Determining radiology staffing requirements in the operating room: a radiation protection compliance perspective

The use of radionuclides and x-ray equipment is highly regulated, and in many states, only a licensed technologist or physician may operate the equipment. These regulatory requirements, coupled with persistent radiologic technologist (RT) vacancy rates, can make adequate staffing a difficult task. While there are numerous reports describing nurse workforce requirements, there is a paucity of published information on what constitutes appropriate staffing levels for RTs. In consideration of future operating room (OR) expansion, the institution determined to measure how its current staffing plan was meeting the needs of the OR as well as to empirically develop a plan that met all radiation safety and regulatory requirements. A 4-week tracking study (N=244 cases) of C-arm and other x-ray utilization was performed by 3 RT full-time equivalents (FTE) assigned to operate or assist with 10 x-ray devices in 40 ORs. The logs demonstrated that a RT was present during 181 cases (181/244 = 74%), while in 63 other cases (63/244 = 26%), the RT only delivered the C-arm for physician use. No nurses were observed operating the equipment. In some instances, simultaneous requests necessitated extra coverage by additional RTs. Regulatory and market forces constrain hospitals to make difficult decisions regarding staffing. Objective documentation of radiology resource utilization in the OR provided evidence leading to improvement opportunities and adjustments to the staffing plan.