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Radiography RD3033 > RD3033 > Flashcards

RD3033 Flashcards

1
Q

WHAT IS QA?

A

Quality Assurance = a programmme for systematic monitoring and evaluation of services/facilities to ensure the standards of quality are met, AND it often relates to whether the equipment is being operated correctly. Identifies human error eg. if further staff training is required

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2
Q

WHAT IS QC?

A

Quality Control = is a set of operations intended to identify whether the equipment is producing diagnostic images at the set performance level already established. This referes to the equipment itself rather than whos operating it and is used to IDENTIFY any deterioration.

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3
Q

What is the purpose of QA?

A
  • To reduce radiation exposure to both staff and service users and others.
  • Contain costs
  • Improve medical imaging
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4
Q

Why is QA important?

A

QA ensures that the principle of ALARP is adhered to
which essentially ensures the safety of all service users and staff.

allows identification of any equipment deteriorations

and ensures legislations are being complied to. eg. IRR or IR(ME)R

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5
Q

What is the IRR?

A

IRR = ionising radiation regulation = legislation which applies to using ionising radiation in the workplace. It requires employers to provide a safe working environment for staff and public and employees to maintain this safe environment for people who enter.

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6
Q

Give examples of roles applied to IRR + IR(ME)R

A

IRR = Eg. EMPLOYER should make suitable arrangements for a QA programme + EMPLOYEE to make sure they correctly carry out QC tests at suitable time periods. MPE makes sure equipment is tested before entering clinical service.

IR(ME)R = EMPLOYER should ensure written procedures for QA programme is made and taking place, ensure operators are trained, enusre MPE is appointed, involved and available.
EMPLOYEE (operator) ensure the dose to individuals for each exposure is ALARP and consistent with the diagnostic purpose

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7
Q

HCPC + QA

A
  • be able to communicate effectively (appropriate verbal + non verbal skills)
  • be able to work as a team (service users, supporting your staff + other professions within a multidisciplinary team)
  • be able to maintain records appropriately eg. QC
  • assure quality of practice eg. participate i clincal auidts, gather feedback
  • be able to draw appropriate knowledge + skills when conducting diagnostic prcedures
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8
Q

What is HCPC

A

HCPC = health and care professions council - all healthcare professions by law must be registered before practicing. They set the standards in which professionals must act upon to ensure public safety.

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9
Q

What is stochastic effect?

A

Refers to diagnostic imaging and is when there is no threshold needed. Stochastic affect will always be a risk but is more likely the risk will be more damaging as the radiation increases. These effects include cancer and inherited diseases

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10
Q

What is deterministic effect?

A

Occurs in radiotherapy, it only occurs when the threshold dose is met it results skin in vomiting, erythema

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11
Q

What is the purpose of radiation protection?

A

To reduce risks of stochastic effects to acceptable levels and prevent deterministic effects by keeping doses below threshold

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12
Q

What is dose limit?

A

Set level of dose that can be reached to protect and staff visitors, it does not apply to patients

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13
Q

What are the 3 principles of radiation protection?

A
  1. Justification (clinical value of taking image must outweigh risk produced by radiation dose required)
  2. Optimisation ( alarp)
  3. Dose limitation
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14
Q

What is the IR(ME)R?

A

Ionising radiation (medical exposure) regulations = legislation to protect patients. Covers duties of an employer and employee to ensure operating procedures, X-ray equipment and sheilding meet the standards of radiation protection

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15
Q

What are the 3 categories of radiation protection?

A
  1. Occupational exposure = employees over 18 their effective dose limit = 20 m Sv /yr
  2. Public exposure = imposed risk their effective dose limit = 1 msv/yr
  3. Medical exposure = does not have a dose limit but have diagnostic reference levels recommendations (refer to radiation in medical setting to benefit patient in diagnosisand treatment)
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16
Q

What is a classified worker?

A

Employee over 18 years of age who has had a health assessment and could possibly receive more than 3/10 of the annual dose limit of 20 m Sv/ yr

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17
Q

What is a controlled area?

A

An area where radiation exposure can exceed 6m sv/yr

Therefore require entry restriction and a physical sign saying controlled area

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18
Q

What is a supervised area?

A

Area not designated as controlled area but is under review as it can receive 1 m sv/ yr

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19
Q

What are local rules?

A

Written statements which inform employees of controlled and supervised areas, risks the of procedures (all staff required to read and sign

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20
Q

When must Rpa be consulted?

A
  • Dose assessment and monitoring
  • radiation risk assessment
  • prior to plans of new or modified sources of ionising radiation examinations
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21
Q

What are some restrictions of exposure?

