|Title||Non Ionising Radiation Biological Effects and Safety Advice|
Imaging and therapeutic modalities employing non-ionising radiation utilise a range of radiations and fields (e.g. magnetic resonance imaging [MRI] utilises strong magnetic fields, radiofrequency fields and magnetic field gradients; ultrasound imaging and high-intensity focused ultrasound [HIFU] therapy employ intense acoustic radiation). These can all be hazardous unless suitable controls and frameworks are established. There are many aspects of non-ionising radiation safety that are technical and scientific. These include but are not limited to interpretation of national and international guidelines and legislation, establishment of safety frameworks, site design, measurement of radiations and fields, and assessment of patients with implants. An effective framework for the provision of safety advice in non-ionising radiation is essential for the safety of patients, visitors and staff.
The Clinical Scientist in HSST will have an effective knowledge of the nature of the local clinical services employing non-ionising radiation, an advanced knowledge of imaging and/or therapeutic techniques relevant to their practice and an appropriate understanding of the clinical applications of these techniques. They will have an understanding of the clinical and safety consequences of decisions made on their advice.
The Clinical Scientist in HSST will be able to critically appraise organisational governance for relevant safety legislation and guidance, and advise the employer on compliance with relevant guidelines and regulations. They will be expected to perform and master a range of technical, clinical and communication skills while consistently demonstrate the attitudes and behaviours required of a Consultant Clinical Scientist.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise and critically apply their expert knowledge with respect to non-ionising radiation safety, including:
- The operational dynamics of the clinical facility in which non-ionising radiation is used.
- The organisational culture of the institution.
- Roles, responsibilities and levels of authority of personnel involved in delivery of services.
- The nature of the applications and protocols used within the clinical facility.
- The range of clinical or research studies undertaken, and their wider context.
Exposure and biological effects
- The nature and biological effects of fields and radiations encountered in modalities relevant to their practice.
- Methods of measurement and calculation of these fields and radiations.
- The relationship between equipment parameters used in imaging or therapy (e.g. MRI pulse sequence parameters, HIFU frequency and intensity) and patient/volunteer exposure.
Guidelines and legislation
- Relevant national and international standards and guidelines on non-ionising radiation safety and their interpretation.
- Relevant legislation and its interpretation.
- Administrative and access controls required to ensure safety in the context of their practice.
- The impact of non-ionising radiation and fields on the environment and on ancillary equipment in the context of their practice (e.g. fringe magnetic fields in the context of MRI).
Compatibility with external equipment and devices
- The nature and principles of interactions between non-ionising radiation and fields encountered in their practice and other items of equipment (e.g. passive and active biomedical implants and foreign bodies subject to RF heating, electrical stimulation and magnetic field force and torque in the context of MRI).
- Methods of mitigating adverse effects of these interactions.
Hazards and risks
- Types of risk and methods of risk management.
- Risks associated with the imaging or therapeutic modalities relevant to their practice.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be able to perform, adapt and master a range of technical procedures, as follows:
- Advise on and develop an appropriate framework for managing safety in the context of their practice, which will include effective review processes and reporting mechanisms within the organisation.
- Specify roles, responsibilities and authority levels of relevant staff at an appropriate level of detail to facilitate implementation and management of a safety framework.
- Advise on, prepare, or review and periodically revise local safety rules or other appropriate documentation in consultation with clinical and management
- Clearly specify potential risks and methods of management.
- Specify the record-keeping requirements regarding staff training, staff and patient exposure, volunteer exposure, contrast media and equipment modifications, as appropriate in the context of their practice.
- Formulate contingency plans for the management and control of incidents and emergencies.
- Perform a comprehensive risk assessment of a non-ionising radiation facility and techniques.
International and national non-ionising radiation safety guidelines and standards
- Interpret, advise on and comply with current guidelines and standards in non- ionising radiation relevant to their practice.
- Advise on compliance with relevant legislation and its interpretation.
Non-ionising radiation and field exposure
- Advise on biological effects of exposure to non-ionising radiation and fields relevant to their practice.
- Identify and use appropriate measuring equipment to establish/investigate patient, volunteer, occupational and public exposure levels.
- Assess and advise on occupational exposure to non-ionising radiation and fields relevant to their practice.
- Advise on the implications of individual patient and/or volunteer exposures.
- Advise on limitation or reduction of patient and/or volunteer exposure consistent with clinical or research requirements.
Compatibility with external equipment and devices
- Critically evaluate the safety of external equipment in the context of non-ionising radiation and fields encountered in their practice (e.g. passive and active biomedical implants and foreign bodies subject to RF heating, electrical stimulation and magnetic field force and torque in the context of MRI).
- Assess the risk and provide advice on risk mitigation for specific cases relevant in the context of their practice where expert scientific input is essential for safe imaging or therapy (e.g. patients with complex or novel implants in the context of MRI, including interpretation of manufacturer’s advice on safe imaging of patients with MR-conditional implants).
- Provide advice on risks to patients and/or volunteers using an understanding of the wider clinical or research setting relevant to the presenting patient or volunteer.
- Where appropriate, identify and evaluate compatibility of external equipment and ensure that appropriate safety systems (e.g. labelling, systems of work) exist for the safe use of such equipment.
Siting and procurement
- Evaluate the mutual impact of non-ionising radiation equipment encountered in their practice and the surrounding environment (e.g. the extent of the fringe magnetic field in MRI).
- Critically evaluate a non-ionising radiation facility design.
- Determine potential risks associated with new non-ionising radiation equipment accommodation and facilities and identify effective management controls.
- Investigate and report on adverse incidents relating to the non-ionising radiation equipment and environment.
By the end of this module the Clinical Scientist in HSST will provide non-ionising radiation safety advice to colleagues across a range of clinical and academic environments, understanding the context in which the advice is sought and the consequences of any advice given, and will:
- Communicate effectively within the clinical environment and multidisciplinary team that manages and maintains the safety and effectiveness of non-ionising radiation facilities relevant to their practice, including unit managers, radiographers, radiologists and other professionals as appropriate.
- Provide expert scientific advice on the risks associated with individual patient examinations, procedures and situations for which generic safety advice is not appropriate for reasons of complexity or novelty.
- Provide the radiologist or other medical specialist with guidance on the risks associated with these procedures and methods to minimise them.
- Plan, deliver and evaluate teaching and training in the relevant aspects of non- ionising radiation safety to a wide range of clinical and non-clinical staff as appropriate.
- Assess and advise on patient, volunteer, public and occupational exposure to non-ionising radiation and fields relevant to their practice.
Attitudes and behaviours
By the end of this module the Clinical Scientist in HSST will be expected to consistently demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist and be able to:
- Appreciate the impact of current clinical and scientific evidence for non-ionising radiation safety in relation to patients, members of staff and members of the public.
- Adhere to, and accept and work within, current governance requirements applicable within an organisation, raising concerns when necessary.
- Promote the importance of research and innovation in the provision of safety advice to the NHS, business and the wider UK economy.
- Engage service users, patients and the public to promote the positive impact of expert advice from a Clinical Scientist with appropriate expertise.
- Display a professional, objective and unbiased approach to all activities.
NB: In the context of MRI, the requirements of this module map to those of the IPEM POLICY STATEMENT: Scientific Safety Advice to Magnetic Resonance Imaging Units that Undertake Human Imaging, 1st edition, published 8 October 2013.