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2008/2009 STUDENT HANDBOOK
Abington Memorial Hospital School of Nuclear Medicine Technology
[Revised: 04/ 2004, 04/2005,04/2006,04/2007,04/2008]
Abington Memorial Hospital School of Nuclear Medicine Technology is accredited by
The Joint Review Committee on Educational Programs in Nuclear Medicine Technology
2000 W. Danforth Rd., Ste 130 #203 Edmond OK 73003
Telephone: (405) 285-0546 fax: (405) 245-0579 e-mail: [email protected]
www.jrcnmt.org
Jan.W. Winn, M.Ed., RT (N), CNMT, Executive Director
AVAILABILITY OF PROGRAM ESSENTIALS
To be an approved and accredited program in nuclear medicine technology, Abington Memorial
Hospital, and the School of Nuclear Medicine Technology, must meet the “Essentials and
Guidelines” for an accredited program in nuclear medicine technology by The Joint Review
Committee on Educational Programs in Nuclear Medicine Technology (JRCNMT).
The “Essentials” present the minimum accreditation standards for an educational program and
includes all the requirements for which the program is held accountable. A copy of the “Essentials”
is available to you in the Program Director’s office, as well as the office of the Clinical Coordinator.
The Review Committee, assisted by on-site review teams, evaluates the program’s compliance with
the Essentials. Educational programs, which meet or exceed the minimum standards stated, are
granted an accreditation status by the Joint Review Committee on Educational Programs in Nuclear
Medicine Technology (JRCNMT) and provide public recognition of such achievement. Program
accreditation is recognized as providing the basic assurance of the scope and quality of professional
preparation.
The Abington Memorial Hospital School of Nuclear Medicine Technology consists of twelve (12)
consecutive months. Students must successfully complete 1900 contact hours and prove
competency. By doing so, students are eligible to take the national certification examination offered
by two approved organizations. They are, The American Registry of Radiological Technologist and
The Nuclear Medicine Certification Board. Once the student passes any one or both of these
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certification exams, they will be afforded the title of Registered Nuclear Medicine Technologist
(ARRT)(N), and/or Certified Nuclear Medicine Technologist. (CNMT)
Abington Memorial Hospital School of Nuclear Medicine Technology reserves the right to
alter, change, amend, or modify any part of this document at any time.
Abington Memorial Hospital
Abington Memorial Hospital is the major sponsor and currently the sole clinical site for AMH
School of Nuclear Medicine Technology.
Abington Memorial Hospital is a fully accredited, not-for-profit, 570-bed, regional teaching hospital
in Abington, Pennsylvania. Located at 1200 Old York Road (Route 611) in Abington, PA, AMH
has been providing comprehensive, high-quality services for people in Montgomery, Bucks and
Philadelphia counties for over 90 years. With more than 34,000 inpatient admissions annually,
AMH is a major regional referral center for cancer care, cardiac care, and surgery (including
orthopaedic surgery and neurosurgery) and has the only level two trauma center in Montgomery
County. AMH has a long tradition of personal, high-quality maternity care. AMH is also a leader in
senior health services.
Abington Memorial Hospital has a strong educational mission and sponsors five residency
programs - in family medicine, internal medicine, obstetrics/gynecology, general surgery and
dentistry. In addition, the hospital provides postgraduate medical education in affiliation with
several area medical schools. The hospital also operates the Abington Memorial Hospital Dixon
School of Nursing. AMH is affiliated with The Children's Hospital of Philadelphia for our CHOP
Connection inpatient pediatric unit.
Abington Memorial Hospital – Mission Statement
The mission of Abington Memorial Hospital is to reduce the burden of suffering attributable to illness, injury and disability for all members of our community and to provide the community with preventive health and wellness services including the full spectrum of maternity and newborn care.
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Abington Memorial Hospital – Vision Statement
Abington Memorial is a community teaching hospital in which all members of our healthcare team, in partnership with our patients, their families and our community, contribute their daily work to the betterment of the health of our individual patients and our community at large. Abington Memorial Hospital is an organization which values and respects all as individuals and the rich cultural diversity each brings to our organization. Abington Memorial Hospital aspires to be the employer of choice in our region.
Abington Memorial Hospital and its staff believes that quality health care should be:
1. SAFE: We will continually strive avoiding injuries to patients from the care that is
intended to help them. Patient safety will be our first priority.
2. EFFECTIVE: We will provide services based on the best currently available scientific evidence to all who could benefit and refrain from providing services to those not likely to benefit (avoiding under use and overuse, respectively)
3. PATIENT-CENTERED: We will provide compassionate care that is respectful of and
responsive to individual patient preferences, needs, and values and will be guided by patient values in all clinical decisions.
4. TIMELY: Wait and delay, sometimes harmful, is wasteful for both those who receive
and those who give care…attention will be given to reducing wait and delay in all processes of the organization.
5. EFFICIENT: We recognize our responsibility to be stewards of the resources given to
provide care and we will work to avoid waste including waste of equipment, supplies, ideas, energy and time.
6. EQUITABLE: We will always strive to provide care that does not vary in quality
because of personal characteristics such as age, gender, ethnicity, socioeconomic status, religion, race, color, sexual preference or ability to pay.
In all our work the Abington Memorial Hospital, staff will pursue excellence in support of our commitment to our patients and our community.
DESCRIPTION OF THE PROFESSION
Nuclear Medicine is a medical specialty that utilizes the nuclear properties of radioactive and stable
nuclides to make diagnostic evaluations of the anatomic and/ or physiologic conditions of the body
and to provide therapy with unsealed radioactive sources. The nuclear medicine technologist is an
allied health professional who, under the direction of an authorized user, is committed to applying
the art and skill of diagnostic evaluation and therapeutics through the safe and effective use of
radionuclides. Responsibilities include, but are not limited to, patient interviews and instruction,
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preparation, quality control testing, and administration of radioactive compounds, execution of
patient imaging procedures including computer processing and image enhancement, laboratory
testing, patient preparation for radioactive compounds and preparation and administration of
prescribed radioactive compounds for therapy, and radiation safety. The nuclear medicine
technologist exhibits professionalism in the performance of these duties demonstrates an empathic
and instructional approach to patient care, and maintains confidentiality of information as required.
He/she applies knowledge of radiation physics and safety regulations to limit radiation exposure of
the general public, patient, co- worker and self to as low as reasonably achievable (ALARA).
Professional growth and development is achieved through participation in the medical and technical
education and research in order to enhance the quality of patient care. For more information on the
profession, students are encourage to explore the Society of Nuclear Medicine website;
www.snm.org.
POLICY OF NON-DISCRIMINATION
Federal and State Laws prohibit unlawful discrimination in education/employment based on factors
such as race, color, religion, sex, national origin, age, handicap, disability, or status as a veteran.
The laws prohibiting discrimination in education/employment and promoting equal opportunity
affect all aspects of the education/employment relationship, including recruiting, hiring,
promotions, transfer, training, compensation, benefits and termination. If you experience any
incident or situation that you believe involves unlawful discrimination, harassment, or violations of
equal employment/education laws, notify the Program Director, Clinical Coordinator,
Administrative Director of Radiology, Diversity Office, or Compliance Office.
Abington Memorial Hospital and the School of Nuclear Medicine Technology is an equal
opportunity institution, and does not discriminate on the basis of race, creed, national or ethnic
origin, gender, sexual orientation, age, disability, marital status or veteran status in their
administered program. The School of Nuclear Medicine Technology is not a Title IV school.
FERPA - Family Educational Rights and Privacy Act
The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a
Federal law that protects the privacy of student education records. The law applies to all schools
that receive funds under an applicable program of the U.S. Department of Education.
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FERPA gives parents certain rights with respect to their children's education records. These rights
transfer to the student when he or she reaches the age of 18 or attends a school beyond the high
school level. Students to whom the rights have transferred are "eligible students”. To find out more
about how the law affect you please visit http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html
WELCOME TO THE ABINGTON MEMORIAL HOSPITAL
SCHOOL OF NUCLEAR MEDICINE TECHNOLOGY
This handbook has been designed to give you the policies and procedures that govern the Nuclear
Medicine Technology Program. You may want to refer to this handbook for many of the questions
you may have concerning the year you will spend with the program. It is our hope your experience
with us is both educational and rewarding. You have chosen a wonderful profession and we will
strive to help you become the best Nuclear Medicine Technologist that you can be.
Students are expected to abide by all policies and procedures of Abington Memorial Hospital
and the Department of Nuclear Medicine. All hospital policies and procedures can be found
on the hospital intranet at http://amhsps1/amhportal/ and can be accessed from major
computer workstations located within the Department of Nuclear Medicine, Libraries, and
other locations throughout the hospital.
Please remember that we are always available for your questions and concerns. We wish you the
best and want to help you in any way we can.
Advisory Committee:
Annette Y. Griffith, M.D., Medical Director, Dept of Nuclear Medicine
Nancy R. Butterworth, MS-RIS .RT(R)(N), CNMT, Program Director
Margaret Cochran, AS, ARRT (N), CNMT, Clinical Coordinator
Eileen Jameson, PT, MHA, DPT, Administrative Director Radiology, Rehabilitation, and
Integrative Medicine
Tina Sokolowski, AS, RT(R)(CV), Director Department of Radiology
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THE PROGRAM
The Abington Memorial Hospital School of Nuclear Medicine is a one-year, twelve (12)
consecutive months, full time day program designed to offer both clinical and didactic education in
the art and science of nuclear medicine technology. Upon successful completion of the program, the
student is qualified to write the registry board examination offered by The American Registry of
Radiologic Technology Certification Board and/or The Nuclear Medicine Technology Certification
Board.
SCHOOL OF NUCLEAR MEDICINE TECHNOLOGY
MISSION STATEMENT
Committed to Excellence
The staff and faculty members of Abington Memorial Hospital School of Nuclear Medicine
Technology, working together, will be committed in developing highly competent and successful
nuclear medicine technologists.
GOALS
Fulfillment of the program’s mission is assessed by the degree to which the program achieves the
following goals:
Graduating students with entry level or higher employment skills.
Graduating students with the knowledge, practical skills, and problem solving
abilities for nuclear medicine technology.
Graduating students with the values of compassion, dignity and respect to patient
care.
Graduating students that value life long learning as a means to achieve personal
and professional growth.
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PROGRAM OBJECTIVES
Upon completion of the program, the student will be able to:
Apply knowledge gained to imaging principles and concepts
To produce high quality diagnostic nuclear medicine images.
Provide patient care and management skills while providing diagnostic nuclear
medicine services.
Educate patients in terms of nuclear medicine exam preparations, expectations and
post procedure care
Make decisions utilizing problem solving and critical thinking techniques while
performing nuclear medicine procedures.
Perform, with confidence, entry-level nuclear medicine procedures.
Meet the needs of patients by practicing within the legal and ethical boundaries of
the profession.
Take a leadership role in both their chosen profession and community
PROGRAM ACCREDITATION
The Abington Memorial Hospital School of Nuclear Medicine is currently accredited by the Joint
Review Committee on Educational Programs in Nuclear Medicine (JRCNMT). Its next review will
be 2009
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QUALIFICATIONS OF THE STAFF
All staff must be at the level of training and experience for which the students are being trained and
qualified. This is accomplished through sound experience, academic preparation, clinical
demonstration, and proven competency and proficiency in their appropriate discipline. (Refer to
department policy and procedure involving competency). All clinical, didactic and faculty members
will be registered by either The American Registry of Radiological Technologists in Nuclear
Medicine or certified by The Nuclear Medicine Technology Certification Board, or, in the case of
non-nuclear medicine faculty, their own professional organization.
Didactic and Clinical practice is taught by a team of clinical technologists, faculty and adjunct
faculty consisting of radiologists, medical physicists, radiation safety technologists, and a major
didactic instructor. Officers of the school consist of: Program Director, Clinical Coordinator,
Medical Director of the Department of Nuclear Medicine, Administrative Director Department of
Radiology/Rehabilitation/Integrative Medicine, and Director of Radiology. Clinical and Didactic
instructors are selected and evaluated on knowledge of the subject and/or skills, also the ability to
organize and present the subject matter in a meaningful way.
ADMISSION REQUIREMENTS
Applicant requirements:
All applicants considering nuclear medicine technology must meet one the following criteria.
Must be a Registered Radiologic Technologist* who has graduated from an accredited program
Holds a Bachelor or Associate of Science Degree with core science courses as described in pre-
requisites, who has graduated from an accredited program
Registered Nurse, with listed pre-requisites, who has graduated from an accredited program
Registered Medical Technologist (ASCP) with pre-requisites, who has graduated from an
accredited program
(*) Any student awaiting board results will be admitted contingent on passing the American
Registry of Radiology Technologist Exam. Students may not enter without a passing grade.
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All applicants considering nuclear medicine technology must meet the following requirements:
Meet health/physical requirements necessary to function as a nuclear medicine technologist
Pass all required pre-requisites with a C+ (75%, 2.5 GPA) or better within the past five years,
unless part of an existing career
Have satisfied all pre-requisite courses of study from an accredited post-secondary school*
Have current CPR certificate
ALL students and applicants must also comply with pre-requisites listed below.
Pre-requisites are as follows:
1. General Chemistry I (with a lab) 4 credits
2. General Chemistry II (with a lab) 4 credits
3. General Physics I (non-calculus based with a lab) 4 credits
4. General Physics II (non-calculus based with a lab) 4 credits
5. Human Anatomy and Physiology I (with a lab) 4 credits
6. Human Anatomy and Physiology II (with a lab) 4 credits
7. Intermediate Algebra, or equivalent
8. Basic Computer Science
9. Medical Terminology
Applicants who fail to document course work with a grade of 75% (2.5 GPA) or better in each
course will not be eligible for admission.
(*)All course work in Human Anatomy/Physiology or General Physics and General Chemistry,
must have been completed within the last 5 years, or the college courses have been a documented
part of work experience. All course work must be taken at an accredited Community College,
College, or University.
In view of the need to learn a vast amount of material quickly and thoroughly, applicants must show
a high level of scholastic aptitude. Therefore, applicants selected will have maintained an above
average academic record in all academic studies. The applicant must possess a high school or
equivalence diploma. Students are considered based on information that depicts the applicant’s total
qualification for the nuclear medicine program and practice without regard to age, race, religion,
color, gender, sexual orientation, disability, or national origin. Decisions are based upon a thorough
review of scholastic record, references and a personal panel interview.
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Interview process: Qualified applicants will be sent an interview appointment and will present
themselves before a panel of no less than 3 persons. Questions asked will be scored on a point
system. The variety and category of questions will be the same for all applicants. Applicants will be
scored based on: knowledge of the profession, creativity, oral presentation skills, work standard,
interest in self-development, stability, maturity, stress tolerance, flexibility, and career goals. These
scores along with scores on written communication skills, and completion of application will be
totaled. The panel then meets again to decide, who will be offered admittance into the program.
The Abington Memorial School of Nuclear Medicine will admit no more than five (5) students per
year.
APPLICATION PROCEDURE
For any application to be processed and considered complete, the following items must be
submitted in one package:
1. Completed application information form
2. Official copies of transcripts from ALL post-secondary educational
institutions and colleges.
3. Required letters of reference (2). One must be from an immediate
employment supervisor or, in the case of newly graduated Students, clinical
coordinator/program director, college professor, research/project supervisor,
ect.
4. Proper application fee ($75.00 U.S. currency) made payable to Abington
Memorial Hospital
The application deadline admission to the next class each year will be January 5th of that year.
(Example: To apply for September 2008 entrance, the application must be in the office January 5,
2008)
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Applications received after the deadline will be not be processed. Completed applications maybe
mailed or hand delivered to:
Program Director
Abington Memorial Hospital School of Nuclear Medicine Technology
2500 Maryland Road, Suite 214
Willow Grove, PA 19090
Incomplete application packages will not be processed. A communication will be sent to the
applicant indicating missing information. If time permits, applicants will have the opportunity to
supply missing information.
Falsification of Transcripts or False statements/answers on any part of the application will result in
termination from the process, and if applicant has been accepted into the program, termination of
acceptance and immediate dismissal will occur.
Dates to Remember
Schedule of dates to remember
Complete application deadline is January 5th
Applicant interviews are scheduled during third week of January to second
week of February (depending on schedules of interview committee
members)
Accepted applicants will be notified by the second week of March
Acknowledgement of acceptance and fee due by April 21st ($600.00 U.S.
currency)
Final tuition payment due by Sept 2nd
Health physical, Abington Memorial Hospital Orientation and OSHA
training, must be completed prior to September 1, 2008
Accepted Applicants must complete all pre-requisites prior to the first day of
school
First day of school, is September 15, 2008
Tuition may also be paid in total at any time following acceptance and prior to September 1, 2008..
Students owing tuition prior to the first day of school will not be allowed to continue. .
All Fees and Tuition is payable to: Abington Memorial Hospital, is in U.S currency, and should be sent to the School of Nuclear Medicine for processing. Please call the school if you need information on paying your tuition with a credit card.
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Abington Memorial Hospital School of Nuclear Medicine Technology 2500 Maryland Road, Suite 214 Willow Grove, PA 19090 Student Capacity As calculated from the criteria set by the accreditation board (JRCNMT), Abington Memorial Hospital School of Nuclear Medicine may accept a maximum of five (5) students or less per school year. Student enrollment is dependent on a ratio of one student per employed Registered Nuclear Medicine Technologist per departmental square foot per year to a maximum not to exceed five students. (JRCNMT, decision 2004)
ADMISSION POLICY
Admissions to the school consists of four parts: Application process Interview Health Physical to include drug test Criminal Background Check All applications will be screened for completeness and any file with incomplete records, or grades lower than the required, will not be considered. Selection into the School of Nuclear Medicine Technology program is made by the Admissions Committee. The members of the committee have the responsibility for interviewing all qualified applicants for the program who have submitted a properly completed application. Interview appointments will be sent to each applicant who summit a complete qualified application. Interviews will be scheduled and completed during the month of February and it is the prospective students’ responsibility to call to confirm interview appointment. Students who are accepted into the program must ensure their state of good health. All students accepted into the program are done so contingent upon passing a health examination. As part of the health record, students must provide documentation of immunization. Health physicals are part of the admissions process and must accompany any or all documentation as part of that process. Drug testing and Criminal Background check is a mandatory part of the physical and students must receive a “negative” result to continue. Students who receive a “non-negative” result to the drug screen or criminal background check will be dismissed and any refunds in tuition will be assessed at 25% less the actual refund owed. Students must also complete Abington Memorial Hospital’s orientation process, which includes OSHA training. It is also strongly suggested the student carry his/her own health insurance. Worker’s Compensation Laws do not cover students.
ADMISSION PROCEDURE
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The Admissions Committee consists of the Program Director (moderator), Clinical Coordinator, Clinical Technologist, and current Student representative from the Nuclear Medicine Program Acknowledgements of interest letters are sent to potential applicants along with an application. This letter states the admission policy and procedure, tuition, tuition refund policy, items needed for completion of application, and application deadline. (Information along with application appears on Hospital’s public Internet site at www.amh.org). After the application is returned and it is determined complete, it will then be checked for accuracy. This is done by verifying references and transcripts. Following this process, the applicant will be sent an interview appointment and requested to call to confirm. If the student fails to confirm, it will be considered as a disinterest in continuing the acceptance process and no further action will be taken on the student’s application for admission. Following the interview period, the Committee will meet and analyze the outcomes in order to select the applicants for the new school year. All interviews are rated using pre-determined interview question sets (interview form is available upon request). Acceptance/regret letters will be sent out no later than end of the first full week of March. It is then the prospective students’ responsibility to return an acceptance letter along with acceptance fee no later than the designated date in the letter. Once this is done, the student will then be sent instructions and materials necessary to proceed toward the first day of class. This includes: health physical appointment information, hospital orientation date and time, photo I.D. Badge information, parking arrangement information, and information to acquire radiation badge. It is the students’ responsibility, once they receive this material, to make the necessary appointments to complete these requirements.
Fees A $75.00 dollar application fee must be sent with the completed application. Fees not sent will result in the application being returned and not processed. There are no refunds for the application fee. Upon acceptance to the School of Nuclear Medicine Technology, the prospective student must send a letter of acceptance along with a $600.00 dollar acceptance fee. There are no refunds for the acceptance fee or application fee. Acceptance letter and fee must be received no later than April 21. If the acceptance letter and fee is not received prior to or delivered on the predescribed date, the student will forfeit their standing as a prospective student and will be replaced. If there is a problem with sending the acceptance fee, the prospective student should call the program director.
Tuition Tuition is required of all students and is payable in full no later than the designated times. Checks or money orders are payable to Abington Memorial Hospital, and must be sent to Abington Memorial Hospital School of Nuclear Medicine Technology, 2500 Maryland Road, Suite 214, Willow Grove, PA, 19090 The tuition for 2008-2009 school year is $9,000 US dollars. ($9,600 including fees*) Payments maybe made in installments of $4250.00 over two payment periods or in total upon acceptance to the program or in total prior to September 1, 2008
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Payment schedule is as follows: First Tuition payment is due on or before June 31 Second Tuition payment is due on or before September 1 (*) Tuition is subject to change without prior notification.
Refund Policy
There are no refunds for application fee or acceptance fee. There are no refunds after four weeks (4) following the beginning of school year. The schedule of tuition refunds is as follows: (days mean school attendance days) 100% refund upon withdrawal two weeks prior to beginning of the program (2 days prior). 80% refund upon withdrawal prior to the end of the two (2) week orientation period (1-14 days
following the first day of school). 50% refund upon withdrawal four (4)weeks following the beginning of the program (15-28 days
following the first day of school). 0% refund after four (4) weeks (day 29)
** THERE WILL BE NO TUITION REFUND FOR ACADEMIC OR CLINICAL
DISMISSAL**
Expenses
In the educational process, the Student Nuclear Medicine Technologist may incur additional expenses. These would be for outside educational experiences to seminars, distance learning centers, or other student activities. These expenses will be kept to a minimum and many student related events are “fee waived/reduced for students”. Students are responsible for their own transportation to any outside student activity. Weekend student activity hours will be compensated during the next normal academic day with a reduced hour day. It is the students’ responsibility to provide their own transportation between the clinical and academic site, and/or additional clinical experiences. Student names will be submitted to the Society of Nuclear Medicine to begin the process of professional development and to take advantage of lower student fees for seminars. Membership for students in a one-year program is provided free from the Society of Nuclear Medicine.
