Abstract
The tenth tri-annual safety survey in nuclear medicine practice in Japan was conducted under the subcommittee for radionuclide imaging and nuclear medicine technology of the Japan Radioisotope Association to promote patient safety.
A questionnaire was mailed to 1279 nuclear medicine facilities, in which seventy-one percents of them(907) responded. The survey revealed that 5634 workers, which comprised 1094 physicians, 3371 technicians, 692 nurses, and 477 other professionals including pharmacists were engaging in nuclear medicine. There were 1087 SPECT systems of which 809(74.4%) were 2-headed SPECT systems, 147 hybrid SPECT/CT systems, and 285 hybrid PET/CT systems. The total numbers of dose calibrators, well counters, and survey meters the facilities possessed were 712, 363, and 1226, and the proportions of the facilities having at least one of these ionization radiation detectors was 66.0%, 38.7%, and 72.4%, respectively. Quality control(QC) procedures of dual-or triple-headed SPECT system, SPECT/CT systems, and PET/CT system, were performed regularly in over 90% of these systems, but the less facilities drafted a plan of QC procedures. Regular QC procedures of the ionization radiation detectors mentioned above were less frequently performed(35.8-47.2%).There were reports on 91 accidents and 146 incidents. The primary factors were patients' careless movement and unfavorable condition, accounting for 48.4%(44cases) of the accidents and the 38.4%(56cases) of the incidents.
The countermeasures taken most frequently were 107 personal advices(42.6%) to workers in charge and 43(17.1%) attempts of improvement in workflow. There were 26 institutions with no countermeasures despite their accidents or incidents. A matter of primary concern of nuclear medicine technicians was about safety of moving or detachable parts of the SPECT, SPECT/CT, and PET/CT systems such as collimators, gamma or positron camera heads, and beds(378 responses, 67.1%). Improvements were applied to the moving parts(56 responses, 18.6%), beds(91 responses, 30.2%), and careful patient monitoring during image acquisition. The survey showed that major troubles of the systems occurred in electronic circuits in 72 cases(20.4%) and natural disasters including East Japan Great Earthquake and Tsunami in 12 cases. The major desire to manufactures were improvement of quality of bed(117 responses, 30.0%) to keep patients free from injury by fall from, or pinching by the table.
The results of the survey may be a valuable basis for improvement of safety in nuclear medicine practice.
