Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging 1

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

2025

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Aims of the Course

The course is aimed at helping the student to provide diagnostic information of a high degree and accuracy. It enable the student to produce a diagnostic image at a minimum cost and hence improve the cost effectiveness of a diagnostic department The medical imaging department is a very costly hospital department to run, any programme of monitoring which encompasses imaging as well as processing equipment is an invaluable aid to ensuring that top-quality images are being produced in the most cost-effective way. Such a monitoring programme is often referred to as a quality assurance or quality control programme

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & IMAGING

INTRODUCTION

Quality assurance in Radilogy & Imaging department refers collectively to all aspects of a Diagnostic Radiography & Imaging service, e.g. patient scheduling, radiation protection of patients, staff and general public, preventive maintenance and the care of instruments, methodology, data interpretation and records keeping, and thing which contribute directly or indirectly to the overall quality of a Diagnostic Radiography & Imaging service in a hospital.

Quality Control, refers to a single component of the system and is usually applied in relation to a specific instrument and its performance.

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

INTRODUCTION

Quality Assurance (QA) therefore, encompasses a range of activities that enable department to achieve and maintain high levels of accuracy and a high degree of skill; expertise despite changes in procedure and recording methods The overall management program, put in place to ensure that a comprehensive range of quality control activities work effectively A quality Assurance program should be comprehensive, looking at all aspects of the work involved in producing high quality radiographs. This program should be cost effective and achieve its aims

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

INTRODUCTION

The radiographer should take responsibility of setting up, running, evaluating and taking remedial action and ensure program run routinely effectively Areas in which a radiographer should influence quality assurance / control e.g., in the x-ray department ( darkroom, sorting bench, reception, filling) and in clinical areas (proper x-ray requisition) Quality control:- The means by which, each area of interest is monitored and evaluated

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Aim of Quality Assurance

Increasing awareness, interest and understanding of quality assurance issues Enable radiographers to establish and continue to carry out an effective quality assurance program Provide a comprehensive knowledge, advice and experience in quality control methods Provide the knowledge and skills to carry out basic care and maintenance of imaging equipment Raise standards

• Reduce imaging costs
• Improve job satisfaction

Improve health and safety issues

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• The benefits of Quality Assurance and Quality Control
• A reduction in the number of 'repeat' radiographs.
• A reduction in the radiation dose to the public.
• Improvement in the rate of flow of patients through the department.
• Good quality radiographs, consistently produced.
• Standardization of radiographic results from one processor to the next.

Automatic processor and imaging equipment reliability, with efficiency maintained.

A more informed selection of future equipment can be made because of accurate knowledge of the reliability of existing apparatus

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

A Good Quality Assurance system should fulfill four requirements Establishes standard operating procedures (SOPs) for each step of the Radiographic projections, ranging from receiving of request form to equipment performance validation;

Defines administrative requirements, such as mandatory recordkeeping, data evaluation, and internal audits to monitor adherence to SOPs;

Specifies corrective actions, documentation, and the persons responsible for carrying out corrective actions when problems are identified;

Sustains high-quality employee performance

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Quality Assurance in Radiology & Imaging Defines
• In Radiology & Imaging , quality assurance involves the entire testing process:
• Pre-analytical, e.g. Validation of request form

Analytical (testing),

Post-analytical processes. … Assess the effectiveness of the Departmental policies and procedures. Identify and correct problems.

Assure the accurate, reliable, and prompt reporting of test results N/B Essential to all aspects of health care and Radiograph results that are accurate, reliable and timely

Determining the customer’s precise requirements

Ensuring that all resources, facilities and skills required to meet the customer's requirements are available Planning, documenting and implementing management procedures to ensure that the customer’s requirements are met consistently Ensuring that staff are trained and provided with the resources to do the job right the first time Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging How do we Achieve Quality Performance in Radiology and Imaging Department Quality is Achieved by:-

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• How do we Achieve Quality Performance in Radiology and Imaging Department
• Quality is Achieved by:-

Ensuring that all activities are undertaken correctly Ensuring that when things go wrong effective corrective action is taken to avoid repetition of errors Undertaking regular reviews and audits of all processes Total and organized commitment from management

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Quality Control/

Quality Assurance

• Management system to guarantee integrity of data
• Everybody’s business
• Goal is value addition
• Management strategy

Quality Control

• Measurement used to check quality of analytical data
• Restricted to a specific area and performed
• Goal is error prevention

Error detection methodology

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Health and Safety

Health and safety issues in any work environment are very important. X –ray departments should be prepared for emergency such as fire, major disaster or any life-threatening situation.

Radiography involves working with:- Machinery, Electricity, Hazardous chemicals, Radiation, and Patients Fire and major disaster plans should be in place. Cardiac arrest training should be given.

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Health and Safety

The first thing to consider is making the work environment as safe as possible, by minimizing the risk of problems arising. To achieve this, ensure that:- Regular maintenance inspections are carried out Safety procedures are followed

• Adequate staff instruction is given

Safety equipment is readily available

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• MACHINERY :- care should be taken with all moving parts, to minimize the risk of:
• Trapping fingers
• Loose parts falling off onto staff or patient
• Equipment moving unexpectedly and striking staff or patient

Staff or patient striking on head on overhead equipment

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Health and Safety

ELECTRICITY:- Regular inspection of all electricity equipment, cables and connections are required.