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It is the students’ responsibility to pay the fees related to taking the American Registry of Radiology Technology for Nuclear Medicine Technologists’ exam, as well as or in addition to the Nuclear Medicine Certification Board Exam.
TRANSFER STUDENTS
Abington Memorial Hospital School of Nuclear Medicine does not take students in transfer for credit for didactic or clinical course work. We do not accept students with “advance standing status”.
TRANSCRIPTS
Students will be afforded one transcript following graduation for no cost. Any transcript requests beyond the entitlement will be at a cost of $15.00, due at time of the request. Requests must be made in writing to the Program Director. Students must supply the following information when making their request:
1. Graduate’s name as it appears on the certificate
2. Graduation Date 3. Name and address of institution transcript is to be forwarded
Transcripts will be sent directly to the requesting institution. Student will be afforded unofficial transcripts sent to them.
NON-PAYMENT OF DEBTS
In the case of non-payment of debts owed to Abington Memorial Hospital or the School of Nuclear Medicine Technology, the following actions may be taken:
Suspend student from participating in the program
Withhold grades and/or official transcripts
Withhold certificate to which student would be entitled
Refusal of the Program Director to sign completion of program form for Registry Exam.
ACADEMIC STANDING
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The School of Nuclear Medicine considers a grade of 75 percent (%) (C+) the minimum passing grade. A final grade of less than 75 percent is considered as FAILURE. All students enrolled in the School of Nuclear Medicine Technology must maintain a minimum grade of 75 percent or C+ in all didactic and clinical education courses and evaluations/competencies/practicum. Any course designated with an (*) as listed will be considered a pass/fail graded course. If, at any time during the completion of the twelve (12) month curriculum, a student earns a final grade of less than 75 percent in any didactic or clinical course of study, the student will be dismissed for academic reasons. Because of the nature of the clinical rotation assignment, students are evaluated and carefully assessed for clinical excellence. Students are progressively assessed as they pass through the different clinical rotations. If a student is not performing up to the professional standards as determined by the ARRT, NMTCB, or Society of Nuclear Medicine, they are counseled by the Program Director and/or the Clinical Coordinator. If a student fails to improve, the student will be dismissed for clinical reasons from the School of Nuclear Medicine. If a student is dismissed for any reason, they will not be considered for re-application to the Program.
GRADES
The grading system for the School of Nuclear Medicine will be as followed by accredited institutions of higher education. Grades will be posted according to the Grade Point Average or G.P.A value of scoring. The system is as follows:
Percent Letter Grade Point value 100-95 A+ passing 4.0 91 – 94 A passing 3.7 – 3.9 85 – 90 B+ passing 3.4 – 3.6 80 –84 B passing 2.9 – 3.3 75-79 C+ passing 2.3 - 2.8 74-70 C failure 0 Courses marked with an (*) in the curriculum will be graded with a Pass/Fail grade The passing grade for all didactic and clinical courses of study is 75 percent (%) Students will be dismissed if a grade of below 75% is received in anyone course. Grades earned that are below a passing grade of 75%/C+ will earn a zero and the student will be dismissed.
ACADEMIC AND CLINICAL STANDARDS
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Students will be given frequent oral, written, lab, and/or practical examinations in both didactic and
clinical areas of study. They will be expected to complete all classes and laboratory assignments on
time and in a neat, orderly manner. Class participation is a component of all academic grades.
The student’s performance is evaluated frequently by the program director, clinical coordinator,
and clinical technologist. Formal counseling sessions will be held by the Program Director
whenever a student falls below the expected standard of performance. Formal counseling sessions
will be held at any time deemed necessary.
Students will begin a combined didactic and clinical schedule. There will be thirteen (13) weeks to
the end of the first quarter and thirteen (13) weeks for the respective following quarters making up
fifty-two weeks (52). Clinical technologists will evaluate the students monthly according to
assignment during the first quarter. Clinical technologists will sign their evaluation forms, and
students will then place those forms in a secured area. The Program Director will evaluate academic
progress monthly and the Clinical Coordinator will evaluate clinical education via a end of Quarter
Evaluation. (See evaluation policy in master clinical plan)
FIRST QUARTER: The first four- five weeks of the school year is introduction to nuclear
medicine technology for the students. During this period, Introduction to Nuclear Medicine,
Introduction to Radiation Safety, Introduction to Radiation Chemistry and the Department of
Nuclear Medicine Radiation Safety course is held. Textbooks, evaluation/competency forms,
binders, journals and daily log sheets will be supplied to each student during the first week of the
program. All students will be aware of their use and importance for their clinical education and
grade. The students may leave the program voluntarily following written notification and are
eligible to receive a tuition refund according to the refund schedule. (See tuition refund policy)
During this period, the student will also be aware of the content and meaning of the combined,
School of Nuclear Medicine Operations Manual/ Student handbook. The student will also become
familiar with academic lectures, assignments, quizzes, exams, projects, papers, and laboratory
assignments, the expectations of the school and the student’s expected level of responsibility.
Students will also have the opportunity to have questions answered. Following an explanation and
answering of all questions, students will sign a document stating they have read and understand the
Abington Memorial Hospital School of Nuclear Medicine Technology policies and procedures.
By the end of this quarter, students must have completed all patient care competencies and all
departmental, and AMH competencies. Those students who have failed to do so will be dismissed.
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Attendance, professionalism, patient interaction, and attitude, is always part of the evaluation
process. It is the students’ responsibility always to hand in all evaluations, forms, and journals
on time.
SECOND QUARTER (13 weeks), students will increase their responsibility by reaching higher
degrees of responsibility and competency. All student paperwork will be turned in on time. Students
will be working with their respective clinical technologists who will complete and sign evaluation
forms. Students will be held responsible for returning those forms in accordance with evaluation
procedure. Monthly and Quarterly evaluations and competencies will be shared by the Program
Director. At the end of the second quarter, class schedule changes and clinical schedules will
change. It is the student’s responsibility to note these changes. It is expected at the conclusion of the
second quarter, students will increase clinical days to 5 days per week interspersed with classes.
Students must complete 12 clinical competencies. It is the student’s responsibility to request
clinical competency for the required procedures. (see clinical competency procedure)
Those students who qualify will begin rotation to the outpatient cardiology office in North
Wales and the ambulatory medical center in Warminster.
THIRD QUARTER (13 weeks) Clinical competency evaluations will continue with greater
responsibility to the student for performance. Students will strive for indirect supervision of all
procedures and clinical examinations done within the Nuclear Medicine Department. Students must
complete 12 clinical competences (See evaluation process in master clinical plan).
Students will begin observational rotations to PET/CT center
FOURTH QUARTER (13 weeks) Monthly and Quarterly evaluations will continue. Students
should be concentrating on completion of mandatory competencies and preparing for final clinical
practicum. Students cannot be graded on the final practicum unless they have completed all major
competencies.
It is the student’s responsibility that he/she has all procedures and clinical exam
evaluations/and final practicum, completed on time, or the student will not graduate.
It is also the students’ responsibility that didactic exams, projects, and all coursework are
completed prior to the end of this quarter or the student will not graduate.
GUIDANCE POLICY
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Due to the high technical quality demanded from today’s Nuclear Medicine Technologist, the one-
year (12-month) program of study is as well demanding. The ultimate success of any student lies
with that student, the means, and materials are at the students’ disposal. Guidance is provided all
though out the course of the program to ensure the success of each student. Personal problems or
any problems the student is confronted with may be discussed without any prejudice and always in
confidence. If a student feels they would benefit from a more professional service, they are
welcome to utilize the hospitals Care Bridge (EASE), program. The program will be discussed in
more detail in the student orientation.
A sincere effort is made to counsel students whose academic performance, clinical practice,
attitude, or personal qualities are not within the standard the requirements of future Nuclear
Medicine Technologists. The Program Director informs students’ when work is substandard, and
evaluates academic progress on a monthly basis. It is not the intent of the Program Director, or any
officer of the School of Nuclear Medicine Technology, to overlook student’s request for guidance
or counseling.
GENERAL INFORMATION AND ATTENDANCE
To achieve the required 1900 contact hours, and required clinical competencies, the Program is a
one-year, 12 consecutive month’s duration. All hospital holidays are observed by the students.
Students will have to manage their own personal time. Each student will have a bank of 80 hours
to use as all inclusive benefit time. (sick, late, day off)
Examples of clinical rotation schedules and academic schedules are available to the student. The
student daily hours will mimic their individual clinical rotations and the hours of the Abington
Memorial Department of Nuclear Medicine.
Sample clinical hours:
6:30 a.m. – 3:00 p.m.
7:00 a.m. – 3:30 p.m.
7:30 a.m. – 4:00 p.m.
8:00 a.m. – 4:30 p.m.
9:00 a.m. – 6:00 p.m.
Academic hours: Classes will be held from 8:00 – 4:30. Students will arrive at 8:00 a.m. with the
first class of the day beginning at 9:00 a.m. The hour prior to and after classes is the student’s time
19
to seek help, study, and work on group projects or go to the library to do research. Once clinical
rotations begin, the student will spend 3 days in academics and 2 days in clinical. This will progress
to 3 days in clinic and 2 days academics, with the student eventually spending 5 days in clinic until
graduation. (Refer to quarterly schedule
Probationary Period:
The first four (4) weeks of enrollment is a probationary period. It is a time of adjustment for each
new student. If the academic, clinical, moral, or emotional capabilities are in doubt, the Abington
Memorial Hospital School of Nuclear Medicine Technology reserves the right to dismiss the student
immediately.
Tuition is not reimbursed after the first four weeks of the program, nor at anytime for academic or
non-academic dismissal.
Didactic Attendance:
The didactic program has been scheduled on a definite format to provide the proper ratio of
practical and classroom experience. Therefore, full time attendance is compulsory.
It is the student’s responsibility to report promptly and on time. Total clinical and didactic studies
will not exceed 40 hours per week, or 8 hours per day not including lunch.
Didactic instruction times may vary according to course/clinical schedule or schedule of the
Instructor.
Clinical Attendance:
The clinical aspect of the program has been scheduled on a definite format to provide cohesiveness
between didactic and practical experience. Therefore, attendance is compulsory. It is the student’s’
responsibility to report to their assigned area promptly. Outside, appointments should not be
scheduled during clinical time. The clinical experience will be scheduled by the School of Nuclear
Medicine, Clinical Coordinator. Over a 12-month period, students will be assigned on a rotational
basis to the different areas of the department. A break of 45 minutes duration is scheduled during
class/clinical days to allow students to have lunch
Absences:
20
Students will be asked to refrain from scheduling appointments during clinical rotations. If a student
needs time off for a necessary appointment, they will be advised to do it during academic times.
Student will report clinical absences to the Clinical Coordinator, and must do so prior to their
assigned times. If the Clinical Coordinator is not available, the student is to contact the Program
Director.
Academic days students will report absence to the Program Director.
Absence is defined as any failure to attend scheduled academic and/or clinical hours. An
unexcused absence is defined as any absence which program officials have not been properly
notified. Students will loose 2 times the hours missed will be deducted from their personal
time for unexcused absences.
Students who do not notify the Program Director of an absence will be given a zero for the
day and a notification of violation of policy, 2 times the hours deducted from personal time
and 5 demerits.
Students, who are absent due to illness for two (2) consecutive or more days per quarter, must
provide the Program Director with their primary physician’s documentation referencing the illness
and giving clearance for the student to resume in the program. The student must also have clearance
from the Employee/Student Health Office.
Hospitalizations of a 24-hour period or longer must have physician approval in order for the
student to return to active participation in the program. Students may not participate in classroom
activities without the accompanying clinical practice.
In cases of illness, students must contact the Program Director directly by 8:00 a.m. If the
Program Director is not available, the Clinical Coordinator will be the next contact.
Procedure:
The following will be the procedure for any or all absences due to illness:
Academic attendance
Notify the Program Director as soon as possible prior to the beginning of class
DO NOT LEAVE A VOICE MAIL MESSAGE, The student must speak with
someone, Program Director or Faculty Assistant. At the beginning of the course,
students will be given contact numbers.
21
TARDINESS POLICY
Tardiness is not acceptable for either clinical or class periods. Students must report to all classes on
time. Classroom attendance is recorded by the Program Director. The students’ clinical instructor
and or Clinical coordinator will monitor the student’s attendance and timeliness. Students who are
late or absent without prior notice will be issued one demerit for every 10 minutes late. Students
will receive a violation of policy notice plus added progressive demerits for each continued lateness.
If the situation persists, the student will earn enough demerits to warrant dismissal from the
program. (26 demerits will earn the student dismissal from the program)
Didactic/Clinical Tardiness: Students who are late will have time deducted from
their personal time off in increments of 2 times the minutes they are late plus 1
demerit per every 10 minutes. In instances of two occurrences in one week, the
student will have 2 demerits for every 10 minutes and 4 times the minutes deducted
from personal time, they are late. Persistent lateness will result in dismissal. Students
who are more than one hour late will not be allowed in clinic and must report to the
Program Directors office. Students who are more than one hour late will be given a
zero for the day, 10 demerits, and 16 hours deducted from personal time
MAKE-UP TIME POLICY
The Nuclear Medicine Department does not allow students to attend clinical sessions during non-
scheduled clinical time. Students who exhaust all allotted time will find it necessary to make –up
time following the end of the program (after graduation date). Students will not be allowed to stay
more than 20 days past graduation date. (See graduation requirements). If it is determined in
advance that a student would have to stay more than 20 days past graduation date to make up
required time, then that student will be dismissed.
22
Students who work:
The School of Nuclear Medicine Technology recognizes students’ work as well as
attend the program. The student must be aware, prior to entering the program, the
commitment and responsibility placed on the student for their success. While the
School of Nuclear Medicine Technology provides direction, education, and clinical
practice, the student is held accountable for their academic and clinical participation.
Students must also be aware that working in a Department of Nuclear Medicine for
wages while still a student is forbidden. Students are advised to limit working hours
during the year.
ACADEMIC DISMISSAL POLICY
Academic dismissal
Failure of the Student Nuclear Medicine Technologist to maintain a grade of passing in all areas of
the program both academic and clinical will be grounds for dismissal. Students will be evaluated
periodically in both didactic and clinical setting. (See evaluation/testing process). If at the end of
any one-quarter, the Student Nuclear Medicine Technologist fails to maintain a passing grade in any
one or all of the courses of study, will be grounds for dismissal. Cheating, plagiarism, deceptive
behavior or consistent incomplete work, will also be grounds for academic dismissal. Unexcused
lateness or absenteeism will also lead to dismissal from the program. (See disciplinary policy)
Tutoring sessions are always available at the request of the student. In cases of imminent failure, the
Program Director will notify the student and offer assistance.
ACADEMIC/CLINICAL DISMISSAL/DISCIPLINARY POLICY
It is essential that certain necessary regulations be established , and for Students to follow. To better
enable us to give the best education possible to each student, care must be taken to give the best
care/safety possible to the patients of Abington Memorial Hospital. For this reason, the following
are examples but not a complete list of “Just Cause” for disciplinary action, up to and including
dismissal from the Program.
Falsification of application to AMH School of Nuclear Medicine
Not meeting the hospital performance standards.
Abuse or inconsiderate treatment of visitors, patients, students, and clinical personnel.
Improper Professional attitude during clinical/academic assignment
23
The use of Profanity
Soliciting or accepting tips from patients and/or visitors
Leaving patients unattended during nuclear medicine procedures
Releasing confidential information without authorization (AMH HIPPA policy)
Mismanagement of hospital funds or property
Violation of safety rules
Refusal to accept or participate in a reasonable clinical assignment
Inability to perform according to hospital or department standards
Excessive absences and /or tardiness
Failure to report absences promptly
Failure to maintain or falsification of required clinical student evaluations
Signing in and out for another student
Leaving the clinical area without permission
Sleeping on clinical assignment
Smoking in areas where it is prohibited
Eating in areas where it is prohibited
Failure to report to clinical/academic assignment
Failure to report to clinical/academic assignment alert and ready to work
Failure to report to clinical assignment in proper complete professional attire. (See dress code)
Insubordination towards a clinical, didactic, or other department or hospital official.
Failure to participate in academic or clinical projects or assignments.
Leaving the clinical or academic area early to go to a job.
Disruption of class either verbally, by gesture, or any other action deemed disruptive by the
instructor
Aggression or behavior considered dangerous to patient safety or hospital personnel
Violation of Code of Ethics for Nuclear Medicine Technology
Procedure:
24
The School of Nuclear Medicine utilizes a demerit and four step disciplinary system that employs a
progressive penalty phase. In case of a violation of a more serious nature, the school may skip one
or more steps in the process. If a student receives a total of four (4 ) Violation of Policy notices of
anyone or more rules or policies, he/she is in immanent danger of being dismissed from the
program.
The types of penalties used in this system and the consequences of each are as follows:
Demerit system - Students who receive a total of 26 demerits will be dismissed (see
demerit policy)
Verbal--- A Verbal warning will be given in cases of first violations of rules, policies, or
procedures. Verbal Warnings will become part of the students’ record
Written--- A Written warning will be given in cases of second violation of a policy or more
serious first violation where verbal warning is not adequate. Written warnings become part
of the students’ record.
SUSPENSION----Suspension is the third step following a written warning for a policy
violation or results from serious violation of any policy, procedure, or rule. Written
documentation is prepared and entered into the students’ file. Any student who is suspended
will be required to make up all time missed. All and any time must be made up for both the
academic and clinical portion of the program at the end of the normal school year. NO grade
will be given either academically or clinically until the time and work has been made up.
Suspensions vary in length dependent on the seriousness of the violation from three (3) to no
more than five (5) days. Personal time off cannot be used
DISMISSAL--- If, after the appropriate action(s) have been carried out, the student still fails
to improve in their performance or continues repeated infractions, the student will be
dismissed from the Program. Dependent on the type of violation, a student can and will be
subject to immediate dismissal without prior disciplinary action being taken. (Refer to
List of Progressive Discipline)
25
Some violations of rules are more serious than others. Consequently, a list of violations has been
prepared that also gives the penalty or disciplinary progression for each violation. This by no means
is a complete list and any action that is deemed “just cause” can lead to immediate dismissal.
VIOLATIONS NOT LISTED—Not all violations are listed. Any violation of policy, procedures,
rules, ethics, or professional standards will result in the disciplinary process; whether it is a school
or hospital policy.
Rules and regulations are necessary in any organization in order to ensure consistency and orderly
operation as well as to protect the rights and safety of all concerned. The rules as outlined in this
procedure manual and student handbook, may be established from time to time, and/or change
accordingly. These policies and procedures are published not to detract from but to promote
understanding of what is considered acceptable behavior.
It is the sincere desire of this school to assist all students in every reasonable way possible. In order
that all of us together can achieve our objectives of providing the best education and finest patient
care available, willful or inexcusable breaches of these rules will be dealt with firmly under a
uniform policy, which applies equally to all students.
26
TABLE OF PROGRESSIVE DISCIPLINE
DEMERIT SYSTEM OF DISCIPLINE
Demerits will be assigned for infractions of policies and procedures. The students will fail if 26
demerits are incurred between academic and clinical portions of the program. Students who receive
26 demerits will be notified of impending dismissal. Student’s, upon written request may review their
record with the Program Director.
STUDENTS WHO REACH THEIR TOTAL DEMERITS WILL BE DISMISSED FROM
THE PROGRAM. THERE IS NO METHOD TO GAIN MERITS.
CATEGORY
OFFENCE
FIRST
OCCURRENCE
SECOND
OCCURRENCE
THIRD
OCCURRENCE
FOURTH
OCCURRENCE
Non compliance
with dress code
Verbal warning
1 DEMERIT
Written warning
2 DEMERITS
Suspension 3 d
5 DEMERITS
Dismissal
Excessive personal
phone calls
Verbal warning
1 DEMERIT
Written warning
2 DEMERITS
Suspension 3 d
5 DEMERITS
Dismissal
Neglect of duty ------------------- Written warning
First offense
3 DEMERITS
Suspension 3 d
Second offense
5 DEMERITS
Dismissal
Third offense
Smoking in
undesignated areas
or times
Verbal warning
1 DEMERIT
Written warning
2 DEMERITS
Suspension o 3 d
5 DEMERITS
Dismissal
Willful violation of
safety rules
--------------------- Written warning
First offense
3 DEMERITS
Suspension 5 d
Second offense
10 DEMERITS
Dismissal
Third offense
Use of profanity
towards anyone
--------------------- Written warning
First offense
3 DEMERITS
Suspension 5 d
Second offense
10 DEMERITS
Dismissal
Third offense
Sleeping during
clinical/academics
Verbal Warning Written Warning
3 DEMERITS
Suspension 3days
10 DEMERITS
Dismissal
27
CATEGORY
OFFENCE
FIRST
OCCURRENCE
DEMERIT
SECOND
OCCURRENCE
DEMERITS
THIRD
OCCURRENCE
DEMERITS
FOURTH
OCCURRENCE
Failure to report
absences
-------------------
---
Written warning
First offense
5 demerits
Suspension 3
days
Second offense
10 demerits
Dismissal
Third offense
Performing nuclear
medicine exams
without a physicians
order/clinical
instructor
knowledge/on self,
other students, other
persons
-------------------
---
---------------------
--------------------
Dismissal
First offense
Disclosing
confidential data
------------------
Written warning
First offense
5 Demerits
Suspension
Second offense
10 Demerits
Dismissal
Third offense
Unauthorized access
of confidential
information on
hospital/school/library
Computer system
-------------------
-
Written warning
First offense
5 Demerits
Suspension
Second offense
10 demerits
Dismissal
Willful falsification of
a document
------------------
--------------------
------------------
Dismissal
First offense
Willful neglect and
damage to hospital
equipment
-------------------
---------------------
-
Suspension 3 d
First offense
5 demerits
Dismissal
Second offense
28
CATEGORY
OFFENCE
FIRST
OCCURRENCE
DEMERITS
SECOND
OCCURRENCE
DEMERITS
THIRD
OCCURRENCE
DEMERITS
FOURTH
OCCURRENCE
Deliberate cheating
on exams
-------------------
----
--------------------
---
---------------------- Dismissal
First offense
Deceptive behavior
(Untruthful
behavior)
-------------------
----
--------------------
---
Suspension 3 days
First offense
5 Demerits
Dismissal
Second Offense
Causing harm to
patient/staff through
inattention
-------------------
--
--------------------
-
Suspension 5 days
5 Demerits
Dismissal
Second offense
Conviction of a
crime while in
school
-------------------
--
--------------------
--
---------------------
Dismissal
First offense
Physically fighting
Verbal
abuse/fighting
-------------------
---
--------------------
-
--------------------- Dismissal
First offense
Failure to maintain
passing grade in all
classes/or
clinical/reaching
prescribed demerits
-------------------
--
--------------------
-
----------------------
-
Dismissal
29
CATEGORY
OFFENCE
FIRST
OCCURRENCE
DEMERITS
SECOND
OCCURRENCE
DEMERITS
THIRD
OCCURRENCE
DEMERITS
FOURTH
OCCURRENCE
Immoral/indecent
conduct on hospital
property or while
on sanctioned
school activity
---------------------
---------------------
---------------------
Dismissal
First offense
Insubordination
(refusal to respond
to a reasonable
request)
---------------------
--------------------
---------------------
Dismissal
First offense
Physical/verbal
abuse of a patient
---------------------
---------------------
---------------------
--
Dismissal
First offense
Possession of
illegal weapons on
hospital property
---------------------
-
---------------------
-
---------------------
Dismissal
First offense
Theft: theft of
service, property
---------------------
-
---------------------
-
---------------------
Dismissal
First offense
Any policy or
procedure that
would cause the
student to become
ineligible to sit for
board exams
---------------------
---------------------
-------------------
Dismissal
30
STUDENTS WHO RECEIVE VERBAL WARNINGS WILL BE NOTIFIED IN WRITING
AND A COPY WILL BE INSERTED INTO THEIR STUDENT FILE. A RECORD OF
DEMERITS WILL BE RECORDED AND ADDED TO ANY EXISTING DEMERITS.
