(1) A
licensee shall provide sufficient authority and organizational freedom to the
radiation safety officer and the radiation safety committee to:
(a) Identify radiation safety
problems;
(b) Initiate, recommend,
or provide solutions;
(c) Require
and verify implementation of corrective actions; and,
(d) Stop unsafe
operations.
(2) A
licensee shall establish in writing and keep current the authority, duties,
responsibilities, and radiation safety activities of the radiation safety
officer and the radiation safety committee.
(3) Authorized users shall have the following
special responsibilities:
(a) For written
directives:
1. A written directive must be
dated and signed by an authorized user before the administration of I-131 as
sodium iodide greater than 1.11 megabecquerels (MBq) (30 microcuries
([micro]Ci)), any therapeutic dosage of unsealed radioactive material or any
therapeutic dose of radiation from material, or
2. Due to 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 provided:
a. The information contained in the oral
directive must be documented as soon as possible in writing in the patient's
record; and,
b. A written directive
must be prepared within 48 hours of the oral directive.
3. The written directive must contain the
patient or human research subject's name and the following information:
a. For any administration of quantities
greater than 1.11 MBq (30 [micro]Ci) of sodium iodide I-131: the
dosage,
b. For an administration of
a therapeutic dosage of unsealed radioactive material other than sodium iodide
I-131: the radioactive drug, dosage, and route of administration,
c. For gamma stereotactic radiosurgery: the
total dose, treatment site, and values for the target coordinate settings per
treatment for each anatomically distinct treatment site,
d. For teletherapy: the total dose, dose per
fraction, number of fractions, and treatment site,
e. For high dose-rate remote afterloading
brachytherapy: the radionuclide, treatment site, dose per fraction, number of
fractions, and total dose; and,
f.
For all other brachytherapy,
(I) Before
implantation: treatment site, the radionuclide, and dose; and,
(II) After implantation but before completion
of the procedure: the radionuclide, treatment site, number of sources, and
total source strength and exposure time (or the total
dose).
4. A
written revision to an existing written directive may be made if the revision
is dated and signed by an authorized user before the administration of the
dosage of unsealed radioactive material, the brachytherapy dose, high dose
remote afterloader dose, the gamma stereotactic radiosurgery dose, the
teletherapy dose, or the next fractional dose, or
5. Due to 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 provided:
a. The information contained in the oral
directive must be documented as soon as possible in the patient's record; and,
b. A written directive must be
prepared within 48 hours of the oral directive.
(b) Review personally the patient's case to
assure that the therapeutic radiation procedure is appropriate.
(c) Review personally the patient's case or
develop and implement adequate written procedures to assure that the diagnostic
radiation procedure is appropriate.
(d) Prior to administration, the authorized
user must document deviations from the diagnostic clinical procedures manual
for each patient.
(e) Use
radioactive material or direct technologists and physicians in training in
using radioactive material.
(f)
Interpret results of diagnostic procedures; and,
(g) Review regularly the progress of the
patient receiving therapy and modify the originally prescribed dose if
needed.
(4) The licensee
shall retain a copy of the written directives specified in paragraph
64E-5.607(3)(a),
F.A.C., for three years.
Notes
Fla. Admin.
Code Ann. R. 64E-5.607
Rulemaking Authority 404.051, 404.061, 404.071, 404.081,
404.141 FS. Law Implemented
404.022,
404.051(1), (4), (5), (6), (8), (9), (10),
(11),
404.061(2),
(3),
404.071(1),
404.081,
404.141
FS.
New 8-25-91, Amended
5-12-93, Formerly 10D-91.713, Amended 2-11-10,
12-26-13.
New 8-25-91, Amended 5-12-93, Formerly 10D-91.713, Amended
2-11-10, 12-26-13.