摘要
【目的】了解《医疗机构放射卫生防护体系管理规范》(以下简称《规范》)实施前后,上海市静安区放射诊疗机构放射防护情况的变化,以期发现放射诊疗机构潜在的问题,进一步提高放射诊疗安全水平。【方法】选取静安区30家医疗机构,采用“放射诊疗机构放射防护监督综合评价表”,对《规范》实施前后医疗机构的放射防护情况进行综合评价,比较《规范》应用前后放射诊疗机构的管理效果。【结果】《规范》实施后,30家医疗机构的各项指标得分均有提高。放射诊疗许可管理方面,只有1家未定级医疗机构未按照规定办理许可证校验,相应得分由86分上升为95分;建设项目管理方面,只有1家未定级医疗机构更换设备后没有进行职业病危害控制效果评价,相应得分由82分上升为97分;未定级医疗机构档案管理方面得分由75分上升为95分。与实施前相比,以上提升均有统计学意义(P<0.05)。此外,未定级医疗机构在人员资质、个人防护用品、检测与评价管理及医疗照射防护方面,提升均有统计学意义(P<0.05)。由于样本量少,无法对一、二、三级医疗机构《规范》实施前后的变化进行统计学检验。30家医疗机构存在的问题主要有:①医疗机构配备专(兼)职管理人员,没有相应的任命书或者任命书分工不够细致等。②放射事件应急预案没有及时修订,应急演练记录不是每年1次。③管理档案相关资料不齐全。④对个人防护材料及用品的配备及使用不规范,没有及时更新,没有对受检者使用防护用品。⑤没有按照相关标准要求定期进行稳定性检测。【结论】《规范》实施后静安区医疗机构放射防护管理情况有明显提升。随着医联体内建立医学影像中心等新事物的出现,卫生监管模式也需要不断改进。
[Objective] To ascertain the differences of radiological protection management levels in medical institution in Jing′an District of Shanghai after the application of Specification for Management of Radiological Protection System in Medical Institution (hereinafter referred to as Specification ),so as to identify potential problems and improve radiological protection management levels.[Methods] A field inspection with radiological protection comprehensive assessment indicators was conducted in 30 medical institutions in Jing′an District.[Results] Big promotion was found in all the selected medical institutions after the application of Specification ,for example,only one unclassified medical institution did not get the licence checked,so the score of this part went up from 86 to 95.Only one unclassified medical institution did not evaluate the occupational hazard after the replacement of X-ray equipment,so the score of this part went up from 82 to 97.The score of radiological health archive management went up from 86 to 95.All of the above improvement had statistical significance( P <0.05).In addition,the improvement of management in qualification,personal protective equipment,measurement and evaluation and medical exposure protection was significantly different( P <0.05). The statistical test could not do because of small samples in secondary and tertiary medical institutions.Problems still remained as follows:(1) Radiological protection management staff was neither authorized with written appointment nor specific job assignments.(2) Radiological emergency plan was neither revised timely nor organized annually.(3) Radiological health archive was incomplete.(4) The distribution and usage of personal protective materials and devices lacked standardization.(5) Constance tests were not regularly done according to relative standards.[Conclusion] The application of Specification proves to be a big promotion for radiological protection management levels in selected medical institutions,yet improvement should still be taken into account with the emergence of new things as the establishment of medical imaging center and others in the medical associations.
作者
班婷婷
陈春晖
BAN Ting-ting;CHEN Chun-hui(Health Supervision Institute of Jing'an District Health and Family Planning Commission,Shanghai 200041,China;Health Supervision Institute,Shanghai Municipal Health Commission,Shanghai 200031,China)
出处
《上海预防医学》
CAS
2019年第7期558-563,共6页
Shanghai Journal of Preventive Medicine
基金
上海市静安区卫生和计划生育委员会基金项目(JWRC2014G16)
关键词
医疗机构
放射防护管理
放射诊疗
medical institution
radiological protection management
radio diagnosis and radiotherapy
