Changes: The Latest Revisions to The ICANL Standards
MARCH 2010
| As an accreditation organization, the ICANL is committed to maintaining a program that balances the changing needs of both the Nuclear Medicine/Nuclear Cardiology/PET imaging community and the general public by influencing the quality of patient care provided. The ICANL Standards are the most important component of that commitment. Composed by physicians, nuclear medicine technologists and physicists from the ICANL sponsoring organizations, The ICANL Standards are critically reviewed by the ICANL Board of Directors and revised every two years.
The ICANL is pleased to announce the release of the 2010 ICANL Standards, now available for download from the website at www.icanl.org/icanl/apply/standards.htm. The 2010 ICANL Standards are effective July 1, 2010.
The following article provides a detailed overview of the key revisions made within the ICANL Standards. Download a printable PDF version of Changes: The Latest Revisions to The ICANL Standards>>
As in all previous versions of the Standards, the revised Standards include both requirements and recommendations for nuclear facilities. For clarity purposes, the Standards are formatted as follows:
- All absolute requirements appear in bolded text. Failure to meet these guidelines will result in a Delayed accreditation decision.
- All revisions made since the prior release appear as highlighted text. Please note: You have the option in Adobe Reader to print this PDF either with or without the highlighting. [In the Print box, locate the drop menu under Comments and Forms; select ‘Document’ to hide highlights or ‘Document and Markup’ to include highlights.]
PART A: STRUCTURE, ORGANIZATION AND DEFINITIONS
SECTION A1: Personnel and Supervision
Standard - Medical Director
MEDICAL DIRECTOR RESPONSIBILITIES
One important change to the responsibilities of the Medical Director is that they will now be required to review the procedure manual at least once per year, rather than once every three years as previously indicated. This is noted under A1.1.3.1, as follows:
A1.1.3.1
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The Medical Director will assure compliance with all policies/procedures/ protocols and will
review and update all manuals periodically as necessary (minimum every year) or as new policies are introduced. This review must be documented via signature (or initials) and date on the reviewed document or manual. |
STANDARD – Technical Director
Several notable changes have been made to the Technical Director requirements. Most significant, the Technical Director no longer needs 3 years of clinical experience in Nuclear Medicine. This standard has been removed.
TECHNICAL DIRECTOR RESPONSIBILITIES
New details have been added regarding the requirements of a Technical Director in the daily operations of the facility. Under A1.2.2, outlining the day-to-day operations of the facility, the following comment has been added:
Comment: The Technical Director is generally a full time position. If the Technical Director is not on site full time, he/she must work a minimum of at least 20% of normal business hours each month in the laboratory AND an appropriately credentialed technologist must be appointed in the Technical Director’s physical absence during normal business hours and report to the Technical Director.
STANDARD – Direct Patient Care Personnel
Clear and specific language was added to the standards for Direct Patient Care Personnel, stating that non-physician staff supervising stress testing must document training and competency to comply with the AHA/ACC Consensus Statement on Stress Test Supervision. There must also be an attestation signed by the medical director verifying competency and training. Under A1.5.1, it states:
A1.5.1 |
All personnel directly supervising stress procedures must have appropriate training/experience. While physician presence during stress testing is not required, the facility must assure that appropriate staff is present based upon the types of procedures being performed and the patients' risks of adverse events. |
A1.5.1.1 |
If a nonphysician (e.g. properly trained nurse, physician assistant, nurse practitioner, exercise physiologist) practicing under the physician's license is supervising the stress test, the medical director or physician director of the stress laboratory must provide written attestation of appropriate training and competence as outlined in the American College of Cardiology/American Heart Association Clinical Competence Statement on Stress Testing (See Bibliography).
Note: See Appendix A for specific training and competence requirements |
A new standard was also added to this particular section, stating that two qualified people must be in attendance during radionuclide injection during stress testing:
A1.5.2 |
At a minimum, at least two qualified people are required to be in attendance at the time of radionuclide injection during stress testing (e.g. person supervising the stress test and person authorized to inject the radionuclide). It is preferable that two people be in attendance during the entire stress test.
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No significant changes were made at this time to Section A2, A3, and A4.
Section A6: Multiple Sites and Mobile Services
STANDARD – Multiple Sites
New requirements have been added for Technical Directors of multiple sites. In particular, criteria for supervision are clearly defined as seen in this section, A6.1.5:
A6.1.5 |
The Medical and Technical Director must assure that they have adequate contact and supervision with each site including periodic observation of operations.
Comment: Supervision by the Technical Director may be accomplished by one or more
of the following:
a. The Technical Director works at each site two days each month
b. Every technical staff member from each multisite(s) works at the main laboratory two days each month
c. An appropriately credentialed lead technologist is appointed at each multisite to report to the Technical Director. The lead technologist:
1. Supervises and assists other in performing examinations
2. Oversees day to day activities at the multisite
3. Communicates weekly with the Technical Director to maintain
compliance with the testing standards
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