title: Does Real-Time Monitoring of Patient Dose With Dose Management Software Increase CT Technologists' Radiation Awareness?
abstract: OBJECTIVE
  Dose management software can be used to increase patient safety. The purpose of the current study was to evaluate whether real-time monitoring of patient dose in CT examinations increases CT technologists' dose awareness.
  
  
  METHODS
  Dose data of two scanners (clinical routine CT scanner, mainly outpatients; emergency CT scanner, predominantly emergency department and ICU patients) were analyzed before (period 1) and after (period 2) dose management software was implemented in clinical routine and technologists were advised to check for dose notifications (dose values above reference levels) after each examination (i.e., real-time monitoring). To assess statistically significant differences between both the scanners and the study periods, we used chi-square tests.
  
  
  RESULTS
  A total of 6413 examinations were performed (period 1 = 3214 examinations, period 2 = 3199 examinations). Dose notifications were mainly because of patient miscentering (period 1 = 45% of examinations, period 2 = 23%), overweight patients (period 1 = 35%, period 2 = 49%), and scanning repetition (period 1 = 10%, period 2 = 15%). Overall, the number of dose notifications significantly declined in period 2 (period 1, n = 210; period 2, n = 120; p < 0.001). Miscentering was more often seen on the clinical routine CT examinations (period 1 = 46%, period 2 = 23%) than on the emergency CT examinations (period 1 = 44%, period 2 = 22%) and occurred significantly less frequently on both scanners in period 2 (period 1: n = 94; period 2: n = 27; p < 0.001). The relative values of dose notifications due to overweight patients or scanning repetition were higher in period 2, but these differences did not reach statistical significance (p > 0.05).
  
  
  CONCLUSIONS
  Real-time monitoring of patient dose with dose management software increases CT technologists' dose awareness and leads to a reduced number of dose notifications due to human error.
authors.affiliation: 1 Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, Zurich 8063, Switzerland.
authors.forename: Christina
authors.initials: C
authors.lastname: Heilmaier
authors.affiliation: 1 Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, Zurich 8063, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Zuber
authors.affiliation: 1 Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, Zurich 8063, Switzerland.
authors.forename: Bernardus
authors.initials: B
authors.lastname: Bruijns
authors.affiliation: 1 Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, Zurich 8063, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Weishaupt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel; D001291:Attitude of Health Personnel; D001364:Awareness; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods*; D012984:Software; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: CT; dose awareness; dose management software; miscentering; real-time monitoring