Guidance Flashcards
(28 cards)
What guidance recommends QA tolerances in RT?
IPEM 81
What guidance discusses small field dosimetry?
IPEM 103
What guidance discusses linac commissioning?
IPEM 94
(new version to be published this year)
What guidance discusses gaps, BED, EQD2 etc?
Timely delivery of radical radiotherapy: guidelines for the management of unscheduled treatment interruptions
Published by RCR
What guidance discusses adaptive planning?
On target 2
What guidance discusses avoiding errors etc in radiotherapy?
Towards safer radiotherapy
Advanced safer radiotherapy
What COPs must we be aware of?
MV CoP
Electron CoP
kV CoP
HDR CoP
What legislation is relevant in brachy?
IRR
IRMER
ARSAC
HASS (under EPR)
Summarise the purpose of IR(ME)R
Ensure ionising radiation is used safely to protect patients from the risk of harm when exposed.
To minimise unintended, excessive, or incorrect medical exposures, ensuring all exposures are justified and optimised to ensure they are ALARP.
Who are the duty holders in IR(ME)R?
Referrer - refers the patient, responsible for providing all relevant patient information to practitioner.
Practitioner - responsible for justifying the exposure.
Operator - carries out any practical aspect of the exposure.
Employer - has overall jurisdiction and responsibility.
MPE - medical physics expert who is recognised and can advise with regard to compliance with regulations.
Summarise the purpose of IRR briefly.
Protect people, including workers and the public, from the harmful effects of exposure to ionizing radiation during work activities.
What is ACOP
Approved code of practice
Provides detailed advice about the scope and duties of the requirements imposed by IRR17.
Tells you what should be in risk assessment/ local rules
What guidance are MPEs, RPAs, RPSs under?
MPE: IRMER
RPA RPS: IRR
What is the role of the RPS and when are they necessary?
RPS necessary when local rules are necessary for a radiation area.
They should ensure compliance with local rules.
(preferably full time employee, sufficiently senior to ensure compliance, and should understand what to do in an emergency and precautions to be taken, should liaise with head of department and RPA)
What is role of RPA?
Give advice on compliance with regulations.
IRR17 specifies particular matters on which radiation employers should seek advice from a suitable RPA:
radiation risk assessment, designation of controlled and supervised areas, handling of investigations, contingency plans, dose assessment and recording
MUST be consulted on: implementation of requirements for designated areas, plans for future radiation installations, calibration and proper use of equipment for monitoring radiation.
How does one become an RPA?
Must meet criteria of competence specified by HSE
How does one become an MPE?
Submit a portfolio which demonstrates evidence of knowledge, training, competency in matters contained in BSSD (basic safety standards directive)
Assessment of portfolio carried out by RPA2000
What is role of MPE?
Advise with regard to general compliance with IRMER regulations. Must be closely involved with RT procedures.
Who is responsible for optimisation?
Practitioner responsible for justification and ‘other such aspects’. Optimisation comes under this.
What is justification?
Showing that there is sufficient net benefit for an exposure, benefit outweighs risk. Alternative treatments musts be considered, but guidelines can be used as justification.
Why must exposures be authorised if they have already been justified?
Allows operators to make technical decisions about individual exposures.
Permits authorisation for concomitant exposures to be given in different way by different people.
IRMER says it is practitioners responsibility, but operators can authorise if practitioner is not available.
How is optimisation relevant in RT?
Target volumes must be individually planned and non target volume doses must be kept ALARP. Doses to OARs should not be lowered so much that the dose to the TV is compromised, no point sparing tissues if you don’t save the patient. Optimisation also important in imaging.
What are some of the roles of the employer in IRMER?
Ensuring QA programme is in place, employer’s procedures have been produced, procedures/protocols are in place and are complied with, appointing MPEs.
The employer must provide a framework through written procedures, protocols and quality assurance programmes that support entitled duty holders to undertake their roles to safely deliver services using ionising radiation.
What is duty of candour and when is it relevant?
Legal requirement for healthcare providers to be honest with patients when something goes wrong with their care or treatment that appears to have caused or could lead to moderate or severe harm.
CQC: remember duty of candour in clinically significant accidental or unintended exposures
