Work Ethics & Preparedness of Radiation Therapists on Implementation of Stereotactic Radiosurgery
Subrata Roy R.T.(T)
HCPC (UK),ESTRO (EU),AERB (IN),ARTTI (IN),ISRT (IN) | Senior Radiation Therapist Nanavati Max Super Speciality Hospital
This Code of Work Ethics is to act as a guide to any Medical professionals including Radiation Therapist.?Radiation Therapists working in all modalities of medical radiation technology to maintain a high level of ethical conduct.
?Radiation Therapists will act in such a manner that will justify public trust and confidence. This will be achieved through high standards of professional competency as well as through professional conduct and appearance. They are committed to the provision of the best possible service to patients.? They will maintain a working knowledge of all legislation pertinent to their practice and operate within such legislation and will ensure that they operate within their scope of practice, delivering only those services for which they are licensed and competent to do so.
?Radiation Therapists are committed to keeping the radiation dose as low as reasonably achievable (ALARA) to produce for treatment needs. Radiation Therapist will provide services in such a manner as to show respect for each individual.? They will act in the best interests of each patient and will maintain their standards of practice for all patients.? They will also regard a patient’s religious and political beliefs, gender, sexual orientation, race/ethnicity, nationality, social or economic status and the nature of the person's health problems and they will also take part in protecting the patient's right to privacy and keep all patient information in the strictest confidence.
Radiation Therapist should be respectful of fellow workers and work professionally and cooperatively with other healthcare workers. Medical radiation technologists will be accountable for their clinical decision-making.
?Informed consent in ethics usually refers to the idea that a person must be fully informed about and understand the potential benefits and risks of their choice of treatment. An uninformed person is at risk of mistakenly making a choice not reflective of his or her values or wishes. It does not specifically mean the process of obtaining consent, nor the specific legal requirements, which vary from place to place, for capacity to consent. Patients can elect to make their own medical decisions,
Preparedness of Radiation Therapists in SRS Treatment
?Stereotactic radiosurgery is ultra-focused radiation to the tumor only. The treatment controls the growth of a tumor or abnormal cells by either killing the cells directly or by disrupting the ability of the cells to grow.
SRS and SRT are very similar, but SRS delivers a large dose of radiation on a single day and SRT has a fractionated treatment schedule. This means that in an SRT treatment, the patient will have treatments spanning multiple days.? Although, the total dose in SRT may be larger than in SRS any single day will have a much smaller dose delivery.? Both are used for the treatment of localized tumors in the brain and more recently in the body sites, called?Stereotactic Body Radiation Therapy (SBRT) or?Stereotactic Ablative Body Radiation (SABR).
?During stereotactic radiosurgery (SRS), a radiation therapist has several critical responsibilities to ensure the procedure is carried out safely, accurately, and effectively. These responsibilities include:
?Patient Preparation:
?? - Patient Positioning: Accurately position the patient according to the treatment plan, often using immobilization devices to ensure precision.
?? - Comfort and Communication: Ensure the patient is comfortable and informed about the procedure. Address any questions or concerns they might have.
?Radiotherapy Machine Setup :
?? - Verify that all equipment, including the linear accelerator or gamma knife, is properly functioning.
?? - Imaging Devices: Set up and verify the proper functioning of imaging devices used for treatment planning and verification.
?Treatment Planning:
?? - Executing the simulation process, including imaging (CT, MRI) to create an accurate treatment plan.
?? - Collaboration: Work with the medical physicist and radiation oncologist to review and approve the treatment plan, ensuring it meets the required specifications.
?Delivery of Treatment:
?? - Precision: Accurately deliver the radiation dose as per the treatment plan, maintaining a high level of precision to target the specific area while sparing surrounding healthy tissues.
?? - Monitoring: Continuously monitor the patient and the equipment during the procedure, making any necessary adjustments in real time.
?Treatment Delivery record documentation:
?? - Records: Maintain detailed records of the treatment parameters, doses delivered, and any observations or incidents during the procedure.
?? -Reports: Prepare reports for the radiation oncologist and medical team, documenting the treatment session and any relevant observations.
?Continuing Professional Development
?? - Training: Should be updated with the latest advancements in stereotactic radiosurgery techniques and technology through continuous education and training.
?? - Protocols: Ensure adherence to the latest clinical protocols and guidelines to maintain high standards of care.
?Pre-Treatment Essential Checklist:
?Patient Identification
?? - Verify patient identity using two identifiers (e.g., name and date of birth).
?? - Confirm the treatment site and side.
?Patient Medical Review
?? - Review the patient's medical history, including previous imaging studies and any allergies.
?? - Confirm informed consent has been obtained and documented.
?Treatment Plan Verification
?? - Double-check the treatment plan parameters (dose, target volume, number of fractions).
?? - Verify the treatment plan against the physician’s prescription.
?Equipment and Software Check
?? - Ensure the linear accelerator (LINAC) or Gamma Knife is properly calibrated.
?? - Confirm that all necessary software updates and QA checks are completed.
?? - Verify the functionality of the treatment planning system and ensure backup is available.
?Patient Preparation
?? - Ensure the patient has adhered to pre-procedure instructions (e.g., fasting, medication).
?? - Confirm the patient is positioned correctly and comfortably using immobilization devices.
?? - Perform a dry run or simulation with the patient to ensure correct positioning.
?Pre Treatment Positional Verification:
?? - Acquire necessary pre-treatment imaging (CT, MRI, or both).
?? - Verify the alignment and registration of imaging with the treatment plan.
?? - Check for any anatomical changes that might affect the treatment.
?Radiation Safety
?? - Ensure all radiation safety protocols are followed and coordinated with RSO in case of discrepancy
?? - Verify proper shielding is in place.
?? - Confirm the room is clear of unauthorized personnel before treatment.
?Communication with the Peer Team Members:
?? - Document all pre-procedure checks and any anomalies.
?? - Ensure clear communication with the radiation oncologist and medical physicist.
?? - Review emergency procedures with the team.
?During The Treatment Delivery Checklist:
?Final Verification
?? - Re-verify patient identity and treatment plan parameters.
?? - Confirm patient positioning and immobilization.
?Monitor and Adjust
?? - Continuously monitor the patient and the equipment throughout the procedure.
?? - Be prepared to pause the treatment if any discrepancies or emergencies arise.
?Initiate Intrafraction Imaging
Radiation Therapists need to ensure the Patient's current position and adequate dose delivery by obtaining Intrafraction Imaging at regular intervals of dose.
?Real-time Imaging
?? - Use real-time imaging (e.g., cone-beam CT) to ensure accurate targeting during treatment.
?? - Adjust patient positioning if necessary.
?Radiation Delivery
?? - Confirm correct dose delivery and monitor for any machine errors.
?? - Ensure the patient remains still and comfortable during treatment.
?Safety Checklist
?? - Quality Assurance: Ensure pre-treatment quality assurance checks, including verifying treatment parameters and ensuring all safety protocols are followed.
?? - Radiation Protection: Ensure appropriate radiation protection measures are in place for both the patient and staff, including monitoring radiation exposure levels.
These responsibilities require a high level of technical skill, attention to detail, and the ability to work collaboratively within a multidisciplinary team. Creating a comprehensive safety checklist for a radiation therapist before performing a stereotactic radiosurgery (SRS) procedure is crucial to ensure patient safety, accuracy, and effective treatment.
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Senior Radiation Therapist at Nirali Memorial Radiation Centre,Surat,Gujrat
9 个月Very informative