CDSS Alert to Prevent Patient Overexposure to Ionizing Radiation
Terry D. Vincent, BSN, RN
Kathy Klimpel, PhD, CNS, RN-BC
BACKGROUND
 Increased prevalence of cancer due to overexposure to ionizing
radiation by way of man-made sources (CT’s, Xray's,
Mammograms, cellular phones, microwave ovens, GPS
systems…..) and sources found in nature (rocks and soil, the food
we eat, our bodies, cosmic rays….).
 The annual safe dosage of absorption of Ionizing Radiation is
100mSv per year
 The fast pace of the Emergency Department prevents physicians
and other clinicians from completing a thorough chart review of
the patient’s radiographic history within the Sharp system.
PURPOSE
 The purpose of the of the alert is to provide each ED
physician and other clinicians with a tool that alerts them
every time a patient is reaching the recommended annual
maximum dosage of ionizing radiation. The alert will
require the provider to decide whether the study is
necessary for life saving measures; or give them the
option to order an alternate study that can be used to
reduce radiation exposure
PROJECT APPROACH DISCUSSION
 Is a CDSS Alert Necessary
 This is a project proposal for future development and implementation
throughout the Sharp enterprise for a radiology alert for ionizing
 Feedback from the providers
radiation (2 to 3-month process).
 Limitations
 SBAR Change Request
 180-day pilot at Sharp Chula Vista Emergency Department (ED)
(Start date not yet determined – Review of feasibility 10/04/2020 -
02/26/2021)
 Target population: Initially, any patient that presents to the ED and
then expanded to all patients receiving studies in all its facilities.
Patient has had “__” radiologic exams within the last 12
months
The estimated millisieverts absorbed is “____”mSv
METRIC CATEGORIES COMPARED NEXT STEPS & OPPORTUNTIES
 Pre- and Post-alert installation radiology study numbers per  Data Analysis and results review of any changes noted in the
provider will be examined (Discern Reports) frequency and number of studies ordered by each physician
 Participants: No patient personal data or health history  Feedback from the end-users
information will be used
 Expand the alert to all of Sharps entities
 Physician (end-user) satisfaction will be evaluated
 San Diego Health Information Exchange (HIE) move to digital
radiology data sharing (All healthcare organizations)