MIRA Wk 13 & 14

Risk Managemnet Model

Types of Risks in MRP

physical

psychological

cultural

Physical Risks - Sources

Radiation

Strong magnetic field

Medicines

Incorrect patient identification

Biological agents

Sharp objects

Manual handling

Slips, trips & falls

Workplace violence

Electricity

Ionising Radiation Risks

Stochastic effects - cancer, genetic effects

Non-stochastic effects - skin erythema, sterility, radiation sickness

Ionising Radiation Risk Control Measures

Eliminate - radiological exam must be justified

Substitute - optimise exposure parameters, use non-ionising radiation when possible

Isolate - restricted access areas

Engineering - structural barriers

Administrative - staff training

PPE - lead apron

Non-ionising Radiation Risks

Thermal effect in US, MRI (tissue heating, burns)

Mechanical cavitation in US (cell damage, tissue disruption)

Acoustic noise in MRI (heightened anxiety, verbal communication difficulties)

Non-ionising Radiation Risk Control Measures

Eliminate - US & MRI must be justified

Substitute - if possible, only conduct 2D US

Isolate - MRI sound isolation

Engineering - thermal and mechanical indices (TI, MI) displayed on US screen

Administrative - staff training

PPE - MRI earplugs

Strong Magnetic Field

Risk:

Metallic objects near MRI scanner become projectiles

Control:

Isolate - restricted access

Engineering - ferromagnetic detection system (FMDS)

Administrative - staff training

Medicines

Risk:

contrast agents and radiopharmaceuticals may cause itching, renal toxicity, anaphylaxis

Control:

Eliminate

Substitue - if possible, use non-ionic contrast agents

Administrative - training, reaction risk questionaire, emergency bell (code blue = medical emergency)

Psychological Risks - Sources

Stressful environment

Intoxication

Disrespectful behaviour

Previous/existing mental health issues

Psychological Risks - Effects

Self & colleagues - anxiety, depression, fatigue, aggression

Patients - anxiety, depression, worse outcomes

Psychological Risks - Control

Eliminate - avoid alcohol at work

Substitue - aggression with respect

Engineering - music for relaxing environment

Administrative - mental health training

Cultural Risks - Sources

Differences in age, gender, religion, race, socioeconomic status, geographical location, sexual orientation

Cultural Risks - Effects

Self, colleagues, & patients - disrespectful & stressful environment, poorer service delivery

Cultural Risks - Contol

Eliminate racism, bias, stereotypes

Substitute disrespect for cultural awareness

Administrative - cultural competency training

Mandatory Notification Requirements

intoxication

impairment - mental health, unwell

sexual misconduct

significant departure from accepted professional standards