Author + information
Interventional cardiologists have one of the highest annual occupational radiation dose exposures. There is a lack of formal radiation safety guidelines among cardiac catheterization labs. Radiation exposure above 2 Gy can risk skin injury for patients. A point prevalence evaluation of radiation exposure for percutaneous coronary intervention procedures (PCI) at our local hospital during one month revealed a frequency of above 10 procedures with a dose exceeding 2 Gy in one Phillips lab. This study sought to reduce the frequency of radiation exposure, for PCI procedures, above 1.5 Gy in one cardiac catheterization lab at our local institution by 40%.
This was a time series study where the primary outcome was the frequency of radiation exposure above 1.5 Gy. Process measures were percent of procedures where collimation and magnification were used and percent of completion of online educational modules. Balancing measures were the number and mean duration of PCI procedures.
Information sessions, online modules, policies and posters were implemented. A novel software (AlluraClarity©) was introduced to reduce radiation dose.
There was a significant reduction in the frequency of radiation exposure above 1.5 Gy especially after utilizing a novel software (AlluraClarity©). Process measures of use of collimation (95.0% to 98.0%), use of magnification (20.0% to 14.0%) and completion of online modules (62%) helped track implementation. Balancing measures of number of cases performed and mean fluoroscopy time did not change significantly.
As per the hierarchy of effectiveness, a forced function in the form of implementation of a novel software system provided the most effective means of reducing radiation exposure compared to educational sessions and posters.