IMS files litigation to challenge nursing supervision of fluoroscopy
June 21, 2010
The Iowa Medical Society (IMS) filed litigation today to challenge the Iowa Department of Public Health and the Iowa Board of Nursing for inappropriately expanding the scope of practice of nursing to include the supervision of fluoroscopy.
The American College of Radiology believes the adoption of this rule makes Iowa an outlier by allowing nurses to supervise fluoroscopy absent physician oversight. The new rule became effective in Iowa on May 15, 2010.
IMS President Timothy Kresowik, MD, said this is a serious patient safety issue for Iowans. "Radiology is the practice of medicine. Iowans deserve to know that the individuals performing and supervising procedures with potentially harmful levels of radiation have been educated and are qualified to do so," he said. Standards of the American College of Radiology also call for physician supervision of fluoroscopy.
Kresowik said that although Iowa physicians value the relationship they have with nurses, national standards do not recognize supervision of fluoroscopy to be within the legitimate scope of nursing. He notes that since fluoroscopy utilizes a potentially dangerous form of ionizing radiation, its use requires elevated safety and training to ensure appropriate radiation exposure.
"It makes no sense for Iowa to require less education and training for nurses than the national education and training standards for radiologic technologists and radiology assistants," he said.
Kresowik said it's ironic the new rule takes effect at a time when the U.S. Food and Drug Administration has announced an initiative to reduce unnecessary radiation exposure from medical imaging procedures, such as computed tomography (CT scans) and fluoroscopy. Exposure to ionizing radiation can increase a person's lifetime cancer risk and cause injuries, such as skin burns, hair loss and cataracts.
The Litigation Center of the American Medical Association and State Medical Societies, which provides physicians with legal assistance and expertise, is supporting this effort.
Fluoroscopy is a type of medical imaging or X-ray procedure that shows a continuous X-ray image on a monitor. It is used to diagnose or treat patients by displaying the movement of a body part or of an instrument or dye (contrast agent) through the body. Fluoroscopy is used in many types of examinations and procedures. Some examples include:
- Catheter insertion (to direct the placement of a catheter during angioplasty or angiography)
- Blood flow studies (to visualize blood flow to organs)
- Barium x-rays and enemas (to view movement through the GI tract)
- Orthopedic surgery (to view fractures and fracture treatments)
The Iowa Department of Public Health is responsible for radiation safety in Iowa and the Iowa Board of Nursing is responsible for assuring safe and competent nursing practice in the state.
The Iowa Medical Society is the professional association representing over 5,200 Iowa MDs and DOs. The core purpose of the IMS is to assure the highest quality of health care in Iowa through our role as physician and patient advocate.-30-
Contact: Lucinda Stephenson,
Iowa Medical Society,
(515) 223-1401 or (800) 747-3070