Laser safety: Risk assessment and quality management - Lasers and Energy Devices for the Skin - page 378

Table 17.2 Skills Validation Checklist. Each healthcare facility must develop its own criteria for validating laser operator skills.
This sample checklist may be used as a guideline.

Laser Operator Performance Checklist

1. Applicant has read laser policies and procedures _____________

2. Knows applicable standards and rules _____________

3. Has submitted certifi cate of attendance for an LSO approved course. _____________

4. Has attended an equipment inservice by an instructor approved by the LSO _____________

5. Knows security system for the laser keys _____________

6. Establishes a laser safe treatment room, following all policies and procedures for hazard control _____________

7. Knows how to assemble and position all laser equipment and delivery systems _____________

8. Performs test fi re/fi ber calibration procedures _____________

9. Operates control panel properly:

power setting _____________

time exposure _____________

standby/ready _____________

emergency off _____________

10. Assembles, positions, and checks plume evacuator _____________

11. Completes all documentation forms _____________

12. Knows proper methods for cleaning and storing laser accessories and equipment _____________

13. Demonstrates ability to monitor a laser safe environment _____________

14. Knows proper endotracheal tube protocol _____________

Table 17.3 Procedure for Obtaining Laser Surgery Privileges
Policy : All laser privilege applications will be submitted to the laser committee for review and recommendation. Physicians must have
current surgical privileges. Applications must be wavelength and specialty specifi c.
Procedure :
A. Obtain application forms from the Medical Staff Offi ce
B. Submit proof of current staff privileges
C. Submit documentation of attendance at laser education programs to include course brochure, certifi cate, and course notes verifying
course content.
1) Course must be no less than 8 hours Category 1 credit
2) Course may not have been completed more than six months prior to application
3) Content must include laser physics, tissue interactions, instrumentation and delivery systems, clinical procedures, patient manage-
ment, alternative treatments, safety and standards, hospital policy and procedure, and laboratory exercises with appropriate tissue
models, designed to teach surgical techniques and understanding dosimetry.
D. Residency training must be documented by a letter from the program director, and must verify education equivalent to the course
criteria stated in C 3.
E. Five documented cases from another facility may be substituted for the above requirements, provided that they were performed with
the same lasers and delivery systems.
F. Under conditional privileges, the applicant will complete three cases under the supervision of a proctor, who will certify safe and
appropriate surgical laser use.
G. Applicant will complete an equipment inservice scheduled with the LSO, prior to booking the fi rst case.
H. Privileges will be reviewed every two years, and if the surgeon has not performed a minimum of one case per month, he/she will be
required to submit proof of attendance at a refresher course.

Table 17.4 Controlled Access
Purpose : To defi ne the area in which control measures must be applied, and to describe the control measures necessary in order to maintain a
laser safe treatment environment.
Policy : Lasers will only be operated in areas where traffi c fl ow can be monitored, and access can be limited by the laser safety offi cer, in
compliance with all safety policies and procedures.
Procedure :
1. Regulation Danger signs will be posted at eye level, on all doors that allow access to a room in which a laser will be used.
2. Signs will be removed when the laser is not in use in the room.
3. Safety goggles labeled with the appropriate wavelength and optical density will be placed on each door, adjacent to the sign.
4. Laser keys will be secured and removed only by those authorized to operate the laser.
5. Only those who are authorized by the LSO may enter the laser room (nominal hazard zone) during laser procedures.
6. Doors will remain closed at all times during laser operation.
7. A temporary controlled access area will be established (NOTICE signs posted) during maintenance and/or repair.
8. The laser will be placed in a “STANDBY” mode when the delivery system is not aimed at target tissue.
9. The laser operator will not leave the laser in Ready mode if the control panel is unattended.
Date Approved:

Date Reviewed: