The Canadian journal of medical radiation technology最新文献

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  To identify and explain potential health risks in the MR environment

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  To discuss patient management related to MR procedures and safety

Abstract

With the increasing use of MRI, there are increasing numbers of medical personnel involved with MR procedures. The purpose of this article is to promote MR safety among health care professionals. The information was gathered at Nanaimo Regional General Hospital, Nanaimo, BC. Although MRI is non-invasive and is free of ionizing radiation, there are health effects associated with this imaging modality even when it is sitting idle. The electromagnetic fields that are used in MRI induce electromagnetic forces and electrical current, which can pose health risks to the patients. Therefore, patient management related to MR procedures must be conducted with an understanding of and respect for this unique environment. To ensure patient safety, MR technologists and medical staff involved in MR studies must follow established safety policies and guidelines.

Objectifs

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  Préciser et expliquer les risques éventuels pour la santé relatifs à un environnement de radiation médicale

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  Examiner la prise en charge du patient en relation avec les procédures et la sécurité afférentes à la radiation médicale

Résumé

Avec l'utilisation accrue de l'IRM, un nombre croissant de membres du personnel médical est concerné par les procédures de radiation médicale. L'objectif de cet article consiste à favoriser la sécurité des professionnels de la santé. L'information présentée provient du Nanaimo Regional General Hospital, de Nanaimo en Colombie-Britannique. L'IRM est non invasive et ne produit pas de rayonnement ionisant, mais des effets sur la santé sont associés à ce mode d'imagerie même lorsqu'il est au repos. Les champs électromagnétiques utilisés par l'IRM produisent des forces électromagnétiques et du courant électrique, lesquels peuvent constituer des risques pour la santé des patients. Par conséquent, la prise en charge du patient en relation avec les procédures de radiation médicale doit s'effectuer dans la compréhension et le respect de cet environnement particulier. Afin d'assurer la sécurité du patient, les technologues en radiation médicale et le personnel médical qui participent aux études sur la radiation médicale doivent respecter les politiques et les directives établies en matière de sécurité.

Purpose

To determine the radiological technologist's performance in detecting abnormalities in film-screen mammographic images.

Methods

Fifty sets of 2-view bilateral mammographic images wereread and judged to be either benign, likely benign, suspicious of abnormality or highly suggestive of malignancy. Seven readers, 5 radiological technologists and 2 radiologists currently working in the field of mammography participated in this study.

Results

The sensitivity of three-fifths of the technologists in detecting abnormalities that were likely to be a sign of breast cancer was 100%, which was comparable to the 2 participating radiologists. Specificity was also high amongst the technologists, with three-fifths being equal to (88.37%) or better (93.02%) than that of the radiologists (88.37%).

Conclusion

Of those participating in this study, the findings indicate that the sensitivity and specificity of the majority of individual technologists to detect mammographic abnormalities is comparable to that of the radiologists when compared to the gold standard.

Objective

To develop and psychometrically evaluate (feasibility, reliability, validity) a questionnaire based multi-source feedback (MSF) system for quality assurance (QA) for medical radiation technologists (MRTs).

Methods

Surveys with 12, 14, 30 and 31 items were developed for assessment of MRTs by patients, co-workers, MRT colleagues and themselves, respectively, using 5-point scales with an “unable to assess” category. Core competencies assessed were related to legislation, standards of practice and ethics, equipment and materials, diagnostic examinations and radiation treatment, safe practice, relationship with patients, records and reporting, communications, team work and professional development. Each MRT was assessed by 25 patients, 6 MRT colleagues, and 6 co-workers. Feasibility was assessed with response rates for each instrument. Validity was assessed with a table of specifications, the percentage of participants unable to assess the MRT for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's α assessed reliability.

Results

A sample of 307 MRTs registered with the College of Medical Radiation Technologists of Ontario (CMRTO) volunteered to undergo MSF assessments. The number of respondents for the MRT peer questionnaire was 1,730, for the co-worker questionnaire was 1,745 and for the patient questionnaire were 7,007. The mean ratings ranged from 4 to 5 for each item on each scale. All of the instruments' full scales had very high Cronbach's α > .92. The factor analyses revealed a 5-factor solution (71.28% of the total variance) for the peer and self surveys, a 3-factor solution for the coworker questionnaire (74.28% of the variance), and a 2-factor solution for the patient questionnaire (81.53% of the variance).

Conclusion

An MSF system employing surveys that have high reliability, validity and feasibility were developed to provide feedback to MRTs on core competencies and skills.

The approval of portal verification images is an important component in the quality assurance of radiation therapy delivery. However, the process of approval can be cumbersome and result in delays. The time spent by staff to ensure that the approval process is completed in an appropriate fashion, is time taken away from other patient related activities. In addition, evolving changes in practice are increasing the requirement that portal verification image approval be done at the time of treatment. This process will inevitably require immediate action by radiation therapists (RT's).

In 2003, a process was initiated to transfer the responsibility for the approval of portal images to RT's. Traditionally, the radiation oncologist had assumed this responsibility. Once the change in practice was implemented, a clinical audit process was put in place to monitor the results. The use of the clinical audit has been an effective learning tool for critical reflection on practice. The clinical audit has shown that the responsibility transfer has been successful and resulted in a more efficient approval of portal images.