E1203. CheckingOff ALARA: Role of a Pre-Procedure Radiation Safety Checklist in Reducing Exposure Doses to Interventional Radiologists
  1. Stephanie Kazi; University of South Dakota Sanford School of Medicine
  2. Jackson Shriver; University of South Dakota Sanford School of Medicine
  3. Max Gallivan; University of South Dakota Sanford School of Medicine
  4. Morgan Sorensen; University of South Dakota Sanford School of Medicine
  5. Lee Kiessel; Avera Health
  6. Michelle White; Avera Health
  7. Douglas Yim; Avera Health; University of South Dakota Sanford School of Medicine
The aviation industry is renowned for its successful use of checklists to improve safety and limit human error. Likewise, the implementation of checklists in medical practice has contributed to reduced patient morbidity and mortality, particularly in anesthesiology and surgery. Limiting radiation exposure to patients and staff is a priority during imaging studies and interventions. By applying a checklist, we sought to evaluate the effect of a pre-procedure radiation safety timeout on radiation exposure to operating interventional radiologists.

Materials and Methods:
A checklist addressing proper use of radiation protection devices and dosimetry badge placement was implemented prior to each interventional radiology procedure. Cumulative monthly whole-body (waist) and lens (collar) dosimetry badge readings for individual interventional radiologists 3 months prior and 3 months following checklist implementation were assessed.

Mean monthly lens of eye dose equivalent (LDE) for physicians was 741 mrem pre-checklist and 362 mrem post-checklist, representing a 51% reduction (p = 0.0383). Mean monthly whole-body deep dose equivalent (DDE) was 77 mrem pre-checklist and 54 mrem post-checklist, representing a 30% reduction (p=0.0485).

Exposure doses to the physicians were decreased after the implementation of the radiation safety timeout. Although the checklist was standardized, each IR had differing individual responses to enacting its components. For example, specific use of overhead radiation shields versus lead glasses varied between physicians. This demonstrates the principle of keeping exposures as low as reasonably achievable (ALARA), in that what is considered “reasonable” may depend on individual operator techniques, procedures, and preferences. While a checklist can serve as an effective reminder to utilize available resources for limiting radiation exposure, cultivating a culture that prioritizes radiation safety and employs methods to limit exposure on an individual level is essential to creating lasting reductions in operator radiation exposure.