Orientation and Safety Policies

Orientation and Radiation Safety

Direct Supervision

All radiation therapy procedures (that involve direct patient care) performed by the student must be done under direct supervision of a qualified practitioner. At no time during clinical education should a student work alone when providing patient care through simulation and/or administering treatment.

Orientation

The technologist designated as Clinical Education Supervisor at the clinical training affiliate is responsible for orientation (or delegation of) student(s) to the facility's policies and procedures.

Safety

Each clinical education facility should orient the student to their safety procedures. This orientation should include:

Fire safety
Location of safety equipment (such as crash cart, blood pressure cuff, etc.)
Instruction in safety procedures
Radiation safety
Personal health and hygiene

Students are required to adhere to all safety regulations and procedures. Failure to do so is grounds for dismissal from NWHSU. The CE Safety Sign off form must be submitted via Dropbox no later than the second week of clinical training.

RADIATION SAFETY AND PROTECTION

All students will practice appropriate radiation safety procedures in protecting themselves, their patients and other personnel from unnecessary exposure.

Radiation protection practices are reviewed at the beginning of the students’ education, in Radiation Physics courses, Radiation Protection/Radiobiology and during the Comprehensive Review course. All students receive a copy of Basic Radiation Safety Principles at orientation. These Principles are posted in each classroom and the simulation laboratory. Students may not expose any person to radiation without direct supervision in the clinical setting.
A monitoring device (film badge) will be provided for and worn by each student while engaged in clinical education. The Radiation Safety Officer and/or Clinical Coordinator can access the record of the results at any time. Students can request the readings as well.
Radiation protection and safety measures will be strictly adhered to.
Because of the limitations placed on pregnant radiation workers, full participation in the clinical training program may be achieved; therefore, pregnancy during this time is ill advised. The program’s Pregnancy Policy (in accordance with the Nuclear Regulatory Commission) can be located within this handbook. If the student chooses to disclose her pregnancy to program officials, NWHSU and all the affiliate hospitals/clinics will protect, as much as possible, the fetus of any student.

RADIATION SAFETY RULES (NRC)

Radiation safety is an integral part of the radiography and radiation therapy professions. Therefore, it is imperative that students be aware of radiation protection rules that are followed by personnel.

The ALARA (As Low AS Reasonably Achievable) concept was developed by the National Council on Radiation Protection and is accepted by all regulatory agencies. This concept is for radiation therapists, radiographers, students in the radiography professions and radiologists to share the responsibility to keep occupational and non-occupational absorbed doses below their allowable maximum levels, which is achieved through the employment of proper radiation control procedures.

Radiation Protection and Monitoring

Adhering to the ALARA concept will be of utmost importance. A student is expected to exercise sound radiation protection practices at all times. At no time should a student participate in a procedure that exhibits unsafe protection practices.

According to ALARA no occupational workers following safe radiation practices should receive more than one-tenth of the maximum permissible dose in an exposure period (40 mrem in a one-month period).

If a students’ monthly film badge reading exceeds 40 mrem the student will be required to complete a Notification Report - Personnel Dosimetry Form (located within the handbook) and will receive instruction and counseling on radiation protection/safety to reduce their monthly radiation dose totals in keeping with the ALARA concept.

Radiation Monitoring Device

Film badges will be provided by Northwestern Health Sciences University to all students for their clinical experience.
Students are required to wear their film badge at the clinical affiliate hospital/clinic. No student will be allowed to participate in activities at the clinical affiliate hospital if he or she is not wearing a current film badge.
The student is responsible for controlled storage of their film badge.
The Radiation Safety Officer or the clinical coordinator will review the Radiation Dosimetry Report. If the report indicates exposure, the student will be notified, interviewed and counseled.
The film badge/dosimetry report is available to all students. The student may contact the Radiation Safety Officer or the clinical coordinator for any and all reports.
If the film badge is lost or damaged, report this immediately to the Clinical Coordinator or Program Chair.
Should a student’s badge be exposed or a radiation monitoring incident occurs, the student must report the incident immediately to the clinical coordinator or program chair. A detailed report must be completed using the Personnel Dosimetry Form. This report will be kept in the student’s file and used for PL Medical – Dosimetry Services Division processing.

