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Radiology! > Quality Assurance > Flashcards

Quality Assurance Flashcards

1
Q

define quality assurance

A

an organised effort by staff to ensure that the DIAGNOSTIC images produced are of sufficiently HIGH QUALITY to consistently provide ADEQUATE DIAGNOSTIC INFORMATION at the LOWEST COST and LEAST EXPOSURE to the patient

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2
Q

give 2 reasons why we need quality assurance

A
  1. it is impossible to eliminate human error (QA minimises)

2. we are told to by legislations

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3
Q

3 ways that human error can be minimised are

A
  1. SIMPLE systems introduced
  2. improve working ENVIRONMENT
  3. encourage REPORTING without BLAME
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4
Q

the 2 legislations are called…

A
  1. IR(ME)R 2000

2. IRR 99

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5
Q

what is the main function for IR(ME)R 2000?

A

to protect the patient

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6
Q

What is the main function for IRR 99?

A

to protect the public, the staff, the patient (with regards to equipment only)

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7
Q

name the 4 allocated roles of the IR(ME)R 2000 legislation..

A
  1. employer
  2. practitioner
  3. operator
  4. referrer
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8
Q

what are the 2 functions of the employer in IR(ME)R 2000 legislation?

A
  1. shall establish QA programs

2. shall ensure that all members of staff undertakes CPD

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9
Q

who is called as the operator in IR(ME)R 2000 legislation?

A

anyone who is involved with the production of a radiograph

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10
Q

who is the referrer in IR(ME)R 2000 legislation?

A

the one who refers the patient for a radiograph

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11
Q

Five necessities for a quality assurance program are…

A
  1. Named person
  2. Details of procedure involved
  3. Frequency of procedures carried out
  4. Frequency records being audited
  5. All of above in writing
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12
Q

6 main points to look at when carrying out a quality assurance program.

A
  1. image quality
  2. X-ray equipment
  3. processing
  4. working procedures
  5. training
  6. audit
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13
Q

which two ways can you audit image quality?

A
  1. image quality rating system

2. film reject analysis

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14
Q

regarding the image quality rating system, what are the 4 stages of rating?

A
  • assess all images
  • rate them 1,2, or 3
  • collage results (analyse monthly, quarterly or at least 6 monthly)
  • feedback information to staff
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15
Q

The criteria for a grade 1 image is..

A
  • no errors with patient preparation
  • no errors with positioning
  • no errors with exposure
  • no errors with processing or film handling
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16
Q

a grade 1 image can be described as..

A

excellent (very diagnostically useful)

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17
Q

a grade 2 image can be described as..

A

diagnostically acceptable, but with some errors

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18
Q

a grade 3 image can be described as..

A

an image with many errors leaving it diagnostically unacceptable

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19
Q

what are the targets for image quality rating system?

A

grade 1 = >70%

grade 2 =

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20
Q

what is film reject analysis?

A

where all graded 3 images are collected and assessed at the end of each month.

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21
Q

what are you looking for in film reject analysis?

A
  • to catagorise faults and detect any trends
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22
Q

what is the IQRS audit cycle?

A 
ASSESS (evaluate images) 
     ^
GRADE images 
     ^
RESULTS (analyse and look for improvement)
     ^
FEEDBACK
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23
Q

What is the minimum and ideal time between X-ray equipment tests?

A 
minimum = every 3 years 
ideal = every 1 year
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24
Q

what must you do to every psp that has not been used in 24hrs?

A

erase the plate with bright light as background radiation could have tampered with the image.

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25
Q

3 ideal ways to store a psp?

A
  1. cool - not too humid
  2. avoid direct sunlight/UV
  3. preferably in an envelope - light protection and cross infection
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26
Q

how do you check the processor performance?

A

the sensitometric test

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27
Q

what is the sensitometric step wedge test?

A

A test that allows a comparison between a film developed in fresh chemistry and a film developed with an exhausted developer.

  • a step-wedge is used (different metal thicknesses)
  • when radiographed you should see from pale grey to black and if step not clear then can indicate an exhausted developer
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28
Q

what is the film developed in fresh chemistry called?

A

the standard reference film

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29
Q

what is the other sensitometric test can be used? what are the benefits of this test over the step-wedge test?

A

the ‘pre-exposed’ test

  • easier to use
  • no operator discrepancies
  • results not variable on viewer
30
Q

What are the 4 IR(ME)R 2000 procedures that are subject to audit?

