Encourage the patient to shower frequently, at least once a day, and to wash their hands thoroughly after each possible contact with bodily fluids, for example cleaning teeth or going to the toilet. The patient should regularly remove any dentures and clean them under running water and remove any contact lenses and rinse in their usual cleaning fluid. All these actions will reduce any radioactivity from the skin or mucous membranes. The nurse should encourage the patient to maintain a fluid intake of between 2 and 3 litres per day to increase the urinary output and elimination of radioactivity from the bladder (Thompson [69]). The patient should have their own personal toilet facilities and flush the toilet twice after use to reduce contamination of others and of the environment as the urine of patients treated with iodine‐131 is initially highly radioactive (Thompson [69]).

Bedbound patients should be catheterized before the dose is given and the bag emptied every 4–6 hours or more frequently if necessary to reduce the radiation level in the room. If the patient requires a bedpan or urinal, this item must be kept solely for this patient's use. The bedpan or urinal must be handled carefully and the contents disposed of in the patient's toilet (and flushed twice). The bedpan or urinal may be washed in the bedpan washer but sealed in a plastic bag for the journey to and from the sluice.

If leakage occurs from injection sites, wound sites and so on, the nurse should contact the medical staff and the physics department immediately. Any contact with the dressing should be carried out with long‐handled forceps and gloves (HSE [29], b). All used linen must be deposited in a special bag provided for this purpose and must be monitored for contamination before going to the laundry.

Collection of laboratory specimens should, if possible, be deferred. If collections are unavoidable, a radiation warning sticker must be attached to the specimen and request card and the specimen delivered to the laboratory following consultations with the physics department in order to reduce the risk of contamination of the laboratory and its staff (Vialard‐Miguel et al. [73]).

Only disposable crockery and cutlery should be used to present meals to patients as china crockery and cutlery may become contaminated. Uneaten food and disposable cutlery and crockery are disposed of in a macerator and all fruit stones and fish and meat bones should be removed from the diet to prevent blocking the macerator.

Visitors must not enter radiation treatment areas unless special training and arrangements have been agreed in order to minimize the exposure of visitors to radiation (DH [15]). Visiting time during the first day following administration of an unsealed source should be limited as advised by the medical physicist because the patient is highly radioactive during this period (Ionising Radiations Regulations [34]).

On subsequent days, visiting is unlimited, providing visitors remain outside the room behind the lead screens, the exception being parents caring for young children who will need to be authorized by the medical physics department. Physical contact with the patient or bedlinen is not allowed as protective clothing is not available to visitors. Children under 16 years of age and pregnant women are discouraged from visiting to ensure that radiation exposure of children and the unborn child is kept as low as practicable (DH [15]).

A patient should not be discharged from hospital until the radiation activity retained has fallen below recommended levels (DH [15], HPA [26]). This level will depend on several factors, including:

Patients will be assessed individually for radiation clearance by the medical physics department before discharge. The treating physician will then be advised of the results of the assessment. Advice will be given to patients on issues such as return to work and visits to public places. On discharge, patients will be given appropriate written information in the form of an instruction card/leaflet carrying details of the precautions to be taken. This varies according to local policies. The card/leaflet must be signed by the patient or parent of a child, the treating clinician or the medical physics staff.

It must be emphasized that this information must be carried and the instructions followed until the latest date shown so that, for instance, staff would be alerted should the patient be readmitted to a hospital setting. Additional verbal instructions may be necessary (IRMER [35]).

During occupancy of the treatment room by the patient, cleaning of the room is kept to a minimum and should be supervised by the medical physics staff. After the patient is discharged, the monitoring and any necessary decontamination of the room will be arranged by the physics department. They will then inform the relevant personnel when this has been completed. Only then may the room be entered and thoroughly cleaned (DH [14]).