Increase in accidental and unintended exposure to ionising radiation events

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In 2020, HIQA received notifications of 76 significant statutory notifications of accidental and unintended exposures to ionising radiation ievents, an increase of 11% when compared with numbers for 2019. 

“This is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year,” said HIQA.

The most common error reported to HIQA involved medical exposures to the wrong service user, which accounted for 34% of all notifications reported. Notifications from the modalities of interventional cardiology, mammography, and fluoroscopy were also received for the first time.

Human error was identified as the main cause in 58% of notifications received, however it was found that undertakings looked beyond the human factor and determined that other factors contributed to these errors in the vast majority of incidents.

John Tuffy, Regional Manager for Ionising Radiation, said “In 2020, our inspections of medical exposure to ionising radiation found that the management of accidental and unintended exposures to ionising radiation was generally good; however, there is room for improvement in local incident management systems. We welcome the increase in reporting in 2020, as it potentially suggests a more open and positive patient safety culture. The increase in reporting is a positive indicator, particularly in the context of the unprecedented additional challenges faced by undertakings during the COVID-19 pandemic.”