title: The syringe shield rule: model for practitioner-initiated regulatory reform.
abstract: OBJECTIVE
  To implement a performance-based method for maintaining radiation exposures to extremities as low as reasonably achievable while handling syringes containing radioactive materials.
  
  
  METHODS
  University hospital nuclear medicine clinic.
  
  
  METHODS
  Nuclear pharmacy and nuclear medicine.
  
  
  METHODS
  The author petitioned the Iowa Department of Public Health to revise its prescriptive syringe shield rule to allow for the development of a performance-based method while handling syringes containing radioactive material.
  
  
  METHODS
  Following enactment of the revised rule, a new performance-based policy and guidelines for the use of syringe shields were developed and implemented. Extremity exposures for nuclear medicine personnel were monitored in the nuclear medicine clinic and evaluated for 6-month periods immediately before and after implementation of the new policy and guidelines.
  
  
  RESULTS
  The Iowa Department of Public Health responded favorably to the author's petition and revised its rule to allow performance-based methods. Implementation of the performance-based method did not significantly affect extremity exposures.
  
  
  CONCLUSIONS
  Practitioner-initiated regulatory reform for revision of a prescriptive rule to a performance-based rule can be feasible and practicable.
authors.affiliation: University of Iowa Hospitals and Clinics, College of Pharmacy, University of Iowa, Iowa City 52242-1077, USA. james-ponto@uiowa.edu
authors.forename: James A
authors.initials: JA
authors.lastname: Ponto
mesh_terms: D005121:Extremities / Q000528:radiation effects; D017408:Guidelines as Topic; D006801:Humans; D007484:Iowa; D016273:Occupational Exposure / Q000331:legislation & jurisprudence*; D011835:Radiation Protection / Q000295:instrumentation* / Q000331:legislation & jurisprudence*; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D013594:Syringes
chemical_list: D019275:Radiopharmaceuticals