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Radiology safety resources

Selected resources listed alphabetically by agency.

American Board of Radiology Foundation

The American Board of Radiology Foundation (ABRF) is a 501(c)3 organization focused on creating a high-functioning, well-coordinated health system in which medical imaging and radiation are used safely and appropriately to deliver all the benefits that can be realized, while minimizing risk and waste.

American College of Radiology - ACR

Publishes white papers, practice guidelines, quality control guidance technical standards, patient education materials on all types of radiology services.

American College of Emergency Physicians

Five Things Physicians and Patients Should Question
As part of the "Choosing Wisely" initiative, One of the recommendations includes "avoiding CT scans of head in ED patients with minor head injury at low risk."

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.

Association of Radiologic Imaging Nursing

The Association's website provides clinical practice guidelines on radiology and imaging topics such as handoff communications, site marking, moderate sedation and analgesia, and contrast-associated nephrotoxicity. Go to "Resources", then "Practice Guidelines".

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.

Choosing Wisely® - Medical Tests or Procedures that Should be Questioned

The Choosing Wisely® Campaign is an initiative of the American Board of Internal Medicine. Over 50 national organizations representing medical specialists have joined the campaign to identify tests or procedures in their fields that may be unnecessary or may even cause harm. Relevant to radiology and imaging safety, see:

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.

FDA

There are numerous U.S. laws that apply to radiation emitting products sold in the United States. There are also overlapping enforcement authorities for radiation-emitting products that include 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 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 Resources on MRI safety

FDA monitors reports of adverse events and other problems with medical devices and alerts health professionals and the public when needed to ensure proper use of devices and the health and safety of patients, such as Magnetic Resonance Imaging (MRI). This page provides references on safety in MRI environments

Image Gently - Radiation Safety in Children

The Image Gently Campaign is an initiative of the Alliance for Radiation Safety in Pediatric Imaging. The campaign goal is to change practice by increasing awareness of the opportunities to promote radiation protection in the imaging of children. The Image Gently website states that NQF guidance is that "when CT imaging studies are undertaken on children, "child-size" techniques should be used to reduce unnecessary exposure to ionizing radiation."

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.

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:

Institute for Magnetic Resonance, Safety, Education, and Research

The IMRSER develops Magnetic Resonance (MR) safety materials and disseminates this information to the MR community. This is accomplished predominantly through the efforts of the Advisory Boards.

The Joint Commission

Radiation overdose - sentinel event
Radiation overdose has been a reviewable sentinel event by The Joint Commission since 2005. The specific language is "Prolonged fluoroscopy with cumulative dose >1500 rads to a single field or any delivery of radiotherapy to the wrong body region or >25% above the planned radiotherapy dose." Thirty-three radiation overdose events have been reported from 2004 through June 2013.

Mayo Clinic radiology course offerings

Medline Plus

Medline Plus is a service of the U.S. National Library of Medicine, National Institutes of Health. They have a website of Health Topics A-Z. See Radiation Exposure at this link, with many articles on basics, treatments, and related issues: 

National Cancer Institute

The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH). The NCI provides web resources on cancer imaging for patients. Information includes:

Cancer Imaging - A visual introduction to cancer imaging, featuring information about imaging technologies and their uses.

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:

 

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:

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.

Pennsylvania Patient Safety Authority

A state agency charged with eliminating medical errors has advisories, toolkits, brochures, and education materials on radiology-related services.

Advisories

Tools

Radiologyinfo.org

This website provides information for patients. It has a "Procedures A-Z" section with information on topics such as MRI, CT Scans, PET Scans and much more. The page on MRI describes what MRI is, and how it works, and considerations to keep patients safe.

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, selected documents include:

University of California, San Francisco: MRI Safety

This is the website of the University of California San Francisco, Department of Radiology and Biomedical Engineering. The website contains:

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 available for purchase at USP website.

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