1.

Introduction
Proposal: Assessment of Radiation Practice and Safety at Yekatit 12 Hospital, Addis
Ababa, Ethiopia

Diagnostic radiography serves as a cornerstone of patient care at Yekatit 12 Hospital, Addis

Ababa, Ethiopia. While it provides invaluable diagnostic insights, it utilizes ionizing radiation,
which carries inherent health risks like cellular and genetic damage. Strict adherence to es-
tablished radiation safety practices is paramount to minimizing these risks for both patients
and healthcare professionals at Yekatit 12 Hospital.

This proposal outlines a comprehensive study designed to assess the current state of radia-
tion practice and safety at Yekatit 12 Hospital. The study aims to identify areas for improve-
ment and recommend targeted interventions to optimize patient care and ensure a safe work-
ing environment for staff.

2. Background
2.1 Risks Associated with Ionizing Radiation

Ionizing radiation can induce stochastic effects such as cancer and genetic mutations. The
risk of these effects increases with radiation dose, highlighting the critical importance of mini-
mizing patient and staff exposure at Yekatit 12 Hospital.

2.2 Radiation Safety Practices

Several established practices contribute to effective radiation safety:

 Justification: Procedures involving ionizing radiation must be justified by the potential

benefits outweighing the risks at Yekatit 12 Hospital.
 Optimization: Techniques should be optimized to minimize radiation dose while main-
taining diagnostic image quality.
 Limitation: Exposure should be limited to the necessary area for diagnosis at Yekatit
12 Hospital.
 Personal Protective Equipment (PPE): Radiographers and other personnel should
utilize appropriate PPE like lead aprons and thyroid shields at Yekatit 12 Hospital.
 Shielding: Patients should be shielded with gonad shields for sensitive organs when
feasible at Yekatit 12 Hospital.
 Quality Assurance (QA): Regular maintenance and quality control checks on X-ray
machines are crucial for ensuring accurate dose delivery at Yekatit 12 Hospital.
2.3 Potential Concerns at Yekatit 12 Hospital
While a comprehensive understanding necessitates further investigation, studies conducted in
Ethiopia have identified potential concerns regarding radiation safety practices in some
healthcare facilities [1, 2, 3]. These concerns may also be relevant at Yekatit 12 Hospital and
include:

 Resource Limitations: Access to modern radiation protection equipment and phan-

toms for machine calibration might be limited.
 Outdated Equipment: The use of older X-ray machines raises safety concerns if
proper maintenance and quality assurance procedures are not strictly followed.
 Shielding Practices: The consistent use of protective shielding devices for patients
might be inconsistent.
3. Significance of the Proposed Study

A comprehensive assessment of radiation practice and safety at Yekatit 12 Hospital is crucial

for several compelling reasons:

 Improved Patient Safety: By assessing current practices, the study can identify areas
for improvement and implement measures to minimize unnecessary patient exposure,
leading to safer diagnostic procedures.
 Optimizing Resource Allocation: The study will identify resource limitations hindering
safe practices, allowing for targeted advocacy for investments in essential equipment
and infrastructure at Yekatit 12 Hospital.
 Promoting Best Practices: The study can contribute to developing tailored guidelines
and training programs for radiographers at Yekatit 12 Hospital, ensuring they stay up-
dated on the latest radiation safety protocols.
4. Methodology

This study will employ a mixed-methods approach, combining quantitative and qualitative
data collection methods to gain a comprehensive understanding of radiation safety practices
at Yekatit 12 Hospital.

4.1 Quantitative Data Collection

• Survey: A self-administered questionnaire will be developed to evaluate the knowledge,
attitudes, and practices of radiographers at Yekatit 12 Hospital regarding radiation safety.
The questionnaire will be based on established radiation safety guidelines and adapted to
the Ethiopian context.
• Medical Record Review: A retrospective review of medical records will be conducted to
assess radiation dose parameters for common X-ray procedures performed at Yekatit 12
 Hospital. This will help assess adherence to optimization principles and identify potential
areas for dose reduction.
4.2 Qualitative Data Collection
• Semi-structured Interviews: Semi-structured interviews will be conducted with key
personnel at Yekatit 12 Hospital, including radiographers, radiologists, and administrators.
The interviews will explore participants' experiences with radiation safety practices,
challenges they face, and suggestions for improvement.
5. Data Analysis
 Quantitative Data Analysis: Quantitative data from the survey and medical record
review will be analyzed using descriptive statistics (e.g., frequencies, percentages,
means, and standard deviations) to understand the prevalence of specific practices
and radiation dose levels. Depending on the data distribution, inferential statistics may
also be used to identify potential associations between variables.
 Qualitative Data Analysis: Qualitative data from the interviews will be analyzed
thematically using a systematic approach to identify recurring patterns and themes in
participants' experiences and perspectives.
6. Ethical Considerations

The proposed study will be conducted in accordance with ethical principles outlined in the
Declaration of Helsinki.

