JRCNMT Proceedings

ESSENTIAL I: SPONSORSHIP

The nuclear medicine technology program shall be conducted in an institution that has documented its commitment to quality, integrity and performance.

I.A Sponsoring Institution

The sponsoring institution and affiliates must be able to provide resources needed to fulfill the mission and educational goals of the program and must be accredited by recognized regional, national and/or state agencies.

Educational programs shall be located in:

1. colleges and universities,

2. community and junior colleges,

3. nuclear medicine laboratories,

4. hospitals and medical centers,

5. medical schools,

6. postsecondary vocational technical schools and institutions, and

7. other institutions or consortia that meet comparable standards for education in nuclear medicine technology.

I.B Affiliated Institution(s)

Affiliated institutions shall be geographically located in geographically convenient areas so that the sponsoring institution can maintain direct supervision, coordination, and continuing communication to ensure that students enrolled receive uniform and adequate instruction and clinical experience. There shall be documented, ongoing communication between the institution and its affiliates for review of the program and its operation. Meetings shall be held at least semi-annually, one of which must be in the form of a formal meeting. Whenever an alternative to a formal meeting is employed, the methodology must be fully described and available for review. Meetings conducted by an alternative methodology must document how program goals and operations were reviewed and the interactive nature of the process. Each affiliated institution and the sponsoring institution shall appoint a representative from the nuclear medicine technology faculty to attend such meetings.

I.B.1 Academic Affiliates

The program has the responsibility for ensuring that prerequisites are met. Where academic affiliates provide the prerequisites and/or award credit for the professional curriculum the responsibilities shall be clearly described in written agreements.

I.B.2 Clinical Facilities

The clinical component of the educational program shall provide an environment for supervised educational competency-based clinical education and experience and offer a sufficient and well-balanced variety of nuclear medicine procedures, examinations and equipment such that the desired educational competencies may be achieved. Modern nuclear medicine equipment, accurately calibrated, in working order and meeting applicable national and state standards must be available for the full range of diagnostic and therapeutic procedures as outlined in the curriculum. Clinical education sites must document satisfactory participation in extramural quality assurance programs appropriate to the practice. In the event that an institution is unable to provide the total clinical education experiences needed, arrangements with additional clinical facilities shall be made to complete the prescribed curriculum.

I.B.3 Clinical Affiliates—Categories

1. Major Affiliate—A participating institution that provides a required portion of the clinical education experience outlined in the Essentials. The length of time assigned to the clinical affiliate must be sufficient for completion of the essential training assigned to this institution.

2. Minor Affiliate—A participating institution that provides clinical education experiences not essential to fulfill the curriculum requirements of the Essentials. A student would be assigned to a minor affiliate for not more than ten business days. The assigned rotation is not needed to complete any educational competencies required for the program.

I.C Accreditation

Accreditation is granted to the sponsoring institution that assumes primary responsibility for curriculum planning and selection of course content; coordinates classroom teaching and supervised clinical education; appoints faculty to the program; receives and processes applications for admission; and grants the certificate or degree documenting completion of the program. The sponsoring institution shall be responsible for providing assurance that the activities assigned to students in the clinical setting are educational.

II.A Human Resources Sponsor

The sponsoring institution must have a qualified program director, clinical supervisor coordinator, and a medical advisor for the nuclear medicine technology program. Primary responsibilities shall include program development, organization, administration, evaluation and revision. The program director may assume the responsibilities of the clinical coordinator position.

Affiliate

In addition to the program personnel, each medical clinical affiliate must have an affiliate medical director and affiliate clinical supervisor responsible for the clinical education of the student. Radiopharmacy and laboratory affiliates must have a clinical supervisor responsible for the student’s clinical education. In accordance with institutional policies and practices, these officials shall possess the qualifications and assume the responsibilities described.

Changes in any of these positions shall be communicated to the JRCNMT. If a position becomes vacant and is not filled within 60 days, or the incumbent is absent or unable to serve for 60 days, the program shall send the JRCNMT a description of the actions taken to maintain the continuity and effectiveness of the program.

