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Stankiewicz M, Maletta A, Tan C, Howard DAF, Olson DR. BC cancer radiation therapists' perspective on the impact of COVID-19 precautions in clinical practice. J Med Imaging Radiat Sci 2024; 55:101734. [PMID: 39116834 DOI: 10.1016/j.jmir.2024.101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION There were many policy and procedure (P&P) changes implemented in health care facilities to combat the spread of the coronavirus disease 2019 (COVID-19). Common changes included an increase in personal protective equipment usage, room occupancy limits, limitations in visitors/family members and the absence of volunteers. This study evaluated the current views and opinions of Radiation Therapists (RTs) in British Columbia relating to how COVID-19 P&P changes have impacted their clinical practice. The goal was to identify gaps in the areas of RT practice, allow for self-reflection among RTs and potentially guide future P&Ps with patient-centred care at the forefront. METHODS A 24-item cross-sectional questionnaire was created and sent via e-mail to all RTs working across the province. Key sections explored in the questionnaire were: 1) patient care delivery, 2) staff-work environment, and 3) work satisfaction. Descriptive analysis was performed on the questionnaire responses. RESULTS Of the approximate 300 invited participants, 107 responses were received from all areas of Radiation Therapy (Treatment units, CT simulation, Dosimetry, etc.) and from all cancer centres in the province. RT staff indicated that COVID-19 P&P negatively impacted patient care, including the ability to verbally and non-verbally communicate with patients (82 %), assess for side effects (85 %), and build rapport (62 %). A majority (79 %) of RT staff felt that communication with co-workers had been negatively impacted as well. When queried regarding the impact on staff environment, 51 % of RT staff agreed that the absence of volunteers increased their workload and the responses were polarized (46 % disagree, 35 % agree) when asked if RT staff have enough time for cleaning their clinical areas with new COVID-19 P&Ps in place. 78 % of RTs were aware of where to go with COVID-19 safety concerns and thought they received adequate education concerning COVID P&Ps. When asked to rank the factors that most impacted RT practice, RTs identified increased PPE usage (83 %), absence of volunteers (74 %), and room occupancy limits (70 %) as the leading P&P changes that negatively impacted their practice; while plexiglass barriers (39 %), re-arranged workspaces (37 %) and working remotely (12 %) were the least negatively impactful. CONCLUSION The majority of RTs across BC Cancer responding to the questionnaire indicated that their ability to provide patient care and their staff-work environment were negatively impacted by implemented COVID-19 P&Ps. Views regarding COVID-19 P&P training/education was positive, yet there was no consensus regarding whether the changes were implemented smoothly. This study can facilitate reflection among both clinical leadership and RTs on how P&Ps can be implemented in the future and can encourage further retrospective analyses in aiding the development of P&Ps regarding future public health outbreaks.
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Affiliation(s)
- Michal Stankiewicz
- BC Cancer Centre for the North, Radiation Therapy, Prince George, BC, Canada.
| | - Anthony Maletta
- BC Cancer Centre for the North, Radiation Therapy, Prince George, BC, Canada
| | - Christopher Tan
- BC Cancer Centre for the North, Radiation Therapy, Prince George, BC, Canada
| | - Dr A Fuchsia Howard
- The University of British Columbia, Faculty of Applied Sciences, School of Nursing, Vancouver, BC, Canada
| | - Dr Robert Olson
- BC Cancer Centre for the North, Radiation Oncology, Prince George, BC, Canada
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Joyce E, Jackson M, Skok J, Rock B, McNair HA. What do we want? Training! When do we want it? Now? A training needs analysis for adaptive radiotherapy for therapeutic radiographers. Radiography (Lond) 2023; 29:818-826. [PMID: 37331130 DOI: 10.1016/j.radi.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/14/2023] [Accepted: 05/24/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Therapeutic radiographers (TRs) have adapted to the changing requirements and demands of the oncology service and in response to advanced techniques such as on-line adaptive MRI-guided radiotherapy (MRIgRT). The skills required for MRIgRT would benefit many TRs not just those involved in this technique. This study presents the results of a training needs analysis (TNA) for the required MRIgRT skills in readiness for training TRs for current and future practice. METHODS A UK-based TNA was used to ask TRs about their knowledge and experience with essential skills required for MRIgRT based on previous investigations into the topic. A five-point Likert scale was used for each of the skills and the difference in values were used to calculate the training need for current and future practice. RESULTS 261 responses were received (n = 261). The skill rated the most important to current practice was CBCT/CT matching and/or fusion. The current highest priority needs were radiotherapy planning and radiotherapy dosimetry. The skill rated the most important to future practice was CBCT/CT matching and/or fusion. The future highest priority needs were MRI acquisition and MRI Contouring. Over 50% of participants wanted training or additional training in all skills. There was an increase in all values for skills investigated from current to future roles. CONCLUSION Although the examined skills were viewed as important to current roles, the future training needs, both overall and high priority, were different compared to current roles. As the 'future' of radiotherapy can arrive rapidly, it is essential that training is delivered appropriately and timely. Before this can occur, there must be investigations into the method and delivery of this training. IMPLICATIONS FOR PRACTICE Role development. Education changes for therapeutic radiographers.
