Radiology safety resources,
news and guidance
Recent news 
- Our patient just died from a medical error: What next? (1/4/2011)
- A pinpoint beam strays invisibly, harming instead of healing-NYT
Download or go to NYT 12.29.10
Selected resources, guidance, laws, regulations and performance standards are listed alphabetically by agency.
- American College of Radiology - ACR
- American Society of Radiation Oncology Resources for Patients
- Centers for Disease Control and Prevention Injection Safety
- ECRI Institute
- Food and Drug Administration - FDA
- FDA Center for Devices and Radiologic Health - CDRH
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FDA Initiative to reduce unnecessary radiation exposure from medical imaging
- Image Wisely™ Radiation Safety in Adult Medical Imaging
- Institute for Safe Medication Practices - ISMP
- International Atomic Energy Organization - IAEA
- The Joint Commission
- Mayo Clinic radiology course offerings
- National Council on Radiation and Protection Measurements - NCRP
- National Quality Forum - NQF
- Nuclear Regulatory Commission - NRC
- Pennsylvania Patient Safety Authority
- Society for Interventional Radiology - SIR
- University of Michigan Health Physics website
- U.S. Pharmacopeia - USP
American College of Radiology - ACR
Publishes white papers, practice guidelines, quality control guidance technical standards, patient education materials on all types of radiology services.
- Guidance document for Safe MR Practices
- Practice guideline for radiation oncology
- Position Statement on quality control and improvement, safety, infection control, and patient education. Search "position statement" on the ACR website.
ACR website: www.acr.org
Website for patients: www.radiologyinfo.org
(sponsored by the Radiological Society of North America (RSNA) and ACR)
American Society of Radiation Oncology Resources for Patients
The American Society of Radiation Oncology has a website with resources to help patients and families better understand how doctors use radiation therapy to treat cancer safely and effectively.
- American Society of Radiation Oncology website: www.rtanswers.org
Centers for Disease Control and Prevention Injection Safety
Improper use of syringes, needles, and medication vials during routine healthcare procedures, including injections and intravascular administration of contrast media, have resulted in patient infections and more than 40 outbreaks involving multiple patients. These outbreaks have resulted from failure to follow basic infection control procedures and aseptic technique in injection safety, including reusing syringes, contaminating multi-dose vials with unclean syringes, and using single-dose vials for multiple patients. CDC has published numerous guidance documents for healthcare providers.
- CDC website on "Injection Safety Information for Providers."
ECRI Institute
ECRI provides resources on evidence-based research related to medical procedures, devices, drugs and processes to improve patient care, including risk assessment tools, guidance documents, alerts, educational programs and other resources and tools on patient safety topics, including radiology safety.
- ECRI website: www.ecri.org
FDA
There are numerous U.S. laws that apply to radiation emitting products sold in the United States. There is also overlapping enforcement authorities for radiation-emitting products that includes Federal Food, Drug, and Cosmetic Act, (Chapter V, Medical Devices); Radiation Control for Health and Safety Act of 1968 (now part of the Federal Food, Drug and Cosmetic Act as Chapter V, Subpart 3, Electronic product radiation control; and the mammography Quality Standards Act of 1992.
- FDA provides information on the laws, regulations, performance standards and industry guidance for radiation emitting products.
FDA Center for Devices and Radiologic Health - CDRH
CDRH responsibilities include regulation of radiation-emitting medical and non-medical electronic products. Their special website on radiation-emitting products contains listings of products, radiation safety information, standards, regulations, news, research, and education for industry, healthcare providers, and consumers.
FDA Initiative to reduce unnecessary radiation exposure from medical imaging
In November, 2010 the U.S. Food and Drug Administration (FDA) updated its initiative of February 9, 2010, to reduce unnecessary radiation exposure from three types of imaging procedures: computed tomography, nuclear medicine, and fluoroscopy. The agency aims to achieve these reductions by promoting safe use of imaging devices (e.g., stronger equipment safeguards, personnel training), supporting clinical decision-making (e.g., standardized dosage reporting, appropriate use criteria), and education patients (e.g., patient medical imaging record card).
- FDA Radiation Exposure Initiative Updated summary of actions November 29, 2010
- FDA White Paper Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging, February, 2010.
- FDA Update Safety Investigation of CT November 9, 2010
- FDA Letter to Medical Imaging Technology Alliance Regarding CT Recommendations Updated November 8, 2010
- FDA Public Meeting Device improvements to reduce unnecessary radiation exposure from medical imaging, March 30-31, 2010.
Image Wisely
Image Wisely is an awareness program of the American College of Radiology, the Radiological Society of North America, the American Association of Physicists in Medicine, and the American Society of Radiologic Technologists. Image Wisely's objective is to encourage practitioners to avoid unnecessary ionizing radiation scans and to use the lowest optimal radiation dose for necessary studies. Radiologists, medical physicists, technologists, and physicians are encouraged to take the pledge to image wisely for the health and safety of their patients.
Institute for Safe Medication Practices - ISMP
ISMP provides resources for medical error prevention and safe medication use, including newsletters, consulting, educational program and webinars, tools, and a voluntary medication error reporting program (MERP). A recent webinar addressed medication errors in the radiology suite and audiotape can be ordered on line.