II.A.1 Program Director

Guideline

Regular visits to the affiliates by the program director or educational coordinator must be scheduled and a record of these visits maintained. Visits to clinical affiliates shall be made by the program director or a designee with administrative responsibility and authority. The purpose of these visits is to establish that the clinical affiliate provides training for the students that meet the requirements of the Essentials. Such reviews of the affiliate institution’s program must be conducted on site at the affiliate institution. Visits by the affiliate clinical director to the sponsor do not fulfill the intent of these reviews. An adequate record of such an on-site visit is a brief, dated note that describes what was seen and what accomplishments or problems the clinical affiliate might be encountering. It should also include any steps that were taken to resolve problems that might have been identified during prior visits. Visits should be at least quarterly and more often if needed.

Guideline

Visits to clinical affiliates shall be made by the program director or a designee with administrative responsibility and authority. The purpose of these visits is to establish that the clinical affiliate provides training for the students, which meets the requirements of the Essentials. Such reviews of the affiliate institution’s program must be conducted on site at the affiliate institution. Visits by the affiliate clinical director to the sponsor do not fulfill the intent of these reviews. An adequate record of such an on-site visit is a brief, dated note that describes what was seen and what accomplishments or problems the clinical affiliate might be encountering. It should also include any steps that were taken to resolve problems that might have been identified during prior visits. Visits should be at least quarterly and more often if needed.

II.A.2.a Responsibilities

The educational clinical coordinator provides supervision, administration, and coordination of the instructional faculty in the academic and clinical phases of the education program.

II.A.2.b Qualifications

The educational clinical coordinator shall be a nuclear medicine technologist certified by a nationally recognized certifying board and have a minimum of three years of post-certification experience in nuclear medicine technology or possess equivalent suitable qualifications.

II.A.3.a Responsibilities

The medical advisor director of the program shall provide competent medical guidance to ensure that the medical components of the curriculum meet current acceptable standards. The medical director coordinates with the program director to assure physician interaction with students and physician review and input into the curriculum.

II.A.3.b Qualifications

The medical advisor director must be a physician certified in the use of radionuclides and be either a diplomate of an American Board of Medical Specialties (ABMS) approved certifying board in Nuclear Medicine, Pathology, or Radiology, or possess suitable equivalent qualifications.

II.A.4.a Responsibilities

The affiliate clinical supervisor shall be responsible for the clinical education, supervision and evaluation of students assigned to the clinical affiliate.

II.A.4.b Qualifications

The affiliate clinical supervisor must be certified by a nationally recognized certifying board in nuclear medicine technology or possess suitable equivalent qualifications.

Clinical supervisors in radiopharmacies must possess a professional license from the appropriate state board or possess suitable equivalent qualifications.

II.A.5.a Responsibilities

The affiliate medical director shall provide input into the clinically related activities of the student and shall participate in clinical instruction.

II.A.5.b Qualifications

The affiliate medical director must be a physician certified in the use of radionuclides and be either a diplomate of an American Board of Medical Specialties (ABMS) approved certifying board in Nuclear Medicine, Pathology, or Radiology, or possess suitable equivalent qualifications.

II.A.6.a Responsibilities

The faculty shall participate in teaching courses, supervising laboratory learning experiences, evaluating student achievement, developing curriculum, formulating policy and procedures, and evaluating program effectiveness.

II.A.6.b Qualifications

Faculty designated by the program must demonstrate be qualified, by education, certification, and experience the ability to teach assigned courses effectively at the appropriate nuclear medicine technology educational level.

II.A.6.c Professional Development

The program shall document ongoing professional development of all program faculty, academic and clinical, to assure that the faculty are able to fulfill their instructional responsibilities.

II.D.1 Library

An accessible library collection or information resource containing professional books published within the last three years, current periodicals, and other reference materials related to all subject areas of the curriculum shall be provided to foster an atmosphere of inquiry, study and learning.

II.D.2 Instructional Aids

Clinical subjects, computer hardware and software, specimens, records and related reference materials, and audiovisual resources shall be available in sufficient number and quality to enhance student learning.

