Radiotherapy Department General Advice

Site: ISRRT e-Learning
Course: Practical guidelines for radiographers/radiological technologists during the pandemic COVID-19
Book: Radiotherapy Department General Advice
Printed by: Guest user
Date: Thursday, 24 September 2020, 9:47 AM

Description

This section has been extracted from the “ISRRT Response Document-appropriate and safe use of Medical Imaging and Radiation Therapy with infection control measures considered in addition to standard radiation protection procedures. April 2020”. It is available on the ISRRT Website (https://www.isrrt.org/full-guideline-protective-measures). It is edited and compiled by A.Stewart Whitley, Director of Professional Practice - International Society of Radiographers and Radiological Technologists(ISRRT) following valuable input from many radiography expert contributors.

1. Treatment/ environment Consideration

  • Consider evidence-based shorter fractionation schedules and deferring radiotherapy for some groups
  • Use the RADS (Remote, Avoid, Defer, Shorten) principle to help plan individual patient treatment
  • Consider re-scheduling of non-urgent routine follow-up cases
  • Wipe down of the treatment couch or accessories after each patient
  • Thorough cleaning of all area used by suspected or confirmed Covid -19 patients
  • Ensure infection prevention measures are employed when managing the treatment room used to treat patient
  • Schedule Covid-19 patient appointment to be different timing from other patients who are at particularly increased risk of severe illness from COVID-19
  • Minimal waiting time of the COVID -19 patient in the radiotherapy department.
  • Upon arrival, Covid-19 patient should be waiting in an isolation room away from the main waiting area
  • If multiple treatment machines are available, to designate ‘dirty’ machine for Covid-19 patients. If not possible, to arrange for Covid-19 patient to be treated as the last patient of the day

2. Patient consideration

  • Explore remote monitoring of patients via telephone or video conferencing and follow up on those who are vulnerable and need support
  • Contact new patients ahead of first appointments to screen patients on symptoms, temperature, travel history and risk of exposure
  • Daily screening process should be in place to screen all patients and accompanying family member before entering the radiotherapy clinic
  • If patient is found to have fever or high risk to exposure during screening, to isolate patient in a separate room and assess by doctor/nurse to determine if patient’s condition is related to cancer treatment. If patients’ fever and respiratory symptoms not related to cancer treatment or condition. Please follow the hospital guidelines for action
  • Request patients to attend appointments without accompany person. If not, limit to maximum one  accompanying person per patient
  • Advise patients on treatment to inform staff if they have fever or respiratory symptoms before coming for treatment
  • Encourage patient  hand-washing / sanitizing prior to entry into the treatment room
  • Encourage patient to wear mask when coming in for treatment


3. Staff Consideration

  • Wearing of surgical mask for radiation therapists when treating all patients
  • PPE MUST BE worn when caring for confirm or suspected COVID-19 patients
  • Hand-washing / sanitizing prior to treatment/procedure rooms for all patient
  • Consider having split team arrangement to ensure continuity of service
  • Implementing working from home whenever possible such as administrative team or the treatment planning team through remote access planning
  • If possible avoid staff rotation to different machines or location during this period to minimize cross infection
  • Consider twice daily temperature taking for all staff- eg. Once before reporting to work and once in mid-day.
  • Mandate self-reporting of symptoms and exposure by all staff
  • If possible identify vulnerable category of RTTs staff to arrange for  non-patient contact work