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Affiliation(s)
- E Joyce
- Royal Marsden NHS Foundation Trust, London, UK.
| | - M Jackson
- St George's University of London, UK
| | - J Skok
- St George's University of London, UK
| | - B Rock
- Royal Marsden NHS Foundation Trust, London, UK
| | - H A McNair
- Royal Marsden NHS Foundation Trust, London, UK; Institute of Cancer Research, UK.
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Devine A, O'Donovan T. Impact of the COVID-19 pandemic on Radiation Therapy Practice: A Catalyst for Research. Radiography (Lond) 2022; 28 Suppl 1:S13-S15. [PMID: 36202470 PMCID: PMC9527504 DOI: 10.1016/j.radi.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Devine
- Corresponding author. UG 13 ASSERT, Brookfield Health Sciences, T12 AK54, Ireland
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Le Tallec P, Gesbert C, Mercier C, Crenn É. [Ethical competence of the radiation therapist in the management of a crisis]. Cancer Radiother 2022; 26:841-845. [PMID: 36075832 DOI: 10.1016/j.canrad.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
Many situations can be considered as a crisis in radiotherapy (failure of equipment, absenteeism, excessive workload, errors, urgent care, pandemic, etc.). Such events are defined as difficult situations in the course of daily activity, they can at any time escape the vigilance of the concerned actors when they are not prepared for it. The crisis can induce a disruption of balance between the normal course of the radiation therapy and the obligation for the manipulators to reconcile the consequences of the ongoing crisis with the objective of taking charge of all patients scheduled for the program. The crisis and its management will inexorably cause stress, fatigue and, as a consequence, impact patient safety. Management has an essential role to play in maintaining team dynamics when a crisis occurs, the work environment may no longer be the same. The aim of this article is to describe these situations in order to highlight the needs of the teams and more specifically the needs of the radiation therapist. It highlights the organization of patient care in the event of crisis management (Covid-19), during palliative radiotherapy with an opportunity to develop advanced practice. The reflection on the ethical concern of the radiation therapist in the prioritization of patients leads us to analyze the knowledge of medical ethics provided during initial training. When they perform their duties, manipulators seem to be confronted with situations that give rise to ethical dilemmas. It is then a question of understanding how they reflect on their practice in order to make it evolve. Is the radiation therapist confronted with ethical issues in the course of his practice? What solutions can be implemented to deal with these issues?
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Affiliation(s)
- P Le Tallec
- Association française du personnel paramédical d'électroradiologie, 92120 Montrouge, France
| | - C Gesbert
- Direction de la qualité, des services aux patients et des parcours, centre hospitalier de Versailles, 78150 Le Chesnay, France; Centre de recherche des Cordeliers, Sorbonne université, Inserm, université de Paris, laboratoire ETRES, 75006 Paris, France.
