Using QCC methods to improve radiation protection in the cardiac catheterization laboratory

• Main Authors: Kai-Hsi Liu, 劉開璽
• Other Authors: Ying-Chun Li
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/52ug64

碩士 === 國立中山大學 === 企業管理學系研究所 === 106 === Abstract The current leading therapeutic strategy for coronary heart disease is percutaneous coronary intervention. If the operators and their staffs ignore the importance of free radiation protection, the patients or operators will suffer from invisible radiation injury. OBJECTIVE: The purpose of this study was to investigate the impact of quality control circle (QCC methods) on reducing radiation exposure during percutaneous coronary intervention. METHODS: Since Jan, 2016, we organized a multidisciplinary team, including interventional cardiologists, dermatologists, intensivists, radiation technicians and nursing staffs. The patients, from 2 hospitals with cardiac catheterization labs, were divided into 3 groups: stage 1 (n=64) from March to November 2016, stage 2 (n=42) from December 2016 to January 2017 and stage 3 (N=46) from February to May 2017. The key interventions were: (1) utilized radiation protection guideline and reduced frame rate of fluoroscopy with 15 frames/second instead of conventional 30 frames/second, frame rate of video recording with 7.5 frames/second instead of conventional 15 frames/second. (2) Meanwhile, we designed innovative radiation protection devices over body parts: head, eyes and thyroid. A p-value less than 0.05 was considered statistically significant. RESULTS: There is no difference among 3 study groups in baseline characteristics. The eyes radiation dose of patients reduced from 4.5±3.9 mSV in stage 1, to 2.2±2.4 mSV in stage 2 and 0.8±0.6 mSV in stage 3 (p<0.001). The thyroid radiation dose of patients reduced from 22.2±39.1 mSV in stage 1, to 8.1±8.6 mSV in stage 2 and 4.1±3.7 mSV in stage 3 (p<0.001). The back radiation dose of patients reduced from 183.8±286.3 mSV in stage 1, to 39.2±49.8 mSV in stage 2 and 33.5±45.1 mSV in stage 3 (p<0.001). CONCLUSIONS: The QCC methods with lower radiation protocol and innovative radiation protection device are demonstrated to reduce eyes, thyroid and back radiation dose in percutaneous coronary intervention patients. Keywords: coronary heart disease, cardiac catheterization labs, QCC, frame rate, radiation protection devices.