Guideline criteria

Student capacity in each clinical facility is calculated according to the following:

1. 1 full-time student for each imaging instrument which completes procedures on 5 or more patients per day, plus 1 full-time student for in-vitro procedures, providing an adequate number and variety are performed daily, plus 1 full-time student for radiopharmacy where adequate numbers and varieties of radiopharmaceuticals are prepared.

2. Student capacity may not exceed more than 1 full-time student per full-time certified nuclear medicine technologist, pharmacist, chemist, or person possessing suitable equivalent qualifications.

On occasion the on-site capacity may be larger or smaller than that calculated above. The final number recommended for on-site student capacity must clearly assure that space, personnel, equipment, and procedure load will enable each student’s experience to satisfy the program objectives for clinical education.

III.C.1 Dismissal

A clear statement detailing causes for student dismissal must be published and available to the student.

III.C.2 Appeal Procedures

A description of appeal procedures shall be distributed to students at the start of the program. These procedures shall include provisions for academic and non-academic types of grievances and a mechanism for neutral evaluation that ensures due process and fair disposition. Rules and regulations governing acceptable conduct must be clearly defined and published.

III.D Evaluation Criteria

Written criteria for successful completion of each segment of the curriculum and for graduation shall be given in advance to each student. The evaluation system shall be related to the objectives and competencies described in the curriculum for both academic and supervised clinical education components. The evaluation system shall be employed frequently enough to provide students and program officials with timely indications of the student’s progress and academic standing and to serve as a reliable indicator of the effectiveness of course design and instruction.

III.E Health

There shall be a procedure for determining whether the applicant’s or student’s health will permit achievement of the written essential standards of the program. Students shall be informed of and have access to the usual student health care services of the institution. The health and safety of students, faculty, and patients associated with educational activities shall be adequately safeguarded. Emergency medical care shall be available for students while in attendance.

The program will maintain compliance with federal and state health and radiation protection regulations. Radiation exposure records shall be discussed with the students at regular intervals (not less than quarterly). Documentation of these reviews shall be maintained.

III.F Guidance

Guidance shall be available to assist students in understanding and observing program policies and practices and in handling professional career issues and personal problems that may interfere with progress in the program.

Guideline

A nuclear medicine technologist education program should foster:

1. development of skills in problem-solving, critical-thinking, and decision-making; in oral and written communication; in human relations; in patient services; and some familiarity of applicable medical law and ethics;

2. a commitment to make a significant contribution to the healthcare team;

3. an appreciation and respect for cultural diversity;

4. a holistic caregiver’s perspective;

5. understanding of departmental organization and function in relation to the healthcare delivery system as a whole; and

6. understanding of the value and responsibilities entailed in being a professional.

Guideline

After completing the program, each student should have attained a level of knowledge and skill to be capable of performing the various tasks as detailed.

1. Patient Care

   1. A. A nuclear medicine technologist provides patient care by:

      1. acquiring adequate knowledge of the patient’s medical history to understand and relate to the patient’s illness and the pending diagnostic or therapeutic procedures;

      2. providing for proper comfort and care of the patient prior to, during and after a procedure; providing for proper comfort and care of the patient before, during and after a procedure, including, but not limited to, the monitoring of intravenous lines (i.e. central lines, mediports, Peripherally Inserted Central Catheter (PICC)  lines), oxygen supplies, drains and patients who are under sedation.

      3. recognizing surgical and disease history that may create artifacts or variants on PET images, and may require modifying the protocol;

      4. establishing and maintaining good communication with each patient (i.e., making introductions, explaining the procedures, answering questions);

      5. providing functionally safe and sanitary conditions for the patient in compliance with universal protection standard precaution policies;

      6. recognizing and responding to an emergency condition; and

         1. initiating a call for assistance,

         2. monitoring and recording physiologic data (i.e., ECG, pulse rate, respiratory rate),

         3. administering cardiopulmonary resuscitation when necessary, and

         4. maintaining intravenous fluids, oxygen, and other life-support assistance until an emergency code team arrives.

