![]() ![]() ![]() Other experienced barriers were the reimbursement for the treatment and financial compensation. The protocol has not yet been implemented in the electronic patient file, which makes it more time consuming. The main barrier for use of the protocol was time. The protocol appeared to provide support in the diagnosis, treatment and evaluation of foot problems in rheumatic disorders and the treatment recommendations were clear and understandable. Practical knowledge on joint palpation, programme variation and the use of practice cases were valued most. The mean satisfaction with the educational programme was 7.6 (SD 1.11), on a 11 point scale. Semi-structured interviews were held to get more in-depth understanding. Facilitators and barriers that they experienced in the use of the protocol were determined by a questionnaire. ![]() Subsequently, podiatrists used the protocol for three months in their practice. They thereafter received a digital questionnaire to evaluate the educational programme. An educational programme was developed and provided to train the podiatrists in the use of the protocol. ![]() This study used a mixed method design and included 32 podiatrists in the Netherlands. to evaluate an educational programme to train podiatrists in the use of the protocol and to explore barriers and facilitators for the use of the protocol in daily practice. To increase uniformity and quality of podiatry care for rheumatoid arthritis (RA), osteoarthritis (OA), spondyloarthritis (SpA), and gout a clinical protocol has been developed. There appears to be large variability in the management of foot problems in rheumatic disorders across podiatrists. Additionally, based on the measurements we conclude that all monitored interventionalists remain below the dose limit and compulsory monitoring limit for the eye lens dose.įoot and ankle problems are common in rheumatic disorders and often lead to pain and limitations in functioning, affecting quality of life. The eye lens dose can be monitored indirectly through the regular dosimeter at chest level. The extrapolated year dose for the eye lens did not exceed 15 mSv for any of the interventionalists (average 3 to 10 studies/month). Measurements were performed in the angiography suite, Cath lab and hybrid OR.Ī clear relation was observed between the two dosimeters: Hp(3) ≈ 0,25 Hp(0,07). The eye lens dose was compared to both the body-worn dosimeter values. The dosimeters were simultaneously refreshed every four weeks. Simultaneously, the surface dose, Hp(0,07), and whole body dose, Hp(10), were measured using regular dosimeters outside the lead skirt at chest level. The eye lens dose, Hp(3), of interventional radiologists (n = 2), cardiologists (n = 2) and vascular surgeons (n = 3) in the Máxima Medical Centre, The Netherlands, was measured during six months, using thermoluminescence dosimeters on the forehead. In this study we propose a method to investigate whether the eye lens dose of interventionalists would exceed 15 mSv/year and to determine if the eye lens dose can be derived from the regular personal dosimeter measurements. Dutch guidelines state that monitoring is compulsory above an expected eye lens dose of 15 mSv/year. Early 2018, the new eye lens dose limit of 20 mSv per year for occupational exposure to ionising radiation was implemented in the European Union. ![]()
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