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Covid-19: Nuclear medicine hints and tips

Version 4. 27 March 2020.

The SoR Nuclear Medicine and Molecular Imaging Advisory Group are sharing their hints, tips and challenges for staff and patient protection during early days of Covid-19 restrictions. The page will be updated as information evolves. Please share your experiences, suggestions or questions.

Nuclear Medicine and Molecular Imaging Advisory Group member, Rayjanah Allie, has co-authored an editorial in Nuclear Medicine Communications: COVID19 - Nuclear Medicine Departments, be prepared! The editorial provides background information and hints and tips for departments on how to manage at this difficult time.

British Nuclear Medicine Society (BNMS) (Posted 26 March 2020)
Guidance for infection prevention and control in nuclear medicine

Administration of Radioactive Substances Advisory Committee (ARSAC) (Posted 27 March 2020)
For V/Q SPECT procedures, employers do not need to apply to ARSAC to amend their licence to administer an activity greater than the DRL if this is for the purposes of reducing contact and scanning times and this has been approved by the local IR(ME)R Practitioner licence holder.

The administration of an activity greater than the DRL must either be directly justified by the IR(ME)R Practitioner, or detailed in a revised emergency protocol that is approved by the IR(ME)R Practitioner. 

General information (Posted 20 March 2020)

Visitors/escorts in the waiting area

  • Aim to significantly reduce the numbers of visitors remaining with patients and encourage them to drop patient off, returning to collect them later
  • Discuss at the booking phase so it is not a surprise for those escorting the patient to their appointment
  • Use discretion, some patients need their carer/relative to get through the examination

Temperature monitoring

  • Where facilities are available, monitor patient temperature on arrival
  • Have an action plan for those with raised temperatures, or who have other symptoms

Clinician contacts

  • Discourage or prevent referrers/clinicians from visiting the department. Publicise phone numbers and e-mail addresses for enquires

Refreshments

  • Remove disposable cups
  • Provide patients with personal cups after their scan with tea or coffee sachet and biscuit. This prevents multiple cups being handled in the tea coffee area

Magazines

  • Magazines may be considered a source of infection and can make hard surface cleaning difficult
  • Advise patients to bring own reading material
  • Leave patient leaflets for single use
  • Leave compliments and concerns slips
  • Aim for very little time to be spent in the waiting area

Patient data forms

  • Minimise paper handling by multiple people. Stop sending forms by post; complete on arrival to ensure it is handled predominantly by the radiographer/CA
  • The patient will still, of course, need to sign and fill in name/address and it may take a fraction longer, but it will avoid forms which have done the rounds at home
  • All appointment letters and supporting documents will be retained by the patient for their own records, or provide a basket for confidential disposal without being handled

Contaminated clothing
Don’t ask patients to bring dressing gowns or extra clothes to minimise contact items

Door signage warning for coronavirus symptoms

  • Display current guidance on the entrance door
  • Be clear about who may/may not enter

Manage workload

  • Follow business continuity/contingency plans
  • Keep supply of isotopes and other essential stocks under review
  • Keep staff availability and status under review
  • Redeploy radiographers to acute areas as per business continuity and with staff skills
  • Make sure induction/training records are completed and staff member feels confident and supported 
  • Identify where other staff can be used, eg technologist cannulating in CT
  • Consider switching all Lung VQ Requests from Perfusion Only (SPECT CT) with CT as screening

At risk/high risk staff

  • Identify high risk procedures, eg VQ scans due to aerosol production
  • Risk assess and identify staff at risk; update regularly using new government advice
  • Escalate concerns to senior managers
  • Identify home working tasks and staff who can do them

Generally

  • Communicate regularly with updates and status information
  • Explain decisions that are made
  • Support staff in understanding where and why patient services are reduced or altered

Practice

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