Legislation Flashcards
Why is legislation necessary?
If you are unsure, who should you seek advice from?
- exposure to ionising radiation involves a risk to the person exposed
- ultimate risk is death - though unlikely
- pts, staff and general public could potentially be exposed to radiation
- complying with appropriate legislation helps minimise risks
If unsure seek advice from radiation protection advisor or medical physics expert
What regulations govern the appropriate use of ionising radiation in medicine and dentistry?
What is the difference between legislation and guidelines?
IRR17: deals with equipment and protection of staff and general public
IR(ME)R17: aimed primarily at protection of patients
Legislation HAS to be followed - must
Guidelines advocate GOOD PRACTICE and EXPERT OPINIONS - should
What does the IRR17 contain?
- risk assessment
- restriction of exposure - ALARP
- radiation protection advisor - RPA
- radiation supervisor - RPS
Give a brief overview of a radiation protection advisor:
- need to appoint one - a medical physicist or specialist company
- consult RPA when planning new surgery, radiation overdose etc
- establishing control area
- name and contact details in radiation protection file
What is a radiation protection supervisor?
- every practice must have one
- usually dentist or senoir member of staff
- must be adequately trained
- ensure compliance with IRR!& and local rules
- closely involved in radiography
- have authority to carry out their duties
What are local rules?
- all practices must have written local rules
- apply to all employees
- relate to radiation protection
- name of RPS and MPE
- name of person with legal responsibility for compliance - usually employer
- identification and description of controlled area
- contingency arrangements if malfunction - must be rehearsed
- details and results of dose investigation levels
- name and contact details of RPA
- personal dosimetry arrangements
- arrangements for pregnant staff
- reminder of IRR17 obligations
- displayed with x-ray equipment
What are the 4 roles in radiography?
- employer
- referrer
- practitioner
- operator
List some points about selection criteria:
- all radiographic exposures must be justified
- selection of radiographs is based on pt history and exam
- choice of radiograph should be based on prevalence of disease and rate of progression and diagnostic accuracy of the imaging technique
- decision to take or not to take radiographs should be documented in pt notes
- selection criteria can help overcome variation in practice and minimise/prevent inappropriate radiographs
What is clinical evaluation?
- all radiographs must be clinically evaluated and findings recorded in pt record
- findings may include quality of radiograph - diagnostic or not? any unusual factors relating to exposure or dose to patient
- note must be made of any abnormal findings
- even if everything normal, this should be recorded
What is a referrer?
Duties of the referrer?
Referrer: registered medical/dental/other health professional who os entitled in accordance with employers procedures to refer individuals for medical exposure to a practitioner
Duties:
- supply practitioner with sufficient information to allow exposure to be justified
- state there is a net benefit to the patient
- sign a request form
- given details to allow correct identification of patient
Questions to ask when justifiying exposure:
- will exposrue lead to change in patients prognosis or management?
- are other radiographs or reports available?
- does the radiograph requested relate to the history and exam of pt
- have the risks and benefits been assessed
- could other techniques with lower or no radiation dose be utilised
What can a registered dental nurse do?
- without an additional qualification can have limited entitlement as an operator
- process dental radiographs - either conventionally or digital scanning
- additional qualification allows entitlement to take dental radiographs on prescription of another dental registrant
What can a dental hygienist and therapist do?
- prescribe, take, process and interpret various film views used in general dental practice
- suggests qualified for limited entitlement as referrer, operator and practitioner
- employer would need to make it clear what these limitations are
What can a clinical dental technician do?
- take and process radiographs and other images related to providing removable dentala appliances
- assumes entitlement as operators
- patients with natural teeth or implants need to be seen by a dentist before the CDT can start treatment
- SOP also states the CDT could develop additional skills including prescribing radiographs
What can a dentist do?
Who can expose a patient to ionising radiation?
- does everything all other DCP can do
- prescribe and interpret radiographs
- eligible to be entitled as referrers, operators and practitioners for all dental related radiography
Dentist, hygienist, therapist, suitably qualified dental nurse or clinical dental technician can expose a pt to ionising radiation.