STUDENTS WILL BE NOTIFIED IN WRITING OF WRITTEN WARNING AND A
COUNSELING SESSION WITH FOLLOW-UP WILL BE COMPLETED. DEMERITS
ASSOCIATED WITH THE OFFENSE WILL BE RECORDED AND ADDED TO ANY
EXISTING DEMERITS
SUSPENSIONS ARE A MINIMUM OF THREE DAYS TO A MAXIMUM OF
FIVE DAYS. SUSPENSION DAYS WILL BE MADE UP AT THE END OF THE SCHOOL
YEAR. DEMERITS WILL BE ASSIGNED AND ADDED TO EXISTING DEMERITS.
STUDENTS DISMISSED WILL NOT BE CONSIDERED FOR RE-ENTRY INTO THE
PROGRAM
THE FACULTY RESERVES THE RIGHTS TO REQUIRE AT ANY TIME THE
WITHDRAWAL OF ANY STUDENT WHO GIVES THE EVIDENCE OF BEING UNABLE
TO CARRY OUT THE RESPONSIBILITIES OF THE NUCLEAR MEDICINE
TECHNOLOGY PROGRAM AND/OR PERFORM TO ENTRY-LEVEL STANDARDS.
STUDENTS WHO REACH THE MAXIMUM ALLOWED DEMERITS WILL BE
IMMEDIATELY DISMISSED FROM THE PROGRAM.
In cases of suspension or dismissal, the student is found to be in violation of any of the above stated
situations or like situations; or any other situation deemed to be an unacceptable standard of
professional behavior, the student will immediately be asked to leave the didactic or clinical
education setting and must comply. The student will then be considered suspended/dismissed by the
school. The student will receive official notification of suspension/dismissal and then may apply the
appeal process.
31
P
APPEAL POLICY
Students may present their disciplinary action for appeal to the Program Director. Students must
appeal in writing no more than one day following decisive disciplinary action. Students May Not
appeal verbal warnings.
Procedure:
Students will submit in writing to the Program Director of the School of Nuclear Medicine
their reasons for appeal of disciplinary action. (one day post disciplinary action
notification)
Students must submit the appeal within one working day of decisive disciplinary action
The Program Director will confer with the Advisory Committee within a reasonable length
of time (5 days ) and return in writing to the student the decision of the appeal.
Disciplinary action is suspended during the appeal process pending the outcome of the
appeal.
Once a decision has been rendered and the results communicated to the student, appropriate
action will then be taken.
In case of a reversal of action for the student, no action will be taken and records of the
incident will not be included in the students’ record
In the case of ‘action stands’, the disciplinary action of the student will then begin and all
documentation to the incident will remain in the students’ record.
32
GRIEVANCE POLICY
The purpose of the grievance procedure is to allow the students the opportunity to work with the
supervisors in resolving student-program issues and to be assured of fair unbiased decisions based
upon the problems. Those students registered in the program are eligible for filing a grievance.
Pending suspension and dismissed students are not eligible to file a grievance. (See appeal process)
Procedure: The student is advised to try to resolve problems and issues informally with the Clinical
Coordinator or the Program Director. If this is not done to the students’ satisfaction, then a
grievance may be filed.
The following is the recommended process:
Present the problem in writing no later than 48 hours after the incident to the Program Director
The Program Director has five (5) days to respond to the student in writing. If the student is not
satisfied, he/she may pursue the matter further to the Director of Radiology.
The student, if not satisfied, may submit in writing the problem along with the Program
Director’s response to the Administrative Director of the Department of Radiology. The
Administrative Director must respond within five (5) days. If the student is not satisfied,
he/she may pursue the matter further and request a meeting of the Grievance Committee.
The student will next inform the Program Director in writing that he/she wishes to have the
Grievance Committee hear the complaint; the student will also include a copy of the
Administrative Director’s response. The Program Director will then call a meeting of the
Grievance Committee. The Medical Director of the school will chair the committee; other
members of the committee will include the Administrative Director of Radiology, Director
of Radiology, Program Director, Clinical Coordinator, and a Staff Technologist. The
aggrieved student will be notified of the date and time of the meeting and given the
opportunity to voice his/her grievance and make any pertinent statements to the committee.
The committee has ten (10) days to respond in writing.
The decision of the committee is final. The student may withdraw his/her grievance at any time.
33
HOUSING
Housing is the responsibility of the student. Abington Memorial Hospital does not provide housing for students.
MEALS
Students are responsible for their own meals. Students may use the cafeteria facilities at either Abington Memorial Hospital or the Willowood Campus for a discount with their Student I.D.
LIBRARY
There are two library facilities; the Wilmer Memorial Library is located in the Dixon building on the main campus of Abington Memorial Hospital. The second facility is located at the Dixon School of Nursing in the Pennwood building. Both facilities are open to the students of the School of Nuclear Medicine. The students will have scheduled library time to work on projects, papers, study for exams, or complete papers. This time will be part of their didactic schedule. Students may use the library facilities on their own time whenever possible. The hours of operation for the Library at the Dixon School of Nursing, Pennwood Building are Monday, Wednesday, Friday, 8-4:30 ; Tuesday and Thursday, 11am-7pm.
TEXTBOOKS
Basic necessary textbooks will be provided to the students as part of their tuition. Any other book the student may desire may be purchased through normal means. All other classroom lecture materials, notes, articles, and outlines will be provided to the student.
GRADUATION REQUIREMENTS
The Student must meet the following requirements to be eligible to receive a school certificate: 1900 contact hours must be achieved and all competencies completed. Student radiation badges as well as security ID must be turned into the school. Complete ALL academic courses, clinical competency program, and all evaluations
according to established criteria. A Student with incomplete records in either area shall not be granted a certificate and will not be authorized by the Program Director as meeting the educational requirements for certification.
Candidate has satisfactorily completed the one-year program in Nuclear Medicine Technology with a minimum grade of a 2.5 GPA (C+ 75%) in all subjects and clinical study.
Candidate is competent in all routine procedures, techniques including terminal competencies as determined by the program faculty, and the standards set by the profession.
Candidate has met all financial obligations of the School of Nuclear Medicine Candidate is recommended for graduation by the School Administration
34
Failure on the students’ part to fully complete the program prior to graduation will require the student to remain after the graduation date. The student will not be allowed to remain after twenty days (20) past graduation date. (see policy on make up time)
GENERAL QUALIFICATIONS FOR REGISTRY ELIGIBLE STUDENTS
Candidates must comply with the “Rules of Ethics” contained in the ARRT Standards of Ethics. This includes, but is not limited to, compliance with State ad Federal laws. A conviction of or a plea of guilty too, or a plea of nolo contendre to a crime, or is a crime of moral turpitude, must be investigated by the ARRT in order to determine eligibility. Those who do not comply with the Rules of Ethics must supply written explanation, including court documentation of the charges, with the application for examination. Additional information may be found in the ARRT Rules and Regulations (APPENDIX F) and in the ARRT Standard of Ethics APPENDIX I. Individuals who have been convicted of, or plead nolo contendre to a crime may file a pre-application with the ARRT in order to obtain a ruling on the impact of their eligibility for examination. The individual may submit the pre-application at any time after the first day of attendance in the professional phase of an accredited educational program. This process may enable the individual to avoid delays in the processing of the application for examination, which is made at the time of graduation. The pre-application is not contained in this handbook, and must be directly requested from the ARRT. Submission of pre-application does not waive the application for examination fee, the application deadline, or any other application procedure.
STUDENT RESPONSIBILITIES
The student is a member of the Nuclear Medicine Technology team, and as such, his/her failure to meet their responsibilities will inadvertently affect all team members but mostly importantly the patient. The student technologist is responsible to:
Be on time to either didactic or clinical assignments
Check posted daily and weekly schedules (these may change depending on the department activity)
Become familiar with and refer to hospital and school policies and procedures
Complete assignments satisfactorily and on time
Display professional conduct
Seek assistance as needed
Hold all patient information in confidence
Meet the departmental objectives satisfactorily Promote harmony among members of the team
35
Be alert and observant while carrying out assignments
Make recommendations through proper channels.
Student Radiologic Code of Ethics:
(Adapted from the standard code of ethics from the American Registry of Radiologic Technologist and Nuclear Medicine Certification Board) The following code of ethics along with the code of excellence makes the foundation for the policies and procedures of AMH School of Nuclear Medicine Technology
The Student Nuclear Medicine Technologist conducts himself/herself in a professional manner, responds to patient needs and supports colleagues, and associates in providing quality patient care.
The Student Nuclear Medicine Technologist acts to advance the principal objective of the
profession to provide services to humanity with full respect for the dignity of mankind. The Student Nuclear Medicine Technologist delivers patient care and service unrestricted by the
concerns of personal attributes or the nature of the disease or illness, and without discrimination on the grounds of age, race, color, sex, religion, sexual orientation, gender, identity or expression, natural or ethnic origin disability or socioeconomic status.
The Student Nuclear Medicine Technologist practices technology founded upon theoretical
knowledge and concepts, utilizes equipment and accessories consistent with the purpose for which they have been designed, and employs procedures and techniques appropriately.
The Student Nuclear Medicine Technologist in conjunction with the Registered Nuclear
Medicine Technologist, assesses situations, exercises care, discretion and judgment, assumes responsibility for professional decision’s, and acts in the best interest of the patient.
The Student Nuclear Medicine Technologist in conjunction with the Registered Nuclear
Medicine Technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment management of the patient, and recognizes that interpretation and diagnosis are outside the scope of practice for the profession.
The Student Nuclear Medicine Technologist utilizes equipment and accessories, employs
techniques and procedures, performs services in accordance with and accepted standard of practice, and demonstrates expertise in minimizing the radiation exposure to the patient, self, and other members of the health care team.
The Student Nuclear Medicine Technologist practices ethical conduct appropriate to the
profession, and protects the patients’ right to quality nuclear medicine technology care.
36
The Student Nuclear Medicine Technologist respects confidences entrusted in the course of professional practice, respects the patients’ right to privacy, and reveals confidential information only as required by law.
The Student Nuclear Medicine Technologist continually strives to improve knowledge and skill
though professional continuing education
Code of Excellence
Breaks the Ice: Make eye contact. Smile, Introduce yourself. Call people by name, using Mr., Mrs. or Ms. When addressing patients and their family members. Extend a few words of concern
Anticipate Needs: You will often know what people want before they ask. Take the initiative,
It’s everyone’s job to help or find help when needed.
Practice Courtesy: Be quiet, courteous, and attentive. Polite words are soothing and reassuring. Noise annoys. Make people feel special
Explain What You are Doing: People are always less anxious when they know what is
happening.
Offer Assistance: If someone is lost and confused, stop and try to help. Respond Quickly: When someone is worried, concerned or ill, every minute is an hour
Waiting time is tolerable if the patient of family is kept informed.
Be Careful of What You Say: Privacy and confidentiality are of extreme importance. Watch what you say and when you say it. Show respect for patients and their families.
Treat All Patients with Dignity: Have patience. Slow down and take time to give. Imagine
yourself on the receiving end. Offer choices and assistance. Be understanding. Make sure your words or tone of voice does not imply impatience.
Take Time to Listen: When someone talks to you, even to complain, take time to listen.
Remember that patient or visitor is forming an instant perception of you hat could be lasting.
Help Each Other: Everyone benefits you when you and your co-workers act as a team. Offer
assistance to others and accept help graciously.
Use Good Phone Skills: When you are on the telephone speak pleasantly, be helpful and listen with understanding. If you don’t know the answers to an inquiry, find someone who does. Remember others often overhear how you speak with a caller.
Look the Part: YOU represent more than just one individual. You are part of a long-standing and
proud medical tradition. Your appearance and attitude are reflective of not just you but
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of the hospital, school, and profession.
STUDENT DRESS CODE
Students appearance is a mark of excellence. Students should be neatly dressed for all clinical schedules, which include all patient, non-patient contact. For the safety of the patients at Abington Memorial Hospital , the staff, as well as the student, the following code is adopted from standard practices and AMH policy. Students out of uniform will be accessed demerits. Acceptable:
Scrub tops and pants (set) neat in appearance no tears or ragged hems, ironed, not worn below waist.
White sneakers or white shoes, dark shoes are acceptable Professional attire, such as polo shirt, button down shirt, and slacks Lab Coat knee/thigh length** (NRC regulation) Student I.D. *** All appropriate radiation monitoring devices Long hair must be pulled back to avoid injury Beards/mustaches must be kept trim and neat at all times
Unacceptable: Jeans of any type Shorts/Capri pants Tank tops, halter tops, midi-shirts, T-shirts with writing of any kind,
Shirts with writing of any kind. Open toe shoes, sandals, boots, high heels Sweatpants Sweat shirts False fingernails, bold/metallic or otherwise noticeable nail polish Bare legs or bare feet anytime Excessive jewelry. No more than one necklace (short), no lip piercing
or multiple piercing, tongue piercing, multiple ear piercing, face piercing
(**) Lab coats are a requirement of all nuclear medicine departments, it is not just part of the uniform but required standard equipment for the job. Students will wear a knee/thigh length lab coat at all times while in the clinical setting. If the student fails to wear a lab coat to the clinical setting it will be just cause for disciplinary action (***) Student identification is a requirement; all students will wear their identification visibly at all times. Students without identification will present with just cause for disciplinary action Definition of out of uniform: In appropriate dress, failure to have lab coat, film badges, student ID
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PERSONAL APPEARANCE
The personal appearance and demeanor of nuclear medicine students reflect the School, Department of Nuclear Medicine and Abington Memorial Hospital standards. The Student Nuclear Medicine Technologist’s appearance is indicative of their interest and pride in their profession. All students are expected to present a professional appearance at all times.
Body hygiene should be maintained Hair should be neat at all times. Long hair should be tied back for reasons of safety and hygiene. Beards, mustaches or side burns should be kept well trimmed. Fingernails should be short, neat, and clean. Nail polish should be muted and not offensive Makeup, if worn, should be used discreetly, Heavy eye shadow, mascara and rouge are not
acceptable Perfume and after-shave lotions should be used in moderation. Strong scents may be offensive
to the patients Keep jewelry to a minimum. Long dangling earrings, multiple rings, long necklaces, etc., are
unsafe and can and will be caught in the equipment or grabbed by a patient. Multiple visible piercing will be removed.
GENERAL SAFETY RULES
Faculty/Staff/Student Responsibilities: The student shall be the person most concerned for his/her own safety. In addition, each student has certain duties to assure safety for the public, patients and other personnel. The students will follow the Abington Memorial Hospital’s Patient Safety polices and rules of safety. These include:
The use of safe practices at all times including Standard Precautions. (Universal Precautions)
Practice Radiation Safety at all times, utilizing the ALARA principle.** Reporting all unsafe conditions and practices observed to their supervisor/clinical instructor
immediately. Never use unsafe equipment that could endanger themselves or others. Knowing and adhering to all the safety and fire prevention procedures set by the Hospital. Assuming his share of responsibility for failure to report any condition that may cause injury
to themselves or fellow employees. Complying with the occupation safety (OSHA) policies as specified. Thinking safety and acting safely in performing any duties assigned to them. Maintaining cleanliness and good personal health habits. Reporting all injuries to their supervisor for proper treatment. Reporting all incidents involving patients to their supervisor/clinical instructor immediately Understanding that the use of equipment by unauthorized personnel must be reported to the
supervisor Knowledge of and use of standard body dynamics in lifting/moving patients Abington Memorial Hospital’s Patient Safety and other safety policies.
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Patient Safety:
Upon arrival in the Nuclear Medicine Department, the safety of the patient is the responsibility of the Nuclear Medicine Department. The Nuclear Medicine Technologist along with the Student Nuclear Medicine Technologist is responsible for the safety and well- being of the patient from the time of their arrival until their departure. The student will practice all hospital/department guidelines for patient safety. These guidelines will be gone over in the Hospital Orientation as well as the School of Nuclear Medicine’s course on Patient Care and Emergency Procedures. The Clinical Coordinator as well as Clinical Instructors will assure these guidelines are adhered to; they include but are not limited to the following safety procedures:
Patient lifting and dynamics for lifting Patients in wheelchairs Patients walking with assistance, i.e. walkers, crutches, canes, seeing eye dogs. Patients in critical condition Patients with extensive medical equipment Attending patients in rooms. Students will never leave a patient alone in a room on an imaging
table or in a chair not firmly secured to the floor (chair with wheels)
CONFIDENTIALITY
Student Nuclear Medicine Technologists are required to keep all information concerning patients strictly confidential. (HIPPA Act). A student found to be looking at or in possession of patient information that is not pertinent to his duties or in discussion about said patient outside of an authorized entity, will be dismissed from the Program. Students overheard talking idly concerning a patient, will be dismissed. (AMH HIPPA policy presides)
PHYSICAL STANDARDS
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Physical Demands: Student Nuclear Medicine Technologist
FREQUENCY FREQUENCY FREQUENCY FREQUENCY
RARE <10% OCCASIONAL 11-
34% FREQUENT 35-66% CONTINUOUS
>67%
WEIGHT
<10 LBS
11-25 LBS
26-60
LBS
>60LBS
<10LBS
11-25
LBS
26-60
LBS>60LBS
<10LBS
11-25LBS
26-60 LBS
>60 LBS
<10LBS
11-25
LBS26-60LBS
>60LBS
Lifting X X X X X PUSHING/PULLING X X X X X FREQUENCY FREQUENCY FREQUENCY FREQUENCY
RARE <10% OCCASIONAL 11-
34% FREQUENT 35-66% CONTINUOUS
>67% BALANCING X CLIMBING X CRAWLING X CROUCHING X FEELING X GRASPING X HEARING X KNEELING X REACHING X REPETITIVE MOTIONS X SMELLING X STANDING X STOOPING X TALKING X TASTING N/A WALKING X Mental/Attitudinal Standards:
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Function safely, effectively, and calmly under stressful conditions Maintain composure while managing multiple tasks simultaneously Prioritize multiple tasks Exhibit social skills necessary to interact effectively with patients, families, supervisors and co-workers of the same of different cultures such as respect, politeness, tact, collaboration, teamwork, discretion
SCHOOL OF NUCLEAR MEDICINE RESPONSIBILITIES
A Student Nuclear Medicine Technologist has a right to expect the Program and Department of Nuclear Medicine to:
Provide equal quality education Adhere to its policies and procedures Provide written evaluations assessing the student progress Provide supervision and consultation as needed Observe professional codes. Secure and provide access upon formal requests to clinical progress
records. Post schedules Encourage its instructors to belong to his/her professional
organizations Remain current in the technology and develop new programs Be open to constructive suggestion and/or criticisms Implement recommendations when feasible Promote harmony among faculty, students and hospital personnel Dismiss a student for academic failure Dismiss a student for clinical failure
HEALTH POLICY
As part of the admissions requirements, students must undergo a complete physical examination conducted by the Department of Employee/Student Health Services of Abington Memorial Hospital. This examination requires the student to provide official documentation of his/her vaccination history. If this documentation is found to be insufficient or in complete, the student may need to receive a specific vaccination(s). At the time of the physical examination, a drug screen will be administered as well as a positive protein derivative (PPD) test will for tuberculosis screening. If the student has a positive PPD response or has had a previous positive response, a PA chest radiograph may be required. Also available to the student during the physical examination is the Hepatitis B vaccination (offered at no cost). The student’s further acceptance into the Nuclear Medicine Program is dependant on passing the Health physical. If an accepted student fails to make
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an appointment prior to the start of the school year, that student will not be allowed entrance until the physical, and all other requirements are complete. Students will also have a criminal background check done It is required each student carry personal health care insurance. Should a student become sick/injured during a scheduled clinical assignment, the Program Director and/or Clinical Coordinator must be informed, no matter how trivial the injury may seem. If notification of either the Program Director or Clinical Coordinator would impede medical attention, it is the students responsibility to see that medical attention first. An Accident/Injury Report must be completed and when necessary, the student will be referred to Employee/Student Health Services and /or the Emergency Department for evaluation. The Accident/Injury Report should accompany the student when sent to the Employee/Student Health Services, who will evaluate/treat only the initial accident/injury and is not responsible for providing subsequent follow-up treatment. Should a student illness/injury require Emergency Room consultation, continuous treatment of the physical illness/injury, and/or prescription, the student will be billed and the student may submit any financial occurrence accordingly to their health care provider. Students are not covered by Worker’s Compensation. Procedure in Event of Illness or Injury
Onsite: Follow hospital procedure, file incident/accident report and report to
Employee/Student Health office or, if closed, Emergency Department. In case of life threatening illness or injury, report directly to Emergency Room.