A
  1. Engineering controls and warning devices eg. Remote operations, rooms have lead shield, warning lights and notices
  2. Systems of work eg. Local rules, staff training, personal dose monitoring, techniques to reduce patient dose eg. Compression
  3. Personal protection equipment (ppe) eg lead aprons, lead glasses
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22
Q

What should local rules contain?

A
  • Arrangements for restricting access eg- locked doors
  • summary of working instructions eg-positive Id check
  • identification and descriptions of areas eg. Signs
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23
Q

What are radiation protection supervisors?

A

They can be superintendents or any senior rachographer.

Rps ensures that radiation protection requirements are fulfilled regularly

24
Q

Who are comfort and cares?

A

A person who willingly receives radiation exposure to support a person who has undergone a medical exposure
They are exempt from dose limits

25
Q

When should qa be carried out?

A

When first being installed to provide baseline values
Periodic testing
After major maintenance

26
Q

How and who produces national Drls?

A

Medical Physics do a patient dose survey once every 3 years to see how much dose patients are receiving. This is produced every 5 years

27
Q

What are the stages of the Life of an X-ray Tube?

A

1) Procurement + installation = employer setting up the requirements, making considerations and seeing if they meet requirements of the hospital.
2) Critical examination = before using the equipment, go through the radiation safety features
3) acceptance testing = checking equipment works as its supposed to, and whether the contractor supplied the equipment as specified
4) comissioning = MP does testing to set baseline values
5) routine use in clinical setting, doing qc tests and if theres results outside the limit informing mp for maintenance, if so you go back to critical examination.
6) if not no solution to the issue, do you sell the parts?, or give them away, is it junk?

28
Q

What is reject analysis?

A

It is a QA test, to identify why an image has been rejected and how the number of rejected images can be reduced

29
Q

What are LUTs?

A

Look up tables are data stored in the computer to change the value of each pixel to improve image quality eg. brightness.
THIS REDUCES REJECT IMAGES DUE TO EXPOSURE

30
Q

When do we reject images?

A
  • when the image does not provide means to answer the clinical question
  • when the image produces is sub-optimal and so cannot make an accurate diagnosis
  • if the image deviates from the standard examination protocol
31
Q

What are the benefits of reject analysis?

A
  • causes of unnecessary patient dose can be identified + actions can be taken to reduce this from happening again
  • assess image quality = as you can identify any issues caused by the equipment or staff
  • any staff knowledge or technique that is lacking can be identified and used in staff training
  • protocols for specific equipment or examination can be optimised to ensure the best images are taken whilst keeping exposures as low as reasonably practicable
32
Q

What are the limitations of reject analysis?

A
  • sometimes reject analysis cannot identify increase in patient dose when images are not being rejected. for example, if a radiographer took an image that has clipped of the anatomy, they may choose to take another image however just on the specififed anatomy missing. Even though this technically reduces the amount of radiation recieved as they are not being exposed for that whole area again. it still means the patient recieved more than they should. this means the potential need for further staff training will not be identified.
33
Q

What might departments do for under/over exposure?

A
  • review protocols to see if they need adjusting. eg. if the AEC is working properly.
  • staff retraining on technique (do they know when to adapt exposures?)
  • QA testing to see if equipments are working as they should
34
Q

What is an operator and what are their DUTIES?

A

an operator is any person who is entitled to carry out a procedure associated with medical exposure
DUTIES = responsible for the practical aspects they carry out, cooperating with other medical professionals involved in medical exposure + comply to employers written procedures

35
Q

Who is a practitioner, AND what are their DUTIES?

A

A registered medical practitioner is is responsible for justifying a procedure that involves medical exposure based on the CLINICAL INDICATIONS provided by the referrer

DUTIES = justifying requests, cooperating with other medical professionals involved in medical exposure + comply with employers written procedures

36
Q

What is a referrer and their DUTIES?

A

a registered medical professional who is entitiled to refer individuals for medical exposure to a practitioner
DUTIES = supply sufficient clinical information to the practitioner

37
Q

Define what is practical aspect

A

anything that leads upto the final exposure. for example, handling the radiological equipment, assessing the parameters like radiation dose, maintaining the equipment, preparing and administering radioactive medical products.

38
Q

When can medical exposures be made?

A
  • justified by the practitioner
  • auhtorised by the practitioner or operator
  • potential diagnostic benefits have been weighted against damage
  • alternatives methods have been discussed
39
Q

What is QMS?

A

Quality management system = activities organisations use to control + minimise variables that affect quality. it involves establishing quality policies to achieve this. eg. QA

40
Q

what are the factors affecting quality?

A
  • equipment
  • image processing
  • veiwing conditions
  • competency of staff
41
Q

How is quality monitored?

A
  • through documentations = internally (used as reference points for employees, externally used as evidence of complianace)
  • clinical audits = systematic review of radiological procedures
  • dosimetry = looking at radiation doses to see if theyre kept at a minimum but still produce optimum images
  • performance indicators = measuring continuous improvements and results. eg. number of incident reports, number of training hours annually taking place, image rejection rates, number of procedures documented
42
Q

What are the components of QMS?

