HCM 5020 Module 8 Final Project Part 2 Example

Nothing Metal Past the Door: An MRI Safety Session for Nurses, Transporters, Code Teams and Security Officers

Student Name

Master of Science in Healthcare Management, Thomas Edison State University

HCM-5020: Healthcare Administrator Leadership

Mentor Name

Month Day, Year

Slide 1: Why We Are Standing in the MRI Suite

Thirty minutes, on site, every shift.

Goal: no one brings danger through the Zone III door.

Who is here: nurses, transporters, rapid response and code team members, security.

Speaker notes: Thank you for coming down to the MRI suite instead of a classroom. We meet here because everything I describe is a few steps away, and you will walk through it with me. In the next thirty minutes I want you to leave able to explain why this magnet is dangerous, recognize the zones, spot the objects that can never enter the scanner room and know what to do if a patient becomes unstable during a scan. Most of you are not imaging staff, and that is exactly why this session exists.

Slide 2: The Magnet Is Always On

The field is present 24 hours a day, scan or no scan.

It pulls ferromagnetic objects toward the bore with great force.

It can heat, move or switch off some implanted devices.

Speaker notes: This is the single most important fact today. An MRI magnet is not switched off at night or between patients. Its field is there now, while we are standing outside the door. Objects that contain iron or certain steels can be pulled toward the opening of the scanner hard enough to crush a hand or fracture a skull on the way in. The American College of Radiology guidance on safe MR practice is built around this fact (Kanal et al., 2013). Every rule that follows comes from it.

Slide 3: What Has Happened Here

Nine near misses involving non-imaging staff in the past year.

Four oxygen cylinders stopped at the door.

Two incomplete screening forms; two pagers or badge clips in Zone IV.

One crash cart headed toward the scanner during a deteriorating patient's scan.

Speaker notes: None of these events hurt anyone, and every one of them was stopped by an MRI technologist. I share them not to blame anyone but because each was a normal person doing a normal job in a hurry. Near misses like these are warnings worth learning from. At one large academic center, a team that analyzed its MRI screening near misses and redesigned screening into several steps brought them from 22 to none within a year (Goolsarran et al., 2019).

Slide 4: Four Zones

Zone I: public areas outside the suite.

Zone II: reception and screening; patients waiting under supervision.

Zone III: controlled access; screened people only, escorted by MR staff.

Zone IV: the scanner room itself.

Speaker notes: Look at the floor plan and then at the doors around you. We are standing in Zone II now. The locked door behind me leads to Zone III, where only screened people may go and only when MR staff allow it. The scanner room is Zone IV. The guidance divides the suite this way so that the closer you get to the magnet, the more control there is over who and what enters. Your badge may open many doors in this hospital, but not these.

Slide 5: Who May Enter, and How

MR personnel control Zones III and IV.

Everyone else enters only after screening and with an MR staff member.

No exceptions for emergencies, seniority or speed.

Speaker notes: Trained MR personnel are the gatekeepers for Zones III and IV. If you are a nurse escorting a patient, a transporter or a security officer, you are not MR personnel for this purpose, however experienced you are elsewhere. You enter only after you have been screened and only with an MR technologist. This applies at three in the morning and during emergencies. In fact, emergencies are when the rule matters most, because that is when people rush.

Slide 6: Never Past the Door

Standard oxygen cylinders, IV poles and pumps.

Scissors, clamps, stethoscopes, pens with metal clips.

Phones, pagers, badges with clips, keys.

Standard wheelchairs, stretchers, monitors and crash carts.

Speaker notes: These are the objects we see most often at the door. Some, like an oxygen cylinder or a stretcher, can become projectiles. Others, like phones and badges, can be damaged or pulled from your hands. The suite keeps MR conditional equivalents, such as a nonmagnetic wheelchair, stretcher and oxygen supply, in Zone II. Before you walk a patient to the Zone III door, transfer them to our equipment and empty your pockets into the lockers to your left.

Slide 7: Screening Is Everyone's Job

Screening form completed before the patient leaves the unit.

MR staff screen again in Zone II.

Unclear answers stop the scan until resolved.

Speaker notes: Screening is a series of checks, not a single form. The nurse on the unit starts it by completing the screening questions with the patient or family before transport. The MR technologist checks again here, and the radiologist decides when an answer is unclear. If any step is skipped, the next one has to catch it, and the near misses on slide three show that sometimes it does not. Please never send a patient down with blanks on the form.

Slide 8: Patients With Devices and Implants

Pacemakers, defibrillators, neurostimulators, cochlear implants, pumps.

Some are safe only under specific conditions.

Tell us early; do not remove or adjust devices yourself.