| | - C Mercier
- Département de radiothérapie, centre Léon-Bérard, 69000 Lyon, France
| | - É Crenn
- Département de radiothérapie, centre Léon-Bérard, 69000 Lyon, France
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Joyce E, Jackson M, Skok J, Peet B, McNair HA. Images and images: Current roles of therapeutic radiographers. Radiography (Lond) 2022; 28:1093-1100. [PMID: 36054937 DOI: 10.1016/j.radi.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Therapeutic radiography is a small profession and has adapted in response to advanced techniques. An increase in on-line adaptive MRI-guided radiotherapy (MRIgRT) will require role extension for therapeutic radiographers (TRs). This study will investigate the current role description for TRs and the activities they currently undertake with regards to MRIgRT. METHOD A training needs analysis was used to ask TRs about their current roles and responsibilities and essential skills required for MRIgRT. For the purposes of this paper, the authors present the results from the demographics of the individual, their current job title with roles and responsibilities, and experience with decision making and image assessment. Descriptive statistics was used to analyse the data. RESULTS 261 responses were received (n = 261). Only 28% of job titles listed contained the protected title of 'therapeutic radiographer'. Advanced clinical practice roles were expressed by participants indicating that if a service need is presented, emerging roles will be created. Variation existed across the standardised roles of TRs and this discrepancy could present challenges when training for MRIgRT. TRs are pivotal in image verification and recognition on a standard linac, and skills developed there can be transferred to MRIgRT. Decision making is crucial for adaptive techniques and there are many skills within their current scope of practice that are indispensable for the MRIgRT. CONCLUSION It has been demonstrated that TRs have a range of roles that cover vast areas of the oncology pathway and so it is important that TRs are recognised so the pivotal role they play is understood by all. TRs have extensive soft-tissue IGRT knowledge and experience, aiding the evolution of decision-making skills and application of off-protocol judgments, the basis of MRIgRT. IMPLICATIONS FOR PRACTICE Role development and changes in education for therapeutic radiographers.
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Affiliation(s)
- E Joyce
- Royal Marsden NHS Foundation Trust, UK
| | - M Jackson
- St George's University of London, UK
| | - J Skok
- St George's University of London, UK
| | - B Peet
- Royal Marsden NHS Foundation Trust, UK
| | - H A McNair
- Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, UK.
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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Galofaro E, Malizia C, Ammendolia I, Galuppi A, Guido A, Ntreta M, Siepe G, Tolento G, Veraldi A, Scirocco E, Arcelli A, Buwenge M, Ferioli M, Zamagni A, Strigari L, Cammelli S, Morganti AG. COVID-19 Pandemic-Adapted Radiotherapy Guidelines: Are They Really Followed? Curr Oncol 2021; 28:3323-3330. [PMID: 34590595 PMCID: PMC8482258 DOI: 10.3390/curroncol28050288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In our department, we provided guidelines to the radiation oncologists (ROs) regarding the omission, delay, or shortening of radiotherapy (RT). The purpose was to reduce the patients' exposure to the hospital environment and to minimize the departmental overcrowding. The aim was to evaluate the ROs' compliance to these guidelines. METHODS ROs were asked to fill out a data collection form during patients' first visits in May and June 2020. The collected data included the ROs' age and gender, patient age and residence, RT purpose, treated tumor, the dose and fractionation that would have been prescribed, and RT changes. The chi-square test and binomial logistic regression were used to analyze the correlation between the treatment prescription and the collected parameters. RESULTS One hundred and twenty-six out of 205 prescribed treatments were included in this analysis. Treatment was modified in 61.1% of cases. More specifically, the treatment was omitted, delayed, or shortened in 7.9, 15.9, and 37.3% of patients, respectively. The number of delivered fractions was reduced by 27.9%. A statistically significant correlation (p = 0.028) between younger patients' age and lower treatment modifications rate was recorded. CONCLUSION Our analysis showed a reasonably high compliance of ROs to the pandemic-adapted guidelines. The adopted strategy was effective in reducing the number of admissions to our department.
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Affiliation(s)
- Elena Galofaro
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-3409328999
| | - Claudio Malizia
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Ilario Ammendolia
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Andrea Galuppi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Alessandra Guido
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Maria Ntreta
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Giambattista Siepe
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Giorgio Tolento
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Antonio Veraldi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
| | - Erica Scirocco
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Alessandra Arcelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Martina Ferioli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Alice Zamagni
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Lidia Strigari
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Silvia Cammelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (I.A.); (A.G.); (A.G.); (M.N.); (G.S.); (G.T.); (A.V.); (E.S.); (A.A.); (M.B.); (M.F.); (A.Z.); (S.C.); (A.G.M.)