Receive treatment if necessary at site, indicate you are covered for incident, and give name and number of student insurance policy.
Notify Program Director as soon as possible or other program faculty/instructors. Notify Program Director of any actions taken such as signed off duty, length of time, and any special medications, instructions, limitations. Pregnancy: It is the option of the students to, upon the discovery or suspicion of pregnancy, notify the Radiation Safety Officer for further direction. The School of Nuclear Medicine adopts the AMH Department of Nuclear Medicine’s policy concerning notification and safety procedures of pregnant technologists.
PERSONAL TIME
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Each student at the will have 80 hours of personal time per year. Hospital Holiday schedules will be given to each student at the start of the program. Lateness will be deducted from PTO time Scheduled time off: If a student needs time off for any reason other than illness, it is the students responsibility to notify the Program Director at least 7 days or longer in advance before the scheduled time off. The student will have that amount of personal time decreased from their personal time off bank. It is the students’ responsibility to:
Make up or take ahead any exam given during the students’ absence Make up any didactic classes through alternative means Make sure any clinical forms/evaluations are completed and turned in prior to
leaving) or following an illness.
Arrangements must be made in advance with the Program Director concerning exams, classes, and evaluations. These policies and procedures are subject to change dependant on ever changing situations. All students are encouraged to express their opinions, and questions regarding any policy or procedure. Changes in policy and procedure can occur at anytime throughout the year.
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SECTION II
COURSE DESCRIPTION
PREFACE
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As the field of nuclear medicine continues to change, the roles and responsibilities of nuclear medicine technologists change as well. The Society of Nuclear Medicine (SNM) along with the American Registry of Radiological Technologists, Nuclear Medicine Technology Certification Board, and the Joint Review Commission on Programs in Nuclear Medicine Technology, conduct task analysis surveys on a regular basis to ensure that exams include all the tasks associated with the profession of nuclear medicine technologist. Also taken in account, are the surveys, which tasks were identified as appropriate requirements for entry-level technologists. These documents, as well as an extensive Practice Analysis that was performed by the Society of Nuclear Medicine Technologist Section (SNM-TS), were all used as references during the revision of the curriculum guide, as published by the Society of Nuclear Medicine. The curriculum guide indicates the information that should be included in the professional component of a nuclear medicine technology program. The guide is not intended to be all-inclusive with regard to course/program content and it is fully understood that the general education requirements vary among organizations. Abington Memorial Hospital School of Nuclear Medicine Technology agrees with these guidelines and incorporates the suggested curriculum into its program.
COURSE DESCRIPTIONS OBJECTIVE:
To give each student a quality education in the field of Nuclear Medicine Technology. Students will systematically progress through the year to higher levels of responsibility and
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academic excellence. Courses are designed following the Society of Nuclear Medicines’ Curriculum Guide for Educational Programs in Nuclear Medicine Technology. Upon graduation, each successful student will qualify to sit for the national registry and board exams, and qualify for entry level employment as Nuclear Medicine Technologist.
ORIENTATION
All students are scheduled to attend the Abington Memorial Hospital orientation/OSHA training prior to the beginning of the school year.
ORIENTATION TO NUCLEAR MEDICINE All students are scheduled to attend a Nuclear Medicine Department specific in-service with the Radiation Safety Officer, prior to the beginning of their clinical rotation. As well, each student will be familiarized with the courses, methods of academic, clinical evaluation and expected levels of performance. Students will become familiar with the Abington Memorial Hospital School of Nuclear Medicine Technology Operations Manual and Student Handbook. Discussions will take place and any questions answered. COURSES: INTRODUCTION TO NUCLEAR MEDICINE
This course will be an introduction to the basics of the functions of nuclear medicine and enable the student to acquire basic knowledge of nuclear medicine technology prior to entering the clinical setting. Students will be introduced to fundamentals of imaging equipment, radiopharmacy, radiation safety and protection, emergency procedures and patient care, and some of the most common procedures they may encounter. The purpose of this course is to give the student the basic nuclear medicine terminology and understanding of nuclear medicine technology prior to entering the clinical setting. (40 hours)
INSTRUMENTATION
This course will familiarize the student with the basic radiation detectors, their applications, functions, and limitations. It presents an over view of basic electronics, gas-filled detectors, statistics and counting, scintillation detection systems (solid and liquid), semiconductors and instrument stabilization and quality control. This material is best presented in lecture format, followed by laboratory experiments to furnish practical applications of learned material. Instrumentation of imaging devices is presented in this course and includes basic function, application of principles and quality control. Study of this course should enable the student to operate, with minimal orientation, any imaging device. (30 hours 4 Labs)
PHYSICS
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Part I is an introductory course in physics to familiarize the student with the nature of radioactivity and its uses in nuclear medicine. Students will become familiar with terminology as it pertains to radiation physics. (8 hours) Part II is a more in-depth course in nuclear physics covering atomic structure, the production of radioactivity, natural and induced nuclear reactions, modes of radioactive decay, binding energy, conservation of energy, types of radioactive decay, decay schemes, interactions of radiation with matter, theory and dosimetry. (40 hours 3 Labs)
MATH AND STATISTICS
Part I is basic math. This course consists of a review of the most basic algebra concepts and progresses into the concepts and usage of advanced algebra and logarithms. A math pre-test will be given prior to the beginning of this course to evaluate student needs. (20 hours) Part II is applied technical math as it pertains to nuclear medicine. This course consists of the derivation, manipulation, and applicability of the decay equation, dose volume concentration, shielding determinations, and descriptive and inductive statistics. Graphic analysis of data, statistical counting, and graphing along with interpretation is also included along with practical labs. (30 hours)
RADIOBIOLOGY
This course covers considerations concerning the medical uses of radionuclides, the biological effects of ionizing radiation and the interaction of radiation with physiological systems. Students will calculate radiation doses to systems using historical events and data. (30 hours; 1 project)
RADIATION SAFETY AND PROTECTION
Radiation Safety and Protection Part I. The proper attitude for working with and handling radioactive materials is implanted in this course. A review of ionization processes precedes discussions of terms used. Definitions and discussions of terms such as Roentgen, RAD, REM, and dose equivalent are explained in detail along with their associated Standard Unit of Measure the Gray and Seivert. Calculations will be done on known data sources and a history of how these terms came into use via historical events. (20 hours) Radiation Safety and Protection Part II. This section will introduce the student to licensing requirements, general principles of licensing and application on the State and Federal levels. Guidelines for radiation protection are included along with basic radiation exposure reduction principles. (ALARA) NRC rules, for the handling of radioactive materials (NRC part 35) and operation of a nuclear medicine department will be included. (26 hours, 1 Lab)
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NUCLEAR MEDICINE IMAGING
An in-depth view of clinical nuclear medicine imaging techniques. Students will be presented with case studies for review of technique, application, procedure, artifact, and pathology. Students will learn how to recognize artifacts due to poor equipment function, poor technique, and pathology. Students will present case studies for critic and discussion. Individual Nuclear Medicine Procedures will be discussed. (40 hours)
RADIOASSAY AND NON-IMAGING NUCLEAR MEDICINE PROCEDURES
The student will be presented with the theory and principles of radioassay procedures and basic immunology. Related competitive radioassay, sequential saturation analysis, and sandwich assays will be introduced. Laboratory experiments in pipetting, instrumentation and assay quality control will be demonstrated and performed by the student. Non-imaging procedures will be presented and labs conducted. (15 hours 2 Labs)
INTRO TO PATHOLOGY
This is an introductory course, a more in-depth discussion will be presented in conjunction with Nuclear Medicine Imaging and Anatomy and Physiology. Material will be presented to the student with examples of disease types, brief descriptions of major classifications of disease and identification of specific diseases and disorders, which can be studied using clinical nuclear medicine procedures. (8 hours)
COMPUTER APPLICATIONS
This course is intended to cover the basics of computers in medical imaging. Students will have hands-on computer practice and will perform computer-imaging analysis in the clinical setting. (16 hours)
INTRO TO RADIOPHARMACY and RADIOCHEMISTRY
This course will be an introduction for the student to radiopharmacy and radiochemistry, hot lab procedures, kit preparation, quality control of radiopharmaceuticals, patient dose preparation, and calculation. The student will learn the importance of proper care and attention to radiation protection and safety procedures, decontamination procedures and techniques while in the hot lab environment, and venapuncture. More in-depth radiopharmacy and radiochemistry will be integrated with Anatomy and Physiology as it pertains to specific physiological functions. (20 hours lecture; 3 Labs)
INTEGRATED ANATOMY and PHYSIOLOGY
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Radiopharmacy Radiochemistry Pathology Imaging Procedures
This course is taught holistically, with a more in-depth discussion of Radiobiology, Radiochemistry, Pathology, and Radiopharmacy as they pertain to the imaging of anatomical and physiological systems. The student will become familiar with each anatomical and physiological system individually with all of the above elements for that system. The student will be taught systems concurrently with a general outline and list of objectives available to serve as a guideline. Each organ system will include a separate exam. (230 hours)
MEDICAL ETHICS
This course is designed to present to the student the humanistic and ethical considerations of medical care. Liability, malpractice, certification, and licensure will also be discussed (15 hours)
METHODS OF PATIENT CARE, SAFETY, AND EMERGENCY PROCEDURES
All students must have current CPR certificates. The student will become acquainted with nursing techniques most often required of nuclear medicine technologist. These may include monitoring and operation of intravenous lines, use of oxygen, acquiring blood pressures, pulse, ECG lead placement, transferring patients to and from imaging tables and performing emergency care. Students will be taught procedures for infection control, and emergency code procedures. (30 hours)
ADMINISTRATION OF HEALTH CARE DELIVERY SYSTEMS
This course will familiarize the student with the administrative responsibilities in the operation of a nuclear medicine department. Topics include inventory control, ordering and interacting with outside vendors, sales representatives, technical representatives, payroll, recruiting of staff, continuing education of staff, budgeting creation, use of statistical data, accurate record keeping, preparing status reports for hospital administrators, regulatory agencies and quality assurance. Students will also become familiar with the aspects of healthcare delivery systems and their role. (20 hours lecture, project)
LEADERSHIP and PROFESSIONALISM
This course will introduce the student to leadership theory, methods, and techniques in teambuilding. The student will also learn the importance of continuing education, professional organizations and the importance of participation on a career level. Students will have several projects and
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outside experiences to aid in their professional development. At the beginning of the school year, the students will be asked to form a student government and choose a student representative. This representative will bring all student issues through their proper channels. The student government will also, hold regularly scheduled meetings throughout the year. (On going; 4 projects)
POSITRON EMISSION TOMOGRAPHY AND RELATED COURSES
Students will be learn the science of PET imaging including physics, radiation safety and protection, radiation biology, instrumentation and diagnostic procedures. Students will also learn fusion imaging utilizing CT and MRI. (85 hours)
CLINICAL EDUCATION
This part of student education includes observation, performance with assistance and performance with supervision of all clinical nuclear medicine procedures. During the last two quarters of clinical instruction, the students will be proficient in many of the routine studies performed and will work independently; however, will always be under supervision directly or indirectly of a registered nuclear medicine technologist. Areas included in the clinical instruction are, static procedures, dynamic procedures, nuclear cardiology, SPECT, and non-imaging nuclear medicine. The student will also learn and have hands on experience with radiopharmaceutical preparation, quality control, and radiopharmaceutical administrations, clinical nuclear medicine procedures, quality assurance, record keeping, computer applications, administrative procedures, and radionuclide therapy procedures. Emphasis is placed on the integration of clinical and didactic education leading to entry-level proficiency in nuclear medicine technology. Actual performance of these procedures under supervision will take place after the observation period has ended. An observation period is defined as one initial rotation (one week) to a specific clinical area. Each student is allowed and encouraged to perform with direct and indirect supervision as they become proficient. (Approximately 1350 hours) Clinical hours may change at the discretion of the Program Director or Clinical Coordinator. Exams will be determined based on the length of the course. All courses will have at least one exam.
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ORIENTATION TO NUCLEAR MEDICINE
SYLLABUS
Objective: Students meet with the Radiation Safety officer to learn about expected behavior while working within the Nuclear Medicine Department at Abington Memorial Hospital. The student will learn proper radiation badge placement, rules governing hot lab procedures, ALARA, and emergency procedures. Instructor: Radiation Safety Officer/Medical Physicist, Ramanik Patel; Peggy Cochran, AS, CNMT Clinical Coordinator, Chief Technologist
I. Nuclear Medicine Department specific in-service
A. In-Service with Radiation Safety Officer pertaining rules under which the Department of Nuclear Medicine operates.
B. Proper radiation badge placement C. ALARA D. Emergency procedures E. Clinical Nuclear Medicine
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INSTRUMENTATION SYLLABUS
This course deals with in-depth instruction on the components, use and quality control of various types of systems, both imaging and non-imaging. The learning experience will include labs, one student project, and three exams. Upon completion, the student will be able to discuss and perform quality control procedures of gamma cameras, and essential equipment necessary for imaging and non-imaging. Instructor: Nancy Butterworth Text:
Instructor handouts, Essentials of Nuclear Medicine, all other texts, handouts Objective:
Imaging: Upon completion of this course, the student should be able to describe the physical properties that affect the resolution and efficiency of Planar scintillation cameras multi-crystal systems and SPECT Non-Imaging: Upon completion the student will be able to describe the physical properties, uses, quality control for: monitoring equipment, dose calibrators, well counters, uptake probes, gas-filled detector systems, liquid and solid scintillation systems, statistics, laboratory equipment. IMAGING SYSTEMS
Planar Scintillation Cameras A. History and development B. Basic Principles and configurations
Collimators Geometric characteristics Resolution Efficiency Selection Considerations
Crystal Photo-multiplier tubes Pulse height analyzer Scalers and rate meters Image display and
recording Cathode ray tubes
Camera Spatial resolution Sensitivity Linearity Uniformity
5.Energy resolution 6.Dead-time 7.Count rates/information density
Multi-crystal Scintillation Cameras A. Single Photon Emission Computed Tomography
1.Principles of operation and design Orbit design Collimator design Multi-head systems Attenuation correction
e. Acquisition parameters B. Performance characteristics
1.Spatial resolution 2.Sensitivity 3.Uniformity 4. Counting efficiency C. Factors that limit Statistics
1.Dose limits 2.Time restraints 3. Detector distance 4. Attenuation
D.Reconstruction
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Simple back projection Reconstruction parameters
Center of rotation correction
Uniformity correction Attenuation correction Filters and filter selection Attenuation correction
with external transmission sources
Motion correction and sinograms
F. Quality Control 1. Center of Rotation
a. Procedure Frequency
2.Uniformity Intrinsic Extrinsic Acceptable limits Frequency
3.Resolution a. Phantom studies b. Frequency c. Table detector
d. Intrinsic/extrinsic FWHM e. Head alignment
f.Imaging/Processing
NON-IMAGING SYSTEMS Gas-Filled Detector Systems
A. Principles of operation B Ion Chambers
1. Dose calibrators a. Operation 2. Quality control a. Geometry b. Linearity c. Accuracy d. Precision e. Constancy 3. Cutie Pie a. Dead time b. Accuracy C. Pocket dosimeters
D.Proportional counters Geiger-Muller counter
1. Deadtime
2. Accuracy 3. Quality control 3. Appropriate uses
E. Scintillation Detection Systems A. History and development of systems
Solid scintillation detector well counter and uptake probe
1. Principles of operation 2. Component parts a. Crystal b. Photomultiplier tubes c. High-voltage power d. Amplification
e. Pulse-height analyzer f. Counters, timers,
ratemeters Energy resolution with full width at half of maximum
(FWHM) 4. Energy calibration 5. Deadtime versus activity 6. Efficiency
7. Pulse height analyzers window determination 8. Effects of geometry 9. Quality control
C. Liquid scintillation systems 1. Principles of operation
2. Use of liquid scintillation 3. Quench correction methods D. New detection systems E. Computer maintenance
F. Daylight film processin
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MATH AND STATISTICS FOR NUCLEAR MEDICINE
SYLLABUS MATHEMATICS: BASIC Instructor: Nancy Butterworth Text: Practical Mathematics in Nuclear Medicine, (Wells), Handouts, notes, lecture Objective: Basic Mathematics: Upon the completion of this course the student should be able to work with a scientific calculator, know basic principles of algebra, scientific notation, exponents, logarithms, graphs and graphing, mathematical units, roots, powers and exponents. Math part II, is applied technical math as it pertains to nuclear medicine. The student will perform, apply and manipulation of the decay formula, dose volume concentration, shielding determinations. Statistics will also be covered during this course and the student will lean data analysis, statistical counting and graphing along with interpretation, chi-square statistical counting and analysis, Gaussian and There will be a pre-math skills test prior to the beginning of this course. Exams will be given following each major subject. I. Math pre-test
4. Basic mathematical manipulations a. Order of operations b. Signed numbers c. Use of Scientific calculator
5. Fractions 6. Algebraic Fundamentals
a. Basic laws b. Algebraic expressions
i. Linear equations ii. Polynomials
iii. Quadratic Equations 7. Root, Powers, Exponents
a. Laws of exponents b. Bases and exponents c. Evaluation of expressions
8. Ratios and Proportions a. Definition of ratio and proportion b. Direct and inverse proportions c. Percents and percentages
9. Significant digits a. Determination of significant digits b. Multiplication and division c. Addition and subtraction d. Combined operations e. Evaluation of complex expressions
10. Scientific notation 11. Mathematical units
a. Rational
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Mathematics: Basic continued
b. Metric system 12. Units and conversations of units
a. Units b. Methods of conversion c. SI units
13. Logarithms a. Definition b. Basic principle c. Determinations of logarithms and anti-log
i. Base ten (10) ii. Base e
14. Graphs a. Linear graphs
i. Abscissa and ordinate ii. Linear equations
iii. Slope and intercept b. Exponential graphs
i. Plot of exponential equation 1. Linear plot 2. Semi-log plot
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MATH IN NUCLEAR MEDICINE
I. Representative equations for radioactive decay A. Decay equation
1. Activity 2. Decay constant 3. Time 4. Half-life 5. Decay factor
B. Pre-calibration and Post calibration C. Problem solving for decay constant and half-life D. Solving for a variable in an exponent (time) E. Average life
II. Exponential graphs A. Plot of exponential equation
1. Linear 2. Semi-log
III. Determination of half- life from a graph IV. Attenuation Equation
A. Terminology B. Linear attenuation C. Mass attenuation D. Half value layer E. Calculation
STATISTICS I. Systematic and random error II. Precision and accuracy III. Percent error and percent difference
A. Calculations B. Graphing
IV. Average value and standard deviation V. Frequency distributions VI. Mean, median, and mode VII. Curve fitting
A. Linear interpolation B. Linear regression C. Log
VIII. Nuclear Counting Statistics a. Poisson distribution b. Gaussian distribution c. Standard deviation and coefficient of variation d. Confidence levels e. Propagation of errors f. Application of statistical analysis
1. Counting rates 2. Effects of background 3. Estimated required counting times 4. Chi-square (lab)
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INTEGRATED ANATOMY AND PHYSIOLOGY
Objective: This course is taught holistically, with a more in-depth discussion of Radiobiology, Radiochemistry, Pathology, and Radiopharmacy as they pertain to the imaging of anatomical and physiological systems. The student will become familiar with each anatomical and physiological system individually, procedures involved in imaging those systems, radiopharmecuticals, pathology, radiopharmecuticals, and radiation biology. The student will be taught systems concurrently with a general outline and list of objectives available to serve as a guideline. Upon completion the student should be able to discuss, describe, and define individual organ systems anatomical and physiologically, discuss appropriate imaging procedures with associated radiopharmaceutical. Students should also know the appropriate radiation safety factors and biological effects of radiation exposure on organ systems. Each organ system will include a separate exam. Instructor: Nancy Butterworth Text: Fundamentals of Nuclear Pharmacy (Saha), Nuclear Medicine: The requisites, MIRD Primer (Loevinger), handouts, lectures, and notes Basic Anatomy and Physiology
I. Anatomical Nomenclature (medical terminology) A. Prefixes, suffixes B. Descriptive terminology C. Surface landmarks
II. Cellular Structure and Function A. Cell structure
1. General structure 2. Cytoplasmic structures 3. Nuclear structures 4. Cell membrane
B. Chemical composition 1. Water 2. Electrolytes 3. Organic molecules
C. Metabolic function 1. Energy
a. Enzymes b. ATP c. Glycolysis
2. Lipid metabolism 3. Carbohydrates 4. Protein metabolism
D. Cellular division 1. DNA 2. RNA 3. Chromosomes 4. Mitosis, Meiosis
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Anatomy and Physiology, Basic continued
5. Differentiation 6. Mutation
E. Cell membrane transport 1. Diffusion 2. Osmosis 3. Active transport 4. Pinocytosis 5. Phagocytosis
III. Tissue Structure A. Epithelial B. Connective C. Muscular
1. Smooth 2. Striated
a. Cardiac b. Skeletal
After beginning with an introduction of tracer kinetics, radiopharmaceuticals, and methods of scintography, the following systems will be covered under a general syllabus: Musculoskeletal Respiratory Circulatory Endocrine Renal Central Nervous System Reproductive Cardiovascular/Nuclear Cardiology Immune/Lymphatic Therapy/Miscellaneous The above systems will be taught in an integrated approach with anatomy and physiology, pathology, radiopharmacy/radiochemistry, radiation biology, and imaging procedures as described in the Society of Nuclear Medicine Curriculum Guide for Educational Programs in Nuclear Medicine Technology The following is a general outline: Anatomy and physiology:
