Quality Assurance 1

Question 1

What are we told to do with radiographs?

Answer 1

• Legislation
• IR(ME)R 2017 – protects the patient
• IRR 2017 – protect staff and public but also deals with patient protection in relation to equipment

Question 2

What does IR(ME)R 2017 stand for with

• Employer
• Practitioner
• Operator
• Referrer

Answer 2

• Employer – the Boss.
• Practitioner – justification.
• Operator – anyone involved in the production of a radiograph.
• Referrer – one who refers the patient for radiographs.

Question 3

What is the quality assurance programme?

Answer 3

• Named person
• Details of procedures involved
• Frequency procedures carried out
• Frequency records will be audited
• All the above must be put in writing

Question 4

What do we look at in a Q.A programme?

Answer 4

• Image quality
• X-ray equipment
• Processing (film and digital)
• Working procedures
• Training
• Audit

Question 5

How do we ensure high quality images?

Answer 5

Audit the images we produce:

1. Image Quality Rating System
2. Film Reject Analysis

• Asses all images produced.
• Grade films by image quality
• Images are rated either 1,2 or 3
• Collate Results - analyse monthly, quarterly or at least every six months.
• Feed-back results to staff.

Question 6

What are the Image Quality Ratings?

Answer 6

Excellent – No errors of patient preparation, exposure, positioning, processing or film handling

Diagnostically acceptable – some errors in patient preparation, exposure, positioning, processing or handling which do not detract from the diagnostic utility of the radiograph

Unacceptable – Errors of patient preparation, exposure, positioning, processing and/or handling which render the radiograph diagnostically unacceptable

• Number of films rated 1 > 70%*
• Number of films rated 2 < 20%*
• Number of films rated 3 < 10%*

Question 7

What do you do in a Film Reject Analysis?

Answer 7

• Collect all rating 3 films
• At end of each month assess these films
• Categorise faults e.g Exposure,Positioning,Processing,etc
• ACT
• Repeat every month and compare results

Question 8

How is x-ray equipment QA?

Answer 8

• Equipment inventory must be kept
• All equipment must be tested regularly to check that it is working satisfactorily.
• Preferably annually but minimum of every 3 years
• These checks must include representative patient doses.
• Routine maintenance - annually

Question 9

How is Processing QA?

Answer 9

• Storage and stock rotation
• Monitoring of processor performance
• Processor maintenance
• Monitoring performance of digital system

Question 10

What is SENSITOMETRY scale?

Answer 10

• Daily check
• Developer
• Compares film processed with fresh chemistry with images produced as developer gets exhausted.
• Exhausted Developer = pale image

Question 11

What are the Causes of fogged film?

Answer 11

• Light entering daylight loading system/darkroom
• Safelight - filter unsuitable for film or too close to worksurface (1.5m)
• Test – Coin test

Question 12

What is the coin test?

Answer 12

• Open an intra-oral x-ray packet and remove film – while hands are inside glove box or in darkroom under safelight conditions
• Place a coin on the film
• Leave coin on film for a specified amount of time (five minutes or average working time)
• Remove coin and process film
• Check the processed film for light fogging
• Repeat test for every different type and speed of film used in the practice
• Act on your findings

Question 13

Answer 13