Term Paper on "Diagnostic X-Ray Imaging Quality Assurance QA and Quality Control QC"

Term Paper 11 pages (4316 words) Sources: 4 Style: APA

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Diagnostic X-Ray Imaging Quality Assurance (QA) and Quality Control (QC)

Diagnostic X-Ray Imaging Quality Assurance (QA): It is a program used by the caregiver management to retain the best possible diagnostic image quality with the least risk and suffering to patients. Included under the program are quality control tests at regular intervals, measures for preventive maintenance, administrative procedures and training. Besides, it also includes continuous evaluation of the competence of the imaging service and the way to start remedial action. The main objective of a radiology quality assurance program is to guarantee the continual provision of quick and precise diagnosis of patient. This objective will be effectively fulfilled by having in place a QA program having three secondary goals as follows: (i) diagnostic imaging quality maintenance (ii) minimize the radiation exposure to patient and staff; and (iii) cost effectiveness. (Health Canada, 2006)

Diagnostic X-Ray Imaging Quality Control (QC): Under this program, sequences of standardised tests are conducted to find out modifications or alterations in X-ray equipment functionality from its original level of performance. The purpose of such tests when carried out on a routine basis permits immediate remedial action to retain the quality of X-ray image. However, it is essential to bear in mind that the doctor in charge of the X-ray facility bears the final responsibility for quality control and not with the regulatory body. (Health Canada, 2006) total diagnostic X-ray Imaging QA consists of six different constituents. These comprise of radiation exposure monitoring, radiographic unit monitoring, sensitometry and darkroom monitoring, the application of technique charts, the evaluation of repeat rates and continuing education. Radiation Exposure Monitoring: For safety measures all radiology departments must apply a system for monitoring the cumulative occupational exposure to employees working with ionizing radiation. Every employee must be provided with thermoluminescent dosimeters or film badges must be given to all employees and monthly dosages posted on a bulletin board. This apart, a lot of departments also scrutinize patient exposure to radiation by simple methods as a patient advisement device as well as a legal precaution. For instance, the total fluoroscopy exposure time collected at the time of a fluoroscopic procedure can be obtained from the fluoro times and recorded on patient database. The number of overhead exposures obtained for each method can even be recorded on the patient database. (Carrol, n. d.)

Radiographic Unit Monitoring: Majority of the quality control and basic measurement checks for radiographic apparatus can be done by the radiographer. The value of this type of evaluation is demonstrated by the reality that the radiation output per milliampere has been observed to differ by 50% from one unit to the subsequent within a radiology department and to the extent of 100% between units in different radiology departments. Besides, it is suggested that each of the equipment inside a department is meticulously inspected by a radiation physicist once every six months at the minimum. (Carrol, n. d.)

Sensitometery and darkroom Monitoring: Majority of these functions are possible and must be carried out by the professional radiographer with intermittent backup from processor experts. In situations when no quality control program is present, processing mistakes and conditions are responsible for more than 35% of every repeats. Hence every quality control programs much start with the processor. (Carrol, n. d.)

Use of technique charts: Repeat rates of radiology departments are reduced by as much as 25% when a systematic approach to the development of techniques is applied. It is seen that 73% of all the repeats are caused due to radiographs emerging as either very light of very dark. Some of this problem is because of darkroom and processing variables; and the remaining is due to inappropriate choice of methods. At the time when technique charts are applied on concert with processing sensitometry, repeats can be reduced to 50%. (Carrol, n. d.)

Analysis of repeat rates: Implementing any other feature of a quality control program in the absence of repeat analysis bear scanty meaning. The maximum value of repeat analysis remains in the finding out of continuing education requirements in case of the imaging personnel. While dealing with those requirements by delivering in-service education, repeat rates are able to be lowered as also patient exposure. Hence education remains an integral constituent in any quality control endeavour, however the exclusive educational requirements of the personnel must be found out in case it has to be effective. (Carrol, n. d.)

Continuing Education: At the time when the technological variables are evaluated and controlled, the highest aspect finding out radiographic consistency and the quality happens to be the expertise of the radiographer. The sphere of radiography is progressing in such a rapid manner with latest image receptor systems, computerization, and various new sub-specialities in imaging methods for which sustained learning must be an issue of survival as also professionalism. (Carrol, n. d.)

Repeat Analysis: It has been observed that one out of every ten radiographs have to be retaken. A lot of radiology departments have been fruitful in lowering their repeat rates down to 5-7% through total quality control program. A lot of variations are possible for repeat analysis program. In cases where there are no QC program, majority of the repeats are due to substandard technical quality of the radiograph, however in cases where a QC program is applied, 41% of all repeats are caused by positioning defects. Hence in these situations, the burden of the errors cannot be placed on electrical line surges, unpredictable processors and the technician of the darkroom. The two largely efficient methods of categorising repeat rates happen to be (i) by type of cause like positioning defects vs. technical defects and (ii) by the type of procedure, like head procedures vs. spine procedures. In case of radiographic quality control, the total number of repeats after deducting the number of green and blank films must be divided by the sum of the repeats and the good films made use for the period. (Carrol, n. d.)

Timer Quality Control in Radiographic Equipment: Modern day exposure timers are able to gauge a single pulse of electricity as short as 1/120 second in duration. Wrong exposure times can be can result in erratic methodology and a loss of control over the density of image. For accuracy, it is recommended that a workable range of accuracy for regular timers will be positive or minus 5%. (Carrol, n. d.)

Collimator Quality Control: In cases where the real size of the X-ray field is higher compared to that stated on the collimator control knobs, needless exposure of patients and more scatter fogging of the radiograph happens. At the time when the real field size is less compared to that stated, the anatomy of interest might be deducted from the field of view, needing repeat exposures. It is important for the radiographer, thus that the size of the field control knobs on the collimator as well as the projected visual light field correctly show the size and location of the real x-ray beam. (Carrol, n. d.)

Vertical Beam Alignment Quality Control: Sometimes, a light field that seems to be off-centered to the x-ray table transversely actually is off-centered however mis-angled. There is a possibility of this happening when the transverse tube angle lock has been used by a radiographer who failed to accord special care to put it to a precise vertical position following use. (Carrol, n. d.)

Two disciplines of activity have been designed to guarantee that the best possible diagnosis at an acceptable radiation dose and with the least cost. These disciplines are Quality Assurance -- QA and Quality Control -- QC. While it is important to note that QA deals with people, QC deals with devices and equipment. A QA program evaluates appropriate patient scheduling, reception and preparation. Besides, QA even entails interpretation of image as regards outcome analysis. On the other hand, QC is more tangible and apparent compared to the QA. A program of QC is devised to guarantee that the radiologist is provided with an optimal image that outcomes from a good equipment performance. QC starts with the X-ray device made use of to produce the image and persists with the regular evaluation of the image-processing facilities. QC ends up with a committed analysis of every image to locate the deficiencies and artifacts and to make the least use of reexamination. The type of QC program is determined largely by the features of the image produced. Normally, the QC program concentrates on the potency of the image to guarantee that those strengths are sustained. Maybe the most vital patient safeguard characteristic in case of a radiographic unit happens to be filtration of its X-ray beam. State laws need that general purpose radiographic units have a minimum total filtration of 2.5mm A1. (Bushong, n. d.)

Collimation: The X-ray field should coincide with the light field of the variable-aperture light-localizing collimator. In case these fields are not aligned in the proper manner, the proposed anatomy will be missed and the unplanned anatomy removed. Sufficient collimation can… READ MORE

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