I. Anatomical structures A. Size B. Shape C. Location D. Landmarks
1. Margins 2. Impressions 3. Fissures 4. Borders 5. Surfaces
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6. Hilums 7. Flexures 8. Sinuses
E. Normal variants F. Organ composition G. Cell membrane transport
1. Diffusion 2. Osmosis 3. Active transport 4. Phagocytosis 5. Pinocytosis
H. Blood supply 1. Arterial routes 2. Venous routes
I. Functions II. Pathology
A. Disease characterizations 1. Familial 2. Hereditary congenital 3. Acute 4. Sub acute 5. Chronic 6. Reversible 7. Irreversible
B. Disease Classifications 1. Neoplasitc
a. Tumor b. Primary c. Metastatic
2. Infectious 3. Inflammatory 4. Vascular 5. Idiopathic 6. Metabolic/hormonal 7. Nutritional 8. Traumatic 9. Psychological 10. Allergic
III. Radiopharmacy/Radiopharmecuticals (as pertaining to specific organ systems) A. Pyrogens B. Radiopharmecuticals
1. Calculations of Dose and activity C. Short and long lived isotopes D. Quality control
1. Commercial radiophamaceuticals 2. Inter- departmentally prepared radiopharmaceuticals
E. Ideal properties
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Anatomy/Physiology continued
F. Radionuclides G. Reagent kits H. Radiopharmaceutical information
1. Route of administration 2. Method of localization 3. Biodistribution 4. Mode of excretion 5. Warnings 6. Precautions 7. Adverse reactions 8. Indications and usage 9. Dosage 10. Method of production 11. Radiocontaminatnts 12. Preparation
I. Adjunctive medications 1. Product information 2. Product effect on exam 3. Types and usage in conjunction with exams
J. Formulation problems and their clinical effects
IV. Radiobiology (as pertaining to specific organ systems) A. Factors influencing absorbed dose from internal sources
1. Concentration and organ mass 2. Effective half-life 3. Physical and chemical characteristics of radionuclide 4. Absorbed fraction 5. Cross irradiations
B. Critical and target organs 1. Target organs 2. Non- target 3. Gonadal exposure
C. Absorbed Dose calculations 1. Classical and MIRD Methods 2. Formulas, charts and tables
D. Risk-to-benefit- ratios 1. Radiation hazard versus medical need 2. Diagnostic exposures 3. Radiation levels in Nuclear Medicine
V. Imaging procedures VI. Therapeutic Nuclear Medicine VII. Immunology
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INTRODUCTION TO RADIOBIOLOGY
SYLLABUS Objective: Following completion of this course the student will be able to discuss, define, and calculate, the interactions of radiation with human tissue, its potential effects, calculations, and dosimetry, and terminology. This is background knowledge needed to understand concepts and importance of radiation protection. System specific radiobiology will be incorporated with anatomy and physiology. Instructor: Nancy Butterworth Text: MIRD Primer, Essentials of Nuclear Medicine, Primer of Medical Radiobiology, handouts, notes. I. Review of Characteristics of Radiation
A. Types of radiation 1. Gamma rays 2. X-rays 3. Beta particles 4. Positrons 5. Alpha particles
B. Half-life C. Energy
II. Sources of radiation A. Environmental
1. Natural 2. Manmade
B. Medical C. Occupational
III. Measurement of Radiation and its Effects A. Exposure B. Absorbed dose C. Dose equivalent
IV. Review of Cell Biology A. Cell structure B. Molecular components
1. Water 2. DNA 3. RNA
C. Cell reproduction 1. DNA synthesis 2. Mitosis 3. Meiosis
D. Cell replication cycle V. Interactions of Radiation with matter
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Intro to Radio Biology Continued
A. Direct action B. Indirect action C. Linear energy transfer D. Relative biological effectiveness (RBE) E. Free radicals F. Target theory
VI. Radiation Genetics
A. Causes and effects of genetic mutations 1. Spontaneous mutations 2. Mutagenesis 3. Carinogenisis 4. Gene mutations and cancer 5. Stoichastic/non-stoichastic
B. Effects of radiation on DNA C. Chromosome and chromatid aberrations D. Repair versus mutation
VII. Cellular Responses to Radiation A. Stage of cell replication cycle versus radiosensitivity
1. Repair mechanism B. Consequences of irradiation
1. Restitution 2. Division delays and cell synchrony 3. Interphase death 4. Reproductive failure 5. Chromosome stickiness
C. Survival curves VIII. Factors Affecting Cellular Response to Radiation
A. RBE and LD 50/30
B. Physical factors C. Chemical factors
D. Biological factors IX. Radiosensitivity and Cell Population
A. Law of Bergoini and Tribondeau B. Cell compartment categories
1. Stem 2. Transitional 3. Differentiated
C. Cell populations X. Tissue and Systemic Reponses to Radiation (gone over in more detail with
anatomy and physiology) A. Acute versus late effects B. Healing of irradiated tissue C. Total-body irradiation
1. Sources of information
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Intro to Radiobiology continued
2. Hematopoiectc syndrome 3. Gastrointestinal syndrome 4. Central nervous system syndrome 5. Cardiac shock syndrome
XI. Late Effects of Radiation Exposure
A. Relating radiation exposure to specific effects B. Dose versus effect models C. Problems associated with researching radiation induced effects D. Non- specific life shortening E. Carcinogensis F. Cataract instigations G. Non-Specific life shortening H. Other diseases
XII. Radiation Doses A. Factors B. Critical target organs C. Absorbed dose calculations D. Therapeutic exposures
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RADIATION SAFETY AND PROTECTION
SYLLABUS Part 1 Upon completion the student will be able to demonstrate, proper safety and handling methods of radioactive materials, as well as give the proper definitions and discussions of terms. The student will be able to perform calculations on known data sources and a history of how these terms came into use via historical events. Part 2, the student will be able to discuss and define government agencies, state and federal licensing requirements, general principles, and guidelines for ration protection and safety. Students will be knowledgeable on section of NRC section 10 CFR parts 35 and 20 Instructor: Nancy Butterworth Text: 10 CFR part 35 and 20, Radiation Safety in Nuclear Medicine, handouts, re-prints
I. Review of the Basics A. Characteristics of radiation
1. Types II.Units
Exposure Roentgen Coulomb/kilogram
Absorbed Dose Radiation absorbed dose (rad) Gray (Gy) Relative biologic effectiveness (RBE) and Quality factors (QF)
Dose Equivalent Roentgen equivalent man (rem) Sievert (Sv)
Calculations and conversions Regulations of Radiation Exposure and Use of Radioactive Materials
Agencies Nuclear Regulatory Commission (NRC) Department of Transportation (DOE) Food and Drug Administration (FDA) Department of Energy (DOE) Environmental Protection Agency (EPA)
Licensing Federal and State Institutional licenses
Dose and Exposure Limit Recommendations and Regulations Definitions
Effective does equivalent (EDE) Total effective dose equivalent (TEDE)
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Radiation Safety and Protection continued
Deep-dose equivalent (DDE) Committed effective dose equivalent (CEDE) Shallow-dose equivalent (SDE) Eye dose equivalent (LDE) D derived air concentration (DAC) Occupational dose Public dose Restricted area Unrestricted area
Occupational limits Whole body total effected dose equivalent Individual organs Skin, Lens of eye, or any extremity Summation of internal and external exposures Planned special exposures Minors Embryo/fetus of occupationally exposed worker Emergency exposures
Limits for individuals, i.e. members of the public Effective dose equivalent limits Exposure rate limits for unrestricted areas Family members of radioactive patients
As low as reasonable achievable (ALARA) philosophy Principles Recommended levels Radiation protection programs as described in title 10 CFR part 20
Restricted and unrestricted areas Exposure rates Access Signage
Radiation Detectors and Monitors Regulations concerning possession of instruments Survey instruments
Geiger-Mueller counter Ionization chamber Liquid scintillation counter Well counter Comparison of devices
Personnel monitors Regulations X-Ray film dosimeter Thermoluminescent dosimeter Pocket ionization chamber Care and use of devices
Radiation Safety and Protection Continued
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Potential sources of erroneous readings Digital systems
Personnel Monitoring Regulations Bioassay following use of radioiodine Personnel exposure records
Practical Methods of Radiation Protection Time
Principles Applications Calculations
Distance Principles Applications Calculations
Shielding Principles Applications Calculations
Possession of Radioactive Materials Licensed materials
Radioactive materials for use in humans Controlled reference sources Exempt sources
Activity inventory limits Sealed sources
Regulations Inventory Leak tests
Lost sources Institutional Oversight (According to NRC regulations)
Radiation Safety Officer (RSO) Responsibilities Training requirements Delegation of authority
Radiation Safety Committee Responsibilities Composition Frequency of meetings Records
Quality Management Program (QMP) Covered radionuclides Written directives Patient identification Following directives Recordable and reportable event
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Radiation Safety and Protection continued
Records Radiation Safety Procedures
Worker protection Regulations Posting notices Radiation safety educations Notification and reports to workers Workers’ rights Declaration of pregnancy
General safety rules when working with unsealed radioactive sources Use of shields and labels
Regulations Syringes Vials
Radioactive liquids Regulations Preparation of kits
Radioactive gases and aerosols Regulation Storage of volatiles and gases Room concentration limits Negative pressure requirements Calculation of room clearance time Handling of iodine 131 liquid
Protection of the Patient Measurement of dose to be administered
Regulation Calibration requirements Instrument requirements Instrument quality control
Labeling of patient doses to be administered Regulation Methods
Recordable event Regulation Definitions Procedures
Reportable event (misadministration) Regulations Definitions Procedures
Radioactive Material Packages Receipt
Regulation
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Procedures
Shipping Regulations Procedures Labels
Waste Disposal Procedures and Regulation Waste exempt from disposal regulations Decay-in-storage Discharge into sewer system Discharge into atmosphere Transfer to authorized recipient
Contamination
Ambient does rate survey Regulations Survey instrument requirements Survey instrument quality control Procedures Action and trigger levels
Removable contamination survey Regulations Procedures Action and trigger levels
Decontamination of minor spill Definition Procedures
Decontamination of major spill Definition Procedures
Radionuclide Therapy Regulations Responsibilities of RSO and authorized user Dose administration
Patient identification Written directives Informed consent Procedure
Release and isolation criteria Restrictions Instructions to patient
Limited restrictions Restrictions Instructions to patient
Radiation Safety and Protection continued
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Safety precautions involving patients in radiation-based isolation
Nursing instructions Instructions to patient Room preparation and sign posting Contamination control Room decontamination upon discharge Disposal of waste Patient care and control Visitor control Personnel monitoring Bioassay of personnel
Measurement of exposure rates Surveys of restricted and unrestricted areas Safe distance markers Calculated nursing time
Procedures in case of death, autopsy, or emergency surgery NRC Rules and Regulations
Title 10 CFR part 19 Posting of notices to workers Instructions to workers Notification and reports to individuals Request for inspections
Title 10 CFR part 20 Radiation protection programs Occupational dose limits Radiation dose limits for individual members of the public Surveys and monitoring Control of exposure from external sources in restricted areas Respiratory protection and controls to restrict internal exposure in
restricted areas Storage and control of licensed materials Precautionary procedures Waste disposal Records Reports
Title 10 CFR part 35 ALARA program Radiation Safety Officer (RSO) Radiation safety committee (RSC) Quality management program (QMP) Misadministration Possession, use, calibration, and check of does calibrators Calibration and check of survey instruments Measurement of radiophamaceutical doses Authorization of calibration and reference sources Syringe shields and labels
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Radiation Safety and Protection continued
Vial shields and labels Mobile Nuclear Medicine Service Storage of volatiles and gasses Decay- in – storage Permissible Mollybdenum-99 concentration Control of aerosols and gasses Use of radophamaceuticlals for therapy
Title 49 CFR 170 1. Regulations and rules governing transportation of radioactive materials
State Regulations Radiation control Program
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PHYSICS PART 1 AND PART 2 SYLLABUS
Objective: Upon completion of part one the student will be familiar with, the basic principles of electromagnetic physics and the nature of radioactivity as it relates to nuclear medicine. Students will become familiar with terminology as it pertains to radiation physics. Part 2 is a more in-depth instruction of nuclear physics covering atomic structure, production of radioactivity, natural and induced nuclear reactions modes of radioactive decay, binding energy, conservation of energy, types of radioactive decay, decay schemes, interactions of radiation with matter, theory and dosimetry. Student will be able to perform calculations pertaining to these principles. There will be three exams, and weekly quizzes. There will be 3 Labs. Instructor: Nancy Butterworth Text: All text , handouts, web based programs and learning modules.
Historical View of the Atom Terminology
Matter Substance Mixture Compound element Atom Subatomic particles Nuclide
Contributors to theory and experimental evidence of the current concept of the atom and nuclear energy
Structure of the Atom Composition
Proton Neutron Electron Neutrinos Antineutrino Other elemental particles
Electron shells and stability Orbital and suborbitals Pauli exclusion principle Energy states Periodic table
Ions and ionization Atomic nomenclature
Symbol notation Atomic number Mass number Neutron number Element
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Valence
Isotopes Isobars Isotones Isomers Units of nuclear mass and energy Mass energy equivalents
Radiation and the Atom Definition Historical contributions
Bequerel The Curies Others associated with early inventions, developments and
applications to the field Types of Radiation
Primary Secondary Electromagnetic
Velocity Wavelength Frequency Energy calculations
Electromagnetic radiation production mechanisms Atomic
Bremsstrahlung Characteristic
excitation electron capture internal conversion binding energy and energy states
Nuclear stability N/p ratio and the line of stability Binding energy Nuclear models
Characteristics of radioactive decay Displacement law Nuclear transformation modes
Beta minus decay Positron decay Beta and gamma decay sequential Isomeric transition Electron capture Alpha decay Photodisintegration
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Physics Part 1 and Part 2 continued
Results of nuclear transformation Primary
Particles Energy
beta particle energy spectrum maximum and average beta energy photons
Secondary Internal conversions Characteristic x-rays Auger electrons
Decay schemes Components Information obtained
Units of activity and exposure Curie (Ci) Radiation absorbed does (rad) SI unites and conversions
Specific activity and radoconcent5rations Trilinear chart of the nuclides Representative equations for radioactive decay
Nuclear reactions Spontaneous Particle bombardment Equations for expressing nuclear reactions Neutron activation Radionuclide production
Fission Reactor production Particle acceleration
Linear accelerator Cyclotron
Generators Parent/Daughter equilibrium relationships
Secular Transient No equilibrium Calculation of generator yield Calculation of time of maximum daughter activity
Photodisintegration
Particulate interactions with matter Alpha
Excitation Ionization Transmutation
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Beta minus particles Excitation Bremsstrahlung Ionization
Positrons Origins Interactions
Excitation Bremsstrahlung Ionization Annihilation
Gamma and X-ray Interaction with Matter Scatter mechanisms
Coherent Compton
Full absorption mechanisms Photoelectric Pair production Photodisintegration
Secondary radiation Bremsstrahlung Characteristic radiation Auger electrons
Interaction Relationships Energy Atomic number
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COMPUTER APPLICATIONS
SYLLABUS
Upon completion of this course, the student will be able to discuss, describe, and perform the configuration function and application of computers in nuclear medicine. Students will have extensive clinical experience performing data acquisitions, manipulations, and processing. Instructor: Nancy Butterworth Text: Clinical Computers in Nuclear Medicine: Harkness, handouts, practical clinical experience.
Types of computer A. Microcomputers B. Minicomputers C. Mainframes D. Supercomputers
Number systems Analog versus digital information Decimal Binary Octal Hexadecimal Conversions from one number system to another Bits, Bytes, Word
General Structure of Computer Hardware Processor of System Unit
CPU Control unit Arithmetic logic unit
Main memory or primary storage (RAM) I/O Devices
Input devices Keyboard Mouse Joystick Light pen Touch screen Digitizer/scanner Pen-based computer
Output devices Image display monitors Printers Plotters Voice output devices
Memory Random access memory Read only memory
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Programmable read only memory EPROM Main memory Cache memory Buffer memory Auxiliary storage
Software Applications software System software
Operation system Utilities Language translators
Languages Machine Assembly Higher level
Communications System model Communications channel Communications equipment Communications software Protocols Networks
Ethernet local area network Wide area network Configurations
Data Management Types of files Types of databases
Internet Definition History Organization structure Hardware requirements Software requirements Services
Nuclear Medicine Computer Systems Gamma camera/computer interface
Analog to digital converters Purpose Types
Buffer Zoom
Magnification vs. resolution Interpolation
Acquisition
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Types Frame List Multiple gated Tomographic
Matrix types and sized Word Byte
Memory requirements Addresses Counts per address
Memory Types Advantages
Display Systems Planar filter options
Temporal Spatial/Smoothing
SPECT Reconstruction techniques Back projection Fourier reconstruction Iterative reconstruction Slice thickness selection Reorientation
SPECT Filters Filter design and selection
Selection criteria Types Cutoff Frequency Nyquist frequency Dampening factor Multi-camera head reconstruction techniques
Data processing programs Field uniformity correction Background and foreground correction Attenuation correction Motion correction Contrast enhancement Scaling and normalization Image arithmetic Display manipulations dead time corrections Center of rotation and error corrections Regions of interest Curve generation and manipulation Automatic edge detection
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Gray scales Image registration and co-registration Three dimensional reconstruction Polar map generation
Use of computers in quality control programs Linearity Sensitivity Gain Analog versus digital conversion Resolution Spatial distortion Integration with imaging systems Validation of software Radiopharmacy management systems
Quality control Environmental control Power supply Test patterns Software QC programs Pixel sizing
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RADIOPHARMACY AND RADIOCHEMISTRY SYLLABUS
Objective: Upon completion of this the student should be able to define and discuss the theory and practice of radiopharmacy and radiochemistry, including preparation, calculation of doses, quality control, radiation safety, and applicable regulations. The student will practice hot lab techniques, kit preparation, and dose withdrawal techniques in preparation for their clinical experience. The student will also visit a local radiopharmacy. Instructor: Nancy Butterworth Text: Nuclear Medicine: The Requisites, Fundamentals of Nuclear Pharmacy, handouts, and practical lab Introduction
Terminology Nuclide vs. isotope Radionuclide and radioactivity Radioactive drug Units of radioactivity Specific activity Specific concentration Carrier content Half-life
Basic characteristics of a radiopharmaceutical Radioactive component Pharmaceutical component
Desirable characteristic for a readionuclide in nuclear medicine Limiting agents
Patient’s radiation dose ALARA Sufficient photon flux and activity for imaging Speed of uptake and imaging times Instrument limitations Diagnostic versus therapeutic requirements
Ideal characteristics for diagnostic nuclide Type of radiation Energy Monoenergetic versus multiple energies Half-life
Ideal characteristics for therapeutic nuclides Type of radiation Energy Half-life
Desirable characteristics for a radiophamaceutical Non- invasive, non-pharmacologic Clearance time
Plasma clearance
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Target uptake Target clearance Biological half-life Target to background ratio Ease of preparation Shelf-life
Routes of administration Oral Intravenous injection Inhalation Intrathecal Intracavity Subcutaneous Urethral infusion
Radiation Protection in reference to radiopharmaceuticals Licensing and regulatory control
NRC and Agreement states FDA DOT OSHA EPA USP
Reducing exposure from various sources Ingestion Inhalation Absorption Injection
Storage and control of licensed materials Quality management program for therapeutic radiopharmaceuticals
Patient identification Dose ranges Written directives Informed consent
Recordable and reportable events Definition Procedures following occurrence
Dose calibrator and quality control requirements Dose measurement Allowable dose ranges Quality control
Permissible Mo-99 concentration Use and labeling of syringe shields and vial shields Storage and dispensing of radioactive volatiles, gasses and aerosols Radioactive Packages
Receipt Shipment Labeling
Waste disposal procedures and regulation
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L. Control of contamination Removal
Procedures Action Trigger levels
Decontamination of minor and major spills Definition Procedure
FDA Control of Pharmaceuticals
Scope of control Research requirements
Basic research Investigational new drugs New drug application
Regulations for use of in nuclear medicine facilities Effects of reimbursement on the use of radiopharmaceuticals
Importance of reimbursement Who controls reimbursement levels How it effects use of radiopharmaceuticals
Radiopharmacy design Layout Safety considerations Record keeping computers
Radiation exposure to nuclear medicine patients Factors General dose levels Hazards and precautions for pregnant women Hazards and precautions for nursing women
VII.Adverse Reactions General information Vasovagal reactions Pyrogenic Allergic Anaphylactic Reporting mechanism
Radiochemistry Definitions
1.Types of aqueous solutions 2.Chemical species
B.Reactivity 1.Valence state 2.Free radical 3.Oxidation numbers 4.Oxidation-reduction reactions
Radiopharmacy/Radiochemistry
Chemical bonds
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Technetium chemistry Terminology and chemical formulas Oxidation state Types of technetium compounds Radiolableling with technetium Undesirable technetium complexes Radiolabeling with long-lived isotopes Tagging blood components
Radionuclide generators Principles
Parent/daughter relationship Equilibrium Transient versus secular equilibrium Effects of elution
Mo-99/Tc-99m generators Components and configuration Changes in activity with time and elution Elution efficiency Calculating yield Elution technique Wet versus dry Causes of fluctuation in yield
Molybdenum loading inconsistencies Channeling Radolysis mechanical problems
Rb-81/Kr81m generators Configuration Changes in activity with time and elution Useful lifespan
Quality control Radionuclide purity
Definition Basic calculation Effects of impurities Sources Test methods Purity versus time
Radiochemical purity Definition Basic calculation Effects of impurities Sources Test methods Limits Purity versus time
pH Definition Effects of impurities
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Desired range Test method
Particle size Definition and ranges Test methods Limits
Visual appearance Color Clarity
Sterility Pyrogenicity
Definition Effects of contaminants Sources of contaminants Methods of achieving apyrogencity Test methods
Preparing Tc-99m labeled kits Kit components Kit production Reconstitution Record keeping Compounding technique
Dose Determination Dose range
Factors affecting dose determination NRC acceptable ranges NRC calibration requirements
Calculation of dose to be administered Specific concentration Volume to be administered Dilution of doses Adjusting unit doses Accounting for decay
Calculation of pediatric doses to be administered Factors affecting pediatric dose determination Methods for administered dose calculation
Minimum and maximums Body surface area Administered dose per unit weight Clark’s rule Webster’s rule Age practical rule
Biorouting Clearance and uptake times
Radiopharmacy/Radiochemistry
Mechanisms
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Individual Radiopharmaceuticals
Individual Radiopharmaceuticals will be gone over in conjunction with anatomy and physiology and nuclear medicine imaging/non-imaging procedures.