   2. A nuclear medicine technologist prepares the patient for an examination by:

      1. verifying patient identification, determining pregnancy status, breast-feeding status, and reviewing written orders for the procedure;

      2. obtaining a pertinent history and checking for contraindications;

      3. measuring peripheral blood glucose level prior to PET imaging;

      4. ensuring that informed consent has been obtained when necessary;

      5. explaining the procedure to the patient or family and, where applicable, to the parents or legal guardian including, but not limited to, the procedure, patient involvement, length of study, and radiation safety issues;

      6. checking patient clothing and linen for objects that may cause artifacts in the images or the proposed measurements; and

      7. waiting an appropriate length of time after the administration of a radiopharmaceutical to begin the procedure.

      8. ensuring that any preprocedural preparation has been completed including, but not limited to, fasting, hydration, taking of thryroid blocking compounds, voiding, bowel cleansing, and suspension of interfering medications.

   3. A nuclear medicine technologist performs administrative procedures by:

      1. maintaining an adequate volume appropriate inventory of medical/surgical supplies, radiopharmaceuticals, and film storage media, and other items to ensure that a patient procedure can be performed whenever necessary;

      2. scheduling patient procedures;

      3. determining the appropriate sequence for executing multiple procedures;

      4. maintaining appropriate records of patient dosages administered radioactivity quality control procedures, patient reports, and other required records;

      5. revising and developing procedures for reporting or recording incidents required by regulatory agencies in collaboration with an authorized user;

      6. revising and developing policies and procedures in conjunction with administration in accordance with applicable regulations and administrative requirements; and

      7. participating in the quality assurance control program.

2. Radiation Safety

   1. A nuclear medicine technologist, under supervision of an authorized user or Radiation Safety Officer, maintains compliance with local, state and federal regulations in radiation safety practices by:

      1. using personnel monitoring devices (i.e., dosimeters, film badges, TLD’s, etc.); and

         1. reviewing monthly quarterly personnel exposure records in regard to maximum permissible dose limits,

         2. taking appropriate measures to reduce exposure when necessary, and

         3. notifying proper authorities of excessive exposure upon occurrence.

      2. notifying appropriate authorities when changes occur in the radiation safety program;

      3. assisting in the preparation of license amendments when necessary;

      4. reviewing and complying maintaining compliance with regulations;

      5. maintaining required records;

      6. posting appropriate signs in designated areas;

      7. following federal, state and institutional regulations regarding receipt and disposition of all radionuclides;

      8. carrying out a program to follow regulations regarding therapeutic dosages and follow-up procedures;

      9. recommending purchase of protective equipment to meet regulations; and

      10. packaging radioactive material according to regulations and keeping accurate records of transfer.

   2. A nuclear medicine technologist follows appropriate protection procedures thereby limiting the radiation exposure of the patient, public, fellow workers, and self to as low a level as reasonably achievable (ALARA) by:

      1. selecting and using proper shielding to reduce radiation exposure;

      2. using proper methods for storage and disposal of radioactive materials;

      3. identifying and using proper procedures for those radionuclides that pose special hazards (i.e., Sr-89, I-131); and

      4. performing a bioassay as per state and/or federal regulations.

      5. using appropriate shielding and techniques for protection from 511 keV PET radiotracers.

   3. A nuclear medicine technologist performs radiation surveys by:

      1. ensuring that instruments are calibrated at regular intervals or after a repair and as required by regulations;

      2. setting frequency and locations for surveys and following schedules;

      3. using appropriate survey meters for each type and level of activity;

      4. following regulations regarding personnel surveys and reporting to the designated physician or Radiation Safety Officer;

      5. performing constancy checks on survey meters;

      6. performing wipe tests where applicable;

      7. performing leak tests on sealed sources, when so authorized; and

      8. recording data in standard format.