 Informed consent will be obtained from all participants before data collection.
 Confidentiality and anonymity of participants will be ensured throughout the study.
7. Dissemination Plan

The findings of this study will be disseminated through various channels to maximize their
impact:

 Report: A comprehensive report summarizing the study's methodology, results, and

recommendations will be prepared and submitted to Yekatit 12 Hospital administration.
 Presentations: Presentations will be delivered to staff at Yekatit 12 Hospital to raise
awareness about the study's findings and promote best practices in radiation safety.
 Peer-reviewed publications: The results may be submitted for publication in relevant
scientific journals to contribute to the broader knowledge base of radiation safety
practices in resource-limited settings.
8. Timeline

Given a three-month timeframe, this revised timeline outlines a more condensed approach to
the study:
• Month 1:
• Obtain ethical clearance.
• Develop and finalize the questionnaire.
• Recruit participants among radiographers at Yekatit 12 Hospital.
• Month 2:
• Conduct data collection through surveys and medical record review.
• Conduct semi-structured interviews with key personnel.
• Month 3:
• Analyze quantitative and qualitative data.
• Prepare a comprehensive report summarizing the study's findings and
recommendations.
• Disseminate preliminary findings through presentations to staff at Yekatit 12
Hospital.

This revised timeline prioritizes core data collection and initial dissemination within the three-
month timeframe. Further detailed analysis or publication in peer-reviewed journals may
require additional time beyond this initial phase.

9. Budget

A detailed budget outlining the estimated costs associated with the three-month study is
provided below:

• Personnel: Research team salaries and benefits (to be determined)

• Materials:
• Survey printing (600 Ethiopian Birr)
• Interview transcription (costs to be determined based on interview volume)
• Data analysis software (costs to be determined)
• Transport: Travel within Addis Ababa for interviews (300 Ethiopian Birr)
Please note: Costs for personnel salaries, interview transcription, and data analysis software
require further investigation and will be finalized upon project approval.

This proposal concludes by outlining a feasible plan for the study within a three-month
timeframe and a preliminary budget breakdown. By focusing on core data collection, analysis,
and initial dissemination, this study can still generate valuable insights to improve radiation
safety practices at Yekatit 12 Hospital.

10. Collaboration

This study's success can be enhanced through collaboration with various stakeholders:
  Yekatit 12 Hospital Administration: Collaboration is crucial for gaining access to
participants, facilities, and medical records. Their involvement is also essential for
implementing the study's recommendations.
 Ethiopian National Radiation Protection Authority (ERPA): Collaboration with ERPA can
provide valuable insights into national radiation safety regulations and best practices.
ERPA may also be interested in the study's findings to inform broader initiatives.
 International Radiation Safety Organizations: Collaboration with international
organizations like the IAEA can provide access to technical expertise and resources for
improving radiation safety practices at Yekatit 12 Hospital.
11. Sustainability Plan

The long-term goal of this study is to promote a culture of radiation safety at Yekatit 12
Hospital. Here are some strategies to achieve this:

 Capacity Building: Training workshops will be conducted for radiographers and other
staff to ensure they possess the necessary knowledge and skills to implement best
practices in radiation safety.
 Development of Local Guidelines: Based on the study findings, tailored radiation safety
guidelines will be developed for Yekatit 12 Hospital, considering the specific context
and resource limitations.
 Integration into Quality Management System: The recommendations from this study
will be integrated into Yekatit 12 Hospital's existing quality management system to
ensure ongoing monitoring and improvement of radiation safety practices.

12. References

Here are some examples of potential references focusing on Ethiopian healthcare settings:

• [1] Endale, A., Amare, B., & Woldearegay, M. (2019). Knowledge, attitude and practice of
radiation safety precautions among orthopedic residents and consultants in Addis Ababa
Burn, Emergency and Trauma Hospital and Tikur Anbessa Specialized Hospital, Addis
Ababa, Ethiopia. Journal of Musculoskeletal & Neuronal Disorders
• [2] Birhanu, B. G., & Walker, N. P. (2018). Implementation of a Radiation Protection System
at Four Hospitals in Ethiopia. arXiv preprint arXiv:1805.03271
• [3] Ethiopian Negarit Gazeta of the Transitional Government of Ethiopia. (2004).
Proclamation No. 191/2004, on Radiation Protection [Legislation on Food, Agriculture and
Rural Development in Ethiopia faolex.fao.org]
Additional References (Expand the reference list to include broader radiation safety
practices):
• International Atomic Energy Agency (IAEA). (2014). Safety Guide: Diagnostic Radiography
in Nuclear Medicine (IAEA Safety Standards Series No. GS-G-4.1). https://www-
pub.iaea.org/mtcd/publications/pdf/pub1206_web.pdf
• National Council on Radiation Protection and Measurements (NCRP). (2000). Limitation of
exposure from medical and dental x-ray examinations. NCRP Report No. 160. National
Council on Radiation Protection and Measurements (.gov)
• World Health Organization (WHO). (2010). Ionizing radiation: health risks and safety. World
Health Organization who.int
• Absolutely, I apologize for the informality. Here's a revised conclusion that
removes "we" and focuses on your singular role:

• 13. Conclusion

• In conclusion, this proposal outlines a meticulous plan to assess radiation

practice and safety at Yekit 12 Hospital within a feasible three-month
timeframe. The proposed mixed-methods approach will gather in-depth data
and leverage collaboration with key stakeholders to maximize the study's
impact. The proposed interventions aim to cultivate a culture of radiation
safety at Yekit 12 Hospital, ultimately enhancing patient care, protecting staff
well-being, and optimizing resource allocation.

• This study has the potential to serve as a valuable blueprint for improving
radiation safety practices in healthcare facilities across Ethiopia. This initiative
not only safeguards the well-being of patients and staff at Yekit 12 Hospital
but also paves the way for establishing a national standard for radiation safety
in healthcare settings.

• I am confident that this research holds significant value and welcome the
opportunity to discuss this proposal further. I stand ready to collaborate with
you to bring this important initiative to fruition.