These radiopharmaceuticals will cover the following: Alternate names Studies for which the radiopharmaceutical is used Dose range and route of administration Specific chemical and physical properties Method of preparation Biorouting mechanism Critical organ dose gonadal dose, whole body dose Quality control consideration and limits Precautions and adverse reactions, including special handing requirements Interfering agents and their effects
Interventional pharmaceuticals Administration by NMT’s Alternate names Studies for which pharmaceutical is used Pharmacologic action Dose range and route of administration for each Method of preparation Precautions and adverse reactions Interfering agents and their effects
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PATHOLOGY SYLLABUS
Objective: Upon completion the student should be able to recognize, discuss, and classify diseases and their general processes. This is an introduction course. More in-depth, system oriented pathology will be integrated in anatomy and physiology. Instructor: Nancy Butterworth Text: Materials provided by instructor I. Introduction to Pathology
A. Terminology B. Disease characterizations
Familial Hereditary Congenital Acute Subacute Chronic Reversible Irreversible
Disease classifications Cellular Inflammatory Neoplastic/tumor Metabolic/hormonal Fluid/electrolyte Infectious Nutritional Traumatic Chemical Allergic Congenital Hereditary Growth disorders Idiopathic Physical environment Vascular Psychological
II. General Disease Processes A. Inflammation
1. Causes 2.Manifestation Progression Treatment
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Pathology continued III. Infection
A. Cause Manifestation Progression Treatment Altered immune system
Allergic reactions Autoimmune disorders Transplant rejection
Benign Neoplasms Causes Manifestation Progression Treatment
Malignant Neoplasms Causes Manifestation Progression Treatment
Healing Normal process Obstacles to healing Complications
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ADMINISTRATION OF HEALTH CARE DELIVERY SYSTEMS SYLLABUS
Objective: Upon completion of this course the student will know the basic process and theory of administering a health care system. Students will have an understanding of the complexities of health care, continuing changes in the system as it relates to patients and their profession, methods, and developments. Instructor:, Administrator Department of Radiology; Nancy Butterworth Text: Lectures, notes, video presentation. I. Historical Overview of Health Care Delivery
A. Health care in the 18th century B. Health care development in the 19th century C. Health care development in the 20th century D. Health care reform in the 1990’s
II. Developing role of government III. Insurance systems
A. Retrospective fee for service system 1. Medicare and Medicaid
a) Health Care Finance Administration (HCFA) b) Original configuration c) Development of DRGs d) Effects of DRGs and other payer plans e) Common procedural terminology (CPT) f) Ambulatory payment codes (APC, and international classification of diseases, Ninth revision (ICD_9) codes g) New developments
2. Managed care systems B. Health maintenance organization (HMO)
1. Configuration 2. How costs are controlled 3. Impact on health care costs 4. Capitation 5. Preferred providers organizations (PPO)
a. Configuration b. How costs are controlled c.Impact on health care costs
d.Capitation IV. Hospital Economics and Organizations
A. Classification 1. Ownership and system affiliation 2. Location 3. Levels of care provided 4. Primary 5. Secondary
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Administration of Health Care Delivery Systems continued
6. Tertiary a) Teaching status
7. Accreditation 8. External influences 9. Internal influences 10. Administrative structure and governance 11. Mission and vision 12. Budgetary considerations
a) Operating budget b) Capital budget c) Monthly budget and variance report d) Effects of managed care
13. Adaptation and survival techniques a) Strategic planning b) Advertising c) Product line and centers of excellence d) Affiliations, networks, and mergers e) Critical pathways
V. Other delivery systems A. Outpatient clinics B. Emergency medical clinics C. Home health care D. Public health E. Mobile clinics F. Nursing home and extended care facilities Telemedicine
VI. Current trends and issues A. Continuous quality management and total quality management
1. Definitions 2. Change in view 3. How they work 4. Effects
B. Shift from hospital-based to outpatient-based care 1. Cost effectiveness 2. Payer problems
C. Shift to manage care 1. Effects on quality of care 2. Effects on the cost of care 3. Effects on patient healthcare relationship
D. Who pays 1. Employer versus employees 2. Independently insured 3. Uninsured 4. Paying for indigent care
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E. Effects of competition
1. For profit environment 2. Quality versus cost savings 3. Measuring productivity and appropriate utilization 4. Marketing of health care 5. Effects of patient satisfaction 6. Surveys and how they are used
VII. How consumers affect the health care delivery system A. Patient rights B. Legislative response C. Difficulties D. Effect
VIII. Role of health care worker A. Professional/ethical responsibilities B. Loyalty C. Cost containment D. Public relations and empathy E. Surviving in today’s health care environment
IX. Future of health care A. Pew Commission’s three major issues
Access 1. Is health care a right 2. Are we rationing health care 3. Why access is now limited 4. Who will pay and how
B. Quality 1. How to measure quality and who measures it 2. Rationing
C. Cost D. Critical pathways
1. Who decides on appropriate treatment 2. What ware we willing to pay 3. How do we contain costs 4. Rationing?
E. Developing technology and drugs F. Does manage care work? G. Alternatives H. Current events
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ETHICS AND LAW IN HEALTH CARE
Objective: Interactive learning techniques such as case studies, group discussions, and incorporation of related current events will be used when presenting this material. Students will become proficient in utilizing analytical and decision-making processes in relation to ethical and medical legal issues. Instructor: Nancy Butterworth Text: Reference, handouts, notes, videos,, interactive sessions. I. Codes of Ethics
A. Examples of professional codes B. Ethical theories
1. Utilitarianism 2. Deontology
C. Ethical principles 1. Autonomy 2. Non- malfeasance 3. Beneficence 4. Justice 5. Paternalism 6. Fidelity 7. Truth
D. Employee responsibilities 1. Facility policy compliance 2. Work ethic 3. Patient Bill of Rights
(i) American Hospital Association (AHA) (ii) Others
E. Patient confidentiality and privacy 1. HIPPA 2. Medical Records 3. Teaching files 4. Ethical behavior
(i) Diagnosis (ii) Prognosis (iii) Counseling
II. Scopes of Practice III. Definition IV. Standards versus Scope V. Liability/legal Issues VI. Civil liability VII. Intentional torts
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Ethics and Law in Health Care continued X. Assault XI. Battery XII. False imprisonment XIII. Infliction of emotional distress
A. Intentional B. Negligent
XIV. Defamation A. Libel B. Slander
XV. Vicarious liability XVI. Elements of torts XVII. Jurisdiction XVIII. Negligence
A. Duty B. Breach C. Injury D. Causation E. Contributory F. Comparative
XIX. Medical A. Standards of care B. Burden of proof
XX. Documentation of errors and other problems XXI. Consent XXII. Patient d Employer/employee responsibilities
A. Labor laws and unions B. Employment discrimination law
1. Equal Pay Act of 1964 2. Age Discrimination in Employment Act of 1967 3. Rehabilitation Act of 1973 4. Americans with Disabilities Act (ADA) of 1990 5. Family and Medical Leave Act of 1993 6. Civil Rights Act of 1866,1871,1966 7. Disparate treatment 8. Disparate impact 9. Retaliation 10. Prima facie case 11. Harassment and mutual respect in the workplace
a. Quid pro quo b. Hostile work environment c. Protected persons d. Unwelcome conduct e. Employer’s liability f. Sexual harassment g. Non- sexual harassment h. Employer’s responsibility for prevention and prompt remedial acti
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12. Assault and battery 13. Infliction of emotional distress
Intentional Negligent
14. Invasion of privacy 15. Wrongful discharge
XXIII. Conditions of employment 1. Position descriptions 2. Drug screening 3. Background checks 4. Misrepresentation
XXIV. Liability coverage
A. Employer B. Personal
XXV. Equipment Safety A. Safe Medical devices Act of 1990 B. Save Medical Devices Act-Compliance Program C. Employee awareness
XVI. Safety A. Patients B. Employee
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LEADERSHIP AND PROFESSIONALISM
Objective: Upon completion of this course the student will earn to deal with interpersonal relations in the professional setting and specific professional issues, such as scope of practice and professional responsibilities. Also included, is a unit on problem solving, and troubleshooting. Instructor: Nancy Butterworth Text: Lectures, discussions, printed materials, case studies, and problem solving exercises. I. Interpersonal Relationships
Definitions Interaction Relationship Role
Types of relationships in health care Patients and families Coworkers Physicians Management
Factors affecting behavior Past experiences Present situation Needs (Maslow’s hierarchy) Roles and responsibilities Environment
Tools for developing effective interpersonal relationships Knowledge Communication skills Technical skills Self-concept Conflict prevention Conflict resolution
Patient- Technologist Relationship Professional Relationships
Patient focus Cooperation and teamwork Role conflict Professional etiquette
Professional Issues Attitude
Upholding goals of profession Support of professional organization Keeping professional confidences Maintaining competency Professional image
Personal Appearanc
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Scope of practice
As defined by profession State regulations and restrictions Job descriptions (institutional scope of practice) Updating skills
Personal Health Stress management Healthy living
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RADIOASSAY AND NON-IMAGING PROCEDURES
Upon completion, the student will be able to define and describe the theory, principles, and procedures for radioassay and perform non-imaging nuclear medicine procedures. Instructor: Nancy Butterworth Text: Printouts, lectures, demonstrations,, labs, I. Basic description and historical aspects II. Antibody production III. Competitive assay
A. Types B. Reagents C. Basic method
1. Procedure 2. Law of mass action 3. Equilibrium
D. Data reduction E. Examples
IV. Direct or sandwich method A. Reagents B. Basic method
1. Procedure 2. Sequential saturation 3. Data reduction 4. Examples
C. Quality control 1. Controls 2. Curve analysis 3. Statistical analysis
a. Standard deviation b. Coefficient of variation c. Levy-Jennings graphs
V. Hematology and In vitro Procedures A. Review of anatomy and physiology B. Pathology for each of the following diseases, these topics will be discussed
1. Anemias a. Pernicious anemia b. Megaloblastic anemia (B-12 or folic acid deficiency) c. Thalassemia d. Autoimmune hemolytic anemia e. Traumatic cardiac hemolytic anemia f. Hypersplenism
C. Malabsorption syndrome D. Polycythemia vera
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VI. Procedures: Schilling Test, Plasma volume, Red cell mass, Total blood volume, Red cell survival and sequestration, GFR, ERPF.
VII. For each of the above procedures, the following format will be followed A. Indications B. Radiopharmaceutical C. Contraindications D. Adverse reactions E. Patient Preparation F. Equipment G. Basic procedure H. Basic processing I. Interpretation of data J. Diagnostic/Prognostic value of the study
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PATIENT CARE AND EMERGENCY PROCEDURES
Objective: Upon completion of this course the student will be able to provide a level of patient care within the scope of practice for entry level nuclear medicine technologists as defined by the JRCNMT. Student will be able to communicate, address age-specific needs, maintain patient care, and provide emergency medical needs as necessary. Student will also maintain CPR or basic life support (BLS) certification. Instructor: Michael Mc Kenna, RN, BSN Text: Printed material, lectures, notes, and skill labs.
I. Patient communications and Interactions A. Components of communication Verbal
Talking Listening Tone, inflection, volume, style
Non-verbal Body language Facial expressions Social distance
Problems in communication Effects of positive and negative methods Barrier to effective communication Confrontational versus non confrontational communication
Methods for communication with patients demonstrating specific behaviors or moods Hostile Upset Anxious Depressed Psychotic Manipulative Frightened
Communications with specific groups Terminally ill chronically ill Cancer Unconscious Developmentally or mentally impaired Physically impaired Sensory impaired Non- English speaking Culturally diverse
Age specific communications and care
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The following will include: Developmental changes, Impact of illness, Patient’s age-specific needs, Adapting to age-specific needs Infant Toddler (1-2 yrs) Preschool and grade school (3-12 yrs) Adolescent (12-17 yrs) Early adulthood (17-44 yrs) Middle Adulthood (45-60 yrs) Older adulthood (61-79 yrs) Late adulthood (80 + yrs)
Verification, Identification, Assessment, and Medical Records Requisition Process
Receipt of order Verification of order
Patient verification Explanation of procedure (importance) Ascertain the patient’s needs as they relate to the procedure.
Comfort Ability to cooperate Safety Level of knowledge and comprehension Medically
Support equipment/personnel Medical Records
Purpose Contents and organization Confidentiality Computer-based Technologist’s responsibilities
Patient transport and safety Transportation
Body mechanics Lifting techniques Proper patient movement Special cases i.e. Casts, Traction, IV’s Catheters, Drainage tubes, Ventilators, Cardiac Monitors, etc.
Safety Safety devices for stretchers, scanning tables, wheelchairs Restraints
Trauma Geriatric Pediatric Physically impaired Psychologically impaired Sedated
“No-restraint’ policies
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Equipment safety Infection Control (It is mandatory students attend the AMH OSHA training and orientation
including Infection Control the following will be a review) General Policy
Medical and Surgical asepsis Disease (nosocomial infections) Methods and sources of transmission Risks to healthcare personnel
Blood borne pathogens Epidemiology risk groups prevention Prophylaxis
Air borne pathogens Controlling Pathogenic contamination
Standard precautions Sharps safety Hand washing techniques Isolation (direct and reverse) Disinfection and antiseptics Sterilization
Autoclaving Dry heat
Disposable equipment Reporting and injury
Special techniques Mask, gowning, gloving for isolation Open sterile packages Maintaining a sterile fields
Patient Support Basic needs
Assistance with dressing and undressing Security of patient property Bedpans and urinal Emesis basins Comfort and modesty Psychological support
Support Equipment Intravenous lines and pumps Catheters Oxygen Drainage tubes Suction devices Traction devices Removable and non-removable braces
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Vital Signs Pulse Respiration Blood pressure Temperature
Emergencies Nausea and vomiting Reactions to medications Syncope and fainting Seizures Diabetes-related hypoglycemia Hemorrhage Shock Cardiac/respiratory events
a. Crash cart b. Codes c. Electrocardiogram d. CPR i. Signs and symptoms of respirator or cardiac distress ii. Obstructed airway iii. CPR techniques for adult, child, infant iv. Infectious disease precautions
Routes of Administration Intravenous
Site selection Commonly used blood vessels
i. Arm ii. Hand iii. Wrist vi. Foot
Factors affecting site selection i. Needle size and gauge ii. Phlebotomy versus injection iii. Angiocatheter placement iv. Bolus injection v. Tissue/vessel quality vi. Procedure requirements vii.
Equipment Needle types and gauges Angiocatheter types and gauges Types of IV tubing Three-way stopcock IV solutions
Patient preparation
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Explain procedure Aseptic technique
Procedure for vessel access Placement of tourniquet Other methods to enhance vessel access Patient position Selection of site Needle position Entering the vessel
Phlebotomy Drawing and dispensing samples Complications Anticoagulants
Injections Routine injection Bolus injection flushes Heparin locks Injection through intravenous lines including central lines, portacateters, etc. Complications
Angiocatheter (IV) setup and use Securing angiocatheter Tubing connections Assuring air free flow Common intravenous fluids Flow rates Removing catheter Complications Proper disposal
Other methods of administration Oral
Aseptic technique Techniques for assisting patients whom have difficulty swallowing pills
Intramuscular injection Site selection Aseptic technique Injection technique
Intrathecal injection Role of the technologist Equipment Maintaining a sterile field
Inhalation Equipment set-up Administration technique
Intracavity Role of the technologist Equipment Maintaining a sterile field
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MASTER CLINICAL EDUCATION PLAN
SECTION III
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INTRODUCTION
The required clinical practicum is referred to as competency-based education. The curriculum is structure based on defined objectives and competencies. Upon successful completion students are able to act as Nuclear Medicine Technologists according to professional standards. The clinical phase of the program is one of the most important aspects of the students’ education. The students put to practice what they are learning in the academic setting. Sixty percent of the students’ grade comprises of their clinical experience. It is therefore, of the utmost importance that the students evaluations are representative of that clinical experience. Clinical education at Abington Memorial Hospital is a planned and structured experience. The entire one year training program is an intersequential integration of didactic and practical learning through classroom presentations, discussions, seminars, demonstrations, and supervised practice of standardized procedures. Each student has access to the clinical facilities. Abington Memorial Hospital Department of Nuclear Medicine offers a balance of nuclear medicine exams sufficient in quantity and variety through means of modern equipment, to offer a diversified education. The clinical experience is governed by an educationally valid plan for all clinical assignments. A standardized evaluation system is followed through documentation of a students’ clinical progress for the purpose of providing developmental assistance. All students’ are required to demonstrate to the Clinical Coordinator, Program Director and Clinical Technologist their competence in carrying out appropriate assignments. Clinical and academic instruction does not exceed forty (40) hours weekly or eight (8) hours per 24-hour day. Academic and Clinical schedules vary, so that the student may acquire the best overall experience during their year. School personnel make every effort to preserve educational cohesiveness without compromising the patient care responsibility of the Nuclear Medicine Department. The program director/clinical coordinator schedules each student to practice individually with a clinical technologist (registered nuclear medicine technologist), on a weekly rotational basis. Students learn under direct supervision from the clinical technologist all phases of routine, specialized, and emergency clinical functions. Clinical assignments are posted. The clinical coordinator or program director supervises clinical assignments and students can expect to occasionally be temporarily assigned to a location other than listed if deemed necessary or advantageous.
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ASSESSMENT OF CLINICAL PERFORMANCE
Evaluations and competencies serve several purposes. They give the Program Director and Clinical Coordinator direction as to how best coordinate the students’ experience. They map the progress of the student and give an overall impression as to how well they are succeeding, and the evaluation and competencies, although subjective, try to provide as close to an assessment to grade the students’ clinical phase of their education. The Clinical Technologist will assess the weekly/bi-weekly evaluation, while the Clinical Coordinator and Program Director will share the duties of doing the Monthly and Quarterly Evaluations, plus the end final Clinical Practicum. Grades will be weighted and assessed on the students’ level appropriate for that evaluation. Monthly evaluations will be ten (20) percent, quarterly thirty (30) percent and the final clinical practicum/competency will be assessed at thirty (50) percent of the total clinical grade. Students will be responsible for having the forms available to the clinical faculty. If the forms are late points will be deducted from the overall evaluation. Monthly reports are due on the last clinical day of the month.. Quarterly reports will be done the last week of the quarter. The final practicum/ competency will be done during the final three weeks of the clinical year. Evaluations will be evaluated toward the student’s expected level of competency. The Program Director will meet and counsel any student at any time if it is felt their progress is not up to expectations Professional Evaluation: Clinical education involves more than just a student being able to successfully complete a particular procedure. Clinical education should teach the student responsibility associated with nuclear medicine technology and the ability of the student to follow direction and work with other people. For this reason, there will be a professional component to all evaluations. There is incorporated into these evaluations, an area where clinical coordinator, program director, or clinical technologist, will note adherence to attendance, personal attitude and behavior, and professional conduct. The following is a list of inclusions: Patient care – conveys confidence and interacts well with patients Professionalism – exhibits logical thought in making decisions and recommendations; demonstrates
respect for confidential patient information; incorporates teamwork into daily routine; asks appropriate questions; goes beyond the basics
Organization – plans time well and is able to perform in a timely manner bases on level of competency
Quality of work – within the students’ limitation based on appropriate level of learning Initiative – motivation and enthusiasm expressed by willingness to progress towards indirect
supervision. Use of Radiation Safety Devices – proper use of shielding, technical factors Department/Room maintenance – cleaning and stocking Punctuality and Dependability – present in clinical site without absence or tardiness. Reliance to
complete all technical procedures begun and to remain in the assigned work area according to
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clinical rotation. Does not leave without notification to clinical technologist or clinical coordinator.
Attitude – receptive to suggestions and constructive criticism, exercises self-control, demonstrates interest in assignments
Technical Application – degree to which student applies knowledge of positioning and technique, knowledge of exams and of department routine.
Clinical Evaluation/Competency Grade Breakdown: Weekly/BiWeekly 20% Quarterly 30% Final Competency 50% Total: 100%
Student Imaging Categories and Procedures: Assessment of the students’ clinical abilities and progress will be monitored and graded on a system of evaluations and competencies. A team consisting of a clinical coordinator, program director and clinical technologists will perform weekly, monthly, quarterly, and final assessments. The supervising clinical technologist, clinical coordinator, or program director according to evaluation will sign all clinical evaluations and competencies. The program director will review all evaluations and meet with any student whom does not receive a satisfactory evaluation. The student will be counseled and will have one week to correct the problem and be reappraised. Clinical meetings will be held on a scheduled basis between the program director and clinical coordinator to determine the progress of students and to make changes where applicable to coincide with their academic lessons. After evaluations are processed, they are to be filed in the students’ clinical record. Definitions: Points:
(n/s) no show, in attendance for 20% of time Poor, rarely equal to approximately 30% of time Below average equal to approximately 50% of time Average equal to approximately 75% of time Above average equal to approximately 85% or above of time
Level 1 – Observation: The student observes but does not directly participate in the procedure with
their assigned clinical technologist. The student observes the clinical technologist in all aspects of the exam/procedure, reviews all aspects of the procedure, and asks appropriate questions.
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Observations should occur when the student is being first introduced to the exam, procedure, or situation where the student is unfamiliar. Observations usually occur during initial rotation to assignment. Students should review case with the radiologist, ask questions, and convey any comments for additional exam information. Students are to release patients according to department policy, and convey any patient instructions for the future if necessary.
Level 2 – Assisted: Students do not work independently but participates on a limited basis under
the direct guidance of their clinical technologist. Students directly perform exams and procedures based on their knowledge. The clinical technologist approves all aspects of the exam, during and after completion. The clinical technologist also evaluates achievement of the student. Students should review exam with radiologist, ask questions, and if necessary convey to clinical technologist any additional exam information required. Students should release patients according to departmental policy, and convey any instructions to the patient for the future if necessary.
Level 3 – Direct Supervision: Students work on a limited dependent basis supervised by a clinical
technologist who reviews the procedure in relation to the students’ achievement, has the student evaluate the condition of the patient in relation to the students’ knowledge, perform patient history, verifies exam under department policy, is present during the procedure, and reviews and approves the procedure. The clinical technologist is present during the procedure but allows the student to perform the majority of the exam. Students are to review exam with radiologist, ask questions, and if necessary convey to the patient the need for further exam information. The student is to release the patient with any instructions to the patient for the future if necessary.
Level 4 – Indirect Supervision: Highest level of achievement for the student. Final Competencies
are based on the student performing at this level. Supervision is immediately available by the clinical technologist *. The student performs all duties associated with the assignment from start to finish. The supervision technologist is responsible for completeness of work. The student will show exam to their supervising technologist prior to completing exam in departmental system and review by radiologist. The student releases patient and coveys instructions for the future if necessary.
