Quality Assurance Program in
MFOR
Definition
• “An organised effort by the staff operating
a facility to ensure that the diagnostic
images produced by the facility are of
sufficiently high quality so that they
consistently provide adequate diagnostic
information at the lowest possible cost and
with the least possible exposure of the
patient to radiation.”
Terminology
• Quality control- the specific measures for
ensuring and verifying the quality of the
radiographs produced.
• Quality audit- the process of external
reassurance and assessment that quality
control and quality assurance mechanism
are satisfactory and that they work
effectively
Quality control procedures
• Image quality and film reject analysis
• Patient dose and x-ray equipment
• Darkroom, image receptors and
processing
• Working procedures
• Staff training and updating
• Audits
Image quality
• High standard reference film
• A formal analysis of film quality every 6
months ( Guidelines for subjective quality
rating of radiographs)
• Performance targets
Film reject analysis
• Date
• Nature of the film fault
• Cause of the error and corrective actions
taken
• Number of repeat radiographs
• Percentage of faulty radiographs taken
Patients dose and X-ray equipment
• The initial critical examination and
report - carried out by the installer
• The acceptance test – carried out by the
radiation protection advisor
• A re- examination report – following any
repair that may have radiation protection
implications
• Day- to –day checks of:
- warning lights and audible alarms
- satisfactory performance of the
counterbalance
• Written records and an equipment log
should be maintained
Darkroom, image receptors and
processing
I. Darkroom
• General cleanliness( daily)
• Light-tightness( yearly)
• Safelights (yearly)
- Type of filters
- Condition of filters
- Wattage of the bulb
- Coin test
Image receptors requirements
• X-ray film
- Ideal storage conditions
- Strict stock control
- Careful handling
Cassettes
• Regular cleaning of intensifying screens
• Regular checks for light-tightness
• Regular checks for film/screen contact
Digital phosphor storage plates
• Regular cleaning
• Regular visual checks for scratches or
other defects
Processing
• Chemical solutions
- Always made up to the manufacturers’
instructions- fill the fixer tank first
-Always at the correct temperature
-Changed or replenished regularly
-Monitor for deterioration- step-wedge
phantom
Processing equipment
• Manual processing- using accurate timers,
thermometers and immersion heaters
• Automatic processing- regular
replenishment and regular cleaning of the
rollers
• Record log
Working procedures
• Local rules- essential for the safe use of Xray equipment
• Operational procedures of work- all
actions that indirectly affect radiation
safety and diagnostic quality
• Procedures log
Staff training and update
• A register for the staff involved in dental
radiography:
- Name
- Responsibility
- Date, nature and details of training
received
- Recommended date for a review of
training needs
Audits
• Clinical audits may include
- The QA programme and associated
records
- The justification and authorisation of
radiographs
- The appropriateness of requests
- The clinical evaluation of radiographs