title: Recommendations for Nuclear Medicine Technologists Drawn from an Analysis of Errors Reported in Australian Radiation Incident Registers.
abstract: When a radiation incident occurs in nuclear medicine in Australia, the incident is reported to the relevant state or territory authority, which performs an investigation and sends its findings to the Australian Radiation Protection and Nuclear Safety Agency. The agency then includes these data in its Australian Radiation Incident Register and makes them available to the public as an annual summary report on its website. The aim of this study was to analyze the radiation incidents included in these annual reports and in the publically available state and territory registers, identify any recurring themes, and make recommendations to minimize future incidents.
  
  
  METHODS
  A multidisciplinary team comprising a nuclear medicine technologist, a radiation therapist, and a diagnostic radiographer analyzed all nuclear medicine technology-, radiation therapy-, and diagnostic radiography-related incidents recorded in the Australian Radiation Incident Register and in the registers of New South Wales, Western Australia, Victoria, South Australia, and Tasmania between 2003 and 2015. Each incident was placed into 1 of 18 categories, and each category was examined to determine any recurring causes of the incidents.
  
  
  RESULTS
  We analyzed 209 nuclear medicine incidents. Their primary cause was failure to comply with time-out protocols (85.6%). By analyzing both the causes and the rates of radiation incidents, we were able to recommend ways to help prevent them from being repeated.
  
  
  CONCLUSIONS
  Information drawn from the Australian Radiation Incident Register and 5 state registers has revealed steps that can be taken by any nuclear medicine department to prevent repetition of the incidents that have already occurred.
authors.affiliation: Department of Nuclear Medicine and PET, Hunter New England Imaging, Newcastle, NSW, Australia; and nicole.kearney@hnehealth.nsw.gov.au.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kearney
authors.affiliation: Department of Radiology, Manning Rural Referral Hospital, Taree, NSW, Australia.
authors.forename: Gary
authors.initials: G
authors.lastname: Denham
mesh_terms: D001315:Australia; D006801:Humans; D009683:Nuclear Medicine; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D012042:Registries; D012107:Research Design; D012449:Safety
keywords: adverse events; incident reporting; patient safety; radiation safety