Investigation of radiation protection and safety measures in Rwandan public hospitals: Readiness for the implementation of the new regulations.

BACKGROUND: An essential concept that all radiographers are required to implement is the use of techniques and the provision of protective devices to minimize radiation to patients and staff. Methods to achieve this could include good communication, immobilization, beam limitation, justification for radiation exposure, shielding, appropriate distances and optimum radiographic exposures factors. PURPOSE: The aim of this study was to assess the availability and utilization of radiation protection and safety measures by medical imaging technologists (MITs) in Rwandan hospitals. METHODS: A quantitative, non-experimental descriptive design was used and data collected by means of a self-designed questionnaire. One hundred and sixteen MITs (n = 116) representing 96.67% of the total population participated in the study. RESULTS: The study found radiation safety measures were not adequately implemented in government hospitals. Only 58.62% of MITs had radiation-measuring devices, with 29% receiving dose readings inconsistently. Lead rubber aprons were available at 99.13% of the hospitals; however, 59% of the participants had never checked the integrity of the aprons. Lead rubber aprons and lead equivalent barriers were most prevalent in the facilities. CONCLUSION: The study found there was a lack of adequate radiation safety equipment. Exposure charts and immobilization devices were not adequately implemented in the hospitals. The level of education and experience of the MITs did not appear to influence the radiation safety practice significantly. There is a need for concerted efforts between the Rwanda Utilities Regulatory Authority (RURA), Ministry of Health, University of Rwanda and hospital management to improve the radiation safety culture, especially in view of the law governing radiation protection that was recently promulgated.

Healthcare assistants in EU Member States: An overview.

With many European countries facing health workforce shortages, especially in nursing, and an increasing demand for healthcare, the importance of healthcare assistants (HCAs) in modern healthcare systems is expected to grow. Yet HCAs' knowledge, skills, competences and education are largely unexplored. The study 'Support for the definition of core competences for healthcare assistants' (CC4HCA, 2015-2016) aimed to further the knowledge on HCAs across Europe. This paper presents an overview of the position of healthcare assistants in 27 EU Member States (MSs) and reflects on the emerging country differences. It is shown that most learning outcomes for HCAs across Europe are defined in terms of knowledge and skills, often at a basic instead of more specialized level, and much less so in terms of competences. While there are many differences between MSs, there also appears to be a common, core set of knowledge and skills-related learning outcomes which almost all HCAs across Europe possess. Country differences can to a large extent be explained by the regulatory and educational frameworks in which HCAs operate, influencing their current and future position in the healthcare system. Further investments should be made to explore a common understanding of HCAs, in order to feed discussions at policy and organisational levels, while simultaneously investments in the development and implementation of context-specific HCA workforce policies are needed.

[Practical training for paramedics : Transformation at the Leipzig University teaching hospital]. / Die praktische Ausbildung von Notfallsanitätern : Umsetzung am Universitätsklinikum Leipzig.

BACKGROUND: The "Notfallsanitätergesetz" (the law pertaining to paramedics), which came into effect in January 2014, has fundamentally changed the training of health personnel in German prehospital emergency medicine. The apprenticeship now takes 3 years including 720 h of practical training in eligible hospitals. To date, however, there has been little experience of how the contents of the guidelines for practical training ("Ausbildungs- und Prüfungsverordnung") can be reasonably applied in the teaching hospitals. METHODS: In a total of nine interdisciplinary working group meetings between October 2014 and June 2016, we developed a curriculum concerning the practical training of paramedics to implement the contents of the guidelines for practical training in a didactically and an organizationally meaningful way. RESULTS: The implementation of the practical training of paramedics is an excellent chance for the teaching hospitals to contribute to higher quality prehospital emergency medicine. Otherwise, the teaching hospitals face an organizational and personal effort that is not to be underestimated. Thus, a modular curriculum constitutes the possibility of standardizing practical training and simultaneously reducing the time and expenditure for the participating hospitals. CONCLUSION: The development of a unique curriculum for the practical training of paramedics may contribute to standardized, high-quality, and cost-efficient training.

Lights and Sirens: How Coronial Inquests Can Highlight Challenges in Paramedic Regulation.

Paramedics provide emergency and community health services to diagnose, treat, transport and provide advice to patients. However, current regulatory structures do not adequately protect the public from the potential for paramedics to cause harm to their patients. Paramedic employers regulate the paramedic industry rather than the National Registration and Accreditation Scheme used for other equivalent registered health practitioners in Australia. A number of coronial inquests have considered the conduct of paramedics and highlight the challenges of the current paramedic regulation in protecting the public from risk.

[Legal Analysis of the Implementation Rules of Delegation of Home Visits by Family Doctors to Non-Physician Health Professionals: Is the Implementation in Accordance with the Intention of the Law?] / Juristische Analyse der Umsetzungsregelungen der Delegation vertragsärztlicher Hausbesuche an nicht-ärztliche Gesundheitsberufe ­ ist die Umsetzung in Einklang mit dem Willen des Gesetzgebers?

