Importance of Radiation Safety Training for Radiology Nurses
This paper aims to critically analyse and evaluate a scenario of a radiology nurse who has taken training and improved their knowledge of radiation safety. The experience of radiation management issues regarding the procedures and policies will be shared in this paper.
The radiology nurses start or check the peripheral by assessing the infusaports, administration of medications, and monitoring vital signs. They also help in the insertion of foley, suction patients and help the patients with their personal requirements. They mainly care for the patients in the department of radiology in a private radiology practice. These nurses involve in the care of those patients who are under radiological tests or procedures (Frane & Bitterman, 2020). As the radiology nurses are working closely with the clinical radiologist they need to know appropriate procedures for maintaining safety during practice for themselves as well as for the patients. They are mainly responsible for protecting patients from radiation exposure by guiding the patients about full procedures (Bárdyová et al., 2021). It is known to all ionizing radiation can cause different health issues such as skin burns, different types of cancers, loss of hair and cataracts. The lack of safety knowledge about how to manage radiation can make them and the patients vulnerable to being affected by ionization radiation (Ghatan, 2020). For this instance, radiology nurses need radiation safety training to protect themselves and their patients.
Maximum hospitals in Singapore have performed their radiation safety training for their nursing staff as in nursing diploma courses nurses are not taught. We have been trained in the hospital while we are working in the radiology department. In our hospital, we have used to participate in the job training regularly on radiation safety through presentation training during working in the radiology department. It helps to make sure that we have adequate knowledge of it. Any staff who is working with the ionizing radiation needs to wear personal radiation monitoring devices as mentioned by National Environment Agency. In radiation safety, three rules are mainly followed time, distance and shielding. In radiation safety training, the nurses need to recognize the sources of radiation, reduce the exposure time, increase the distance from the radiation, shield own from radiation and avoidance of radioactive contamination. The nurses have faced difficulty in maintaining the shielding and distance rules in their daily practice. Few members of the nursing group have not used gloves and eyeglasses. Some of them not used the personal monitoring devices such as Thermo-luminescence Dosimeter (TLD) during their training. It reflects the ineffective training procedure and issues in maintaining policies or principles of radiation.
In the radiation safety knowledge, the nurses need to cover the nuclear physics, natural sources of radiation, nuclear reactions, production of the X-rays and others. The structure of atoms, atomic numbers, and mass numbers are all concepts that need to be developed during the training (Hirvonen et al., 2019). In our training, we had to give a presentation on each topic where we can demonstrate our knowledge about the topic. The basic knowledge of the radiation physics and biological effect is vital as it helps them to understand the factors that affect the nature and degree of ionization in the radiation safety and protection for the patients in the X-ray, ultrasound or other screening imaging procedures (Nassef & Kinsara, 2017).
Potential Health Hazards of Ionizing Radiation
Sources of Ionizing Radiation
At first, the nurses need to understand the source of ionising radiation which involves neutron, gamma, beta and alpha. In this ionising radiation, the energy passes through the matter and can cause some of the atoms to be electrically charged (Rahimi et al., 2021). However, understanding radiation sources helps the nurses to detect the radiation and they can take steps or actions.
The action of Radiation on the Cell
Ionizing radiation can damage the cells by changing the chemical structure, breaking the hydrogen bonds that are connecting base pairs. This radiation process can strike the DNA molecule directly, ionizing and also damaging it. The radiation can kill cells through two mechanisms (Shabani et al., 2018).
Recognition of Ionizing radiation
After getting knowledge of the sources of ionising radiation the nurses can detect the ionizing radiation. Most of the time the exposure has been found from the diagnostic x-rays. After understanding the half-life of the radionuclides and decay in radioactivity can give the knowledge to the patient that how to manage the nuclear medicines adequately (Shafiee et al., 2020).
Physical and biological effects of ionizing radiation
Bone marrow, lymphoid tissues and reproductive parts are more sensitive to radiation. However the radiosensitive organs are the bone, muscle and brain. For this reason, there is a need to use shield protection for the radiosensitive organs. Ionizing radiation can increase the incidence of cancer, erythema, birth anomalies and other issues (Thambura & Vinette, 2019). In order to remove the biological effects, there is a need to give only an adequate or limited dose to the patient. During giving radiation doses there is a need to follow the principle as low as reasonably achievable.
Radiology nurses are in a central role in the radiology department. They are accountable for assessing, preparing, educating and monitoring the patients during the processes of radiological (Ünal, Geli? & Baykan, 2018). Therefore, they need to reduce the risks of radiation by using the various principles 3 rules of radiation protection, ALARA, the 10-day rule and using different monitoring devices.
