Quality audits of nuclear medicine practices in Namibia

Abstract

Introduction: The International Atomic Energy Agency (IAEA) introduced a Quality Management Audits in Nuclear Medicine (QUANUM) programme, to improve nuclear medicine practice standards aligned with international standards through self-assessments. The absence of quality management audits in nuclear medicine departments could potentially result in a compromise in the safety and quality of patient care. To date, there is no evidence that quality audits have been conducted in nuclear medicine departments of this middle-income country. This quality audit therefore assessed conformance to the IAEA QUANUM programme in four nuclear medicine departments. Methods: The study adopted a quantitative methodological exploratory approach. The IAEA QUANUM programme was used and data collected via document analysis in four nuclear medicine departments within a middle-income African setting. This quality audit was done to evaluate each department’s overall conformance. QUANUM comprises a series of checklist questionnaires designed to audit nuclear medicine services’ overall activity such as clinical practice, management, radiopharmacy, general and radiation safety, quality assurance, operations and services amongst others with the intention of continuous service improvement. Each checklist has criteria that are referred to as counts. The checklists were scored based on conformance or non-conformance during the audit. The four nuclear medicine departments were identified as Sites A – D. Results: Overall results showed that Site A conformed with 247 out of 370 (67%) counts and non-conformed with 123 out of 370 (33%) counts whilst Site B conformed with 205 out of 342 (60%) counts and non-conformed with 137 out of 342 counts (40%). Site C conformed with 259 out of 345 (75%) counts and non-conformed with 86 out of 345 (25%) counts. Site D conformed with 166 out of 349 (48%) counts and non-conformed with 183 out of 349 (52%) counts. The study yielded 125 overall recommendations. Conclusions: All the sites demonstrated good compliance to international standards in radionuclide therapy. Site A complied poorly in strategies and policies, whilst Site B complied poorly in quality control of equipment. Site C showed poor compliance to human resource development and Site D showed aspects pertaining to administration and management as well as evaluation of quality systems.