Introduction To Quality Assurance Flashcards
What are the 2 types of quality management?
Quality Assurance (QA)
Quality Control (QC)
What are the features of quality assurance (QA)?
(4)
It’s a system to assure quality
It sets out standards, processes and procedures
They include written documents and instructions
They help to prevent errors and ensure safety
What are the features of quality control (QC)?
(4)
It’s a tool that’s used as part of the QA process
It verifies the quality of the output
It tests systems
It detects errors
What are examples of actions and activities related to QA and QC in relation to radiation safety?
(4)
Documentation- policy, procedures, risk assessments, etc
Training
Monitoring- dosimeter badges
Testing of equipment
What are the 2 bodies to advise us about radiation safety?
Radiation Protection Advisor (RPA)
Medical Physics Expert (MPE)
What does RPA do?
It provides advice about the protection of its employees and the public from harmful effects of ionising radiation
What are examples of what has been done because of RPA?
(4)
Installation of radiation sources being introduced into service
Critical examination
Controlled and supervised areas
Physical control measures
What does the MPE do?
(2)
It provides the performance test required for each type of medical radiation equipment (x-ray tube and generator, CR, DR, dental, fluoro, etc)
It’s required to be involved in every medical exposure involving ionising radiation
What are examples of what has been done because of MPE?
(3)
Optimisation projects
Patient dosimeters
Selection and purchase of new equipment
What are the benefits of having a QA program with QC testing?
(5)
It’s a legal requirement
Doses are kept ALARP
There’s suitable monitoring of image quality and performance is us
It highlights drift in performance to see if things are getting worse
It provides good evidence for audit and inspectors to prove that departments comply with IRMER 2017
What are the key stakeholders and agents involved in the QA programme?
(4)
Employer, e.g. chief executive
Clinical, e.g. clinical leads, QC leads
Radiation safety, e.g. RPA, MPE
External, e.g. vendors, engineers
Why is local QC testing done?
To ensure that equipment meets the quality standards and that it performs consistently and safely
What are the 2 QC tests?
Level A tests
Level B tests
What are the QC level A tests?
Local QC
What are the level B QC tests?
Medical physics level QC
What are the features of the level A local QC tests?
(4)
It’s done 1-3 times a month
It’s a simple and quick pulse check
It uses inexpensive equipment
It’s relatively frequent
What are the features of the level B medical physics level QC tests?
(4)
They’re done 1-3 times a year
They’re relatively difficult
They use specialised equipment
They’re less frequent
What is the radiographic equipment life cycle?
(9)
Replacement/new x-ray equipment
Selection process (decide what specifically we need)
Installation (make sure the equipment is safe to use)
Acceptance/commissioning
Clinical use
Maintenance/routine QC testing
Optimisation (ensure that the equipment provides the least amount of radiation for adequate imaging)
Cease clinical use
Decommission/disposal
When do we do local QC testing?
(4)
Local QC is performed monthly as routine
Full local QC is done after every engineer visit
When repairs need to be done
When doing updates on equipment, including software
What does ad hoc mean?
Random testing
What components form part of a QA programme?
(5)
Fault logging within a log book (useful for future issues to refer back to)
Image reject analysis (assessing how frequently images get rejected)
Clinical audits
Patient dose audits (assess if the amount of radiation used was expected)
Handover forms
How is QC recorded?
Why?
(4)
Electronically
Because when paper was used, it was hard to find documents and record data
It ensures that all resources are accessible to everyone
There’s less risk of error
It’s easier to do
What’s a limitation of electronic records of local QC?
We need to write access to be able to save ad edit spreadsheets
Where is QC equipment used?
(2)
Plain imaging
Fluoroscopy
What QC equipment is needed in plain imaging?
(4)
Radiation dosimeter
Filters made out of copper (the copper can damage digital detectors)
Alignment test object
Radiopaque marker (paperclip/pen)
What QC equipment is needed in fluoroscopy?
(2)
Filters made out of copper
Image quality test objects
What are common local QC errors?
(4)
Incorrect setup (most common)
Using the same copper filtration
Selecting the wrong exposure factors
Using the wrong AEC settings
What should we do when using removable digital detectors?
(2)
Consider when moving and taping copper, not to drop the copper onto the detector
Make sure not to put objects over the detector, as this will cause ghosting artefacts
What should we do when we get acceptable results?
(3)
Save the spreadsheet forms in an appropriate location
Make sure that during an audit everyone could find them quickly
If the results are acceptable, the LRSS don’t need to be notified
What should we do when we get failed remedial results?
(3)
Contact LRSS for advice
Follow local handover procedure and inform relevant colleagues
What should we do when we get suspension results?
(3)
Repeat the test again to confirm the result
When confirmed, contact LRSS for advice as to whether we should remove the equipment from clinical use
Follow local procedure for fault logging