A
  1. patient identification
  2. clinical evaluation of images
  3. justification of radiographic examination
  4. image quality
31
Q

the most common cause for a pale film image is?

A

underdeveloped (not enough time in developer)

32
Q

what is another cause for pale film image other than underdeveloped?

A

underexposed

33
Q

What may be the 3 causes of an underdevloped film?

A
  • Too COLD a developer
  • Too WEAK a developer (not enough chemicals)
  • Too OLD a developer
34
Q

If underdexposed image what may you see other than a pale image? (1. digital & 2. film)

A
  1. blank spot - not enough X-rays hitting it

2. grainy image

35
Q

which common error with film can lead to and underexposed image?

A

placing the film in the holder the wrong way so that the X-rays hit the lead foil before the film. (lead pattern)

36
Q

what are the two possible causes of a dark film image?

A

overexposed and overdeveloped

37
Q

how may a film be over developed?

A
  • too HOT a developer

- too STRONG a developer

38
Q

what may you see in addition to a darker image on a overdeveloped film?

A

grainy (usually due to too hot a developer)

39
Q

What will give you a blurred image on film?

A

movement - patient, film or X-ray tube

40
Q

what 2 things will give a partial image on film?

A
  • failure to directly centre the collimator

- film only placed partially into developer

41
Q

excessive bending of a film will give you..?

A

black lines/crimp mark (sometimes known as finger nail marks)

42
Q

you see a black star appearance on image, thoughts?

A

static electricity discharge

43
Q

when are you likely to get static electricity discharge?

A

when removing the image receptor from the mouth

44
Q

is static electricity more common in digital or film image receptor?

A

digital

45
Q

Fogging and extreme blackening can be cause by what? 3 things

A
  • storage in adverse conditions
  • out of date film
  • film exposed to white light (commonly before going into processor)
46
Q

what is a green colour in an image usually caused by? give something else it can be caused by

A

not enough time to fix during processing but sometimes due to being inadequately washed

47
Q

clear chemical splashing indicates..

A

fix splashing on film be processing

48
Q

a dark chemical splash indicates…

A

an issue with the developer

49
Q

if the wash has not worked properly what might you see and how will the film feel?

A

the map of gb example and will feel rough

50
Q

a double exposure will cause…

A

two images to be superimposed upon each other as the receptor used twice

51
Q

how to avoid double exposure

A

always put used receptors separate to the unused when taking radiographs on the same patient

52
Q

for digital, a scratch would appear to be…

A

thin white line on psp

53
Q

for digital, the phosphor coating delaminating will look like…

A

white areas at the edge of the psp

54
Q

for digital, an area of white ‘burn out’ could be caused by… 2 things

A
  1. underexposed

2. plate pre-exposed to light before X-rays hit

55
Q

for digital, a grainy image is indicatory of..

A

underexposure

56
Q

for digital, dust in the scanner at laser level will cause a..

A

fine uniform (microscopically zig-zag) line

57
Q

for digital, white cured areas at the corner indicates…

A

psp corner folded over in mouth

58
Q

for digital, a finger print will look like..

A

a paler finger shaped area

59
Q

for digital, darker curved areas at the corner indicates..

A

damage to photocells in solid state sensor only

60
Q

for digital, a bend across the psp will give a..

A

pale area after bend

61
Q

for digital, if the psp has been exposed to heat it will look like..

A

a ‘marble’ effect

62
Q

if a line is running down a psp image and is not uniform then this indicates..

A

physical damage

63
Q

a small white dot will indicate..

A

a bite mark

64
Q

the wire over the solid state sensor will cause…

A

a white line

65
Q

for DPT, a slight rotation from R to L is cause by..

A

mid sagittal plane not aligned properly - making one side look larger and more exposed.

66
Q

for DPT, chin up will cause

A

a sad looking occlusion

67
Q

for DPT, chin down will cause a..

A

smile looking occlusion

68
Q

for DPT, what is the issue with earring etc..

A

they create a ghost shadow which will be overlying some teeth which can cause issues for diagnosis

69
Q

what is the coin test used for?

A

to test the overall safety of safe lights

70
Q

“blooming” on a digital receptor can be caused by what…

A

overexposure of a CCD type solid state sensor

Radiology! (10 decks)

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