Blog Post

The first step in radiation safety: Evaluate your culture

February 13, 2017

    Slowly but surely, the use of higher-dose radiation procedures such as CT and interventional radiology has been rising. In the last 15 years alone, the number of CT exams has nearly tripled—and CT examinations have doubled in the past 20 years for children under five, who are at a greater risk for complications due to radiation exposure.

    So how can imaging departments remain vigilant in regards to radiation safety?

    Moving towards a Radiation Protection Culture

    While every program has some guidelines in place for radiation safety, the difficulty lies in ensuring awareness of these practices and promoting an overall culture of safety when it comes to radiation dose.

    That's why the academic community has been pushing for programs to establish a strong Radiation Protection Culture (RPC). The International Radiation Protection Association (IRPA) since 2008 has defined radiation protection culture as "the combination of knowledge, values, behaviors, and experience of radiation protection in all its aspects for patients, workers, population and environment, and in all exposure situations, combining scientific and social dimensions." Essentially, RPC is a combination of an imaging program's practices and staff attitudes toward safety in radiation.

    The below chart, found in the IRPA's 2014 Guiding Principles for Establishing a RPC document, illustrates how various types of culture can impact how radiation safety is viewed. The five columns represent different types of radiation protection cultures, with "Generative" as the most progressive culture. Each row represents a specific aspect of radiation safety and the individual items in the chart describe how each specific culture would approach that aspect of radiation safety.

    A strong RPC ensures a safe working environment for staff, discovers and curtails unsafe practices, educates staff on radiation risks, and delegates responsibilities for managing these risks to all staff members.

    Two approaches to improving Radiation Protection Culture

    One of the easiest ways to improve RPC is to provide continued education for staff members on radiation safety. A recent study found that only 35% of pediatric fellows and residents have sufficient knowledge of radiation risk in common exams. Physicians, radiologists, and nurses need to be taught both the strict regulations that exist around radiation safety and the broader methods for reducing radiation dose when possible.

    Beyond education, developing a robust quality assurance program can help improve a program's RPC. This should include creating standards across modalities, monitoring dosage, maintaining equipment, and establishing a committee dedicated to maintaining the program. While quality assurance systems can address radiation safety to varying degrees, it is critical for all programs to maintain a baseline system that includes radiation dose management in order to begin shifting attitudes toward radiation safety over time.

    We are currently researching patient safety in preparation for our 2017 national meeting series. If you are facing challenges when it comes to patient safety or have developed solutions to these issues and are willing to discuss them with us, please email me.


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