Test 1 Flashcards
Anything human or equipment problems that can result in overall decreased customer satisfaction
Variables
Benefits of QM in imaging
Lower repeat rates Lower equipment downtime Greatest dept efficiency Increase customer satisfaction Decreased wait times
Who mandates quality management programs in radiology sept
The Feds
All encompassing management program to ensure excellence of healthcare through systematic collection and evaluation of data
Quality Assurance
Human factors Ex press gained and collecting data
Quality assurance
Level at which the institution is at that time
Quality Assesment
Part of total management program that deals with instrumentation and equipment
Quality control
Levels of quality control
Level 1: noninvasive and simple. Performed by any tech, warm ups troubleshooting, and lead apron checks Level 2: noninvasive and complex uses special testing tools performed by specially trained tech. Level 3: invasive and complex, performed by engineers and physicist
JCAHO 10 step method incorporates CQI (4 things method consists of)
Design (assign responsibility for dept monitoring) Measure (delineate the scope of care) Assess (identify important aspects of care) Improve (identify indicators or performance measures)
Sentinel event
involving death or serious physical/emotional harm
Identifies potential physical and financial risk to pt, employees, or visitors an establish process to minimize them
Risk management
Filtration does what
Removes low energy photons that would not contribute to image
How much filtration is needed above 70 kvp
2.5 mmAl
Lead apron equiv
At least .5 mm of pb
Lead gloves equiv
At least .25mm (.5 is preferred)
Eyeglasses equiv
At least .35 mm al
The measurement of the level of quality at some point in time with no effort to change or improve the level of care is known as quality…
Control
Under the safe medical devices act of 1990, voluntary reporting of unsafe medical devices will require the use of form….
3500A
Customers who come from outside the healthcare organization are generally referred to as
External customers
When did mammography quality standards act become effective
April 1999
W. Edwards Deming’s management approach can be summarized by his______ points
10
How many levels of quality control testing and monitoring are there
3
Which of the following statements is correct about 80/20 rule
20% of causes will result in 80% of the problems
How many different methods of disease transmission are stated to be minimized by Tier 2 precautions
Three
Invasive quality control equipment Testing is considered to be
Complex
Which of the following are normally considered external customers
Inpatients
Which of the following is a pictorial representation of a frequency distribution
Histogram
The range of variation around the mean is called
Standard deviation
The number of items actually measured from a population is called
Sample
The FDA uses how many classifications of medical devices
Three
What is the average amount of background radiation per yr in the US
360mrem
Any activity that costs a facility either money or its reputation is known as
Loss potential
Which federal agency is responsible for establishing standards for safety and for monitoring the workplace environment
OSHA
Members of the general public who may be exposed to frequent or continuous exposure from artificial sources other than medical exposure have a recommended maximum effective dose equivalent of ____ rem/yr
0.1
The maximum dose to the fetus of an occupational worker for the emote gestation period is _____ rem
0.05
What is the humidity range for the darkroom an why
30-60% to prevent static electricity (will expose film)
A light that emits wavelengths to which some film is not sensitive to
A safelight
How far should the safelight be mounted from the feed trays or counters
3-4ft
A red safelight is called
GBX light bulbs
Program that controls and minimizes variables that result in lost business and revenue or death of or
Quality Management
Orthochromatic film
Sensitive to green colors and blue violet Must use purebred light GBX SAFELIGHT
Panchromatic film
Sensitive to all colors Cannot be used with any safe light
Safelight/ dark room fog test
Xray a penetrometer/ step wedge then take to dark room and cover up 1/2 for 2 min process film then use densitometry to check densities.
Store film (upright/flat) to prevent _____ fog
Upright Pressure
Normal results for developer temp
+/- .5° 95°
What happens if GBX safelight is damaged
Over developed film/ increased fog
What does a Densitomitor do
Measures optical density
What does a Sensitometer do
Creates optical step wedge by taking unexposed film in dark room expose film with Sensitometer then develop film
What do you use and what are the steps involved for testing the wash.
