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HIQA

Increase in number of patients accidentally exposed to ionising radiation in hospitals

The most common error reported to Hiqa in 2020 involved exposure to the wrong person.

THERE WAS AN 11% increase in the number of notifications of accidental and unintended exposures to ionising radiation reported to the Health Information and Quality Authority (Hiqa) last year.

In 2020, Hiqa received notifications of 76 “significant” such events – an increase of 11% when compared with 2019.

Hiqa said 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”.

Medical exposure to ionising radiation is when radiation is used as part of diagnosis such as a dental X-ray or CT scan or the use of radiotherapy as part of cancer treatment at a hospital. It also includes radiation received for medical research purposes and radiation received by carers and comforters while attending a patient.

The most common error reported to Hiqa in 2020 involved medical exposure to the wrong person, which accounted for 34% of all notifications reported. Notifications related to 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 reviews of the incidents determined that other factors contributed to these errors in the vast majority of cases.

In 2019, new regulations were put in place to transpose into Irish law the EU Council Basic Safety Standards (BSS) Directive of 2013. Under this legislation, Hiqa is the authority for patient protection in relation to medical exposure to ionising radiation in Ireland.

Speaking about the figures, John Tuffy, Hiqa’s 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.”

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