Radiation Protection Rules Governed by ALARA

Understand and apply the Cardinal Principles of Radiation Control – Time, Distance and Shielding.
Do not allow familiarity to result in poor radiation protection procedures.
Should not routinely hold a patient while making an exposure
Always wear your film badge.
Wear film badge at the thyroid level.
Wear film badge outside lead apron if working in simulation and requested to stay in room toattend to a patient while exposure is being made.
Never leave your film badge in a treatment room or simulation room.
Never wear your film badge if you are having medical or dental radiographs taken of yourself.
Wear lead apron when appropriate.
Always use collimation.
Never make an exposure while the door to the simulation room is open.
Follow the appropriate rules for radiation safety set by each clinical affiliate.

Accidents and/or Incidents Involving the Student

Immediately report all incidents and/or injuries and accidents to the Clinical Supervisor so that proper care can be given.
The Program Chair/ Clinical Coordinator must be informed of any such accidents by the beginning of the next work day.

Accidents and/or Incidents Involving the Patient

The hospital policy for accidents and incidents must be followed.
The Program Chair / Clinical Coordinator and clinical instructor must be notified of any such accidents or incidents.

NWHSU Radiologic Sciences Pregnancy Policy

Certain aspects of Northwestern Health Sciences University (NWHSU) curriculum may be potentially hazardous to the embryo or fetus. Therefore, it is the responsibility of NWHSU and affiliated clinical sites to take all practical steps to reduce radiation exposure. It is the student’s responsibility to decide whether to declare pregnancy and to make an informed decision whether the exposure they are receiving is low enough to protect their embryo or fetus.

Students must be aware of the following options regarding pregnancy while in the radiation therapy or radiologic technology program:

If a student decides to declare their pregnancy to the program, they must do so in writing.
At any time after declaration of pregnancy, students may withdraw the declaration in writing.
After declaration of pregnancy students may choose to continue the program without modification.
After declaration of pregnancy students may choose to continue the program with modifications that consider possible radiation exposure to the embryo or fetus.
Confidentiality of the pregnancy will be maintained by the program chair, program clinical coordinator, and consulted clinical site personnel.

The advice of Northwestern Health Sciences University’s radiation safety officer or that of a medical physicist should be obtained to determine whether radiation levels in the clinic working areas are high enough that an embryo or fetus could receive 0.5 rem or more before birth. If dose levels could exceed 0.5 rem there are several alternatives to consider:

If a student is pregnant or expects to be soon, they could decide not to accept or continue assignments in these areas. This may result in a delay in graduation from the program since graduates need to be entry level skilled in all required areas as described in the Clinical Education Handbook.
Students may reduce exposure where possible by observing the basic rules of radiation safety:
- Reducing the time spent in a radiation area
- Increasing distance from the source of radiation
- Proper use of shielding

Students may also choose to continue working in higher radiation areas, but with full awareness that doing so could result in increased risk for the embryo or fetus.
Please be aware of the following:

The first three months of pregnancy are the time of most risk to the embryo or fetus, so you should make your decision quickly.
In most cases of occupational exposure, the actual dose received by the embryo or fetus is less than the dose received by the mother because some of the dose is absorbed by the mother’s body. Purpose:

To ensure the safety of any student who is pregnant when training as an occupational worker in a radiation area.

Procedure:

During orientation, all students must sign a statement stating they have read and understand U.S. Nuclear Regulatory Commission – appendix to the Regulatory Guide 8.13 – Possible Health Risks To Children Of Women Who Are Exposed To Radiation During Pregnancy.
Make a voluntary decision regarding declaration of pregnancy based on the previously stated alternatives.
As stated in the Regulatory Guide 8.13, you have the right to “revoke” your declaration of pregnancy, however, “the lower dose limit for embryo/fetus no longer applies”.
Declare pregnancy in writing to the program chair.
Complete an assessment with the program chair to review the clinical schedule and determine what adjustments may need to be made.
When a pregnancy has been declared in writing to the program chair, a fetal monitor film badge may be issued to the student and will be worn at the level of the abdomen during the gestational period