Ariz. Admin. Code § R9-7-707 - Written Directives

A. A licensee shall ensure that a written directive is dated and signed by an authorized user before the administration of I-131 sodium iodide greater than 1.11 MBq (30 microcuries (µCi)), any therapeutic dosage of unsealed radioactive material or any therapeutic dose of radiation from radioactive material. If, because of the emergent nature of the patient's condition, a delay in order to provide a written directive would jeopardize the patient's health, an oral directive is acceptable. The information contained in the oral directive shall be documented as soon as possible in writing in the patient's record. A written directive shall be prepared within 48 hours of the oral directive.

B. A written directive shall contain the patient or human research subject's name and the following information:

1. For any administration of quantities greater than 1.11 MBq (30 µCi) of sodium iodide I-131: the dosage;

2. For an administration of a therapeutic dosage of unsealed radioactive material other than sodium iodide I-131: the radiopharma-ceutical, dosage, and route of administration;

3. For gamma stereotactic radiosurgery: the total dose, treatment site, and values for the target coordinate settings per treatment for each anatomically distinct treatment site;

4. For teletherapy: the total dose, dose per fraction, number of fractions, and treatment site;

5. For high dose-rate remote afterloading brachytherapy: the radionuclide, treatment site, dose per fraction, number of fractions, and total dose;

6. For permanent implant brachytherapy:

a. Before implantation: the treatment site, radionuclide, and total strength; and

b. After implantation but before the patient leaves the post-treatment recovery area: the treatment site, number of sources implanted, total source strength implanted, and date; or

6. 7. For all other brachytherapy, including low, medium, and pulsed dose rate remote afterloaders:

a. Before implantation: the treatment site, radionuclide, and dose; and

b. After implantation but before completion of the procedure: the radionuclide, treatment site, number of sources, total source strength and exposure time (or the total dose), and date.

C. The licensee shall retain a copy of the written directive for three years after creation of the record.

Notes

Ariz. Admin. Code § R9-7-707

New Section R9-7-707 recodified from R12-1-707at 24 A.A.R. 813, effective March 22, 2018 (Supp. 18-1). Amended by final expedited rulemaking at 25 A.A.R. 3561, effective 12/3/2019.