Quality assurance

Question 1

what is quality assurance?

Answer 1

Ensure diagnostic images are of sufficient quality to provide adequate diagnostic information at the lowest possible cost and least exposure to patient

Question 2

we cant eliminate human error but we can reduce them by ? 3

Answer 2

standard operating procedures

improved working environment e.g. too hot, dark etc

encourage reporting mistakes without blame

Question 3

what are the 2 legislations that protect patients and staff?

Answer 3

IRMER 17 (ionising radiation medical exposure regulations)

IRR 17 (ionising radiation regulations)

Question 4

IRMER states that employers should ensure what two things?

Answer 4

theres quality assurance programmes for standard operating procedures

every practitioner and operator undertakes CPD (continuing professional development)

Question 5

from IRMER 17

Must be able to prove they have undergone ? hrs of CPD specific to radiation every ? years

Answer 5

5
5

Question 6

who does IRMER 17 protect?

Answer 6

patients

Question 7

who does IRR 17 protect?

Answer 7

protects staff, public and patients

Question 8

quality assurance programme needs to have what 4 things?

Answer 8

Named person in charge of overseeing compliance - radiation protection supervisor

Details of procedures involved

Frequency the procedures are carried out

Frequency records are audited

Question 9

what 6 things does a quality assurance programme look at?

Answer 9

image quality
x-ray equipment
processing
working procedures
training
audit

Question 10

what is image quality rating systems?

Answer 10

images are rated either diagnostically acceptable or not acceptable. the results are collated regularly and told to staff

Question 11

what percentage of images need to be acceptable from a quality rating system?

Answer 11

> 95% for digital
90% for film

Question 12

image quality
what is reject film analysis?

Answer 12

Assess and categorise unacceptable films faults e.g. exposure, positioning, processing, operator error or patient moving
Look for ways to improve the results e.g. training

Question 13

in a quality assurance programme what happens to x-ray equipment? 3

Answer 13

inventory of equipment

test equipment regularly
- including dose output

anual service by a suitably qualified engineer

Question 14

processing film
what needs to be checked?

Answer 14

storage and stock rotation of film

processing maintenance and monitoring

sensitometry -> exhausted developer

fogged film -> overexposure to light

Question 15

how does sensitometry work?

Answer 15

compares film processed with new chemistry to current developer to ensure developer isn’t exhausted (exhausted developer = pale image)

Question 16

how do you test for fogged film (overexposure to light)?

Answer 16

Coin test -> open film in glovebox, place coin and leave for average working time, remove coin and process film

Question 17

if fogging appears after coin test what do you do?

Answer 17

check safelight or light leakage

Question 18

working procedures should include what?

Answer 18

SOPs (standard operating procedures)

Question 19

who requires training and evidence that this has been done?

Answer 19

any person taking the radiograph

anyone indirectly involved in the production of radiographs

Question 20

remember
Audit

Each procedure in a QA programme is subject to audit

Patient identification, clinical evaluation of images, justification of radiographic examination, image quality

Employ the services of an external radiation protection advisor such as public health England to ensure you are IRMER compliant

Question 21