Pre‐procedure

ActionRationale

1. 1.Show
   Explain and discuss the procedure with the patient, and, if relevant, with the relative/significant other accompanying the patient.
   To ensure the patient is physically and psychologically prepared for the procedure and understands the procedure andy gives their informed consent (O'Dwyer et al. [117], E).
2. 2.Show
   Before administering, look at the patient's prescription chart or protocol and confirm patient's identity.
   To ensure the correct patient is given the correct radioactive source (NMC [115], C). To protect the patient from harm (NMC [115], C).
3. 3.Show
   Apply the relevant TLD meter and film badge.
   To measure radiation doses received by member of staff (Ionizing Radiation Regulations 1999, C).
4. 4.Show
   Wash hands with liquid soap and warm water.
   To reduce the risk of contamination (DH [36], C).
5. 5.Show
   Apply disposable gloves and plastic apron.
   To reduce the risk of contamination (DH [36], C).

Procedure

1. 6.Show
   Cannulate patient as per Procedure guideline 17.4: Peripheral cannula insertion.
   To ensure venous access is obtained. E
2. 7.Show
   Place the empty syringe in a lead syringe shield and attach needle. Place behind the lead body shield.
   To reduce exposure to radiation (DH [36], C; IRMER [76], C).
3. 8.Show
   Stand behind lead body shield and draw up the prescribed dose of the radiopharmaceutical.
   To reduce exposure to radiation (DH [36], C).
4. 9.Show
   Administer the radionuclide intravenously via cannula with cap. There is no evidence to support the use of central venous access devices (CVADs). Please refer to local guidelines.
   To administer the radionuclide. E
5. 10.Show
   Remove cannula, apply pressure and cover the exit site with gauze and secure with tape.
   Prevent any blood loss from skin exit site and possible contamination. E
6. 11.Show
   Dispose of all used syringes, needles, and cannula in a designated radioactive sharps disposal bin which is stored within a lead shield.
   To contain radioactivity and allow safe disposal (Ionizing Radiation Regulations 1999, C).
7. 12.Show
   Remove disposable gloves and wash hands at end of procedure.
   To remove any possible radioactive contamination (DH [33], C; DH [32], C).

Post‐procedure

1. 13.Show
   Place a yellow identity bracelet on the wrists of all inpatients and complete information card with the details of when precautions can be discontinued. Give the completed information card to the patient or the nurse accompanying the patient.
   The yellow wristband will provide visual warning to inform all healthcare workers of the patient's recent diagnostic investigation. The information card will inform ward staff of restrictions related to managing a patient, as well as when measures that have to be adopted in the event of the patient vomiting or being incontinent can be discontinued (DH [32], C).

   The card also states where to obtain help and advice related to the patient's diagnostic investigation. E
2. 14.Show
   Sign and complete administration documentation.
   To ensure timely and accurate record keeping (NMC [114], C).
3. 15.Show
   Monitor hands at end of procedure and before leaving the room by using the hand and foot monitor.
   To check for possible radioactive contamination (DH [32], C).
4. 16.Show
   Monitor the room for radioactive contamination at the end of each day or if contamination may have occurred.
   To establish whether contamination has occurred (DH [32], C).