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

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


Clinical risk management
Medical devices / Equipment
GOP Description
Implementation level
Clinical settings
Interventional procedures in Cardiology
To apply the radiation protection principle ALARA and enhance patient radiation safety for patients undergoing interventional procedures in cardiology.
Patients subject to interventional procedures in Cardiology.
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.
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.)
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?
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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