A
  1. Risk management = identifying potential risks to staff/visitors and select the most advantageous methods to minimise them to provide safe envirnoment
  2. equipment quality control = carrying out QC tests to assess performance, creates baseline values, identify changes and correct deterioration, acceptance testing
  3. administrative reponsibilities = data collection, costs control
  4. radiation safety programme= programmes/actions taken to abide by ALARP
43
Q

What are the 5 steps to risk management programme?

A
  1. analyse the potential risk
  2. written policies to reduce all risks and how to deal with them
  3. educate employees of all policies
  4. have periodic inspection to ensure these policies are being implemented
  5. keep records tp check all policies have been implemented
44
Q

what is ACCEPTANCE TESTING?

A

checking whether the equipment meets the orginal manufacturers specifications indicated in the purchase agreeement and operates according to standard of design

45
Q

what is QA lead role?

A

comittee to ensure the proper implementation of quality managment system by doing preiodic evaluation.
ROLES = ensure radiographers are trained for qc testing , manage data collection and maintain equipment performance, report any deterioration to radiology manager

46
Q

what are clinical audits?

A

systematic review of the quality of healthcare to ensure standards are met + improve patient care through implementing changes

47
Q

Why is it important to carry out clinical audits + what does it achieve?

A
  • critically analyse your own skills and ways to improve
  • critically look at the environment that delivers care to patients
  • benefits the department and trust
  • overall identifies changes to make quality of care better.
    ACHIEVES = improved patient care, enhanced professionalism, continuing education
48
Q

what is retrospective and propective audits?

A

retrospective = analyisng data that already exists eg. electronic databases

prospective = collecting data yourself and analysing it. it is more time consuming BUT allows for dynamic change of data

49
Q

What are the different types of clinical audits?

A
  • standard based audits = sees if standards are met or improved
  • critical incident = monitoring incidents that have occured
  • peer review = looking at case reviews with a multidisciplinary team to assess if proper quality of care taken
  • patient surveys = to gain patients perspective of quality of care
50
Q

What is the difference between audits and research?

A

audit = reviews current practice to ensure standards that were determined through reserach are being met and if theres a need for chnage to improve care. usually an on going process. practice based

research = seeking new knowledge/ validifying existing knowledge to set the standard of care to improve knowledge. usually a one off process. theory based

51
Q

what is a service evaluation?

A

similar to an audit, where it reviews current practice to see if it meets the standard of quality of care but DOES NOT NEED TO SUGGEST IMPROVEMENTS. SOLELY USED TO JUSTIFY

52
Q

How to conduct an audit?

A
  1. select a topic thats relevent and has potential benefits with A KNOWN STANDARD
  2. define the criteria - need evidence of standard to set the criteria and state exactly what is happening/what the aims are
  3. plan methadology - detailed but simple, engage with collegues and involve others and have sufficient time to carry it out.
  4. collect and analyse data
  5. implement changes - which is never easy SO see if it meets the criteria, provide justification. the organisation must be willing to support the change.
  6. re-audit - at a reasonable time periodto monitor + evaluate the changes to see is it worth reinforcing
53
Q

What does D.E.P.E.S.T stand for?

A

Demographic, Economic factors, Political, Environmental, Social, Technical considerations to equipment design

54
Q

EQUIPMENT DESIGN CONSIDERATIONS:

A
  • DEMOGRAPHIC = staff demographic eg. their age - see if they can use and maintain the equipment regularly to consider if adaptations are needed.
  • ENVIRONMENT = is the design providing support to the staff + meet the needs of the service user. eg. is it easy to use efficiently?, is the environment calming for patients?, does it meet the PATIENT DEMOGRAPHIC.
  • POLITICAL = allows staff to follow regulations, follow trust and department policies
  • ECONOMICAL = refers to financial considerations. eg. equipment costs.. enough costs to manage the life of an xray tube, staff costs .. training?, budget.
  • SOCIAL = equipment should have a functional design to ensure stress reduction, dignity and privacy of patients to be maintained.
  • TECHNICAL = need to have the basic knowledge + understanding of the equipment, it should promote staff interaction, allow modernisation of diagnosis/treatment and be adaptable.
55
Q

What could cause erronous QC tests results?

A

human error: not properly conducted, for contrast + resolution it would be due to diff eyesight, ambient lighting of the room, brightness of the veiwing monitor, if the image was manipulated or zoomed in. For OUTPUT CONSISTENCY.. maybe the meter wasnt reset or callibrated in a long time, was the tube warmed up, was the correct MA and time set

Radiography RD3033 (1 decks)

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