   4. A nuclear medicine technologist performs decontamination procedures by:

      1. wearing appropriate clothing and foot covering as necessary;

      2. blocking access to a contaminated area and confining a spill;

      3. removing contamination or reducing the activity to acceptable levels;

      4. monitoring the area and personnel involved and repeating decontamination procedures until activity levels are acceptable;

      5. closing off all areas of fixed contamination that are above acceptable levels;

      6. identifying, storing, or disposing of contaminated material in accordance with regulations;

      7. maintaining adequate records concerning cleanup;

      8. notifying appropriate authority (i.e., Radiation Safety Officer) in the event of possible overexposure or other violations of regulations; and

      9. assessing and managing patient contamination performing appropriate radioactive contamination monitoring and any necessary decontamination procedures.

   5. A nuclear medicine technologist disposes of radioactive waste and maintains appropriate records according to license conditions.

   6. A nuclear medicine technologist participates in a hospital’s in-service education program to instruct other personnel about regarding radiation hazards and principles of radiation safety.

3. Nuclear Instrumentation—Quality Control

   1. A nuclear medicine technologist evaluates the performance of scintillation cameras by:

      1. assessing camera uniformity;

         1. selecting a radionuclide source of appropriate type, size, (if necessary), quantity and energy,

         2. selecting an appropriate pulse height analyzer (PHA) photopeak and window,

         3. obtaining uniformity images using standardized imaging parameters,

         4. evaluating the images qualitatively and, if possible, quantitatively in comparison to the manufacturer’s specification,

         5. identifying the source of any non-uniformity (i.e., checking collimator, PHA peak setting), and

         6. f.initiating corrective action when necessary.

      2. performing a detector spatial linearity evaluation;

         1. selecting a radionuclide, a spatial linearity phantom and obtaining images,

         2. identifying any nonlinearity in the image and, where possible, determining the source, and

         3. initiating corrective action when necessary.

      3. performing spatial resolution checks;

         1. selecting an appropriate radionuclide,

         2. choosing a phantom that is compatible with the specified resolution of the camera,

         3. analyzing the resulting images for degradation of resolution, and

         4. initiating corrective action when necessary.

      4. conducting sensitivity checks;

         1. selecting a source with an appropriate level of activity and half-life; and

         2. assuring identical geometry, source placement and measurement parameters for repetitive checks.

      5. performing SPECT quality control procedures;

         1. obtaining a high count uniformity flood,

         2. obtaining a center of rotation correction,

         3. evaluating energy corrections and spatial coordinates,

         4. verifying multi-head detector alignment,

         5. evaluating reconstruction results of a phantom acquisition, and

         6. initiating corrective action when necessary.

   2. checking computer parameter settings and data interface verifying accuracy of ECG gating.

      1. assuring camera and computer register same frame rate at max frame rate,

      2. verifying that the camera and computer have the same image orientation,

      3. obtaining a dead time measurement on the computer, and

      4. verifying accuracy of ECG gating.

   3. checking the analog and/or digital recording device(s);

      1. performing a lens focus check (i.e., CRT),

      2. checking and adjusting imaging device for contrast and brightness (i.e., densitometry),

      3. assessing integrity of imaging device, and

      4. maintaining cleanliness of all equipment (i.e., lens, fan covers).

   4. maintaining the required records for the quality control program. B. A nuclear medicine technologist evaluates the performance of a PET or PET/CT scanner by:

      1. assessing detector array uniformity;

      2. acquiring applicable calibration data prior to clinical imaging (as applicable: blank scan, normalization, coincidence timing, well counter, etc.);

      3. testing transmission imaging systems;

      4. checking alignment of emission and transmission images.

   5. A nuclear medicine technologist evaluates the performance of NaI (Tl) scintillation probes and well counters by:

      1. calibrating a spectrometer with a long half-life radionuclide source;

      2. determining energy resolution;

      3. performing constancy measurements and determining proper operation;

      4. conducting sensitivity measurements at appropriate energies;

      5. checking background and determining the cause for levels greater than established normal levels;

      6. performing a chi-square test and interpreting results; and

      7. maintaining required records for quality control programs.

   6. A nuclear medicine technologist operates survey meters by:

      1. ensuring calibration is completed by an approved agent;

      2. performing a reference check-source test and comparing with previous results; and

      3. maintaining required records for quality control program.

