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Process Map:
HDR Breast Record
Description:
Provided by American Brachytherapy Society (courtesy of Bruce Thomasden and Zubir Ouhib). Read more in the process map's blog:
Updated at:
April 11, 2016
Scoring Scale:
Modified
Statistics:
Incidents:0 FMEAs:0 Favorited: 5
Created by:
Moe2
Share:
Color legends: Processmap Steps Checklists
Planning Planning
1 Treatment time printed
0 0 0
2 Plan approved
0 0 0
3 Physics Check performed
0 0 0
4 Consents verified
0 0 0
5 Lengths entered
0 0 0
6 Number of Fx on Rx

0 0 0
7 Dose/Fx on Rx:

0 0 0
8 Dose/Fx on Plan:

0 0 0
9 Isodose plan printed
0 0 0
Treatment Treatment
1 Fraction:
0 0 0
2 Date:
0 0 0
3 Time:
0 0 0
4 Patient survey before treatment
0 0 0
Treatment Time out
1 Two forms of ID
0 0 0
2 On hand: survey meter, Lead Container, Tongs
0 0 0
3 Tx times compared with printout
0 0 0
4 Applicator imaging verified by: (MD initials)

0 0 0
5 Applicator connected by: (Initials)

0 0 0
6 Authorized user signature

0 0 0
7 Backup timer set (Minutes & seconds)

0 0 0
Post Treatment Post treatment
1 Total accumulated dose (Gy)

0 0 0
2 Review post treatment record
0 0 0
3 Operator Initials

0 0 0
4 Dose per fraction

0 0 0
5 Authorized Medical Physicist (Initials)

0 0 0
6 Survey room & record
0 0 0


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