Hypo retention or fixer retention (small bottle with color card) it tests the wash to make sure it has removed the fixer from film to ensure proper archiving. Steps Take a processes film and dab chemical. Wait 2 minutes then develop. Look for yellow spots on film
Normal fixer temp variation
+/- 5°
pH for fixer
4-4.5
pH for developer
10-11.5
Another name for step wedge
Penetrometer
What is the wire mesh test
Tests film screen contact Looks like a window screen
Affecting factors of screen ️️speed
Type of phosphors used ️️Thickness of phosphor layer ️size of phosphor crystals Reflective layer Light absorbing dyes Ambient temp KVp
Film and no screen has highest ______
MTF However direct digital ha highest
The acceptable variation o luminance uniformity for a single view box is
10%
15 ft-cd would be equivalent to approx _____ lux
160
The amount of light either scattered or emitted by a surface is known as
Luminance
Which would be considered an acceptable humidity range for film storage
30-60%
The acceptable variation of luminance uniformity for view boxes in a single bank is
15%
T/F dark rooms that process film images must have adequate water supply and drainage
True
Which type of film is designed to be primarily sensitive to ultraviolet light
Duplicating film
The recommended color temp for view of illuminators is
6200° K
The acceptable level of luminance uniformity for view boxes within the sept is
20%
What materials can be found in intensifying screen phosphors
Tungsten Gadolinium Lanthanum
Relative screen ️️speed values and screen resolution capability can be said to be
Inversely proportional
The ability of an imaging system to distinguish structures with similar xray transmition as separate entities is known as
️contrast ️resolution
Which of the following can be thought of as the amount of info recorded in an image divided by the info available in the part
MTF modulation transfer function
The rare earth phosphor, lanthanum oxybromide, emits what color of light
Blue
Why is it important to perform hypo retention test
Important for archival properties to make sure film doesn’t yellow too soon. Too much fixer yellows film quickly
Densitometer (looks like)
Blue box
Wht is the ️resolution chart
Metal with lines Measures ️resolution in line pairs per mm
What is used To check screens for scratches
Ultraviolet light (silver with handle
chemical fog
Over development of film. Excessive base + fog and excessive optical density.
Can be caused by developer temperature being too high, time, pH, and concentration.
Curtain effect
Solution dripping on or running down a film. Forms a pattern resembling a lace curtain.
Occurs if wash water is dirty.
Guide Shoe Marks
Scratches on images made by jagged edges of the guide shoes because they may be bent, warn, or damaged
Appear white on radiograph
Run parallel to direction of the film in travel
Pi Lines
Artifacts that occur relative to the circumference of a roller and therefor occur at regular intervals
Appear as dark lines that are perpendicular to the angle of the film in travel
Hesitation Marks
Stripes of decreased OD where transport rollers are left in contact with the film and further development is prevented
Water spots
Occurs when water or other liquid contacts unprocessed image
-A pattern of increased optical density appears after processing
Wet Pressure Sensitization
Dark stripes caused by wet rollers
Grid Lines
Shadows of the lead strips caused by failure of grid to move.
Improper grid focus
Improper angle
Improper CR and centering.
Decreased density-White lines
Grid cut off
Decrease in Optical density caused by primary radiation being absorbed by grid.
Any improper use of grid can cause this.
Cresent marks
Half moon shaped marks of increased density.
Caused by bending the film.
Tree Static
Resembles trees or bushes and is usually caused by low humidity conditions in processing area.
Decreased density. Black “trees”.
Crown Static
Marks radiate in one direction to resemble a crown.
Excessive friction from pulling on film
Smudge Static
Resembles “thumb”, dark spots on film
Caused by excessive light exposure on film, rough handling in film processing areas.
Light Age Safelight Fog
Light of any improper color lowers contrast.
Age may lower image contrast if film has been processed beyond expiration date.
Safelight has improper filter, incorrect distance, incorrect wattage
Emulsion Pick Off
Emulsion is removed or picked off of film base.
Occurs when two images are stuck together before processing and then pulled apart.
Decreased Density
Tube not detented
Vertically: Upright bucky, image all at the top or bottom.
Horizontally: Table bucky, image all on one side or the other.
Radiation Safety program in QM includes
Rad Safety Officer to ensure ALARA and keep track of personel protection (film badges)
Max Effective dose for occupational worker
5 rem/yr
.05sV/ yr
occupational fetal dose per month
.05 rem
.5 mSv
occupational fetal dose for entire gestation
5 mSv
.5 rem
Most common pathology for radiologist
leukemia
Half Value Layer (HVL)
reduces the iontensity of the beam by 1/2
Ideal repeat percentage
4-6%
Non random; difference in true value
Bias
Ideal temp for darkroom
65-75 degrees
processing times are checked with
a stopwacth
toe of sensetomtry graph
Dmin
Phenidome
Shoulder of sensitometry graph
D max
hydroquinone
Set of techniques that will proiduce a diagnostic image
Latitude