   7. A nuclear medicine technologist evaluates the operation of a dose calibrator by:

      1. performing a constancy test and determining proper operation;

      2. performing accuracy measurements with a National Institute of Standards and Technology (NIST) source;

      3. ascertaining linearity over the entire range of radionuclide activity to be measured; and

      4. testing for significant geometric variation in activity measured as a function of sample volume or configuration and determining correction factors.

   8. A nuclear medicine technologist operates and maintains film processors by:

      1. monitoring and recording sensitometry and temperature of water and dryer daily; and

      2. maintaining required records for quality control program.

4. Radiopharmaceuticals

   1. A nuclear medicine technologist initiates purchases of radiopharmaceutical products and adjunct supplies by:

      1. anticipating and procuring a sufficient supply of radioactive drugs for an appropriate time period in accordance with anticipated need and license possession limits;

      2. storing drugs and supplies in a manner consistent with labeled product safeguards and with radiation safety considerations;

      3. performing and documenting radiation wipe tests upon receipt of radioactive materials;

      4. recording receipt of radioactive materials; and

      5. following Department of Transportation (DOT) and radiation safety guidelines in the transport, receipt and shipment of radioactivity.

   2. A nuclear medicine technologist prepares and verifies quality of radiopharmaceuticals under the direction of an authorized user by:

      1. employing aseptic technique for manipulation of injectable products;

      2. assembling and maintaining radionuclide generators;

      3. eluting radionuclide generators according to manufacturer’s specification;

      4. verifying radionuclide purity of generator eluates;

      5. selecting and preparing radiopharmaceuticals in accordance with manufacturer’s specification;

      6. calculating and measuring activity of the radionuclide with a dose calibrator;

      7. confirming the quality of a radiopharmaceutical in accordance with accepted techniques and official guidelines;

      8. preparing labeled blood cells (i.e., In-111 WBC) in accordance with established protocols; and

      9. recording use and/or disposition of all radioactive materials.

   3. A nuclear medicine technologist is responsible for the identification and labeling of all radiopharmaceutical preparations by:

      1. labeling the container with the radiopharmaceutical, hour, date, expiration time, and radiation symbol;

      2. recording radiopharmaceutical and medication information on a patient’s administration form and preparation records; and

      3. labeling and segregating radioactive waste and recording this information.

   4. A nuclear medicine technologist prepares individual dosages under the direction of an authorized user by:

      1. applying radioactive decay calculations to determine required volume or unit form necessary to deliver the prescribed radioactive dosage;

      2. selecting and preparing prescribed dosages and entering this information on a patient’s administration form and other records;

      3. labeling the dosage for administration; and

      4. checking the dosage activity prior to administration in a dose calibrator and comparing this measurement against the identification label of the dose’s immediate container.

5. Diagnostic Procedures

   1. A nuclear medicine technologist performs imaging procedures by:

      1. selecting imaging parameters;

         1. selecting and preparing the instrument for the procedure,

         2. selecting appropriate parameters for digital and/or analog image data acquisition, and

         3. recognizing artifacts on static, dynamic, gated, SPECT and PET images that are due to instrumentation malfunction and initiating appropriate action.

      2. administering radiopharmaceuticals and/or pharmaceuticals using universal standard precaution techniques as authorized by the institution;

         1. verifying patient identity prior to the administration of medication or radiopharmaceuticals,

         2. determining route of administration according to established protocol (i.e., subcutaneous, intramuscular, intravenous, aerosol, inhalant, or oral, intravisecal, and subcutaneous),

         3. establishing and/or verifying venipuncture access using aseptic techniques,

         4. using and maintaining established venous access routes (i.e., heparin infusion, IMED),

         5. establishing patterned breathing when introducing radiopharmaceuticals by inhalation,

         6. administering oral radiopharmaceuticals,

         7. documenting medication and/ or radiopharmaceutical administrations on a patient’s permanent record, and.

         8. preparing, determining dosage, and administering non-radioactive pharmaceuticals under medical direction.