* Immediately available is interpreted as the physical presence of a qualified nuclear medicine technologist adjacent to or within verbal distance to the room or location where a nuclear medicine procedure is being performed, and is available for immediate assistance when necessary. Clinical Technologists are always responsible for the end product of their assigned student. The student is responsible for keeping and maintaining their own records and having them available at all times. Students who do not return or maintain required documentation will be sited and assessed demerits. Student Journal:
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It is the students’ responsibility to keep a daily journal of all patient exams and procedures, and non-imaging exams and procedures. Journals must be turned in on a weekly basis for review. Students will draw from their journals, information that maybe used in the academic setting. Students will be provided with a journal and when necessary any additional journals. Students will record patient data in accordance to HIPPA policy and procedures, exam/procedure type and level of performance. Students will also note any technical difficulties or comments about exam. Students will be asked to present cases based on the data in their journals. Attendance Sheets: Students will not sign in or out for themselves and must have their times recorded or initialized by the Clinical Coordinator or designee. If a student is found signing in for themselves or another, he/she will face disciplinary action. Attendance sheets will be reviewed by the Clinical Coordinator and assigned demerits if late. Patient Care: Students enrolled in the Nuclear Medicine Technology Program must be respectful and courteous to the patient at all times, regardless of the circumstances. Should a student witness any physical or verbal abuse of a patient or visitor by a fellow student or employee at any time, that student is required to report it immediately to the nuclear medicine supervisor, program director, or director of radiology. Any student who is responsible for any physical or verbal abuse of a patient or visitor will be subject to dismissal. Solicitation or Distribution: Solicitation is defined as urging or attempting to verbally persuade another individual to buy a product or service, support a cause, join an organization or make contributions to a fund. Distribution is defined as the handing out of printed written or electronic materials that are not official hospital/school business. The primary purpose of this policy is to protect students, employees, patients and visitors from embarrassment or inconvenience caused by unwanted solicitations. Students in violation of the above are subject to disciplinary action. Tips or Gratuities: Accepting tips or gratuities from patients or visitors for services rendered is prohibited. Tokens of appreciation such as flowers, candy or cards sent to the department are for all staff and students to enjoy and are not considered tips. Students who are faced with a patient wanting to show their appreciation should direct them to the Clinical Coordinator. Personal Visitors: Students may not entertain personal visitors during any scheduled clinical hours. If a person visitor comes to your assigned area, you should explain to the person that your assigned area is restricted,
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and that you will meet them at the time of your lunch or break period. If it is an emergent situation, see the clinical coordinator for instruction. Answering Department Phone: Students will be rotated through the office to learn scheduling and office practices. Students are required to employ a polite and courteous manner while using the telephone. Calls should be answered promptly and by giving your name, and department name. Students are advised not to receive personal calls during clinical time unless in an emergency. Equipment: Nuclear Medicine equipment is very costly and needs to be functional on a daily basis for the sole use of patients in need. Students will be responsible for the safe use of all equipment in the department of nuclear medicine. Students will also be responsible for reporting any condition regarding equipment that may jeopardize a patents safety or exam. Students found damaging or causing damage due to inattention, or willful destruction will be disciplined as outlined in operational manual. Substance Abuse: Abington Memorial Hospital and its School of Nuclear Medicine Technology, agree to fulfill their responsibility under the Federal Drug-Free Workplace Act, and to provide a safe and healthy work environment for all employees/students and patients, with the reasonable expectation that all employees and students, will perform their duties at an acceptable performance level and not be impaired by drug or alcohol use. If, however, a student is in need of assistance for his or her own abuse problem, they should seek appropriate treatment through their personal physician or contact the hospital employee program. A student found “under the influence” of drugs or alcohol will be removed from the department and will face disciplinary action. Any student, who uses, possesses, or distributes narcotics, opiates, hallucinogenic, or any other controlled substance or alcohol, while on hospital property or on hospital business is subject to immediate dismissal. In addition, it is the responsibility of the hospital to report such illegal acts to local, state, or federal law enforcement authorities for appropriate action. Students who receive a non-negative report from Employee/Student Health on admission physical will no longer be accepted to the program. Students who receive a non- negative result and who work for Abington Memorial Hospital in a paid /volunteer/student capacity other than the Nuclear Medicine School, will have their result communicated to their supervisor. Legal Prescription Drugs: The above does not apply to the possession and use of controlled substances legally prescribed by a licensed physician for the sole use of that individual.
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Students must report any use of controlled prescription drug use to the Program Director or Clinical Coordinator as they may impair safely using Nuclear Medicine equipment.
PART I
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STUDENT OBJECTIVES
Radiation Safety, Instrumentation, Clinical Procedures……………………………………………..................................................….100 Radiopharmacy, Pulmonary, Cardiovascular, Endocrine………………………......................................................…………………..…101 Skeletal Oncology, Infection, Hematopoietic, Renal, Gastrointestinal, Central Nervous……………………………................................………………………………...102 Radionuclide Therapy, Equipment List, Display Media, Quality Control, Laboratory Equipment……………………………....................................................……………….103 Pharmaceutical List, Patient Care Equipment, Radiopharmaceuticals…………….....................................................…………………..104 Therapeutic Radiopharmaceuticals, Interventional Pharmaceuticals, Non –Radioactive Agents………………………….............................................................…………….….105
Scope of Practice for Student Nuclear Medicine Technologists (As determined by the NMTCB revised for March 2004)
Student Objective List
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Group I Radiation Safety 1. Post appropriate signs in designated areas to comply with NRC regulations. 2. Prepare and package radioactive materials for transportation. 3. Use personal radiation monitoring devices. 4. Review monthly personnel exposure records. 5. Take appropriate measures to reduce radiation exposure. 6. Notify the appropriate authority of excessive radiation exposure. 7. Notify the appropriate authority of misadministration. 8. Utilize proper methods for the use and storage of radioactive material 9. Instruct the patient, family and staff in radiation safety precautions after the administration of radiopharmaceuticals 10. Provide instruction on proper radiation emergency procedures 11. Perform wipe tests and area radiation surveys 12. Prepare, survey and clean radiotherapy isolation room 13. Survey, inspect and inventory incoming radioactive materials. 14. Monitor and dispose of radioactive waste 15. Use proper procedures for managing a radioactive spill
Group II Instrumentation 16. Perform and evaluate quality control on a well counter or probe 17. Calibrate scintillation camera 18. Perform and evaluate field uniformity on the scintillation camera 19. Perform and evaluate detector linearity and spatial resolution on a scintillation camera 20. Assess performance of image recording equipment 21. Determine operational status of survey meter 22. Perform and evaluate accuracy, linearity, and geometry tests of the dose calibrator 23. Perform and evaluate dose calibrator constancy test 24. Perform and evaluate quality control procedures for SPECT camera 25. Perform and evaluate quality control procedures for PET system
Group III Clinical Procedures 26. Maintain and operate auxiliary equipment (as described in equipment/procedures list) 27. Schedule patient studies, ensuring appropriate sequence of multiple procedures, and interact with staff regarding special orders 28. Receive patient and provide proper nursing care during nuclear medicine procedures 29. Communicate effectively with patient, family and staff 30. Provide safe and sanitary conditions and utilize standard (universal) precautions. 31. Recognize and respond to emergency conditions 32. Receive patients verify patient identification and written orders for study; follow up on inappropriate
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orders Obtain pertinent patient history and check procedural contraindications 34. Prepare patient for procedure 35. Select and administer the appropriate radiopharmaceutical by the proper route 36. Prepare proper instrument, computer and auxiliary equipment and acquire imaging procedures as indicated by protocol 37.Evaluate image appearance and perform additional views as required 38. Process and evaluate computer-generated data 39. Prepare and perform cardiac monitoring and/or stress testing 40. Prepare/administer interventional pharmacologic agent 41. Obtain samples and/or data for non-imaging studies 42. Calculate and evaluate results of non-imaging studies
Group IV Radiopharmacy 43. Elute radionuclide generator (if in use ); perform and evaluate quality control tests 44. Review the daily work schedule to plan radiopharmaceutical needs 45. Prepare radiopharmaceutical kits, perform quality control and evaluate results 46. Prepare and dispense diagnostic radiopharmaceut1cals 47. Prepare and dispense therapeutic radiopharmaceuticals 48.Label blood components with a radiopharmaceutical according to protocol Procedures List Pulmonary
Radio aerosol ventilation
Xenon ventilation
Perfusion Perfusion/ventilation quantization Cardiovascular Myocardial perfusion, planar Myocardial perfusion, gated SPECT First pass for EF and wall motion Gated cardiac blood pool, rest
Gated cardiac blood pool, stress Gated cardiac blood pool, SPECT Venogram/thrombus localization Cardiac shunt Endocrine Adrenal imaging Parathyroid Thyroid imaging Thyroid uptake Whole body survey for thyroid metastasis Bone/Musculoskeletal Bone scan, limited, planar Bone scan, whole-body, planar
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Bone scan, 2-phase Bone scan, 3-phase Bone scan, 4-phase Bone scan; SPECT Oncology Breast imaging Ga67 tumor imaging, planar Ga67 tumor imaging, SPECT Monoclonal antibody imaging Peptide imaging Lymphocintigraphy / sentinel lymph node localization Tumor imaging, FIS FDG Infection Ga67 infection imaging Tagged WBC imaging Hematopoietic Bone marrow imaging Plasma volume Red Cell Mass Red cell sequestration Red cell survival Spleen scan with denatured RBCs Renal/Genitourinary Cystogram, direct Effective renal plasma flow (ERPF) Glomerular filtration rate (GFR) Renal anatomy, planar Renal anatomy, SPECT Renal flow Renogram Gastrointestinal Esophageal motility/transit Gastric emptying (liquid/solid) Gastroesophageal reflux Gastrointestinal bleeding Hemangioma Hepatobiliary Gallbladder ejection fraction LeVeen Shunt patency Hepatic pump patency Liver-spleen, planar Liver-spleen, SPECT Meckles Diverticulum Salivary (parotid) Schilling determination H. Pylori breath test
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Central Nervous System Brain flow Brain imaging, planar Brain imaging, SPECT Cisternogram CSF leak CSF shunt patency Radionuclide Therapy Intracavity Polycythemia Vera/leukemia Thyroid carcinoma Hyperthyroidism Metastatic bone pain Monoclonal antibody therapy
Equipment List
Camera/Computer Systems Camera, planar only Camera, with SPECT Camera, dual head, planar Camera, dual head, SPECT Camera, multihead (3-4 heads) Camera, multicrystal Attenuation correction for SPECT Nuclear medicine-specific computer PET/CT Display Media Formatter, multi-imager Laser printer Wet film Dry film Video system Teleradiography (modem) Quality Control Equipment Flat-field flood source (fillable) Co57 sheet source Planar spatial resolution phantom 3-dimensional SPECT phantom Sealed sources, including check sources and transmission sources Non-Imaging Equipment Dose calibrator/G-M meter (Geiger counter) Xenon delivery system Xenon gas trap Aerosol delivery system Thyroid probe
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Well counter Mo99-Tc99m generator Ionization chamber (Cutie Pie) Laboratory Equipment Centrifuge Pipettes Fume hood Laminar flow hood Microscope/hemocytometer Patient Care Equipment Intravenous infusion pump ECG monitor Treadmill O°2 saturation monitor (pulse oximeter Defibrillator Glucose meter
Pharmaceuticals List Tc99m Labeled Radiopharmaceuticals
Tc99m sodium pertechnetate
Tc99m HDP/MDP Tc99mDTPA Tc99m MAA Tc99m sulfur colloid Tc99m disofenin/mebrofenin Tc99m mertiatide/MAG: Tc99m pyrophosphate/PYP Tc99m sestamibi Tc99m tetrofososmin Tc99m DMSA Tc99m HMPAO Tc99m RBC’s Tc99m glucoheptonate Tc99m labeled RBCs Tc99m denatured radiolabeled RBCs Tc99m HMPAO labeled WBCs Tc99m labeled FAB for colorectal cancer imaging (arcituffiomab) Tc99m apcitide Tc99m depreotide Iodine Labeled Radiopharmaceuticals I123 sodium iodide I131 sodium iodide I131 MIBG I125 serum albumin RISA
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Indium Labeled Radiopharmaceuticals In 111 DTPA In 111 oxine labeled WBC’s In111 MAB for prostate cancer imaging(capromab pendetide) In111 pentetreotide Cancer imaging (satumomab pendetide) In111 ibritumomab tiuxetan Misc. Diagnostic Radiopharmaceuticals T120 1 thallous chloride Ga67 gallium citrate Xe133 gas Cr51 sodium chromate labeled RBCs Radiolabeled vitamin B12 (cyanocobalamin) F18 FDG, other PET radiopharmaceuticals Therapeutic Radiopharmaceuticals P32 chromic phosphate colloid P32 sodium chromate Sr89 chloride I 131 sodium iodide Y90 ibritumomab tiuxetan Interventional Pharmaceuticals Dipyridamole Adenosine Dobutamine Aminophylline Captopril Enaloprilat Furosemide Acetazolimide Cholecystokinen/sincalide/CCK Morphine Cimetidine/pentagastrin/ glucagon Misc. Non-Radioactive Agents ACD solution Heparin Ascorbic acid Hetastarch Intrinsic factor Vitamin B 12 Lugol's solution/SSKI Potassium perchlorate TSH EDTA Lidocaine Lidocaine (EMLA) cream Atropine
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SECTION III
PART 2
TABLE OF CONTENTS Introduction …………………………………………………………………….......................…107 Part I Patient care Patient Preparation Administrative Procedures……………………………………………………………….108 Radiation Safety Radiation Protection Radiation Surveys
Decontamination………………………………………………………………………….109
Disposal of Radioactive Waste In-service Education Quality Control Uniformity…………………………………………………………………………….…110 Spatial Linearity/Resolution
Sensitivity Checks SPECT Quality Control Computer Parameters Recording Devices Well Counters/Probes………………………………………………………………..….111 Radiopharmaceuticals Quality of Radiopharmaceuticals Identification and Labeling of Radiopharmaceuticals Dosing of Radiopharmaceuticals……………………………………………………….112 Part II Diagnostic Procedures Positioning Nuclear Cardiology…………………………………………………………………….113 Part III Non-Imaging In- vivo and/or Radioassay Studies……………………………………..114 Part IV Radionuclide Therapy………………………………………………………………….115
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MASTER PLAN FOR CLINICAL INSTRUCTION
The goal of the School of Nuclear Medicine is to produce students of academic and clinical excellence ready to enter the profession with better than entry level skills. Clinical Technologists should be aware that it is the students responsibility to ensure they are getting the proper quantity of the clinical experience to become competent for an entry level technologist. It is the Clinical Technologist’s responsibility they share the knowledge and experience necessary for the student to accomplish their goals. Demonstrating, explaining, and allowing practical experience concerning the scope of practice of nuclear medicine technologists will aid the students towards their goal. Supervised clinical education, experience, and demonstration must include the following:
Patient care and patient recordkeeping
Radiation safety techniques that will minimize radiation exposure to the patient, public, fellow workers and self. (ALARA)
All aspects of Quality Control
Preparation, calculation, identification, administration (when permitted), disposal of radiopharmaceuticals and performance of all radionuclide quality control procedures.
Performance of an appropriate number and variety of procedures to achieve desired clinical
competencies.
Clinical correlation of nuclear medicine procedures. (read with radiologist, clinical staff input)
Learning opportunities for students to develop personal and profession attributes and values relevant to the practice.
After completing the program, each student should have attained a level of knowledge and skill to be capable of performing the various tasks and prepared for entry level into the profession.
Part I Patient care:
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Explanation of procedure and questions that may be asked (by patients or family
members) and appropriate answers Provides safe and sanitary conditions for patient in compliance with universal protection Acquiring medical history, chart review, how exam relates to patients medical history Understanding patients illness, diagnostic procedures related to illness
and how it correlates to diagnostic findings Provides patient comfort and care during and after a procedure. Initiating and calling for assistance, CPR, maintaining oxygen and intravenous fluids and
other life-support assistance until emergency code team arrives.
Patient preparation:
Verify patient identification utilizing hospital policy (name and date of birth) Determine pregnancy status Review written orders for the procedure Obtain a pertinent history and check for contraindications Ensure that informed consent has been obtained when necessary Explain procedure to patient Check patient clothing and linen for objects that may cause artifacts in the images or the
proposed measurements Wait the appropriate length of time after the administration of a radiopharmaceutical to
begin the procedure
Administrative procedures: Students should know the following and perform as part of the daily clinical routine:
Maintains adequate volume of medical supplies, linen, etc… Knows the procedure for ordering radiopharmaceuticals, kits, bulk isotopes, therapy doses. Determine the appropriate sequence for executing multiple procedures Maintains appropriate records of patients dosages, quality control procedures, patient reports
and other required records Knows where to find all pertinent policies and procedure manual
Participates in quality assurance program.
Radiation Safety:
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Students under the supervision of a Registered Nuclear Medicine Technologist, and/or Radiation Safety Officer, maintains compliance with local, state and federal regulations in radiation safety practices
Radiation badges are worn at all times (ring and body) Review monthly personnel exposure records Takes appropriate care to reduce radiation exposure Who to notify in the event of excessive radiation exposure Review and comply with regulations Maintain required records for local, state and federal agencies Appropriate signs for radiation designated areas. Follows regulations regarding receipt and disposal of all radionuclides. Carries out a program to follow regulations regarding therapeutic dosages and follow
up procedures (students are not allowed to directly give therapeutic radionuclide doses)
Packaging radioactive materials according to regulations and keeping accurate records of transfer.
Radiation Protection: Students under the supervision of the Nuclear Medicine Technologist follow appropriate protection procedures thereby limiting the radiation exposure of the patient, public, and co- workers not excluding themselves.
Selecting and using proper shielding to reduce radiation exposure Proper methods for storage and disposal of radioactive materials Identifying and using proper procedure for those radionuclides that pose special
hazards (I131, Sr89) Performing bioassay as per state and/or federal regulations.
Radiation surveys:
Performing and knowledge of calibration methods and procedures Setting frequency, locations for surveys, and following a schedule of performing
surveys. Using appropriate survey meters for each type and level of activity Follow regulations regarding personnel surveys and reporting to the designated
physician or RSO Performing constancy checks on survey meters Performing wipe tests where applicable Performing leak tests on sealed sources Recording data in standard format
Decontamination procedures:
Demonstration and experience wearing appropriate clothing and foot covering as necessary
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Blocking access to a contaminated area and confining a spill Removing contamination or reducing the activity to acceptable levels Monitoring the area and personnel involved and repeating decontamination
procedures until activity levels are acceptable Closing off all areas of fixed contamination that are above acceptable levels Identify, storing, or disposing of contaminated material in accordance with
regulations Maintaining adequate records concerning clean up Notifying appropriate authority (Radiation Safety Officer) in event of possible
over exposure or other violations of regulations Assessing and managing patient contamination
Disposal of Radioactive waste
Demonstrates and allows experience with disposal techniques and maintains appropriate records according to license conditions, policy and procedures
In-service Education:
Students participate in all hospital in-service educational programs appropriate for nuclear medicine technologists and other personnel concerning radiation safety, radiation hazards, radiation disaster plans, and principles and practices of radiation exposure and handling.
Quality Control: Students must evaluate the performance of scintillation cameras by means of quality control programs and procedures. Uniformity:
Selecting a radionuclide source of appropriate type, size, quantity and energy Selecting an appropriate pulse height analyzer (PHA) photopeak and window Obtaining uniformity images using standardized imaging parameters Evaluation the images qualitatively and if possible quantitatively in comparison to
the manufacturer’s specifications. Identify the source of any non-uniformity (checking collimator, PHA peak setting) Initiate corrective action when necessary.
Spatial Linearity/Resolution:
Selects a radionuclide, a spatial linearity phantom and obtains images Identifies non-linearity’s in the image and when possible determines the source Initiates corrective action when necessary
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Sensitivity checks:
Selects an appropriate source with an appropriate level of activity and half-life Assures identical geometry, source placement and measurement parameters for
repetitive checks.
Performs SPECT Quality control:
Obtains a high count uniformity flood Obtains a center of rotation correction Evaluates energy correction and spatial coordinates Verifies multi-head detector alignment Evaluates reconstruction results of a phantom acquisition Initiates corrective action when necessary
Computer parameter settings and data interface:
Assures camera and computer register same frame rate at max frame rate Verify that the camera and computer have the same image orientations Obtains a dead-time measurement on the computer Verifies accuracy of ECG gating
Checks analog and/or digital recording devices(s):
Performs a lens focus check of CRT Checks and adjusts imaging device for contrast and brightness (dosimetery) Assesses integrity of imaging device: Maintains cleanliness of all equipment lens, fans, notices if plugs are worn Maintains records for the quality control program
Well Counters/ Scintillation probes:
Calibrates a spectrometer with long half-life radionuclide source Determines energy resolution Performs constancy measurements and determines proper operation Conducts sensitivity measurements at appropriate energies Checks background and determine the cause for levels grater than established
normal levels Performs a chi-square test and interprets results Maintains required records for quality control program
Radiopharmaceuticals: It is a student’s responsibility to learn and experience the purchase of radiopharmaceutical products and adjunct supplies. Administration:
Anticipating and procuring a sufficient supply of radioactive drugs for an appropriate time period in accordance with anticipated need and license possession limits
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Storing drugs and supplies in a manner consistent with labeled product safeguards and radiation safety considerations
Performing and documenting radiation wipe tests upon receipt of radioactive materials
Recording receipt of radioactive materials Following Department of Transportation (DOT) and radiation safety guide lines in
the transport, receipt and shipment of radioactivity.
