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BACKGROUND: Registered radiologist assistants (R.R.A.s) and other health care providers frequently are responsible for placing peripherally inserted central catheter (PICC) lines. Postprocedure blood stream infections are a potentially costly and medically serious complication. PURPOSE: To determine the most effective methods for R.R.A.s and other health professionals to reduce blood stream infections related to PICC line insertion and management. METHODS: Using specific inclusion criteria, the authors searched for scholarly reviewed articles related to PICC lines, infection, and adulthood. RESULTS: The search produced 2237 articles, from which the authors selected 35 for review, in addition to 6 articles identified in the reference lists of articles not selected. The authors investigated 6 topics related to infection control in PICCs among nonimmunocompromised adults: securement devices, staff education, needleless systems, site preparation, maximum sterile barriers, and antimicrobial patches. CONCLUSION: In the long run, proactive continuing education is less expensive than the cost of complications caused by postprocedure infections. Although further research is needed, specific strategies reported in the literature included prepping the skin using chlorhexidine and antimicrobial patches to reduce the microorganisms in the area. These steps should be followed by maximum sterile barriers. Needleless connectors and positive-pressure valves were found to be more effective than the alternatives, and proper securement with self-adhesive anchoring devices was found to be more effective than suturing for reducing blood stream infections.

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PURPOSE: This article provides a detailed analysis comparing the educational requirements for physician assistants, nurse practitioners, and radiologist assistants (RAs) working in radiology. The authors examine the curricular requirements as they pertain to radiology for each program and highlight the advantages and limitations of each within potential roles in radiology. METHODS: A literature review was performed using the following databases: CINAHL Plus, MEDLINE, and Academic Search Complete. The search parameters were English-language peer-reviewed articles published from 2002 through 2010. The search terms included "physician assistant," "nurse practitioner," "radiologist assistant," "radiology practitioner assistant," and "physician extender." The inclusion term applied was "radiology" to further hone results. RESULTS: The RA curriculum includes a core education that is comparable with the physician assistant and nurse practitioner curricula, with the exception of prescriptive authority and health promotion and disease prevention. The RA curriculum adds instruction in radiobiology, radiation safety, radiologic procedures, fluoroscopic unit operation and safety, and radiopharmaceuticals. CONCLUSIONS: The RA curriculum is specific for the radiologic imaging area and advantageous to radiologists, radiology managers, and patients undergoing diagnostic procedures.

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Since the discovery of x-rays, many investigations of radiation effects on humans have taken place. From the discovery of severe x-ray dermatitis near the end of 1896, the multiple radiation burns endured by Thomas Edison's assistant, Clarence Dally, to the establishment of early radiation regulation in 1929, radiation exposure has been a continuing concern. Studies from the 1940s to the 1960s looked at effects such as leukemia and other cancers that appeared to be caused by exposure to radiation; outcomes of these studies resulted in increased regulation, establishment of dose tolerances and the development of the National Council on Radiation Protection (NCRP). Since the 1960s, similar studies have continued resulting in stricter dose limits. However, a recent resurgence of radiation exposure injuries led to this literature review that revealed a gap in the literature concerning the radiation practices and continued education of today's radiologic technologists. Through this review, recommendations for dose reduction strategies are included.

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To protect themselves, their patients and their coworkers, radiologic technologists should regularly refresh and reinforce their understanding of key radiation biology and protection principles. This article reviews the concepts of radiation physics, human biology and radiation protection strategies, with emphasis on how historical events and developing research affect radiation protection understanding and practice.

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BACKGROUND: Currently used positioning landmarks for the lateral scapula and Y projections often yield inconsistent results and lead to repeats. OBJECTIVE: To determine whether new positioning landmarks can help radiographers position the lateral scapula and Y projections more accurately. METHODS: Following laboratory experimentation on dry bone specimens, a small pilot study was conducted in the clinical setting to test the new landmarks. RESULTS: Laboratory and clinical testing of the use of the acromial tip and superior angle of the scapula suggest that these landmarks are easier to use and improve accuracy of positioning.

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CONTEXT: Computed tomography (CT) exams are increasingly common and account for a significant portion of individuals' mounting exposure to medical radiation. OBJECTIVE: To explore issues surrounding patient radiation dose, including techniques for minimizing dose and the feasibility of tracking lifetime exposure to medical radiation from CT and other imaging exams. METHODS: The authors conducted a review of the recent literature to assess current knowledge of dose levels, protocols for minimizing patient dose and possible systems for tracking cumulative dose. RESULTS: Currently, no regulations are in place to track cumulative patient radiation dose. However, the authors discuss possible means of recording, tracking and storing this data, such as standardizing its inclusion in DICOM headers and transmitting it to electronic personal health records. CONCLUSION: More research is needed to develop and implement uniform dose tracking procedures and protocols for minimizing patient dose.

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Health professionals share a common interest in improving the quality of healthcare provided to the notion's underserved citizens, many who live in rural areas. This article examines the quality of radiology services found in rural Texas hospitals as reported by radiology managers through online survey research in terms of staffing, radiologist availability, and quality control measures. A 22 question survey was developed and 72 of 106 possible responses were obtained for a 67.9% response rate representing 45% of the total population. Texas is a licensure state for radiologic technologists. Texas rural counties with fewer than 50 thousand citizens have only 9% of MRTs, 10% of LMRTs, and 12% of NCTs licensed to practice radiology imaging. Licensing all three levels of technologists through the some administrative body could result in more standard educational and training requirements, thereby increasing the quality of care given by these individuals. Patients seen at lower-volume rural facilities benefit from convenient scheduling and lower prices and are beginning to see faster reporting with the prevalence of teleradiology and voice recognition dictation.

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CONTEXT: Radiography program applicants far outnumber available class capacity in many programs. Educational accountability requires that programs justify their admission practices, work to retain all qualified students and evaluate their attrition rates. Thus, radiography programs are interested in identifying the best candidates for admission. PURPOSE: The purpose of this small survey study was to document admission requirements of entry-level programs in radiography accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) in Oklahoma and Texas. METHODS: A 14-question survey was sent to 45 JRCERT-accredited entry-level radiography programs in Oklahoma and Texas. The survey included questions concerning program demographics, admission criteria and admission practices. RESULTS: Cumulative grade point average, interviews, successful completion of math and science courses, and performance on standardized tests were the most commonly used admission criteria, although no criteria were used by all of the programs surveyed. CONCLUSION: The current study is the first step toward identifying the most effective admission criteria for radiography programs. Future research should examine the correlation of specific admission criteria with program success (ie, program retention, program completion and professional certification).

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OBJECTIVE: This article views, collectively, the problems associated with darkroom disease, multiple chemical sensitivity and latex allergy. Each is discussed individually to establish a case definition. METHOD: Common threads and similarities are identified among the 3 conditions along with potential sources. RESULTS: A model is proposed to change attitudes among radiographers in individual departments to improve workplace safety. CONCLUSION: We propose the use of an established health education/disease prevention model to change the attitudes of radiographers toward chemical threats.

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