      3. positioning the patient and obtaining images;

         1. recording image data according to established protocols and acquiring additional views when needed to optimize information content,

         2. placing the patient in correct position using supportive materials and immobilizers as necessary,

         3. exercising independent judgment in positioning a patient or detector unit to best demonstrate pathology,

         4. indicating appropriate anatomic landmarks for each view of the procedure, and

         5. reviewing images to assure that correct information is supplied.

      4. assisting the physician in cardiac stress testing when performed in conjunction with nuclear medicine procedures;

         1. preparing patient’s skin and placing ECG leads appropriately,

         2. recognizing and being responsive to any changes that may occur on either a resting or stress ECG, and

         3. recognizing the parameters that should terminate a cardiac stress study.

      5. performing data collection, processing and analysis;

         1. performing data collection, processing and analysis in accordance with established protocols,

         2. exercising independent judgment in selecting appropriate images for processing,

         3. selecting appropriate filter, filter parameters, and attenuation correction when reconstructing SPECT images,

         4. applying corrections to PET images for attenuation, randoms, scatter, etc.

         5. defining regions of interest (ROI’s) with reproducible results and correctly applying background subtraction,

         6. performing time activity curve generation and additional manipulation (i.e., T1/2),

         7. labeling processed images to reflect anatomical position, ROI’s, etc., and archiving and retrieving data from storage media.

         8. performing image fusion of PET and SPECT with CT and MRI

   2. A nuclear medicine technologist performs non-imaging in-vivo and/or radioassay studies by:

      1. operating laboratory equipment and checking accuracy, precision, and operation of pipetting device.

         1. checking accuracy, precision, and operation of pipetting device, and

         2. determining hematocrit using appropriate equipment.

      2. preparing dosage according to standards;

         1. quantitating dosage by,

            1. determining decay factor and calculating remaining activity,

            2. determining volume necessary to deliver activity for the prescribed dosage,

            3. drawing dosage into syringe using appropriate techniques and materials,

            4. dispensing appropriate quantity of liquid or capsules for the prescribed dosage, and

            5. confirming calculated activity by using a dose calibrator.

         2. preparing standard by,

            1. choosing appropriate volumetric or gravimetric techniques to dilute standard,

            2. adding radioactive material identical to that given the patient q.s. (quantity sufficient) to appropriate volume, and

            3. diluting capsule in appropriate solvent, if necessary, for preparing a standard.

         3. collecting proper the appropriate specimens for procedures using universal standard precautions techniques;

            1. collecting blood samples by,

               1. selecting proper supplies (i.e., needles, syringes, evacuated tubes, anticoagulants, etc.),

               2. labeling patient information on collection containers,

               3. performing venipunctures at appropriate time intervals using aseptic technique,

               4. adding hemolyzing compounds to samples when necessary,

               5. centrifuging blood and separating blood components, as required, and

               6. storing aliquot of serum, plasma, or whole blood according to protocol.

            2. collecting and processing urine samples for radiometric assays by,

               1. instructing patient and nursing staff as to correct method and time of urine collection,

               2. aliquoting urine sample and measuring total urine volume,

               3. measuring specific gravity of urine, if required,

               4. recognizing and documenting all technical circumstances which would produce invalid results, and

               5. labeling patient information on collection containers.

         4. performing calculations;

            1. subtracting room or patient background from appropriate samples,

            2. applying appropriate formulas, including conversion and dilution factors,

            3. calculating results according to procedure used, and

            4. reporting both patient values and normal range of specific procedures used.

      3. managing bio-hazardous, chemical, and radioactive waste using disposal methods adopted as facility policy in accordance with applicable regulations and specific facility policies.

6. Radionuclide Therapy

   1. The nuclear medicine technologist assists an authorized user in the preparation and application of therapeutic radionuclides by:

      1. assuring the correct radiopharmaceutical and dosage are prepared;

      2. having the authorized user and the technologist verify the dosage;

      3. assuring the patient is correctly identified by the technologist and authorized user according to the quality management program in effect at the particular institution;

      4. preparing and/or coordinating environmental preparations (i.e., decontamination supplies);

      5. observing prescribed radiation safety procedures during the preparation and the administration of such treatment;

      6. assisting the authorized user in supplying proper patient care instructions to hospital staff, patient, and/or caregivers;

      7. conducting and documenting radiation surveys of designated patient areas, when indicated; and

      8. supplying hospital staff, patient, and/or caregivers with proper instructions on handling and disposal of all contaminated supplies when necessary.

