The practical considerations of dose constraints in diagnostic medical departments using ionizing radiation

The term “dose constraint” has been used in radiological protection since 1990. Its practical application has varied from country to country to the present day. The authors of this paper believe that it is an underestimated tool for the purpose of radiological protection. This study aims to estimate local dose constraints for workers in conventional nuclear medicine and radiology departments, on the basis of doses received in the last 3 to 4 years by different groups of workers. The levels of exposure to employees of the nuclear medicine department correspond well to levels in other countries, but for employees belonging to the radiology department, the levels are significantly lower. Unification of the practical application of dose constraints and legislation concerning their specific values would increase the relevance and effectiveness of these operational units. This is a playing field for radiation safety officers for the determination and widespread publication of local dose constraints in their particular medical departments

Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

<p>Abstract</p> <p>Background</p> <p>Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study.</p> <p>Methods/design</p> <p>A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient.</p> <p>Discussion</p> <p>The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients’ well-being, quality of life, and satisfaction with care.</p> <p>Trial registration</p> <p>ClinicalTrials.gov Identifier NCT01654029</p