Department of Radiation Oncology, University of Virginia, Charlottesville, VA.
Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton, FL.
Brachytherapy. 2020 Nov-Dec;19(6):762-766. doi: 10.1016/j.brachy.2020.08.014. Epub 2020 Sep 17.
Safe delivery of brachytherapy and establishing a safety culture are critical in high-quality brachytherapy. The American Brachytherapy Society (ABS) Quality and Safety Committee surveyed members regarding brachytherapy services offered, safety practices during treatment, quality assurance procedures, and needs to develop safety and training materials.
A 22-item survey was sent to ABS membership in early 2019 to physicians, physicists, therapists, nurses, and administrators. Participation was voluntary. Responses were summarized with descriptive statistics and relative frequency distributions.
There were 103 unique responses. Approximately one in three was attending physicians and one in three attending physicists. Most were in practice >10 years. A total of 94% and 50% performed gynecologic and prostate brachytherapy, respectively. Ninety-one percent performed two-identification patient verification before treatment. Eighty-six percent performed a time-out. Ninety-five percent had an incident reporting or learning system, but only 71% regularly reviewed incidents. Half reviewed safety practices within the last year. Twenty percent reported they were somewhat or not satisfied with department safety culture, but 92% of respondents were interested in improving safety culture. Most reported time, communication, and staffing as barriers to improving safety. Most respondents desired safety-oriented webinars, self-assessment modules, learning modules, or checklists endorsed by the ABS to improve safety practice.
Most but not all practices use standards and quality assurance procedures in line with society recommendations. There is a need to heighten safety culture at many departments and to shift resources (e.g., time or staffing) to improve safety practice. There is a desire for society guidance to improve brachytherapy safety practices. This is the first survey to assess safety practice patterns among a national sample of radiation oncologists with expertise in brachytherapy.
安全实施近距离放射治疗并建立安全文化，对于高质量的近距离放射治疗至关重要。美国近距离放射治疗学会（ABS）质量与安全委员会对其成员进行了调查，内容涉及提供的近距离放射治疗服务、治疗期间的安全措施、质量保证程序，以及开发安全和培训材料的需求。
2019 年初，向 ABS 会员发送了一份包含 22 个问题的调查问卷，调查对象为医师、物理学家、治疗师、护士和管理人员。参与调查是自愿的。采用描述性统计和相对频率分布对调查结果进行总结。
共收到 103 份唯一回复。约三分之一为主治医生，三分之一为主治物理学家。大多数人从业时间超过 10 年。91%的人在治疗前进行两次身份验证，86%的人进行了停工期。95%的人有事件报告或学习系统，但只有 71%的人定期审查事件。在过去一年中，有一半人审查了安全措施。20%的人表示对科室安全文化有些满意或不满意，但 92%的受访者有兴趣改善安全文化。大多数人表示时间、沟通和人员配备是改善安全的障碍。大多数受访者希望获得以安全为导向的网络研讨会、自我评估模块、学习模块或由 ABS 认可的检查表，以提高安全实践。
大多数（但不是全部）实践都采用了符合协会建议的标准和质量保证程序。许多科室都需要加强安全文化，并且需要调拨资源（例如时间或人员）来改善安全实践。人们希望学会提供指导，以提高近距离放射治疗的安全实践。这是首次对具有近距离放射治疗专业知识的全国范围内的放射肿瘤学家的安全实践模式进行评估的调查。
