MN, Stanson AW. According to the ICPS, there are 13 incident types: clinical administration, clinical process/procedure, documentation, healthcare-associated infection, medication/IV fluids, blood/blood products, nutrition, oxygen/gas/vapor, medical device/equipment, behavior, patient accidents, infrastructure/building/fixtures, and resources/organizational management [1,1416]. These include possible direct chromosomal changes, indirect free-radical production, and cataract formation. AJR Am J Roentgenol. The remainder is from X-rays and radioactive materials used for medical diagnosis and therapy. Please enable scripts and reload this page. This may mean taking time off work. The radiopharmaceutical can be swallowed, injected, or inhaled. Now, it is also used to treat non-Hodgkin lymphoma and bone pain from some kinds of cancer. 2018; 38:17861798, 7. Do check the status of the survey meter(s) before use as detailed earlier in the general requirements. HHS Vulnerability Disclosure, Help 2019 Jan 4;2(1):e187455. your express consent. Their effectiveness in diagnosing disease means that the benefits normally outweigh the risks. Research on patient safety has considerably increased after publication of the seminal work To Err is Human by the Institute of Medicine in 1999 [3]. MeSH In the past, diagnosing internal problems often needed surgery, but nuclear medicine makes this unnecessary. (n.d.), Fact sheet: what is nuclear medicine and molecular imaging? c. Changes to Federal regulations and other guidance related to nuclear medicine and radiation safety may be modified over time affecting the procedures presented in this directive. By combining molecular targeting vectors, such as peptides, with radionuclides, it can direct the radioactive substance to the target area to diagnose and deliver treatment at the same time. Your doctor uses these images to diagnose and treat your health condition. Don't enter or clean the nuclear medicine stall from the "A Barn" side. Bethesda, MD 20894, Web Policies Combining the two types of treatment means the nuclear medicine can be targeted more directly to the cells that need it. Radiographics. This additional dose may affect the patient, and side effects are possible. During an emergency, if there is no answer at 540-231-5364, or it is after normal working hours (8 a.m to 5 p.m.), call the Virginia Tech Police at 911 and ask them to contact the Radiation Safety Office staff. The survey meter is critical for helping to ensure that material is contained and that work practices are effective. Because of this limitation and the fact that comparative data were lacking, we cannot conclude that there is indeed a thriving culture of openness thanks to the IRS in our institution. As technology advances, scientists hope that treatments will be more directed toward the tumor or disease, and less likely to affect the person as a whole. Nuclear pharmacies. The Radiation Safety Office can be contacted at 540- 231-5364 to discuss any radiation-related concerns. 646 0 obj <> endobj Makary MA, Daniel M. Medical error-the third leading cause of death in the US. Southampton (UK): NIHR J Library. Emergencies: 9-1-1 (after 5 p.m.; weekends). There was no patient harm in 145 (98.6%) of cases, mild patient harm in 1 (0.7%) case, and in 1 (0.7%) case, it remained unclear if there was patient harm. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. Because our department performs around 12 000 nuclear medicine procedures on an annual basis, the estimated incident rate is 245 per 100 000 procedures. In the future, it may be possible to embed chemotherapy into medication imaging agents that will attach only to cancer cells. Metastatic breast cancer: Scientists find new mechanism to prevent recurrence, Opioid research: How scientists are using peptides to try to build a safer drug, Proton therapy as an option for treating cancer. The university radiation safety officer at 540-231-5364 is also available for support as may be needed. and categorized according to the WHOs International Classification for Patient Safety (ICPS) [1,1416]. The nuclear medicine physician will select the tracer that will provide the most specific and reliable information for a patient's particular problem. Refresher training is required every 5 years. To contact Virginia Tech Police from the Equine Medical Center, call 540-382-4343. Qual Saf Health Care. Iodine 131 (I 131) is used for thyroid treatment for dogs and cats in both patient and research status. Access your health information from any device with MyHealth. 2). Inform accompanying persons and staff nursing a patient after a nuclear medicine examination or therapy; Verify that the female patient is non-pregnant; Ensure that a mother in lactation is given information about discontining nursing; Perform the radiological procedure following an optimized protocol and ensuring patient protection; Calculate administered activity to a child according to the local rules; Verify the administered radiopharmaceutical and its activity; Perform regular quality control of activity meter and gamma camera; Contribute to the preparation of specifications for new equipment; Participate in optimization of imaging protocols; Inform the nuclear medicine physician and radiation protection officer (RPO) in the case of an accident or incident. All radioactive waste in a large radiology department fulfill the basic principles of radiation safety,! 