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1113 poster A skin care protocol for Flemish radiotherapy and oncology departments
S466
width of the EPID defines the magnification factor and the vertical EPID-position. The lateral and longitudinal EPIDpositions can be calculated by multiplying the coordinates of the centre of the treatment field by the magnification factor. These steps are affected by collimator rotation. By taking the couch positions into account, collisions can be avoided. "Epibrator" is written in HTML and JavaScript and is supported by many webbrowsers. The utility is currently in use on our Varian LC 250 and AS 500 EPID. Programming the EPID-positions will always result in electronic portal images (EPI's) encompassing the whole of the treatment field, making visualization of all matching structures and field edge detection by the matching software possible. By using "Epibrator", incomplete EPI's can be avoided. Even field edge detection of large split fields EPI's can be achieved. Therefore, match performance has improved. 1112 poster
A computerized radiotherapy chart with directly imported data from planning system
R.H. Somme8 H.N. Jager, F. Ong Medisch Spectrum Twente, Radiotherapy, Enschede, The Netherlands We have developed an automated form of printing radiotherapy (RT) charts using directly imported data from the planning system to reduce possible errors in copying data by hand onto the chart. In some RT systems this option is included, however, many institutions do not yet have these sophisticated systems. In our department Varian equipment is used. Until February 2004, we utilized Varis 1.4 in conjunction with the CadPlan planning system and for AP-PA fields the Irreg monitor units calculation system. We used the Microsoft Excell spreadsheet programme with Visual-basic to generate a chart closely resembling the charts formerly used. All radiotherapy data were exported from CadPlan as a parameter file. In Excell variable names were assigned, and various formulae were used to generate the proper input values used by the accelerator. In addition, a patient photo, picture of the irradiated location, as well as a graph showing the different gantry angles can be added to the chart. The main advantage of this system is the direct incorporation of the planning data, thus eliminating a potential source of error. Added benefits are a clear and legible print, use of a simple (laser) printer, reduction of paper size by half to A4 sized paper. This has reduced costs and made our charts easier to read than the old folded A3 sized charts. Our system can be widely used, as the Excell programme and a simple (laser) printer is available to most institutions and will lead to a reduction in errors as well as being costsaving. 1113 poster
A skin care protocol for Flemish radiotherapy and oncology departments
T. Bate1, Radiotherapy group2 1University Hospital Gent, Radiotherapy, Gent, Belgium 2VVRO, Radiotherapy, Belgium Skin reactions are a common adverse effect of radiation treatment.Although the widespread use of lineair accelerators has reduced the severity of skin reaction by more skinsparing techniques, it is estimated that 80-90% of selected
Posters
patient groups develop some kind of reaction. The use of comcommitant chemotherapy and high dose radiotherapy might further increase the frequency and severity of skinreactions. The management of skin reactions demands a multi-disciplinary approach in wich nurses play an important part. Nursing care should be aimed at creating an ideal environment to promote healing and patients'comfort and to reduce possible pain and infection. Much conflicting evidence exists as to how skin reactions should be prevented and managed.Nursing practice in Flanders shows considereable variation and a lack of research results on wich to base skin care.Further, there is a lack of translation on existing evidence to practice. The radiotherapy group of the Flemish Society for Radiotherapy and Oncology nurses(VVRO)conducted a survey of nursing practice in Flemish radiotherapy departments.The results of this survey show that the management of skin reactions varies. Moreover, old fashioned techniques are still used by a considerable number of nurses. This is probably caused by the lack of clear research results and, more importantly,the lack of adequate translation and implementation into daily practice. Based on the results from this survey and after intensive literature review, a skin care protocol for Flemish radiotherapy and oncology departments was developed.The protocol has been made available to all departments. It helped to enhance standardization of skin care practice in the university hospital in Gent.We hope to ensure with the protocol quality of care and to establish evidence based practice. 1114 poster A Quality Assurance comparison between Europe and
Canada
B. Vosters, M. Spigt, Assigned by: NVMBR (Dutch Association on Medical Imaging and Therapy) Hogeschool Inholland, Haarlem, The Netherlands In the Netherlands and Canada, different regulations exist to ensure the delivery of quality care by hospitals and their employees. Each radiation therapy department has developed their own Quality Assurance, QA, system based upon national laws. The importance of having a good quality policy is to give the public a sense of confidence in the hospital and the care offered. The graduation assignment, that we received at our four year course MBRT (Medical Imaging and Radiotherapy) deals with quality assurance within radiation therapy. We were offered the opportunity to participate in an exchange programme in Toronto, which greatly aided in our research efforts. We have investigated the various standards and policies used within radiation therapy departments in the Netherlands and Canada. Due to the fact that the daily labor of the therapists is influenced by the standards, we thought it was important to assess the outcomes of the quality policy. To create a wide range view on Quality Assurance in general, we also involved the governmental and insurance parties. The cooperating hospitals were the Academic Medical Center and the Netherlands Cancer Institute (NKI) which are both located in Amsterdam. In Toronto, we visited the Princess Margaret Hospital and the Toronto Sunnybrook Regional Cancer Centre. Our main area of interest was the most recent developments in the field of quality assurance for healthcare professionals. In a presentation, we will present our conclusions concerning the differences and similarities that exist between the way healthcare professionals work in the Netherlands and Canada, the education and criteria for the registration of health care professionals, the quality systems in radiation
