Assessing radiation protection knowledge in diagnostic radiography in the Republic of Cyprus. A questionnaire survey.

INTRODUCTION: Radiation protection knowledge is essential for medical personnel in ensuring that the possible risks do not outweigh the benefits of diagnostic imaging. This study aimed to assess the radiation protection knowledge of radiographers in Cyprus. METHODS: A cross-sectional study was carried out among radiographers in Cyprus through the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. The study was a quantitative descriptive analysis, using a questionnaire with 22 multiple-choice questions. Analysis of the data was done using the statistical software Stata, by performing mean knowledge score comparisons by different participants' characteristics, using t-test and analysis of variance test. Statistical significance was assumed as a p-value < 0.05. RESULTS: The answers provided for each question indicate that some areas of radiation protection are less known compared to others, as there is quite a wide range of correct-to-incorrect ratios. The analysis based on participant characteristics in relation to overall radiation effects knowledge, identified important determinants, namely the workplace of the participant (p = 0.006), the type of work licence the participant held at the time of the questionnaire (p = 0.024), and the years of clinical experience of the participant (p = 0.021). CONCLUSION: The study showed that the levels of knowledge in radiation protection are of a very good standard. However, work is needed to clarify the specifics of dose limits and the national radiation protection legislation with regards to informing patients about the possible effects of ionising radiation. IMPLICATIONS FOR PRACTICE: The study results indicate the importance of educating radiographers about the requirements of national radiation protection legislation and how this new knowledge can be linked with practise.

Rules and Regulations Relating to Roles of Nonphysician Providers in Radiology Practices.

Nonphysician providers (NPPs) in radiology practices include nurse practitioners, physician assistants, and radiologist assistants. The number of NPPs has been increasing both within and outside of radiology departments. In order for leaders in radiology departments to incorporate NPPs effectively into their practice, they require nuanced knowledge of appropriate coding and billing for services these professionals render. Furthermore, the existing body of literature suggests that with a defined and appropriate scope of practice and proper supervision, NPPs can provide care that is at least equivalent to that provided by attending physicians for narrowly defined tasks. A broader understanding of the rapidly evolving NPP workforce both within radiology practices and throughout other health care specialties will inform practice leaders who are adapting to a health care system that is moving rapidly toward value-based incentive payment models. ©RSNA, 2018.

Medical Ethics and Law in Radiologic Technology.

At every stage of their careers, radiologic technologists and student technologists must adhere to high ethical standards, obey the law, and consistently conduct themselves with professionalism. This article explains how modern health care ethics evolved, focusing on 8 important theorists. It also describes the ethical responsibilities of health care providers and the rights of patients. Important civil rights laws are discussed, focusing on the rights of health care workers as employees. A brief overview of the U.S. legal system follows, including the causes of action that most commonly involve health care professionals. Finally, this article discusses professionalism and its implications for radiologic technologists.

Governmental regulations and radiation exposure.

BACKGROUND: The use of radiation for medical purposes falls under the purview of the Food and Drug Administration (FDA) and individual states. Enhanced regulations are in place to promote the right exam for the right reason at the right time for every patient exposed to medical x-rays. METHODS: The February 2010 FDA initiative to reduce unnecessary radiation exposure from fluoroscopy, CT, and nuclear medicine studies is reviewed along with regulations currently in place. RESULTS: Facilities granting privileges to physicians performing fluoroscopic procedures need to ensure appropriate education so they can assess individual patient risk and benefit on a case-by-case basis. These are guidelines with individual states controlling requirements. CONCLUSION: Regulation of education, training, and credentialing for physician operators of fluoroscopic equipment is currently controlled by individual states and is not uniform. There are strong indications that the FDA and or the Joint Commission will become increasingly involved to increase documentation of patient exposure and safety.

[Typical patient radiation doses in diagnostic imaging]. / Ordre de grandeur des doses délivrées en radiodiagnostic.

Radiologists should be able to appreciate the radiation dose delivered to patients for routine diagnostic procedures. The radiology report should include data necessary to calculate the patient dose in Gray. Using the effective dose, it is possible to compare with other source of radiation exposure. Simple formulas, taking into account different anatomical regions, derived from dose-area product (conventional radiography) or dose-length product (CT) are provided to calculate the effective dose in Sievert. For conventional (non-interventional) radiography, the effective dose for a given exam is inferior or equal to the yearly background radiation. For CT, the effective dose corresponds to 1 to 10 years of yearly background radiation.

[The radiologist's responsibilities for the radiation protection of patients]. / Obligations du radiologue pour la radioprotection des patients.

The obligations of the radiologist for the radiation protection of patients include a review of the appropriateness of the examination and optimization of the protocol. Both internal and external quality assurance programs are mandatory. The specific tasks and their frequency are defined by the AFSSAPS. The radiology report of procedures performed over radiosensitive regions must include the delivered dose. The imaging technique must be optimized based on published guidelines or law for the most frequent examinations. All radiologists should be familiar with radiation protection. Incidents should be reported to the Nuclear Safety Authority.

Ensuring quality and safety.

The certification model addresses quality and safety by directly targeting the qualifications of individuals. The practice accreditation model takes a more global approach to quality and safety and addresses the qualifications of individuals and standards for additional components of the quality chain. Although both certification and practice accreditation fundamentally are voluntary, the programs may become mandatory when enforcement mechanisms are linked to the programs via state or federal legislation or via private reimbursement policies, effectively resulting in mandatory standards. The CARE bill takes a certification approach to quality and safety by focusing on the qualifications of the individual. MIPPA takes an accreditation approach by focusing on the practice. MQSA is somewhat of a hybrid in that it takes an accreditation approach, but spells out standards for the individual that the accreditor must follow. If the practice accreditation standards require that all technologists employed in the practice be certified in the modalities performed, then the practice accreditation model and the certification model become functionally equivalent in terms of personnel qualifications. To the extent that practice accreditation models are less prescriptive regarding personnel standards, the certification model results in more stringent standards.

Pre-reading mammograms by specialised breast technologists: legal implications for technologist and radiologist in The Netherlands.

This paper focuses on the legal implications in terms of duties and responsibilities for radiologists and radiologic technologists of independent pre-reading of mammograms by radiologic technologists, so patients could be discharged without being seen by a radiologist. Pre-reading could be effectuated when preconditions are met to perform reserved procedures by unauthorised professionals as stated in the Individual Health Care Professions (IHCP) Act. Furthermore, compliance with a protocol or code of conduct in combination with adequate training and supervision should be sufficient to disprove potential claims. For a wide implementation, pre-reading should be well-embedded in legal rules and should answer the professional standard of care.

Mala praxis: a study of malpractice claims and litigation in the field of radiology.

Risk management plays an integral role in the mitigation of malpractice claims in the radiology environment. This holds true for the radiologist and professional association as well as the facility that supports the radiologic service. The radiologist and the radiology department or imaging center are separate entities which have a symbiotic relationship. Radiologists may function as an independent contractor, yet their function is dependent on the facility with which it contracts. The function of the radiology department is directly related to the radiologist's performance, staff competency, and equipment performance. Mammography poses particular concern with regard to medical malpractice, as there is an inherent subjectivity in the differential diagnosis with regard to breast cancer in mammography.