Quality Assurance 1 Flashcards
What is quality assurance?
- an organised effort by staff to ensure that diagnostic images are of sufficiently high quality to consistently provide adequate diagnostic information at the lowest possible cost and least possible exposure to the patient
How can human error be reduced?
Human error - impossible to eliminate
Can be reduced by:
- standard operating procedures (SOP)
- improve working environment
- encourage reporting without blame
Give a brief explanation of the roles of the:
- employer
- practitioner
- operator
- referrer
Employer: boss
- responsible to ensure that their establishment is complying with IRMER 17
Practitioner: person who justifies exposure
- must be aware of and adhere to the correct referral criteria for dental exposures and assumes legal responsibility for the exposure when they put their name to it
Operator: anyone who is involved in the production of a radiograph. That includes the person who asks the patient to simply sit in the chair, to the nurse who develops the film
Referrer: the person who has clinically examined the patient and referred them for the radiographs and who is responsible for viewing that radiograph and recording the findings in the patient’s notes
What are the two specific statements in IRMER17 relating to quality assurance?
- employer shall establish QA programmes for SOPs
- employer shall ensure every practitioner and operator undertakes CPD - 5 hrs specific to radiation safety every 5 years
What should be included in a quality assurance programme?
What is looked at in a QA programme?
- named person - usually RPS
- details of procedures invilved and how to carry them out
- frequency procedures are carried out
- frequency records will be audited
- all must be put in writing
Must include:
- image quality, x-ray equipment, processing (film and digital), working procedures, training, audits
How do we ensure high quality imaging using the image quality rating system?
Image quality rating system:
- grade films by image quality
- diagnostically acceptable (A) or not acceptable (N)
- collate results - analyse monthly, quarterly or at least 100 images every 6 months
- feedback results to staff
What is classed as a diagnostically acceptable image?
Not acceptable image?
Diagnostically Acceptable:
- no errors, or minimal errors in either patient preparation, exposure, positioning, image receptor processing or image reconstruction and of sufficient image quality to answer a clinical question
Not Acceptable:
- image must be repeated, errors in either patient prep, exposure, positioning, image processing or reconstruction
- must record reason why
What is film reject analysis?
Film reject analysis - how to analyse diagnostically not acceptable images:
- collect/record all (N) images
- at end of each month, assess these films
- categorise faults specifically to identify trends e.g. exposure, positioning, processing etc
What is the IQRS audit cycle?
- assess, grade, results, feedback
How should x-ray equipment be looked after?
- inventory must be kept
- must be tested regularly, ideally annually but must be at least every 3 years
- must include checks on representative pt doses
- routine maintenance should be carried out annually
When developing your QA programme, what should be considered in terms of processing?
Processing:
- storage and stock rotation
- montioring of processor performance
- processor maintenance
- monitoring performance of digital systems
What is sensitometry?
What are some common problems associated with film processing?
Sensitometry: measure of processor performance
- daily check of developer, compare image to film processed with fresh chemistry
- exhausted developer = pale image
Common problems:
- poor handling - bends/crimps
- insufficient training - overlapped
- light exposure - fogging
What are some causes of fogged film?
- light entering daylight loading system/darkroom
- safelight - filter unsuitable for film or too close to work surface (must be 1.5m away)
- perform coin test