width of the EPID defines the magnification factor and the vertical EPID-position. The lateral and longitudinal EPIDpositions can be calculated by multiplying the coordinates of the centre of the treatment field by the magnification factor. These steps are affected by collimator rotation. By taking the couch positions into account, collisions can be avoided. "Epibrator" is written in HTML and JavaScript and is supported by many webbrowsers. The utility is currently in use on our Varian LC 250 and AS 500 EPID. Programming the EPID-positions will always result in electronic portal images (EPI's) encompassing the whole of the treatment field, making visualization of all matching structures and field edge detection by the matching software possible. By using "Epibrator", incomplete EPI's can be avoided. Even field edge detection of large split fields EPI's can be achieved. Therefore, match performance has improved. 1112 poster
A computerized radiotherapy chart with directly imported data from planning system
R.H. Somme8 H.N. Jager, F. Ong Medisch Spectrum Twente, Radiotherapy, Enschede, The Netherlands We have developed an automated form of printing radiotherapy (RT) charts using directly imported data from the planning system to reduce possible errors in copying data by hand onto the chart. In some RT systems this option is included, however, many institutions do not yet have these sophisticated systems. In our department Varian equipment is used. Until February 2004, we utilized Varis 1.4 in conjunction with the CadPlan planning system and for AP-PA fields the Irreg monitor units calculation system. We used the Microsoft Excell spreadsheet programme with Visual-basic to generate a chart closely resembling the charts formerly used. All radiotherapy data were exported from CadPlan as a parameter file. In Excell variable names were assigned, and various formulae were used to generate the proper input values used by the accelerator. In addition, a patient photo, picture of the irradiated location, as well as a graph showing the different gantry angles can be added to the chart. The main advantage of this system is the direct incorporation of the planning data, thus eliminating a potential source of error. Added benefits are a clear and legible print, use of a simple (laser) printer, reduction of paper size by half to A4 sized paper. This has reduced costs and made our charts easier to read than the old folded A3 sized charts. Our system can be widely used, as the Excell programme and a simple (laser) printer is available to most institutions and will lead to a reduction in errors as well as being costsaving. 1113 poster
A skin care protocol for Flemish radiotherapy and oncology departments
T. Bate1, Radiotherapy group2 1University Hospital Gent, Radiotherapy, Gent, Belgium 2VVRO, Radiotherapy, Belgium Skin reactions are a common adverse effect of radiation treatment.Although the widespread use of lineair accelerators has reduced the severity of skin reaction by more skinsparing techniques, it is estimated that 80-90% of selected
Posters
patient groups develop some kind of reaction. The use of comcommitant chemotherapy and high dose radiotherapy might further increase the frequency and severity of skinreactions. The management of skin reactions demands a multi-disciplinary approach in wich nurses play an important part. Nursing care should be aimed at creating an ideal environment to promote healing and patients'comfort and to reduce possible pain and infection. Much conflicting evidence exists as to how skin reactions should be prevented and managed.Nursing practice in Flanders shows considereable variation and a lack of research results on wich to base skin care.Further, there is a lack of translation on existing evidence to practice. The radiotherapy group of the Flemish Society for Radiotherapy and Oncology nurses(VVRO)conducted a survey of nursing practice in Flemish radiotherapy departments.The results of this survey show that the management of skin reactions varies. Moreover, old fashioned techniques are still used by a considerable number of nurses. This is probably caused by the lack of clear research results and, more importantly,the lack of adequate translation and implementation into daily practice. Based on the results from this survey and after intensive literature review, a skin care protocol for Flemish radiotherapy and oncology departments was developed.The protocol has been made available to all departments. It helped to enhance standardization of skin care practice in the university hospital in Gent.We hope to ensure with the protocol quality of care and to establish evidence based practice. 1114 poster A Quality Assurance comparison between Europe and
Canada
B. Vosters, M. Spigt, Assigned by: NVMBR (Dutch Association on Medical Imaging and Therapy) Hogeschool Inholland, Haarlem, The Netherlands In the Netherlands and Canada, different regulations exist to ensure the delivery of quality care by hospitals and their employees. Each radiation therapy department has developed their own Quality Assurance, QA, system based upon national laws. The importance of having a good quality policy is to give the public a sense of confidence in the hospital and the care offered. The graduation assignment, that we received at our four year course MBRT (Medical Imaging and Radiotherapy) deals with quality assurance within radiation therapy. We were offered the opportunity to participate in an exchange programme in Toronto, which greatly aided in our research efforts. We have investigated the various standards and policies used within radiation therapy departments in the Netherlands and Canada. Due to the fact that the daily labor of the therapists is influenced by the standards, we thought it was important to assess the outcomes of the quality policy. To create a wide range view on Quality Assurance in general, we also involved the governmental and insurance parties. The cooperating hospitals were the Academic Medical Center and the Netherlands Cancer Institute (NKI) which are both located in Amsterdam. In Toronto, we visited the Princess Margaret Hospital and the Toronto Sunnybrook Regional Cancer Centre. Our main area of interest was the most recent developments in the field of quality assurance for healthcare professionals. In a presentation, we will present our conclusions concerning the differences and similarities that exist between the way healthcare professionals work in the Netherlands and Canada, the education and criteria for the registration of health care professionals, the quality systems in radiation