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51-403 / Patient safety during interventional procedures in Cardiology.

Cyprus
GOP Information  
 
Organisation sharing the GOP
Related practices from PaSQ database
Medical Physics Department Nicsia General Hospital

Topic

Clinical risk management
There is no specified text here
Category
Medical devices / Equipment
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GOP Description
 
Implementation level
Regional
Clinical settings
Interventional procedures in Cardiology
Objectives
To apply the radiation protection principle ALARA and enhance patient radiation safety for patients undergoing interventional procedures in cardiology.
Population
Patients subject to interventional procedures in Cardiology.
Methods
 
Methodology
Radiological exposure data for each patient are extracted from individual Electronic Dose Report .
Data analysis based on exposure condition?. (Physician, Details of Intervention).
Comparison of results with relevant internationally established references.
Recommendations to Departments for control and minimisation of patient dose.
Timeframe implementation
- Preparatory stage for procedure establishment (research and development): 1 MONTH
-Data validation : 1 DAY
-Data Collection : 3 MONTHS
-Analysis of results: 2 WEEKS
- Feedback of results (preparation for presenting results and arranging departmental management liaison) :3 WEEKS
Repeat loop for re-evaluation of patient dose: Infinite
Implementation tools available
- Electronic Dose Reporting capability from ionizing radiation modality (Angiography system)
-Power Point Presentations
- SPSS Statistics
Implementation cost
10000-15000 Euros for both hospitals including human resources.
Results
 
Method used to measure the results
The indicators used to assess the GOP are:
a) Average Total Accumulated Dose Area Product per patient per procedure (Average Total DAP)
b)Average Total Fluoroscopy Time per patient per procedure (Average Total FT).
c) Average Entrance Surface Dose at International Reference Point (Average ESD at IRP).
A set of 100 patients dosimetric data are collected from each hospital. (10% confidence interval with a population of 1200 patients/year at 95% confidence level.)
Results
For PCI (including CA) procedures:
(Average Total DAP): 186 Gy.cm2
(Average Total FT) : 24,2 mins
(Average ESD at IRP):3464 mGy
Dosimetric indices are also available per physician
For purely diagnostic (CA) procedures:
(Average Total DAP): 63 Gy.cm2
(Average Total FT) : 9,5 mins
(Average ESD at IRP):1000 mGy
Dosimetric indices are also available per physician
Analysis of the results
Results are higher than international references.
Strong correllation of excessive fluoroscopy time with doses.
Implementation barriers
 
Did you find implementation barriers?
Yes
Please describe implementation barriers
Yes. Availability of Medical Personnel and correct conditions to explain the impact of these results on patients and the safety implications.
Describe the strategies used to overcome the barriers (If needed)
Involve the hospital administration and communicate the risks using opticoacoustical aids from international organizations (e,g data and pictures of over-irradiated patients).
Other information
 
Other information about the GOP that you would like to add (Link or attached document)
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Contact information
 
Name: Mary Avraamidou
Position/function: National Contact Person on Patient Safety
Department: Occupational Health Department Nicosia General Hospital
Organisation: Ministry of Health
City: Nicosia
Country: Cyprus
Region: N
E-mail: mavraamidou@mphs.moh.gov.cy
Phone: 0035722604170
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