V.A Fair Practices

V.A.1 Announcements and advertising must accurately reflect the program offered.

V.A.2 Student and faculty recruitment and student admission and faculty employment practices shall be non-discriminatory with respect to race, color,creed, sex, age, disability conditions (handicaps) and national origin.

V.A.3 Academic credit and costs to the student shall be accurately stated, published and made known to all applicants.

V.A.4 The program or sponsoring institution shall have a defined and published policy and procedure for processing student and faculty grievances.

V.A.5 Assignments during hours other than the normally scheduled clinical experience (i.e., evenings, weekends, and holidays) shall be justified. Specific objectives and evaluations must be developed to address the uniqueness of these learning experiences.

V.A.6 Policies and processes for student withdrawal and for refunds of tuition and fees shall be published and made known to all applicants.

V.A.7 Policies and processes by which students may perform service work while enrolled in the program must be published and made known to all concerned in order to avoid practices in which students are substituted for regular staff. Students may not take the responsibility or the place of qualified staff. However, after demonstrating proficiency, students may be permitted to undertake certain defined activities with appropriate supervision and direction outside assigned program hours. Class credit shall not be awarded for such activities.

V.A.8 The health and safety of patients, students and faculty must not be jeopardized in any way by activities of the students.

V.B Student Records

Student records shall be maintained for admission, evaluation, and counseling or advising sessions. Individual grades and credits for courses shall be recorded and permanently maintained by the sponsoring institution. The program shall maintain the student records for a reasonable period of time (e.g., 10 years) and shall conform to applicable federal and/or state regulations. Ideally, the student files should be maintained permanently, intact or microfilmed.

VI.A Effectiveness

VI.A.1 The extent to which the sponsoring institution and affiliates fulfill their responsibilities related to the mission and educational goals of the program must be assessed.

VI.B Outcomes

Programs shall routinely collect sufficient qualitative and quantitative information regarding the post-graduation activities of its graduates to demonstrate an ongoing evaluation of outcomes consistent with the graduate competencies.

VII.A.1 Applying for Accreditation

The accreditation review process conducted by the JRCNMT can be initiated only at the written request of the chief executive officer or an officially designated representative of the sponsoring institution.

This process is initiated by requesting an application form from: Joint Review Committee on Educational Programs in Nuclear Medicine Technology, PMB # 418, #1 2nd Avenue East, Suite C, Polson MT 59860–2107

The accreditation review process includes submission of the Application for Accreditation, completion and submission of a Self-Study Report, payment of appropriate fees, and agreement to an on-site evaluation.

An institution sponsoring a program may voluntarily withdraw from the JRCNMT accreditation process at any time.

VII.A.2 Administrative Requirements for Maintaining Accreditation

VII.A.2.a The program must submit a Self-Study Report or a required progress report within a reasonable period of time, as determined by the JRCNMT.

VII.A.2.b The program must agree to a site visit date near the end of the period for which accreditation was awarded.

VII.A.2.c The program must inform the JRCNMT within 60 days of changes, absence or inability to serve of required program personnel.

VII.A.2.d The program must submit an application for all clinical affiliates.

A program may not have a separate clinical facility which is not recognized by the JRCNMT when that affiliate has students who receive benefits due to the accredited status of the program or students who are recruited using the name or accredited status of the program. An Application for Clinical Affiliate(s) must be received 60 days prior to the assignment of students.

VII.A.2.e The sponsoring institution must inform the JRCNMT of its intent to transfer program sponsorship in accord with JRCNMT policy.

VII.A.2.f The program and the sponsoring institution must pay the JRCNMT fees within a reasonable period of time, as determined by the JRCNMT.

Failure to meet these administrative requirements for maintaining accreditation may lead to Administrative Probation and ultimately to withdrawal of accreditation.

VII.B JRCNMT Responsibilities