SGRT Forum

What is your department policy with this going on?  How are you minimizing contact?  Gloves, masks, hand sanitizer.  Any set up techniques changing.  Use of vacs, no vacs, using Align RT to set up?   Do you wear a mask, the patient?  Any issues with DIBH and patient wearing a mask?

Hello! Our department policy is that all employees wear masks when in the hospital, not N95 yet but we are getting fit tested soon.  We are to assume that every patient has or is carrying Covid-19 so using hand washing/gloves with all patients. As of this post we do not have any known positive cases in our department, when/if we do we are to use droplet precautions. Gown, gloves, masks with face shield (preferable N95 mask).  We have reviewed donning/doffing procedures with all direct patient contact employees.  As far as hand sanitizer, we still have bottles/cans placed around the department.  We have been told to conserve our sanitizing wipes, therefore are limiting one wipe for cleaning after each patient.  We have been wiping down door handles to changing areas and bathrooms regularly.

As far as changes departmentally, we have removed all magazines, books, drinks/food from patient areas. We are only offering water with single use disposable cups for bladder fill patients.  We are screening each patient upon entry to our department.  3 questions: do they have a cough, shortness of breath, or have traveled recently.  And we take their temperature.  We are not allowing visitors in our department, all drivers/support people are to stay in the car in our lot and not enter the department.  They can walk them to the screening desk and then go back out and wait in their vehicle.

No changes to our set-ups for SGRT.  Still using wingboard or breast board. We use a ring for patients to hold onto for pelvis set-ups, and have suspended use of that for now. We have had no issues with patient's wearing masks and having trouble breathing for DIBH.  As of right now it is the patient's choice to wear a mask or not.  Only if they are coughing do we require them to wear a mask.

I hope this answers your questions, feel free to reach out if not!

Align rt helping with social distamcing in the room with almost hand free set ups ! Using straight to ISO set up as and Align RT for breast and thorax patients.  Working very well so far.

I think the biggest benefit of being tattooless for us at Beacon, Ireland is that we don't have to come in to close contact with certain cohorts of patients by using SGRT. We treat most patients except from head and neck with full head and neck mask and motion monitoring only for SBRT cases with full bodyfix bags.

SGRT Measures:

With the recent event of Covid 19 we have started ID-ing patients outside of the room so that 1 RT sets up the patient and the other remains in the control room communicating via intercom & CCTV and monitors/interacts on the VisionRT computer. This reduces transmission risk by 50%. A large proportion of our patients are over 70 (cocooning from Covid19 in Ireland still at this time), we can maintain our social distancing, by getting the patients mount the bed themselves, we use the hand pendant to go directly to couch actuals acquired on day 1 of RT. For example with pelvic cases, we instruct the patient to adjust their own position so that their feet are fixed at the bottom of the footlock (reducing long shifts), instruct the patient to move hips left or right to correct lateral shifts indicated by SGRT and if pitch, roll or yaw is indicated by the system we verbally instruct the patients on how to move their pelvis to correct for same. We utilize the move couch icon on the SGRT system to reduce physical proximity to patients, when applying shifts in and out of treatment room. Staff have reported reduced incidences of back and wrist pain from reduced patient position manipulation/manual handling. We use SGRT for set up, we use verification imaging daily, we motion monitor using SGRT throughout verification and delivery of treatment. All set ups including common sites like Breast, Chest and Abdomen are more efficient using the SGRT system here at Beacon. With improved set up times, we have reduced contact time. Treatment capture can be used to check surface stats and SSDs prior to leaving the room using the SGRT tools instead of visually inspecting coverage/SSDs beside the patient again reducing contact time. Our team feel that the SGRT system has reduced risk significantly in our department and the measures we have taken are deemed safe by our MDT and departmental quality team.

Other Measures:

RTs are in a paired buddy system, social distancing from all other staff and wearing masks when treating or in necessary close proximity with other staff. Work stations have been moved to allow for social distancing. Staff rotations have been halted for the duration of this period. Disinfection of work stations, equipment, control room before and after use.

Patients are not required to wear masks unless they have a cough or respiratory issues. Patients do all preparations including enemas/hydration en route. Hospital has a rigorous screening station and the front of the hospital, which includes Temperature & Symptom Assessment, Travel History (recent 2020) and Exposure History (check exposure to Covid positive cases in the last 2 weeks) performed by trained medical staff.

Where possible Prostate Cases are prescribed CHHIP fractionation schedules (20), and Breast Fast Forward fractionation schedules (5).