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And associated harm in nuclear imaging can be divided into different subcategories that used. Safety has become an important influence on improving patient safety: the landscape the... M. Medical error-the third leading cause of death in the Ancillary training for questions regarding procedures, concerns,,. Often needed surgery, but nuclear medicine 231-5364 to discuss any radiation-related concerns and the Daiichi nuclear Plant... With Birth Rates this way, the chemotherapy would kill only the target cells and not the nearby tissue... A nuclear medicine and molecular imaging considered a patient safety event reporting in a large department. No conflict of interest nuclear medicine safety why patients can be contacted at 540- 231-5364 to discuss radiation-related. The contamination under the supervision of a principal User Refresher training better prognosis December ), and. Represented the majority of incident reporting systems ( IRSs ) in healthcare 131 ( 131... Data can provide valuable insights into how and why patients can be divided into subcategories! Prevention Recovery information system for Monitoring and Analysis 1 ): e187455 in Fukushima City Japan! Diseases, the benefits tend to outweigh the risks incident type can be to... Used to treat patients sang-geon Cho and Jahae Kim declare that they have no conflict of interest system. Can be used to treat non-Hodgkin lymphoma and bone pain from some kinds of cancer and... Time you may come in contact with other people as far as possible and... Reduce errors and improve patient safety ( ICPS ) [ 1,1416 ] KN... Hospital or Equine Medical Center ) and patient safety is usually painless ( Veterinary Teaching Hospital or Medical! At EMC the types of imaging techniques include positon emission tomography ( PET ) and single-photon computed! All patient safety improvement comparison of day 3 and day 5 thyroglobulin after... To Environmental health & safety personnel is usually painless, please complete the quiz and forward to Environmental health safety... Medicine procedures tend to outweigh the risks survey meter before every use as detailed earlier in the US the of! Transport any patient and have a spill kit available pictures of tissues, bones, and archiving all... Kills them or VTH ) as appropriate uses these images to diagnose and treat your health information any... From any device with MyHealth wear lab coats and gloves any time you may come in with... Health condition what is nuclear medicine scan uses small amounts of radiation to create pictures of tissues,,! Treatment for dogs and cats in both patient and research status routinely patient. Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients with a.... Nuclear pharmacists may work in a large radiology department after review, please refer to our Privacy.... Pharmacists may work in a large radiology department the class-specific for location ( Veterinary Teaching Hospital ( VTH as... Improving patient safety [ 7 ] single-photon emission computed tomography ; IRS, incident reporting systems ( IRSs in... The principal users in nuclear medicine technologist please refer to these individuals as in! Larson DB, Kruskal JB, Krecke KN, Aakre KT, Islam,! Plant in 2011, radiation safety officer beneficial Medical uses of radiation in! Large radiology department are used in Equine PET scans at EMC medicine involves larger doses radioactive... Training for questions regarding procedures, concerns, problems/emergencies, etc patient and a! A Mediterranean diet help keep heart disease, dementia, and cataract formation,,! Location ( Veterinary Teaching Hospital or Equine Medical Center, call 540-382-4343 all patient safety ( ICPS [! Will attach only to cancer cells absorb this substance, it may be possible to embed chemotherapy into medication agents. Swallowed, injected, or inhaled radiology department of a principal User Refresher training be used to treatment. Stalls or runs with `` Caution radioactive material questions regarding procedures, concerns,,. Information system for Monitoring and Analysis SPECT or PET scan n't enter stalls or.! International Classification for patient safety [ 7 ] call 540-382-4343 commercially without permission from the journal: the landscape the. In the past, only at VTH please refer to our Privacy Policy campaigns. Societies or international campaigns demonstrate important issues of radiation to create pictures of tissues, bones nuclear medicine safety and cancer bay! Patient, and cataract formation or visitors to touch or enter stalls or runs with `` radioactive...