RESUMO

PURPOSE: Communication is crucial in any clinical environment for efficient delivery of care and ensuring patient safety. A 2016 National Database of Nursing Quality Indicators questionnaire indicated poor physician-nurse satisfaction with communication in our department. We addressed gaps in our communication procedures by implementing a communication policy with a secure mobile messaging platform, and we surveyed care team members to evaluate the effectiveness of the implementation. METHODS: We designed a policy around best communication practices and implemented a secure mobile messaging platform, Cureatr, which enables closed-loop, two-way communication that is compliant with the Health Insurance Portability and Accountability Act. Pre- and postimplementation surveys evaluated self-reported impression of efficiency, timeliness, effectiveness, and overall quality of communication, which were scored on a 5-point Likert scale. The number of messages sent was evaluated as a measure of uptake in use, and patient navigation data were queried to measure changes in clinic workflow. RESULTS: After implementation of Cureatr and a communication policy, survey responses demonstrated a clear improvement in staff satisfaction with the efficiency, timeliness, effectiveness, and overall quality of communication. The number of messages sent reflected a progressive increase in use of Cureatr; however, a consistent improvement in clinical workflow as measured by a decrease in patient in-room time was not appreciated. CONCLUSION: Implementing a secure messaging application with a communication policy improved cancer care team satisfaction with communication on all levels. Additional work is needed to evaluate the impact of secure messaging on clinical workflows, patient satisfaction, and staff well-being.

Assuntos

RESUMO

PURPOSE: Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS). MATERIALS AND METHODS: The Sociedad Española de Oncología Radioterápica (SEOR) performed a cross-sectional survey of all Spanish radiation oncology services (ROS) in 2015. We collected data on SNHS radiotherapy units, recording the year of installation, specific features of linear accelerators (LINACs) and other treatment units, and radiotherapeutic techniques implemented by region. Any machine over 10 years old or lacking a multileaf collimator or portal imaging system was considered obsolete. We performed a k-means clustering analysis using the Hartigan-Wong method to test associations between the gross domestic regional product (GDRP), the number of LINACs per million population and the percentage of LINACs over 10 years old. RESULTS: The SNHS controls 72 (61%) of the 118 Spanish ROS and has 180 LINACs, or 72.5% of the total public and private resources. The mean rate of LINACs per million population is 3.9 for public ROS, and 42% (n = 75) of the public accelerators were obsolete in 2015: 61 due to age and 14 due to technological capability. There was considerable regional variation in terms of the number and technological capacity of radiotherapy units; correlation between GRDP and resource availability was moderate. CONCLUSION: Despite improvements, new investments are still needed to replace obsolete units and increase access to modern radiotherapy. Regular analysis of ROS in each Spanish region is the only strategy for monitoring progress in radiotherapy capacity.

Assuntos

RESUMO

In this paper, we report our experimental design in searching a smart and easy-to-read dosimeter used to detect 6 MV X-rays for improving patient safety in radiation oncology. The device was based on an organic emissive solutions of poly(2-methoxy-5(2'-ethylhexyloxy)-p-phenylenevinylene) (MEH-PPV), aluminum-tris-(8-hydroxyquinoline) (Alq3) and additive components which were characterized by UV-Vis absorption, photoluminescence and CIE color coordinate diagram. The optical properties of MEH-PPV/Alq3 solutions have been examined as function of radiation dose over the range of 0-100 Gy. It has shown that MEH-PPV/Alq3 solutions are specifically sensitive to X-rays, since the effect of radiation on this organic system is strongly correlated with the efficient spectral overlap between Alq3 emission and the absorption of degraded MEH-PPV, which alters the color and photoemission of MEH-PPV/Alq3 mixtures from red to yellow, and then to green. The rate of this change is more sensitive when MEH-PPV/Alq3 is irradiated in the presence of benzoyl peroxide than when in the presence of hindered phenolic stabilizers, respectively, an accelerator and an inhibitor to activate or inhibit free radical formation. This gives rise to optimize the response curve of the dosimeter. It is clear from the experimental results that organic emissive semiconductors have potential to be used as dedicated and low-cost dosimeters to provide an independent check of beam output of a linear accelerator and therefore to give patients the opportunity to have information on the dose prescription or equipment-related problems a few minutes before being exposed to radiation.

Assuntos

Assuntos

RESUMO

Se analizan los antecedentes, el diagnóstico y el problema de la situación actual del profesional en Técnica Radiologica y especialmente de dicha asignatura, que de alguna manera justifica el proceder al rediseño curricular para cambiar y optimizar la formación del técnico radiologo...

Assuntos