Quality of radiopharmaceuticals:
Demonstrate aseptic technique for manipulation of injectable products Verifying radionuclide purity of bulk eluates Selecting and preparing radiopharmaceuticals in accordance with manufacturers
specification Calculation and measuring activity of the nuclide with a dose calibrator Configuring
the quality of a radiopharmaceutical in accordance with accepted techniques and official guidelines
Preparing labeled blood cells ( In 111 WBC) in accordance with established protocols
Recording use and/or disposal of all radioactive materials Identification and Labeling
Labeling the container with the radiopharmaceutical, hour, date, expiration time and radiation symbol
Recording radiopharmaceutical and medication information on a patient’s administration form and preparation records
Labeling and segregating radioactive waste and recording this information. Dosing: Student Nuclear Medicine Technologists are under the supervision of a Nuclear Medicine Technologist until such a time they are deemed competent to complete task
Apply radioactive decay calculations to determine required volume or unit form necessary to deliver the prescribed radioactive dosage
Selecting and preparing prescribed dosages and entering this information on a patient’s administration for and/or other records
Labeling the dosage for administration Checking the dosage activity prior to administration in a dose calibrator and
comparing this measurement against the identification label of the dose container ( pre- prepared doses from radiopharmacy)
Using syringe shields at all times
Part II
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Diagnostic Procedures
Students must perform a quantity and variety of nuclear medicine diagnostic procedures to pass competency
Selecting and preparing the instrument for the procedure Selecting appropriate parameters for digital/and or analog acquisition Recognizes artifacts that are due to instrumentation malfunction and initiating
appropriate action Administering/choosing radiopharmaceuticals and/or pharmaceuticals using
standard precautions (universal precautions) Determining route of administration according to established protocol
(subcutaneous, intramuscular, intravenous, aerosol, or oral) Establishing and/or verifying venapuncture access using aseptic techniques Using and maintaining established venous access routes Establishing patterned breathing when introducing radiopharmaceuticals by
inhalation Administering oral radiopharmaceuticals Documenting medication and/or radiopharmaceutical administrations on a
patients permanent record Preparing, determining dosage, and administering non-radioactive
pharmaceuticals under medical direction Positioning:
Recording image data according to established protocols and acquiring additional views when needed to optimize information content
Placing the patient on correct position using supportive materials and immobilizers as necessary
Exercising independent judgment in position a patient or detector unit to best demonstrate pathology
Indicates appropriate anatomic landmarks for each view of the procedure, reviews images to assure that correct information is supplied
Nuclear Cardiology:
Assists the physician/nurse in cardiac stress testing when performed in conjunction with nuclear medicine procedures
Prepares patient’s skin and placing ECG leads appropriately Recognizes and is responsive to any changes that may occur on either a resting or
stress ECG
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Recognizes the parameters that should terminate a cardiac stress study and seeks assistance
Performs data collection, processes and analyzes in accordance with established protocols
Exercises independent judgment in selecting appropriate images for processing Selects appropriate filter, filter parameters, and attenuation correction when
reconstruction SPECT images Defines regions of interest with reproducible results and correctly applies
background subtraction Performs time activity curve generation and additional manipulation Labels processed images to reflect anatomical position Archives and retrieves data from storage media
Part III
Non-Imaging In-vivo and/or Radioassay studies
Operating Laboratory equipment: Check accuracy, precision, and operation of pipetting devices Determines hematocrit using appropriate equipment Prepares standards by choosing appropriate volumetric or gravimetric techniques to dilute standard
Adding radioactive material identical to that given the patient (quantity sufficient) to appropriate volume
Diluting capsule in appropriate solvent if necessary for preparing a standard Uses standard/universal precautions in collecting and preparing patient samples Selects proper supplies (needles, syringes, evacuated tubes, anti coagulants, etc Labels patient information on collection containers Performs venapuncture at appropriate time intervals using aseptic technique Adds hemolyzing compounds to samples when necessary Centrifuging blood and separating blood components as required Storing aliquot of serum, plasma or whole blood according to protocol Instruction of patient and nursing staff as to correct method and time of urine
collection Aliquoting urine sample and measuring total urine volume Measuring specific gravity of urine if required Recognizing and documenting all technical circumstances, which would produce,
invalid results Performing calculations subtracting room or patient background from appropriate
samples Applying appropriate formulas including conversions and dilution factors Calculating results according to procedure uses Reporting both patient values and normal range of specific procedures uses Managing bio-hazardous waste using disposal methods adopted as facility policy
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Part IV
Radionuclide Therapy
Because of certain risk management issues, and according to the ARRT, NMTCB, and Society of Nuclear Medicine recommendations, students are NOT allowed to calculate or administer radionuclide therapy doses to patients. They are, however, allowed to observe and participate with direct supervision, all functions leading up to but not including, administration of a radionuclide therapy dose. Students will observe the following:
Correct radiopharmaceutical identification and dosage preparation Verification of dosage Administration of dose to patient
Students will participate in the following:
Assuring the patient is correctly identified by the technologist and authorized user according to the quality management program in effect
Preparing and/or coordination environmental preparations (decontamination supplies)
Observing prescribed radiation safety procedures during the preparation and administration of such treatments
Patient care instructions to hospital staff, patient, and/or caregivers Conducting and documenting radiation surveys of designated patient areas when
indicated Supplying hospital staff, patient and/or care givers with proper instruction on
handling and disposal of all contaminated supplies when necessary
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SECTION III
PART 3
CLINICAL ROTATIONS Descriptions:………………………………………………………………………………117
ABINGTON MEMORIAL HOSPITAL SCHOOL OF NUCLEAR MEDICINE TECHNOLOGY
MASTER CLINICAL SCHEDULE
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Clinical Rotation Hot Lab: hours (7:00 a.m. – 3:30 p.m.) Objective: Preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals, performance of radionuclide quality control, patient care and recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, quality control procedures. Duties: Q.C of dose calibrator Q.C. Well Counter and Uptake Probe Survey, wipe test, receive shipments from radiopharmacy Prepare returns for radiopharmacy Radionuclide trash storage and disposal Maintain inventory in Syntrak computer system Interview patients for imaging Prepare/Administer appropriate radiopharmaceuticals Perform non-imaging studies (Shillings, RBC Mass, 131 I retention studies, thyroid uptakes Assist and observe therapeutic administrations.
Rotation schedule is Monday to Friday. The student is responsible for having the Clinical staff perform evaluation for the week. Siemens: hours (9:00 a.m.- 5:30 p.m.) General Nuclear Medicine Imaging Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedures, preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Thyroid Uptake and scan Radionuclide VCUG Pediatric Imaging Gastric Reflux Other general imaging as necessary Rotation schedule is Monday to Friday. The student is responsible for having the Clinical staff perform evaluation for the week.
Clinical Rotation continued Vertex: hours (8:00 a.m. – 4:30 p.m.) Nuclear Cardiology/ General Nuclear Medicine
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Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedures, preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Rest/Stress Cardiolite Stress/Rest Thallium Gated SPECT Vantage General Imaging Rotation is from Monday to Friday. The student is responsible for having the Clinical Staff perform evaluation for the week Forte: hours (6:30 – 3:30) Nuclear Cardiology/General Nuclear Medicine Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedures, quality control procedures, preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Technologist/student scheduled to this rotation is responsible for all camera Q.C. Rest/Stress Cardiolite Gated SPECT Vantage General Imaging Rotation is from Monday to Friday. The student is responsible for having the Clinical Staff perform evaluation for the week Skylight: hours (8:30 a.m. – 5:00 p.m.) Nuclear Cardiology/General Nuclear Medicine Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedure preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Rest/Stress Cardiolite Gated SPECT General Imaging Rotation is from Monday to Friday. The student is responsible for having the Clinical Staff perform evaluation for the week
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Dual Head Genesys I: hours (8:00 a.m. – 4:30 p.m.General Nuclear Medicine Imaging Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedure preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Renal Imaging Parathyroid Imaging General Imaging Rotation is from Monday to Friday. The student is responsible for having the Clinical Staff perform evaluation for the week Dual Head Genesys II hours (7:30 a.m. – 4:00 p.m. Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedure preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Technologist/student scheduled to this rotation is responsible for injecting resting Cardiolite
patients. ProstaScint MIBG Octreotide Gallium 131I Whole Body Scan General Nuclear Medicine Imaging. Rotation is from Monday to Friday. The student is responsible for having the Clinical Staff perform evaluation for the week Float: hours (8:00 a.m. – 4:30 p.m) Objective: Patient care and patient recordkeeping, radiation safety techniques (ALARA), performance of an appropriate number and variety of procedures to achieve desired clinical competency, clinical correlation of nuclear medicine procedure preparation, calculation, identification, administration (where permitted), acceptance and disposal of radiopharmaceuticals Observation/assistance during Radionuclide Therapy Bookings of in patient and out patient exams Be present when Radiologist reviews exams. Fill-in where needed.
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It is the students’ responsibility to report to their clinical assignments ON TIME. As scheduled the students will travel to the following Abington Memorial Sites PET/CT – Blairwood Building, Schilling Campus.
This is an observational only rotation. Students will not be allowed to participate and the imaging, injecting, processing of any patient.
Abington Memorial Hospital – Outpatient Nuclear Cardiology Department – Montgomeryville facility.
When appropriate students will rotate with a Registered Staff Nuclear Medicine Technology to this facility and may participate in imaging procedures. Students must have passed all cardiac competencies in order to rotate to this facility. All students must rotate to this facility. The facility is located in New Wales PA. 3 days rotation per week. Abington Memorial Hospital Medical Center, Warminster, PA When appropriate students will rotate with a Registered Staff Nuclear Medicine Technology to this facility and may participate in imaging procedures. Students must have passed all cardiac competencies in order to rotate to this facility. All students must rotate to this facility. The facility is located in New Wales PA. 2 days rotation per week
STUDENTS MUST BE ON TIME AND READY TO PARTICIPATE IN THEIR CLINICAL ASSIGNMENT CHANGES IN THE SCHEDULE WILL BE POSTED ON THE STUDENT BOARD AND IT IS THEIR RESPONSIBILITY TO CHECK SCHEDULE DAILY. STUDENTS MUST BE FLEXIBLE TO TIME, ASSIGNMENTS, AND SHORT NOTICE ACTIVITIES. EVERY EFFORT WILL BE TAKEN MAINTAIN SCHEDULES. (rev nrb 04/ 2008)
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SECTION III
PART 4
TABLE OF CONTENTS
Evaluations Monthly……………………………………………………………………………….….123 Quarterly…………………………………………………………………………………124 Radiopharmacy…………………………………………………………………………...134 Quality Control of Cameras………………………………………………………………133 Final Clinical Practical………………………………………………………………...…TBA
Abington Memorial Hospital School of Nuclear Medicine Technology
Monthly Clinical Evaluation
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Student Name: ________________________________ Date: __________ Circle one: Observed Assisted Direct Supervision In-Direct Supervision 1.) Professional conduct: 0=n/s; 1= poor (failure); 2= below average (less than 75%); 3= average (75% - 89%); 4= above average (90%- 100%) a.) Attendance -observes clinical attendance rules and regulations _____ -ethical use of sick, personal, vacation time _____(#days out) b.) Punctuality -observes clinical schedule start and finish times _____ c.) Appearance -observes dress code rules and regulations _____ d.) Attitude -interacts positively with patients and staff _____ e.) Dependability -reliable and trustworthy _____ f.) Courtesy -polite behavior toward patients and staff _____ 2.) Professional growth: a.) Motivation -demonstrates enthusiasm toward clinical assignments _____ b.) Initiative -readiness and ability to perform/self-starter _____ c.) Judgment -respect for patient confidentiality _____ d.) Communication -effectively interacts with patients and staff _____ e.) Efficiency -speed and accuracy in performing duties _____ f.) Preparation -ability to identify needs of situation _____ g.) Improvement -demonstrated improvement throughout rotations _____ h.) Competence -demonstrates required skill to perform exam _____ 3.) Comments __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Clinical Technologist Signature __________________________________________________ Student signature: _____________________________ Date: ________________________
(revised 2007)
Abington Memorial Hospital School of Nuclear Medicine
Quarterly Clinical Evaluation
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Student Name: --------------------------------------------------------------- Date: ------------------ Total Score:_____ Signature of Evaluator:___________________________________________________ Signature of Student_____________________________________________________ There are four categories of the evaluation form. Each category has specific objectives that must be met in order to pass the evaluation. Each has been given a weight according to its importance and the number of objectives involved. Scores will be weighted in accordance with performance and a total score will be given following each section. Objectives(Obj) Total Weight #of Obj. 1. Performance Tasks
Performs diagnostic nuclear medicine exams 12 pts 8
Performs radiopharmacy
duties 12 pts 7
Performs non-imaging procedures 6 pts 4
Performs quality control
procedures 6 pts 3
Practices radiation safety and protection 9 pts 3
Support functions 5 pts 5
2. Customer Service 30 pts 6 3. Safety 10 pts 5 4. Attendance and Punctuality 10 pts 4
TOTAL 100 pts Students must pass with a 75% (C+)
Part I If a task does not apply, please enter N/A Performance Tasks
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Does the student perform task
Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-90% of time----- ---3 Meets standard 91-100% of time-------4
A. Performs diagnostic nuclear medicine examinations.
Performs high quality dynamic, static, gated and SPECT imaging procedures to obtain the desired diagnostic patient information for the referring physician.
_____1a. Performs the daily operation of a variety of planar and/or tomographic scintillation cameras and associated computer systems in accordance with prescribed departmental procedures to produce information of high diagnostic quality.
_____2a. Checks the quality of images in general, and is responsible to make technical adjustments.
_____3a. Performs qualitative computer analysis on images according to departmental procedures and guidelines. Judges acceptability of results and consults with clinical staff, supervisor or physician when necessary.
_____4a. Recognizes abnormal images and performs special positioning or additional views when necessary, or as requested by the nuclear medicine physician.
_____5a. Receives and positively identifies patient, exam request, and explains procedure in order to obtain cooperation and allay anxieties during performance of procedure.
_____6a. Always obtains data from patients’ chart and records any visual findings that may contribute too additional information in the evaluation of test results, example, surgery, prosthesis, mediations, patient condition.
_____7a. Continually assessed the needs and condition of assigned patient and follows prescribed procedures if a change is observed.
_____8a. Performs exams/procedures in accordance to prescribed protocols. Score _______/(12 pts)
Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-89% of time----- ---3 Meets standard 90-100% of time-------4
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B. Performs radiopharmacy duties.
Performs various radiopharmacy duties including receipt, preparation, administration, and storage of radionuclides and radiopharmaceuticals to ensure safety and integrity of the agents used.
_____1b. Obtains radionuclides from bulk shipments (or generators where applicable) maintaining sterile technique and shielding. All radioactive materials received are checked for leakage and activity according to departmental procedure.
_____2b. Prepares the correct type of radiopharmaceutical and dose for the desired scan with the associated recordkeeping according to departmental policy and procedure. _____3b. Performs quality control of the radiopharmaceuticals to ensure radionuclidic purity, and integrity of agents before administration to patient according to departmental policy and procedure _____4b. Administers correct radiopharmaceutical and dose to patient via the prescribed route; intravenously, orally, or by inhalation.
_____5b. Performs daily surveys of all radiation areas and decontaminates if necessary according to departmental procedure.
_____6b. Stores and disposes of radioactive materials in accordance with departmental, hospital, and state and federal regulations.
_____7b. Records all information regarding receipt, quality control, administration and disposal of radioactive materials in the appropriate log according to departmental, state, and federal regulations with no more than two exceptions per month.
Score________/(12 pts) Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-90% of time----- ---3 Meets standard 91-100% of time-------4
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C. Performs non-imaging procedures.
Performs various non-imaging procedures according to departmental protocol to obtain the desired result or information requested.
_____1c. Performs all non-imaging procedures including collection of blood, urine, or other specimens, and prepares them for counting according to departmental procedure.
_____2c. Performs in vitro, modified, or in vivo red blood cell and white blood cell labeling according to protocol.
_____3c. Operates all laboratory auxiliary equipment (pipettes, centrifuges, water baths, balances, ect) properly.
_____4c. Prepares standard solutions and records all results in laboratory record keeping system.
Score: _______/(6 pts) Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-90% of time----- ---3 Meets standard 91-100% of time-------4
D. Performs quality control procedures. Performs quality control procedures to ensure optimal performance of gamma cameras, computers, and other related auxiliary equipment (dose calibrators, well counters, video imagers, etc.
_____1d. Performs daily, weekly monthly quality control on all instrumentation.. _____2d. Performs calibration procedures on dose calibrator, survey meters, probes and well counters according to departmental procedure _____3. Performs voltage and uniformity checks, linearity, resolution, center of rotation and other indicated tests according to departmental procedures to ensure all equipment is in proper working order.
Score: _______/ (6pts) Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-09% of time----- ---3 Meets standard 91-100% of time-------4
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E. Performs radiation safety and protection.
Practices safe handling of radioactive materials according to departmental, state and federal regulations to ensure minimal radiation exposure to self and others.
_____1e. Follows ALARA (as low as reasonably achievable) guidelines for radiation exposure including the use of syringe shields with no more than one variance per month as observed.
_____2e. Always practices safe handling of radioactive materials to minimize exposure to self and coworkers of the time.
_____3e. Wears film and ring badges and lab coat at all times in departmental areas of the time.
As part of the radiation safety requirement it is mandated that students be counseled concerning film badge reports. The student was informed/counseled on his/her periodic film badge readings, and any action(s) if any were taken ______yes _____no actions taken ______yes _______no, if yes include written report. Student Initials _____________ Score _____/(9 pts)
Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-90% of time----- ---3 Meets standard 91-100% of time-------4
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F. Support Functions.
Performs various assigned duties to ensure goals of the department are met
_____1f. Schedules patients for procedures using radiology information computer system.
_____2f. Maintains work areas in clean and orderly condition and checks daily that exam rooms are properly supplied, equipped, and operational before each exam.
_____3f. Notifies clinical instructor or clinical coordinator when supplies are low. _____4f. Maintains patient exam records (films, computer library, medical history) _____5f. Independently offers assistance to others when not actively doing procedures Score_____/(5pts
Does the student perform task Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-89% of time----- ---3 Meets standard 90-100% of time-------4 Customer Service
Demonstrates standards of behavior in accordance with training to ensure a professional, responsive, and courteous environment for patients, visitors, and colleagues.
_____1. Greets patients courteously, making eye contact and introduces him/herself to the patient. Determines how the patient would like to be addressed, actively listens to patient concerns and assures patient and family or brings it to the attention of clinical staff.
_____2. Maintains confidentiality of designated hospital and patient information at all times with out discussions in public domain areas of the hospital or department.
_____3. Protects the dignity of all patients, avoiding transporting or moving patients in high use areas. Provides sheets, blankets, or other items to keep patients comfortable. Provides other appropriate patient services if requested.
_____4. Demonstrates a professional image/impression to patients and coworkers. Wears I.D. badge, radiation monitoring badges, and all necessary departmental attire (lab coat).
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_____5. Cooperates with staff and supervisors to maintain a courteous and respectful working environment.
Score______/(30 pts)
Part III Does the student perform task
Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-89% of time----- ---3 Meets standard 90-100% of time-------4
Safety
Follows established program and departmental precautions and procedures in the performance of all job duties to ensure a safe work environment for patients, self and others
_____1. Operates assigned equipment and performs duties in a safe manner by following all hospital and departmental procedures as instructed during training /orientation.
_____2. Corrects/reports hazardous spills, equipment, exposed wires. Uses protective equipment/clothing. Uses good body mechanics. Knows/utilizes hospital resources to find appropriate safety polices and procedures (hospital intranet)
_____3. Prepares for all possible emergencies, knows what actions to take. Reports all accidents/incidents promptly. Informs clinical staff/supervisor of any issue, practice or procedure that might impact health and safety.
_____4. Does not take any unnecessary risks. Asks for help freely. Complies with the laws and regulations regarding the handling of radioactive materials. Knows how to contact radiation safety officer, departmental supervisor, nuclear medicine physician. Knows how to report any/all emergencies.
_____5. Makes sure all patient equipment is in order ( oxygen tanks are full and on, i.v.’s not caught in equipment or out of place, monitors are working), and if there is a question, notifies or call the appropriate person (nurse, supervisor, clinical staff)
Total Score_____/(10 pts)
Part IV Does the student perform task
Does not meet standard------------------- 0 pts Meets standard 50% of time------------ 1 Meets standard 75-79% of time ------- 2 Meets standard 80-89% of time----- ---3 Meets standard 90-100% of time-------4
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Attendance and Punctuality Meets program and departmental attendance/punctuality requirements to ensure proper academic/clinical training, and consideration to patients and staff.
_____1. Provides notification for unscheduled absence or lateness in accordance with established program guidelines and practices with no more than one incidence per month.
_____2. Requests scheduled time off in accordance with established procedure. _____3. Arrives to/from clinical/academic site on time.
_____4. Informs program director/clinical coordinator of absence according to procedure Score_____/(10 pts) Comments:______________________________________________________________ ________________________________________________________________________
________________________________________________________________________________
____
Signature of
evaluator______________________________________________________Date_____________
(revised 2007)
ABINGTON MEMORIAL HOSPITAL SCHOOL OF NUCLEAR MEDICINE TECHNOLOGY
Quality Control of Camera Systems
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Evaluates the students understanding and performance of scintillation camera systems quality control.
Circle one of the following: Observed Assisted Direct Supervision Indirect Supervision 1 = poor (failing) 2 = below expectation 3 = expectation 4 = above expectation Select radionuclide source of appropriate activity and energy …….
Calibrate pulse height analyzer …….
Perform field uniformity intrinsically
Perform field uniformity extrinsically …….
Perform spatial and linearity resolution checks …….
Perform QC on SPECT systems …….
Analyze and compare with prior images …….
Maintain the required records for all quality control checks. …….
Total Score: ………
Clinical Evaluator…………………………………………..Date…………… Student Signature………………………………………… Date:_…………_______________ Comments (revised 2007)
AMH SCHOOL OF NUCLEAR MEDICINE TECHNOLOGY RADIOPHARMACY EVALUATION
This evaluation will aid in assessing the student's performance in the Radiopharmacy.
Student Name:_________________________________Date:__________
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Circle one of the following: Observed Assisted Direct Supervision Indirect Supervision 1 = poor (failing) 2 = below expectation 3 = expectation 4 = above expectation Wears whole body and ring badge properly at all times ……. Wears gloves ……. Wears lab coat ……. Uses pre-established technique in preparing radiopharmaceutical kits. ……. Uses aseptic technique. ……. Performs quality control procedures on radiopharmaceutical kits. ……. Demonstrates proper record keeping and labels vials and syringes. ……. Checks expiration dates on radiopharmaceutical kits. ……. Calculates and draws up patient doses. ……. Demonstrates ability to handle contamination. ……. Practices good housekeeping. …….
Arrives on time, and follows assigned schedule. …….
Disposes of radioactive materials properly. …….
Performs quality control procedures on dose calibrator and survey meter. ……. Performs wipe tests and surveys package …….
Total Score: ……. Evaluators Signature: ……………………………………….Date_________________ Student Signature:……………………………………………………._Date_________________ Comments: (revised 2007)
