MRI technology has recently garnered the interest of those in the C-suite, particularly after the ECRI Institute ranked ultrahigh-field-strength MRIs second on its list of hot technologies for 2009.
HealthLeaders Media first reported on the more powerful MRIs that produce higher quality images in July and although this new technology can greatly improve efficiency and quality, MRI technology old and new poses significant safety risks that often impede infection control (IC) best practices.
For years, many MRI suites in hospitals and outpatient facilities have operated without proper IC procedures, primarily because the dangers of the MRI's magnetic field bar almost all employees from entering the room, says Peter Rothschild, MD, president and founder of Patient Care Systems, Inc., in Newark, CA. As a result, the area has flown under the IC radar.
"Unfortunately, it's an area that has just been ignored," Rothschild says. "I think that's the nicest way to say it."
The dangers of the MRI
Employee safety is one of the main reasons that the MRI suite lags behind in IC and environmental cleaning, says Tobias Gilk, M. Arch, president and MRI safety director at Mednovus, Inc., an MRI safety consulting firm in Leucadia, CA.
Because the MRI houses a powerful magnet (tens of thousands of times more powerful than Earth's magnetic field, according to Gilk), it creates a hazard for those unaware of how it operates.
"We restrict access to it, and a lot of times this means that we restrict access such that infection control officers or chief nursing officers or directors of medical care don't spend the same amount of time or have the same degree of day-to-day oversight for the MRI part of an enterprise that they do for, say, the patient care floors," Gilk says.
The machine's magnetic field can be harmful to people with pacemakers or orthopedic inserts, such as metal plates, rods, or screws. Further, the incredible strength of the magnet draws in anything ferromagnetic with dangerous strength and speed, meaning equipment used by environmental services should be restricted.
"Let me tell you, a floor polisher is going to do six figures' worth of damage to the MRI if it's brought into the room," Gilk says.
Ramping up surveys
In May, Rothschild released a paper, Survey of Infection Control in the MRI Environment, in which he questioned 53 hospitals and 47 outpatient imaging centers about their MRI-specific IC plans. Only 35 hospitals and just 18 outpatient facilities stated they had a written plan.
But a Joint Commission surveyor is going to be looking for those specific written plans. The February Environment of Care, a Joint Commission–published newsletter, included an article about IC in the MRI suite that indicated surveyors would pay closer attention to this area.
Louise Kuhny, RN, MPH, MBA, CIC, senior associate director of the Standards Interpretation Group at The Joint Commission, says the MRI suite is treated the same as any other part of the hospital.
"The MRI suite is considered an integral part of any Joint Commission survey," Kuhny says. "All Joint Commission standards apply to care in the MRI suite in the same way that they apply to other areas of a hospital or ambulatory center. Some compliance areas that prove particularly challenging for accredited organizations are HR (particularly competence), PC (verifying the correct order for testing), and IC (cleaning of equipment and the general environment, as well as hand hygiene)."
Establishing a detailed plan that involves specific cleaning procedures, routine evaluation of torn or frayed pads, and restrictions on equipment and employees that can enter the suite will ensure employee and patient safety, and a passing grade on a Joint Commission survey.
For more information on MRI safety and IC, download Rothschild's "11 Steps to Prevent Infection in the MRI Environment" by visiting OSHA Healthcare Advisor.