James Daphne J, Cardew Paul, Warren-Forward Helen M
School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia.
J Nucl Med Technol. 2011 Sep;39(3):220-5. doi: 10.2967/jnmt.111.088740. Epub 2011 Jul 27.
Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients.
Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded.
Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation.
This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.
诊断性核医学程序中使用的电离辐射有可能对胎儿产生生物学效应。因此,核医学技术人员有责任在开始任何程序之前询问所有育龄患者的妊娠状况,以避免不必要的胎儿辐射。在澳大利亚,没有明确界定的实践指南来协助核医学技术人员确定该询问哪些患者或如何询问患者。
对澳大利亚8个核医学科室的首席核医学技术人员和普通核医学技术人员进行了半结构化访谈。问题围绕5个领域展开:法规与政策、胎儿辐射暴露、询问患者、确定妊娠状况的困难以及使用混合成像的影响。访谈的音频文件被转录并编码。
主题被编码为5个主题:政策和指南意识、询问患者、辐射知识、核医学技术人员做出的决策和假设以及妊娠检测的使用。各科室之间以及科室内部的实践存在很大差异。核医学技术人员表现出对辐射可能产生的生物学效应缺乏了解和认识。
本研究确定澳大利亚的核医学需要达成一种验证患者妊娠状况的共识方法,以便核医学技术人员能够成功询问患者的妊娠状况。还需要开展继续教育项目,以使核医学技术人员了解最新知识。