Speaker notes: Many implanted devices are now labeled MR conditional, which means they can be scanned only under specific conditions that our team must verify, sometimes with a device representative present. Others cannot be scanned at all. The key point for you is timing: tell the MRI team about any device as soon as the scan is ordered, not when the patient arrives. Patients may also have metal fragments from work, such as welding, which belong on the form.

Slide 9: When a Patient Deteriorates in the Scanner

MR staff stop the scan and bring the patient out of Zone IV.

Resuscitation happens outside the scanner room.

The code team waits in the designated area; nothing enters Zone IV.

Speaker notes: This is the hardest rule for code team members, because your training tells you to bring help to the patient. In the MRI suite we do the opposite: our technologists wheel the patient clear of the magnet room on a nonmagnetic stretcher to the designated resuscitation area just outside, where you and your equipment are waiting. The guidance is clear that resuscitation should not take place inside Zone IV. We will walk this path together in a moment so your feet know it.

Slide 10: Speaking Up and Reporting

Anyone may stop anyone at the door.

Report every near miss; it is a system signal, not a confession.

We review each report and share what changed.

Speaker notes: Rules alone will not keep this room safe; how we treat each other when someone makes a mistake matters just as much. Writing about MRI safety, Alkhulaifat et al. (2025) emphasize a just culture that favors openness and process improvement over punishment. If a technologist stops you, it is not personal; if you see a colleague heading toward the door with a cylinder, stop them too. When you report a near miss, we will look at what in the system allowed it and tell you what we changed.

Slide 11: Practice

Walk the path from the unit elevator to the resuscitation area.

Sort the pictured objects: safe or never.

Find three errors on the sample screening form.

Speaker notes: Now we practice. First we will walk from the elevator to the Zone III door and then to the resuscitation area, so you know the route. Next, the cards on the table show common objects; sort them into the two piles. Finally, each pair will get a screening form with three errors to find. These activities match the objectives we set for this session and show me what you can actually do, not just what you have heard.

Slide 12: Take-Home Points

The magnet never turns off.

Zones III and IV only with MR staff after screening.

Our equipment, empty pockets, complete forms.

Patients come out to be resuscitated.

Report every near miss.

Speaker notes: If you remember only five things, remember these. Before you leave, please complete the short knowledge check you also took when you arrived; comparing the two tells us whether the session worked. The handout repeats these points with the floor plan and a contact number for the MRI team. Please post a copy on your unit. Thank you for helping us keep this room safe for patients and for each other.

Supporting Handout: MRI Safety at a Glance

The magnet is always on. It pulls metal objects with great force and can affect implanted devices, even when no scan is running.

Zones: Zone I public areas; Zone II reception and screening; Zone III controlled access, screened people only, with MR staff; Zone IV the scanner room. Enter Zones III and IV only after screening and with an MR technologist.

Never past the door: standard oxygen cylinders, IV poles and pumps, scissors, stethoscopes, pens, phones, pagers, badge clips, keys, standard wheelchairs, stretchers, monitors and crash carts. Use the suite's MR conditional equipment and the lockers in Zone II.

Before transport: complete the screening form with the patient or family, list every implanted device and any history of metal fragments, and call the MRI team about devices when the scan is ordered.

If a patient deteriorates during a scan: MR staff bring the patient out of the scanner room to the resuscitation area. The code team waits there. Nothing from the code cart enters Zone IV.

Speak up and report: anyone may stop anyone at the door. Report every near miss through the safety reporting system; the imaging team reviews each one and shares what changed.

Questions: call the MRI control desk on its internal line at any hour; the number is printed on the floor plan.

References

Alkhulaifat, D., Vidal, L., Larsen, E., Serai, S. D., Sinti-Ycochea, M., Mecca, P., Orfe, L., & Sotardi, S. (2025). MRI safety: Developing the right culture. Pediatric Radiology, 55(5), 895-901. https://doi.org/10.1007/s00247-025-06179-5

Goolsarran, N., Martinez, J., & Garcia, C. (2019). Using near-miss events to improve MRI safety in a large academic centre. BMJ Open Quality, 8(2), Article e000593. https://doi.org/10.1136/bmjoq-2018-000593

Kanal, E., Barkovich, A. J., Bell, C., Borgstede, J. P., Bradley, W. G., Froelich, J. W., Gimbel, J. R., Gosbee, J. W., Kuhni-Kaminski, E., Larson, P. A., Lester, J. W., Nyenhuis, J., Schaefer, D. J., Sebek, E. A., Weinreb, J., Wilkoff, B. L., Woods, T. O., Lucey, L., & Hernandez, D. (2013). ACR guidance document on MR safe practices: 2013. Journal of Magnetic Resonance Imaging, 37(3), 501-530. https://doi.org/10.1002/jmri.24011