Legislation

Question 1

what main legislation is important ?

Answer 1

IRR17 (ionising radiation regulation 2017)

IRMER 17 (ionising radiation and medical exposure regulations 2017)

Question 2

what does IRR17 include?

Answer 2

this law deals with equipment, and the protection of staff and the general public

includes risk assessments, restriction of exposure (ALARP), RPA and RPS

Question 3

who is the RPA - radiation protection adivsor

Answer 3

they are a medical physicist or specialist company
should be consulted when planning a new surgery and establishing a controlled area
their name and details will be in the radiation protection file

Question 4

explain the controlled area

Answer 4

only the patient is allowed to be in this area at the time of x ray exposure
size of controlled area depends on the kV of machine (however ultimately local rules)
DDH area is 2m away

Question 5

what is the RPS? - radiation protection supervisor ?

Answer 5

RPS is usually a dentist or senior member of staff

they ensure compliance with IRR17 and local rules

Question 6

what are local rules?

Answer 6

written documents relating to radiation protection and includes

• name of RPS and RPA (RPA also contact details)
• name of person with legal responsibility for compliance which is usually the employer
• info about about the controlled areas
• contingency plan if machine malfunctions
• dose investigation levels - details and results
• personal dosimetry arrangements
• arrangements for pregnant staff
• IRR17 obligations
  THESE SHOULD ALL BE DISPLAYED NEXT TO THE X-RAY EQUIPMENT

Question 7

what does MPE do?

Answer 7

advise on IRMER compliance
must be involved in the development and review of all dental procedures (not the case under IRMER2000)

Question 8

what does an MPE do?

Answer 8

advise on IRMER compliance
must be involved in the development and review of all dental procedures (not the case under IRMER2000)

Question 9

what are the 4 designated roles under IRMER2017

Answer 9

employer, referrer, practitioner, operator

Question 10

who produces written procedures

Answer 10

the employer

Question 11

what must these written contain

Answer 11

entitlement of duty holders
identification of the patient
demonstrate staff training and competence
quality assurance of procedures with documentation
clinical audit

Question 12

what are the other duties of the employer

Answer 12

produce protocols for taking radiographs
appoint RPA/MPE and RPS
ensure (staff have read local rules, and there is clinical evidence of every image taken)
establish (recommendations for selection criteria, recommendations for radiation dose levels)

Question 13

who is the referrer

Answer 13

a registered medical or dental practitioner, or health professional who is entitled to refer patients to a practitioner for x ray exposure

Question 14

what are the duties of the referrer?

Answer 14

the person who wants x ray
give practitioner sufficient info to allow radiation exposure to be justified
state there is a net benefit to patient
sign a request form and given details to allow patient to be identified

Question 15

who is the practitioner

Answer 15

registered health care professional
usually a dentist
legally responsible for exposure

Question 16

what can dental nurses do

Answer 16

limited entitlement as operator
process radiographs
additional qualification allows them to take radiographs on prescription of a dental registrant

Question 17

what can dental hygienists and therapists do

Answer 17

prescribe radiographs
take, process, and interpret various film views in GDP
limited entitlement as referrer , operator, and practitioner (limitations clarify limitations!)

Question 18

what can clinical dental technicians do

Answer 18

take and process radiographs and other images related to providing removable dental appliances
entitlement as operators

Question 19

what can dentists do

Answer 19

entitlement as referrer, operators, and practitioner (basically all)

Question 20

who can take radiographs in GDP?

Answer 20

dentist, dental hygienist or therapist, qualified dental nurse, and clinical dental technician

Question 21

what is the role of the operator

Answer 21

involvement in the radiograph
clinical evaluation in an operator duty (can only be done by those qualified to do so)
not all operators can do all operator duties

Question 22

what does a clinical evaluation involve?

Answer 22

required for every x ray exposure
interpretation of the outcome and implications of, and the information resulting from an exposure
may have a diagnosis or enquiry for advice

Question 23

what info about equipment does IRMER include?

Answer 23

must have up to date inventory
x ray units must be tested regularly (preferably yearly, minimum every 3 years, must include rep patient dose)
must carry out routine maintenance by yourself and the manufacturer/supplier

Question 24

what happens if the radiation is greater than intended?

Answer 24

under duty of candour legislation (tell the patient if something needs to be repeated or has gone wrong)
inform referrer