Objective: Triggered by the AGnES model project of the University Medicine Greifswald, the Code of Social Law V was changed by the German Lower and Upper House of Parliament (Bundestag and Bundesrat) in 2008 so that the delegation of GP's activities to non-physician colleagues was allowed under highly restricted preconditions. Delegated home visits should become an integral part of the standard care in Germany. In this study, the implementation of § 87 para 2b clause 5 SGB V, established in Annex 8 of the Federal Collective Agreement, was checked for its legality in terms of qualification. Methods: The problem was checked with the legal methods of interpretation in pursuance of the norm and the methods of systematic, historic and teleologic interpretation. Results: Even though the Parliament clearly required orientation to the AGnES model project (in order to assure safety and effective care of delegated home visits), self-management in the implementation of the law remained far behind these guidelines. The main outcome of the legal analysis was that the implementation arrangements of the Code of Social Law V are predominantly illegal. Conclusions: The parties of the Federal Collective Agreement have to change the arrangements to meet the requirements of the Parliament and to avoid risks of liability for delegating GPs.

Defining deviation: The peer professional opinion defence and its relationship to scope expansion and emerging non-medical health professions.

The law imposes a duty to exercise reasonable care and skill in the provision of professional advice and treatment on all health practitioners, which in Australia is assessed via a modified Bolam principle. In an era of medical dominance, this standard was clearly related to the standards of the medical profession. However, the evolving nature of the Australian health workforce has fuelled speculation as to how non-medical professions are assessed to be practising in accordance with established standards. This article explores the peer-professional defence in relation to new, emerging and established non-medical professions practising in areas that were not historically part of their remit, and finds that individual health professions--even those which do not possess traits historically defined by professionalism--have ultimate discretion in determining the standards by which they are assessed, though such standards may be rejected by courts if they are deemed irrational.

What Contract? With Whom? For What Purpose?

The central point in the U.S. Supreme Court upholding the Federal Trade Commission's action against the North Carolina State Board of Dental Examiners was that they acted without proper supervision from the State of North Carolina in curbing commercial activity: issuing cease and desist orders to teeth-whitening businesses, for example. It appears unlikely that the law of the land will allow professions to enforce and may substantially limit a profession's voice in defining nearby commercial activity. The line between professional services and commercial ones is not clear. Vending whitening agents, as drug stores do, is commercial but may not be professional. Providing such services in the dental office certainly should be professional, but is also certainly commercial. As dentistry becomes more overtly commercial in nature, it is likely that the profession will have less say over defining and enforcing oral healthcare practices.

Norma técnica de los centros de atención prehospitalaria móviles: acuerdo ministerial No. 221-2015 / Technical standard for mobile prehospital care centers: ministerial agreement No. 221-2015

El documento tiene algunos problemas de nitidez, que dificultan un tanto su lectura. Su objetivo es la regulación del procedimiento de autorización y funcionamiento en dichas unidades móviles (tipo ambulancia). Se establecen así mismo, los requisitos y características que deberán cumplirse en estas unidades, tanto terrestres, marítimas como aéreas. Esto incluye al personal que las maneja. Incluye un listado de términos técnicos referidos al tema principal. Presenta también las características técnicas así como el perfil del personal que las maneja además de la infraestructura y el equipo de deben contener para proveer del cuidado médico adecuado.

[Duties of physicians or other healthcare workers connected with diagnosis, treatment, dissemination of information, assessment and registration of TB patients]. / Prawne obowiazki lekarza oraz innych pracowników sluzby zdrowia zwiazane z diagnostyka, leczeniem, informowaniem, orzekaniem i rejestracja chorych na gruzlice.

Effective laws provide a series of duties to be performed by physicians and other medical personnel associated with TB. Every TB case and death resulting from TB as well as any case of undesirable result of BCG test requires notification and filling in of a special form. The physician has a duty to inform TB patients their legal guardians, close relatives or friends about the need to undergo sanitary and diagnostic procedure, treatment or vaccination, as well as on how to prevent disease from spreading. Persons failing to comply with the relevant numerous legal requirements in this respect are subject to a fine.TB patients can use special sick benefits extending up to 270 days. There is a requirement to use appropriate codes to define TB irrespective of LCD-10 classification.

[Soft tissue-cutting law, i.e. the career concept of an autopsy assistant]. / Lágyrészbe vágó jog, avagy egy boncmester-életpálya koncepciója.

Practical experience shows that the autopsy assistant society is fairly divided. There are some people who would have needed a thorough basic training, and there are those who - due to their diligence and the close cooperation with physician colleagues - would deserve an opportunity for further progress due to their extensive knowlegde. As regards the autopsy assistant profession the training, and the training system as well has changed significantly, and it requires further changes. Examining the issue in a wide spectrum, the aim of the authors is, as much as possible, to promote the formation of an "Autopsy assistant career," in which they want to create a predictable way for the members of the profession from the phase of becoming a student (competency, training, exams, vocational training, single note) to obtaining the master's degree. The authors would like to provide a summary about their experience and plans regarding this issue.