Implementation of a Shielding Guideline for Pediatric Patients Receiving Intraoperative Ionizing Radiation

Abstract

Abstract Introduction Approximately 350 million diagnostic radiation imaging procedures are performed on pediatric patients annually. This population is at a greater risk of developing cancer after exposure to ionizing radiation because of a higher intake, accumulation, and increased sensitivity to radiation as well as a long-life expectancy postexposure. Methods This quality improvement project used convenience sampling with a pre–post design to evaluate two independent samples: (a) pediatric intraoperative staff members including registered nurses and scrub technicians and (b) pediatric patients receiving intraoperative ionizing radiation imaging. Outcome measures included pediatric intraoperative staff knowledge and confidence of education for intraoperative shielding (preimplementation: n = 9; postimplementation: n = 6). Shielding audits were performed to assess for frequency of shield placement to radiosensitive organs and accuracy of shield placement (preimplementation: n = 26; postimplementation: n = 27). Results Data analysis showed improvement in staff confidence related to gonad shield placement (p = .013) and self-reported frequency of gonad shield use (p = .032). Knowledge scores showed nonsignificant improvement (p = .076). Shielding audits showed statistically significant improvement in shield placements for thyroid, gonads, and breast tissue (p < .05). Discussion The pediatric population has unique characteristics to consider when making decisions about shielding practice. This project discusses these characteristics, considerations for “exception-based shielding,” and how to improve the rates of shielding in situations where the practice is appropriate.