Assessment of Anesthesia Providers’ Radiation Safety Practices Using Operating Room Black Box Data

Background: Advancements in medical imaging led to increased usage of ionizing radiation in operating rooms. However, despite radiation safety guidelines, studies report suboptimal compliance with only 50% of healthcare providers demonstrating adequate knowledge of radiation safety practices. The purpose of this project was to evaluate anesthesia providers’ compliance with radiation safety practices and identify recommendations to improve radiation safety practices. Methods: The project was conducted at an academic hospital in the Southeastern United States. The Operating Room Black Box ® (ORBB; Surgical Safety Technology Inc., New York) was used to retrospectively review de-identified video recordings and assess anesthesia providers’ compliance with radiation safety practices (adequate shielding, maximum distance from radiation, and appropriate lead storage). A survey was also distributed to assess self-reported practices and barriers related to radiation safety. Findings: Thirty-four anesthesia providers were observed across 82 video clips. Findings revealed 53% ( n = 18) appropriately wore lead aprons and thyroid shields. However, 29% ( n = 10) did not wear lead aprons and 41% ( n = 14) did not wear thyroid shields. Only 38% ( n = 13) of providers demonstrated observable efforts to maximize distance from radiation source, and 53% ( n = 10) appropriately stored lead aprons. Barriers were driven by environmental and workflow challenges, such as limited storage space and the need to remain near the radiation source for patient care. Conclusion: Recommendations to mitigate barriers include increasing radiation personal protective equipment availability, standardizing communication prior to radiation use, and providing periodic refresher training.