• When carrying out simple maintenance, repair, or cleaning of electricity equipment:
• Switch off and disconnect before starting
• Ensure that all parts are correctly and safely installed or adjusted
• Ensure that all protective panels are replaced

Never use excessive amounts of water when cleaning electrical equipment Report all faults to your immediate senior and ensure all member of staff are aware of any problem

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

Health and Safety

FIRE :- Adequate fire fighting equipment, instructions and evacuation procedures must be in place at all times

EQUIPMENT:-

• Fire extinguishers.
• suitable for electrical fires, near electrical equipment and switchboards
• General purpose in all other areas
• Smoke detectors in all rooms
• ? Hoses in central areas
• Fire alarms easily accessible
• Regular maintenance of alarms and equipment
• Illuminated EXIT signs in all public area

Emergency exit doors not locked or blocked

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Fire fighting instructions:-
• Readily available
• Staff training
• Annual refresher courses
• Evacuation procedure:-
• Instructions readily available
• Clearly defined evacuation routes
• Recognized assembly points
• Responsibilities clearly defined

Staff training

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety Hazardous
• Chemicals (Law and Requlations to be Followed

Developer and fixer are hazardous chemicals and should be handled with care.

Display manufacturer’s instructions for mixing, care and first aid treatment, in a prominent place in the area in which the chemicals are to used The risks involved are:-

• Inhaling fumes or powders

Ingestion (Swallowing )

Contact with the skin or eye

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety Hazardous
• Chemicals (Law and Regulations to be Followed
• When mixing solutions:-
• Work in a well ventilated room
• Avoid skin or eye contact with chemicals
• Wear a mask, goggles, rubber gloves and a plastic apron
• Avoid splashes
• Wash all equipment used after mixing

Clean up any spills or splashes

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• When processing films:-
• Avoid skin or eye contact with chemicals
• Ensure that the darkroom is adequately ventilated
• Minimize splashes
• Clean up any splashes as soon as possible
• Replace any tank lids when finished
• Disposal of empty chemical bottles:-
• Should not be used as used as drinking water containers

Punctures and place in a sealed plastic bag before disposal

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety

Disposal of exhausted chemistry . THINGS NOT to do Do not flush into common drains or simply throw away. The chemicals may get into the local water supply or contaminate crops Do not flush into a septic tank system. The chemicals will kill the good bacteria and stop the breakdown of solid matter.

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Disposal of Exhausted Chemistry

Helpful Suggestions.

Ideally use a silver recovery unit and dispose of the chemistry through a recognized hazardous chemicals agency Select a suitable site where the chemicals can be buried and are not likely to get into the local water supply or in any way affect humans, animals or crops Further refinements of the “bury method” is to use a stand trap first, then bury the residual sand or use an evaporative trench lined with sand and burry the sand when the water has evaporated Local soil, terrain and weather conditions should be considered

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety

First Aid Treatment

• Follow manufacture’s recommendations
• Skin contact
• wash eye thoroughly, immediately
• Darkrooms should be equipped with emergency eye wash kits
• Inhaled
• move out into fresh air immediately
• seek medical advice
• Swallowed
• wash mouth and lips in clean water
• Seek medical advice immediately

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Radiation
• Follow national laws and regulations
• Use an ongoing personal monitoring system
• Do not produce x-radiation unnecessary

Request for x-ray examinations should be justified Avoid the use of x-ray examinations on pregnant women wherever possible, especially in the first trimester Keep clear of the primary radiation beam Keep clear of any scattered radiation

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Radiation
• Collimate the beam as much as practicable
• Minimize repeat films
• Use lead rubber shielding whenever possible, especially of radiosensitive organs

Make sure that all items of lead rubber are in good condition and effective

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Radiation
• Make sure that shielding to the control panel is effective
• Make sure that x-ray room walls effectively protect people in adjacent areas
• Close door to x-ray room when exposing

Standard radiation warning symbols must be placed on the doors of all x-ray rooms Illuminated signs should be placed at the entrance to all x-ray rooms where prolonged x-ray exposures are made, warning when x-rays are being used. e.g. screening rooms

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Radiation

Make sure that all unnecessary personnel are clear of the radiation area when exposing Make sure that x-ray equipment is working properly and is safe, by carrying out regular quality control checks X-ray equipment should be switched off when not in use and any safety lock keys removed

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Radiation

Use correct filtration of the x-ray beam Special care must be taken when using mobile/portable x-ray units, in wards or operating theatre situations Apply the ALARA or ALARP principle when exposing anyone to radiation ALARA PRINCIPLE :- When exposing anyone to ionizing radiation the dose should be kept AS LOW AS REASONABLY ACHIEVABLE ALARP PRINCIPLE:- When exposing anyone to ionizing radiation the dose should be kept AS LOW AS REASONABLY PRACTUCABLE

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Working with the Patient
• Moving and handling:-
• Use recognized moving / handling techniques to reduce the risk of back injury
• Use appropriate moving / handling aids when necessary and when available

Encourage patients to move themselves where possible

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety
• Working with the Patient

Cross Infections:-

• Be aware of any indications that the patient may be infectious

Follow infection control procedures

Have gowns, gloves and masks readily available and ensure that they are worn when necessary Disinfect all equipment used, immediately after use, not forgetting cassettes Where possible wrap cassette in towel or cloth before using, with an infectious patient Wash hands before and after each contact

Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging

• Health and Safety

Disaster

Is any major catastrophic event, earthquake, major accident involving many people, civil disturbance or war. An x-ray department must have its own emergency plan that will fit in with the overall hospital plan Designing plan

• Become familiar with the hospital plan
• Design an x-ray department plan that is compatible
• Determine
• Individual responsivities
• Staff call – out procedure
• Organization
• Amount of stock to hold