Patient Safety in Brachytherapy

It is everyone’s responsibility and duty within the Brachytherapy team. The "Do No Harm" should be a priority at every step while considering, planning or performing a Brachytherapy procedure. It is not a choice but an expectation.

ABS Mission on Patient Safety:

The ABS is committed in informing and educating its members through workshops, schools, newsletter, and national meetings about patient safety and safe Brachytherapy procedures.

NEW ALERT

Common Errors in Brachytherapy:

Valuable information can be found in the ACMUI links for errors previously reported.

• NRC
• NRC (starting FY14)
• IAEA
• RO-ILS
• CARS

Update from the Committee:

Update from the committee will be provided through the ABS newsletter and Brachyblast. We encourage members to read the “Patient Safety Corner” and send us any valuable information related to patient safety in brachytherapy that can be shared with our members.

Medical Event Cases

• Case 0003: Patient Delivered Radiation Dose to Right Lobe of Liver versus Left Lobe
• Case 0004: Dose Error on Second Day of Electronic Brachytherapy Treatment
• Case 0005: Received Dose Greater than Prescribed Dose
• Case 0006: Administration of Iodine-131 to a Pregnant Patient
  • Medical Event case 0006- Feedback and Corrective Actions
• Case 0007: Misadministration Involving Iodine-125 Eye Plaque Brachytherapy Implants

Articles/Link of Interest:

1. “Patient safety is no accident"
2. ACR–ASTRO PRACTICE GUIDELINE FOR THE PERFORMANCE OF HIGHDOSE-RATE BRACHYTHERAPY
3. "High dose-rate brachytherapy treatment delivery: Report of the AAPM Radiation Therapy Committee Task Group No.59"
4. "A PRACTICAL GUIDE TO QUALITY CONTROL OF BRACHYTHERAPY EQUIPMENT"
5. ICRP97: Prevention of high-dose-rate brachytherapy accidents — Available for AAPM members at AAPM.ORG
6. NRC link:
   1. The NRC Medical List Server provides automated e-mail notification of documents and meetings pertaining to medical use of NRC-licensed material.
      To subscribe to the Medical List Server, send an e-mail to "Medical-GC.Resource@nrc.go" with the word 'subscribe' in the subject line.
   2. The NRC Medical Uses Licensee Toolkit provides a wide variety of information in a centralized location. It is located here.
   3. The Advisory Committee on the Medical Uses of Isotopes (ACMUI) advises the NRC on policy and technical issues. Information about the ACMUI is available here.
      New for September, 2014
   4. Proposed rule for 10 CFR Parts 30, 32, 35
      The ACMUI report on part 35 draft final rule can be viewed here
      The ACMUI preliminary draft final rule provided for ACMUI review can be viewed here
      proposed rule can be viewed here
7. Link to related patient safety meetings/workshops and “Treat Safely”
8. Radiation oncology peer review and education