Laser, Ultraviolet and Artificial Optical Radiation Protection Advice

Details

Title

Laser, Ultraviolet and Artificial Optical Radiation Protection Advice

Type

Stage Two

Module code

HPE116

Requirement

Optional

Module objective

The Consultant Healthcare Scientist in Medical Physics will be responsible for the organisational governance of relevant laser and artificial optical radiation protection legislation and guidance and provide advice on regulatory compliance. By the end of this module the Clinical Scientist in HSST will have gained the knowledge and experience required to achieve a certificate of competence as a Laser Protection Adviser (LPA) from an HSE approved body within a range of healthcare settings. They will also be expected to evaluate adherence to regulations and guidelines for the use of lasers and take appropriate action in the event of non-compliance.

Employers providing medical, surgical, or other laser treatments using class 4, 3B or intense pulsed light sources are regulated by CQC under the The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Guidance documents in support of these regulations state that employers should appoint a Laser Protection Adviser, who will advise on laser safety of patients, employees and members of the public.

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 the safe use of lasers and other hazardous incoherent optical sources in healthcare, including all areas required by the approved LPA certification body to be awarded an LPA certificate for medical lasers [1], including:

• Principles of source operation and beam propogation.
• Eye and skin biology.
• Interaction of optical radiations with matter, including hazards and biological effects, detection and measurement methods, including uncertainties and limits of detection:
  • lasers
  • intense light sources.
• Quantities and units.
• Basis of laser radiation protection standards:
  • meaning of the laser classification system;
  • application of standards to intense light sources;
  • exposures via intrabeam viewing and extended sources;
  • ICNIRP Guidelines/Statements.
• National and international regulations, standards and guidance applicable to healthcare, including:
  • The Control of Artificial Optical Radiation at Work Regulations 2010.
  • international laser safety standards (e.g. ISO, BS EN).
  • MHRA Guidance on the safe use of lasers, intense light source systems and Light-Emitting Diodes (LEDs) in medical, surgical, dental and aesthetic practices.
• Operational protection for lasers and intense light sources.

Types of lasers and intense light sources, including:

• Hazard identification and risk assessment, including the concept of maximum permissible exposure and nominal ocular hazard distance in relation to the environment and people in which the devices are used.
• Management of risk, including designation of areas, control measures, operating rules, contingency and emergency procedures.
• Analysis, remedial action and management of incidents.
• Organisation of laser protection, including roles of duty holders and management of optical safety, with reference to the importance of maintaining a good safety culture and communication framework.
• Record keeping and audit framework.
• Non-radiation hazards.

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 synthesising and evaluating differing and innovative options for the management of optical radiation protection in medicine, and will:

• Safely advise a range of individuals and organisations (e.g. clinicians, nurses, managers/executives) on all aspects of relevant artificial optical regulations and associated guidance and standards for medical lasers and other hazardous artificial optical sources.
• Develop and critically evaluate a corporate artificial optical radiation safety policy.
• Critically appraise the policy and procedural documentation required under the relevant artificial optical radiation safety legislation, including safety, responsibilities, local rules, work supervision, contingency plans and other relevant working procedures and communicate these policies and procedures.
• Promote safety management and contribute to the resolution of safety conflicts between employers and employees.
• Design and critically appraise the key considerations for a new laser and ultraviolet facility with regard to patient, public and staff safety, including the designation of areas, safety and warning features, access control measures and the control measures required consistent with the risk and with the hierarchy of those control measures.
• Develop and critically evaluate prior risk assessments and associated documentation, including the calculation of projected exposure from actual or potential sources, and identify the necessary control measures consistent with the risk and with the hierarchy of those control measures, acknowledging the limitations of personal protective equipment.
• Perform, analyse, report and present safety audits for lasers, ultraviolet sources and other optical sources where relevant, including identification of shortfalls in safety management, personal exposure to hazards and compliance with legislation and standards, and promote action to rectify shortfalls.
• Review, advise on and deliver the requirements and provisions for artificial optical radiation protection training for a medical facility.
• Contribute to advances in local artificial optical radiation safety and provide support to enable others to contribute to advances, including evaluation of advances in local safety practice.
• Advise on laser and optical source incidents where applicable.
• Calculate and advise on Nominal Ocular Hazard Distance and its links to Maximum Permissible Exposure and safe systems of work.
• Give formal advice on the application of national and international standards publications (e.g. BS EN, IEC).
• Synthesise or critically evaluate a programme for quality assurance of ultraviolet radiation sources used in medicine, to include:
  • routine dosimetry;
  • commissioning and acceptance testing of replacement sources;
  • protocols for treatment of patients.

The Clinical Scientist in HSST will also be expected to reflect on the challenges of applying research and innovative technologies to practice in relation to these procedures and suggest improvements, building on a critique of available evidence.

By the end of this module the Clinical Scientists in HSST will provide laser protection advice and advice on other hazardous artificial optical sources to colleagues and patients across a range of clinical environments (e.g. operating theatres, ophthalmology, gynaecology, physiotherapy, phototherapy, ENT), including an emphasis on patient and user safety and will:

• Advise clinicians and patients as appropriate on laser and optical source protection (e.g. by provision of training, giving formal advice).
• Commission new clinical laser facilities and facilities for other optical sources where relevant.

The Clinical Scientist in HSST will be able to communicate complex scientific principles to individuals at all levels (e.g. clinicians who already have a sound knowledge of laser physics, managers who have no specialist knowledge through to patients who may have significant concerns about advice they are receiving, which means that information needs to be delivered sensitively and in terms that are easy to comprehend).

Attitudes and behaviours

By the end of this module training the Clinical Scientist in HSST will be expected to consistently demonstrate the professional attitudes, behaviours and insights required of a Consultant Clinical Scientist working within the limits of professional competence, referring as appropriate to senior staff, and be able to:

• Appreciate the impact of current clinical and scientific outcomes for the medical LPA 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 innovation in service and/or delivery, including the contribution of research and innovation in artificial optical radiation protection to the NHS, business and the UK economy.
• Engage service users, patients and the public to promote the positive impact of expert laser protection advice from a certified LPA.
• Display an objective and unbiased approach.

Reference

1.         RPA 2000. The Competence Certification Schemes. Document LPA2. Instructions for the creation of the portfolio of evidence for LPA certification, published 15 March 2011. http://www.rpa2000.org.uk/images/stories/documents/lps/DocLPA2PortfolioInstr uctionse26Nov04.doc