In the training, the nurses have not gained proper knowledge about the safety procedure of radiation. The nurses have only been involved in the presentation on the above topics which has not given them a proper clear picture. The nurses in the training have not followed the minimum distance and have not used the appropriate shields during practice due to a lack of management and a casual attitude regarding practice. The main health issue with alpha radiation sources can cause some possible internal contamination. There are three main ways of internalization of a radiation source are an absorption, ingestion or inhalation (Ünal, Geli? & Baykan, 2018). The basic laboratory guidelines for safety are not to drink, eat or smoke. Using gloves and laboratory coats can minimize the absorption of radiation. However, in this scenario, few nurses have not used the gloves that can make more absorption of radiation in the body that can make internal hazard for them.
Principles of Radiation Safety Followed in Hospitals
As per Thambura & Vinette, (2019), greater distance reflects the less received radiation by the factor of 1 over the distance squared. The distance needs to be maintained by the inverse square law. The formula of maintaining distance is I1(D1)2=I2(D2)2 . In this calculation I is intensity and D is the distance from the source. By using this formula the exposure rate can be calculated (Thambura & Vinette, 2019). However, during working the nurses need to maintain a greater level of distance for less absorption of radiation. However, in the scenario, few nurses have not maintained the procedure and policies properly as they are lacking knowledge about safety maintenance. They need to learn more proficiently about the policies or rules f the safety procedure.
It is necessary that any nursing staff who is working with ionizing radiation needs to wear a personal monitoring device. For example, Thermo-luminescence Dosimeter (TLD) is applied for personal monitoring in the radiology department (Thambura & Vinette, 2019). The radiology nurses need to strictly wear these TLDs during the management of radiation and the TLDs are also changed every 3 months. However, few nurses have no proper knowledge about using the TLDs and they are avoiding to use which may cause some critical health issues.
Conclusion
It can be concluded that radiation safety training is vital for radiology nurses to practice safely. A well-structured and appropriate management of the training can help the radiology nurses to implement all methods of radiation safety in a proper manner. The radiology nurses can improve their skills and knowledge through presentation training. Although they need to more focus on practical training procedures.
References
Bárdyová, Z., Horváthová, M., Pin?áková, K., & Budošová, D. (2021). The importance of public health in radiology and radiation protection. Journal of Public Health Research, 10(3), jphr-2021. https://doi.org/10.4081/jphr.2021.2141
Frane, N., & Bitterman, A. (2020). Radiation Safety and Protection. https://europepmc.org/article/nbk/nbk557499
Ghatan, C. E. (2020). Understanding and managing occupational radiation exposure for the pregnant interventional radiology nurse. Journal of Radiology Nursing, 39(1), 20-23. https://doi.org/10.1016/j.jradnu.2019.10.004
Hirvonen, L., Schroderus-Salo, T., Henner, A., Ahonen, S., Kääriäinen, M., Miettunen, J., & Mikkonen, K. (2019). Nurses’ knowledge of radiation protection: a cross-sectional study. Radiography, 25(4), e108-e112. https://doi.org/10.1016/j.radi.2019.04.011
Nassef, M. H., & Kinsara, A. A. (2017). Occupational radiation dose for medical workers at a university hospital. Journal of Taibah University for Science, 11(6), 1259-1266. https://doi.org/10.1016/j.jtusci.2017.01.003
Rahimi, A. M., Nurdin, I., Ismail, S., & Khalil, A. (2021). Malaysian Nurses’ Knowledge of Radiation Protection: A Cross-Sectional Study. Radiology research and practice, 2021. https://doi.org/10.1155/2021/5566654
Shabani, F., Hasanzadeh, H., Emadi, A., Mirmohammadkhani, M., Bitarafan-Rajabi, A., Abedelahi, A., … & Ziari, A. (2018). Radiation protection knowledge, attitude, and practice (KAP) in interventional radiology. Oman medical journal, 33(2), 141. doi: 10.5001/omj.2018.26
Shafiee, M., Rashidfar, R., Abdolmohammadi, J., Borzoueisileh, S., Salehi, Z., & Dashtian, K. (2020). A study to assess the knowledge and practice of medical professionals on radiation protection in interventional radiology. Indian Journal of Radiology and Imaging, 30(01), 64-69. https://www.thieme-connect.com/products/ejournals/html/10.4103/ijri.IJRI_333_19
Thambura, M. J., & Vinette, C. I. (2019). Nurses’ knowledge of ionizing radiation in northern gauteng state hospitals in South Africa. Journal of Radiology Nursing, 38(1), 56-60. https://doi.org/10.1016/j.jradnu.2018.11.002
Ünal, E. S., Geli?, K., & Baykan, P. (2018). Investigation of awareness levels about the radiation safety of personnel working in the imaging units of the hospitals in Agri, Turkey. Journal of radiation research and applied sciences, 11(2), 111-115. https://doi.org/10.1016/j.jrras.2017.10.009
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