DoseWise, radiation dose management program
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Maximizing the use of the equipment and improve radiation protection

The case submitted by Mrs Tamara van der Beek focuses on maximizing the use of the equipment and improve radiation protection at Rijnstate hospital, Netherlands. It was noticed that there had been an increase of the effective dose for the whole team. This could not be explained by a related increase in procedure volume. Due to their background in radiology, they noticed that the team was not using the equipment properly.

Case objectives
The main goal was to decrease the dose for the team. As a radiographer, I was able to identify that the problem was the way the equipment was being used. The challenge was to motivate the whole team to adjust their way of working. We teamed up with the medical physicist to address this problem. Together we created case-based training on site. To visualize radiation in practice we used Philips DoseAware. With this training, we provided the team with insights into the daily use of radiation.

Mrs Tamara van der Beek

Radiographer/Interventional technician

Rijnstate hospital


Clinical and patient background
Our interventional cardiology department has two interventional suites, five intervention cardiologists and sixteen interventional nurse/technicians. Every year we treat approximately 3000 patients. More than half of these patient have suffered acute myocardial infarctions.

Dose management methods and techniques that were used
We used a phantom patient so the whole team could practice the use of different radiation protection techniques and see the results. Step-by-step we showed and explained the effect of various factors including distance, collimation, and tube positioning. For every training session, we had a small mixed team of cardiologists, nurses and technicians. Therefore, we were able to facilitate a discussion on the benefits of teamwork.

We achieved a collective dose reduction of approximately 35%. Also, the average patient dose decreased by 35%.”

– Mrs Tamara van der Beek - Radiographer

Rijnstate hospital, Netherlands

Conclusions and results

We achieved a collective dose reduction of approximately 35% as measured by the personal TLD. This was measured the year after we facilitated case-based training in comparison to the year prior without case-based training. Our production slightly increased by 10% over the same period. Also, the average patient dose decreased by 35%.

Discussion of case outcome(s) and future implications
The beneficial effects persist. In our team, we’ve noticed a positive change in attitude towards radiation protection. We address each other more easily on unsafe behavior. Furthermore, other departments have noticed our results. Most interventional teams (Radiology, OR, Endoscopy) attended our training.

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