- ISMP website: www.ISMP.org
International Atomic Energy Organization - IAEA
The IAEA was set up in 1957 within the United Nations family work with its members and worldwide partners to promote safe nuclear technologies. A number of documents have been release in collaboration with their partners, including the World Health Organization to address occupational, public, medical, and emergency exposure situations. Selected documents:
- Applying radiation safety standards in diagnostic radiology and interventional procedures using X Rays
www-pub.iaea.org/MTCD/publications/PDF/Pub1206_web.pdf - International basic safety standards for protection against ionizing radiation and for the safety of radiation sources
www-pub.iaea.org/mtcd/publications/pdf/ss-115-web/pub996_web-1a.pdf
IAEA website: www.iaea.org
The Joint Commission
- Sentinel Event Alert Issue 38, Feb 14, 2008 Preventing accidents and injuries in the MRI suite.
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Sentinel Event Alert Issue, Issue 47, Aug 24, 2011 Radiation risks of diagnostic imaging
- Articles and audio conferences from Joint Commission Resources at http://www.jcrinc.com/Sentinel-Event-Alert-38/
Mayo Clinic radiology course offerings
- Offers a number of courses for clinicians, including advanced radiology life support www.mayo.edu/cme/radiology.html
National Council on Radiation and Protection Measurements - NCRP
NCRP was chartered by the U.S. Congress in 1964 to support radiation protection by providing independent scientific analysis, information and recommendations. A few selected documents include:
- NCRP Report No. 160 - Ionizing Radiation Exposure of the Population of the United States (2009). Detailed information on exposure of the U.S. population to ionizing radiation highlighting the two major sources of contributors to exposure of the U.S. population from ionizing radiation: exposure to ubiquitous radiation and medical exposure of patients.
- Press Release on Report: Medical Radiation Exposure of the U.S. Population Greatly Increased Since the Early 1980s or go to: www.ncrponline.org/Press_Rel/Rept_160_Press_Release.pdf
- Order report from NCRP
- Where can $700 billion in waste be cut annually from the U.S. healthcare system? Thomson Reuters. White paper discussing waste in healthcare, including medical imaging.
NCRP website: NCRPonline.org
National Quality Forum - NQF
All of the NQF-endorsed Safe Practices for Better Healthcare address patient safety and a number of them specifically impact on patient safety during radiologic care, including:
- Labeling of diagnostic studies
- Contrast media-induced renal failure prevention
- Pediatric imaging
NQF website: www.qualityforum.org
Nuclear Regulatory Commission - NRC
The U.S. Nuclear Regulatory Commission (NRC), created as an independent agency by Congress in 1974, to enable the nation to safely use radioactive materials for beneficial civilian purposes while ensuring that people and the environment are protected,. The NRC regulates uses of nuclear materials, such as in nuclear medicine, through licensing, inspection and enforcement of its requirements. NRC also has formal agreements with 37 states that have assumed regulatory responsibility and jointly with NRC develop new regulations and guidance.
- NRC website: www.nrc.gov
Pennsylvania Patient Safety Authority
A state agency charged with eliminating medical errors has advisories, toolkits, brochures, and education materials on radiology-related services. Go to www.patientsafetyauthority.org to download. Examples of resources and tools available at this site include:
Advisories
- Errors in Radiation Therapy
- Medication errors occurring in radiologic services departments
- Safety in the MR environment
- Diagnostic ionizing radiation and pregnancy
- MRI patient screening forms
Tools Sample policies
- MRI patient screening forms
- Providers reference guide for radiation exposure
- Contrast induced nephropathy
- Management of patients undergoing contrast-related procedures
Society for Interventional Radiology - SIR
The Society of Interventional Radiology has a taken a leading role in measuring and assessing radiation dosage; developing educational programs and publications on radiation safety, radiation protection and reduction of skin dosage; and promoting the safety of patients and health care professionals.
Selected documents published in the Journal of Vascular and Interventional Radiology and publicly available on the SIR website at: www.sirweb.org/clinical/safety.shtml Selected documents include:
- Position Statement on Radiation Safety Interventional Fluoroscopy: Reducing Radiation Risks for Patients and Staff
- Guidelines for Patient Radiation Dose Management
- Quality Improvement Guidelines for recording patient radiation dose in the medical record
- Occupational health hazards in the interventional laboratory
- X-Rays and radiation safety (Patient information brochure)
- Recommendations for the implementation of Joint Commission guidelines for labeling medications
SIR website: www.sirweb.org
University of Michigan Health Physics website
An internet resource for radiation, nuclear, and health physics topics that includes information and resources
U.S. Pharmacopeia - USP
The U.S. Pharmacopeia's (USP) Revised General Chapter 797 Pharmaceutical Compounding Sterile Preparations, which sets practice standards to help ensure that compounded sterile preparations are of high quality, is available in the Second Supplement to USP 31-NF 26, This revised version became official on June 1, 2008.
Complete document: USP website at: www.usp.org/products/797Guidebook/
- Excerpts from Chapter 797 on safe practices when handling hazardous drugs, radiopharmaceuticals.