- Department of Experimental, Diagnostic, and Specialty Medicine—DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
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Samper Ots PM, Zapatero Ortuño J, Pedraza Fernández S, Mayrata Canellas E, González San Segundo C, Campo Vargas M, Caballero B, Ramos Albiac M, Vázquez Masedo G, Álvarez B, Rodríguez Villalba S, Muñoz Miguelañez T, Diezhandino Garcia P, Sancho G, Guzmán Gómez L, Tripero J, Rico Oses MR, Ibañez Villoslada C, Soler Rodríguez AMS, Chust ML, Fondevilla Soler A, Lozano Martin EM, Morillo Macias V, Fuentes Sánchez C, Torrado Moya L, Fernández López J, Solé JM, Guijarro Verdú M, Mira Flores M, Wals A, Expósito Hernández J. Impact of covid-19 on patients in radiotherapy oncology departaments in Spain. Radiother Oncol 2021; 161:148-151. [PMID: 34118358 PMCID: PMC8189749 DOI: 10.1016/j.radonc.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022]
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Tsang Y. Advanced practice in radiotherapy: How to move to the next level? Tech Innov Patient Support Radiat Oncol 2021; 17:57-58. [PMID: 34007907 PMCID: PMC8111034 DOI: 10.1016/j.tipsro.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yat Tsang
- Radiotherapy Department, Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom
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Kearney M, Coffey M, Rossi M, Tsang Y. Future-proof Radiation therapist (RTT) practice in a pandemic - Lessons learnt from COVID-19. Tech Innov Patient Support Radiat Oncol 2021; 17:18-24. [PMID: 33564723 PMCID: PMC7862908 DOI: 10.1016/j.tipsro.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/05/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022] Open
Abstract
RT is an essential service that must continue despite the challenges posed by COVID-19. Our study suggests changes were implemented into RTT practice in response to COVID-19. Proactive measures are needed to protect both RTTs and patients in future Covid surges.
Background and Purpose The European SocieTy for Radiotherapy and Oncology Radiation Therapist Committee (ESTRO RTTC) published a guidance document and infographic providing recommendations to minimise risk of COVID-19 transmission in radiotherapy (RT) departments. The purpose of this study was to investigate the changes embedded in RT practice in the COVID-19 era and to recommend proactive measures to protect RT practice in future pandemics. Materials and Methods The study was initiated by the ESTRO Radiation Oncology Safety and Quality Committee (ROSQC). A survey consisting of multiple choice, open ended and Likert scale questions was created to analyse the extent of changes embedded in RT practice in response to the COVID-19 pandemic under the four domains: patient care, RTT workflow, remote working and RT practice. This online survey was distributed globally in May 2020. Results 229 respondents across 27 countries completed the survey. 60% of respondents reported continuing/commencing RT in COVID-19 patients. Routine testing of patients and RTTs was not common. Split teams' procedures, hot linacs and separate entrances were implemented by 50% of respondents. Remote working was implemented for RT team members where face to face patient contact was not essential. Lack of staff, connectivity issues and lack of confirmed positive cases in the department were the main reasons cited for not implementing recommended measures. Conclusion It is suggested that RT departments have responded to the COVID-19 pandemic and implemented certain changes in RT practice. RT departments should act now to implement recommended proactive measures to protect patients and RTTs – frontline healthcare workers.
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Affiliation(s)
- Maeve Kearney
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College, Dublin 2, Ireland
| | - Mary Coffey
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College, Dublin 2, Ireland
| | - Maddalena Rossi
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Yat Tsang
- Radiotherapy Department, Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom
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Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group. J Geriatr Oncol 2020; 11:1190-1198. [PMID: 32709495 PMCID: PMC7365054 DOI: 10.1016/j.jgo.2020.07.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 12/25/2022]
Abstract
The COVID-19 pandemic poses a barrier to equal and evidence-based management of cancer in older adults. The International Society of Geriatric Oncology (SIOG) formed a panel of experts to develop consensus recommendations on the implications of the pandemic on several aspects of cancer care in this age group including geriatric assessment (GA), surgery, radiotherapy, systemic treatment, palliative care and research. Age and cancer diagnosis are significant predictors of adverse outcomes of the COVID-19 infection. In this setting, GA is particularly valuable to drive decision-making. GA may aid estimating physiologic reserve and adaptive capability, assessing risk-benefits of either providing or temporarily withholding treatments, and determining patient preferences to help inform treatment decisions. In a resource-constrained setting, geriatric screening tools may be administered remotely to identify patients requiring comprehensive GA. Tele-health is also crucial to ensure adequate continuity of care and minimize the risk of infection exposure. In general, therapeutic decisions should favor the most effective and least invasive approach with the lowest risk of adverse outcomes. In selected cases, this might require deferring or omitting surgery, radiotherapy or systemic treatments especially where benefits are marginal and alternative safe therapeutic options are available. Ongoing research is necessary to expand knowledge of the management of cancer in older adults. However, the pandemic presents a significant barrier and efforts should be made to ensure equitable access to clinical trials and prospective data collection to elucidate the outcomes of COVID-19 in this population.
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