Policyandprocedure Radiationsafety Patients(1)

RADIATION SAFETY-MINIMIZING PATIENT EXPOSURE

[Insert facility name or a header]

ADMINISTRATIVE APPROVAL

Date Created:

Last Date Revised:

Last Date Reviewed:

Date of Next Review:

Approval signature(s) with title and date of signature:

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Purpose

To provide guidance to perioperative personnelforminimizing patient injury from ionizing radiation exposure during therapeutic, diagnostic, or interventional procedures performed in the perioperative environment. The expected outcome is that the patient is free from signs and symptoms of radiation injury.

Policy

It is the policy of [insert name of facility] that:

The perioperative team will implement measures to minimize the patient’s exposure to radiation.
The pregnancy status of all premenopausal patients will be assessed preoperatively by the perioperative RN.

The perioperative RN will notify the responsible physician when a patient has declared that she could be pregnant.

Procedure Interventions

All patients

Move extraneous patient body parts out of the path of the radiation beam.
Place shielding (eg, lead or lead equivalent) over the patient's thyroid, ovaries or testes (ie, gonads), and breasts when these body parts are near the source of radiation.
Place shielding between the patient and the source of radiation but not in the path of the beam that originates from the x-ray tube.
Position thepatient as close as possible to theimage intensifier side of the fluoroscopic unit and away from the tube side of the unit.
[Facility-specific personnel] will monitor the radiation dose received by the patient and inform the operator when [facility-specific peak value for notification]has been reached.

Patients having an image-guided procedure

The perioperative RN responsible for discharging the patient or for transferring the patient to an inpatient bed will consult with the physician regarding the need for postprocedure education and timing of follow-up care.
If necessary, provide the patient with education that includes
signs and symptoms of overexposure to radiation, (eg, gastrointestinal symptoms, radiation burns,potential hair loss),
the potential time frame for appearance of signs and symptoms, and
the importance of follow-up with the physician who performed the procedure if questions arise regarding the procedure.

Pregnant Patients

Place lead shielding between the fetus and the source of radiation when the shielding will not interfere with the performance of the procedure.

Documentation

The perioperative RN will document the diagnostic and therapeutic radiation dose, type, and location of patient radiation protection, and pre-radiation and post-radiation exposure patient skin assessment.

Competency

Perioperative personnel participating in operative or other invasive procedures with the potential for radiation exposure will receive initial and ongoing education and complete competency verificationactivitiesas applicable to their roles and responsibilities related to minimizing patientradiation exposure.

Quality

Perioperative personnel participating in operative or other invasive procedures with the potential for radiationexposure will participate in quality assurance and performance improvement activities as applicable to their roles and responsibilities related to minimizing patient radiation exposure.

References

Guideline for Radiation Safety. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

Petersen C, ed. Radiation therapy. In: Perioperative Nursing Data Set. 3rd ed. Denver, CO: AORN, Inc; 2011:196-198.

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