Radiation protection legislation Flashcards Preview

Principles of Patient Management > Radiation protection legislation > Flashcards

Flashcards in Radiation protection legislation Deck (32)
Loading flashcards...
1
Q

IRR99 overview

A
Concerned with safety of staff and members of public, not pxs
Stems from Management of Health and Safety at Work Act
Some of main requirements:
-RPAs
-Risk assessment
-Local rules and RPS
-Controlled areas
-Dose limits
2
Q

IRR99 Documentation

A

Approved Code of Practice

-contains both raw IRR and explanatory notes on interpretation and some official non-regulatory guidance

3
Q

Medical and Dental Guidance Notes

A

Contains advice of examples for all requirements of IRR and IRMER e.g.

  • risk assessment forms
  • incident forms
  • signs and warnings
4
Q

Guidance notes for dental practitioners on safe use of x-ray equipment

A

More useful

What you need to know

5
Q

RPA

A

Radiation protection adviser
Appointed expert who can help you will all things legislative, assist in determining necessary requirements for your facilities and
setting up a QA programme for your equipment.
Can be found in local hospital Medical Physics departments or private
consultancies

6
Q

RPS

A

Radiation protection supervisor
Ensures that local rules are followed when
working in controlled areas. E.g. senior
radiographer, a senior partner in a private dental
practice

7
Q

Regulation 4: duties of employer

A

The employer is responsible for…
-Fulfilling IRR99 with regard to the exposure to employees
and exposure to members of public that arise from
work done within organisation
-Employer may delegate tasks and other managers may have some responsibilities under IRR99
-Responsible for managing risk to employees and public
-For NHS Trusts employer would be taken to Chief
Executive. If you run your own practice, YOU are the
employer

8
Q

Regs 5 and 6: authorisation and notification of work

A

Before starting any new work with IR:
• Appoint/notify a local Radiation Protection Adviser (RPA)
• Notify Health and Safety Executive (HSE)
• 28 days before commencing
• By email, fax or letter
• Generic Authorisation (providing all conditions are met)
• General info
• The necessary form

9
Q

Regulation 7: Prior risk assessment

A

Identify hazard –> evaluate risk –> record findings –> identify provisions –> review/ revise –> back to beginning
Must be done prior to commencing any new work involving ionising radiation

10
Q

Reg 7 - doing your assessment

A

Must be written down
Do one whenever introducing new procedures/ equipment/ locations
Update if anything changes and periodically changes and periodically review
Investigate incidents
Must involve RPA
Special procedures for expectant mothers
Should be ‘suitable and sufficient’

11
Q

ALARP

A

As Low as Reasonably Practicable

12
Q

Reg 8: Restriction of exposure (ALARP)

Hierarchy of controls

A

Engineering (design) –> Administrative –> PPE

13
Q

Reg 8: restriction of exposure

A
Acceptance testing for new equipment
Hierarchy of controls
Monitoring
Proper use of PPE
Dose constraints
Restrictions for pregnant workers
Formal investigation levels
14
Q

Regs 9 & 10

A

Wear and look after your PPE

15
Q

Reg 11: dose limitation

A

Employees ages 18+, whole body dose 20mSv/annum
Trainees under 18, whole body dose 6mSv/annum
General public, whole body dose 1mSv/annum

16
Q

Reg 12: contingency plans

A

If risk assessment shows radiation accident is reasonably
foreseeable, contingency plans must be designed to restrict
exposure
Must be reasonable grounds for believing it could
occur
E.g. failure of intraoral x-ray exposure to terminate – switch off at wall

17
Q

Reg 14: info, instruction and training

A

People need to be trained first, if you haven’t been trained, don’t do it!

18
Q

Reg 16: designation of controlled or supervised areas

A

Controlled: areas where there is potential to exceed 6mSv per year
>7.5 µSvh-1 (time averaged over 1min and untrained employees likely to gain access)
OR if special procedures needed to restrict exposure

19
Q

Reg 17: local rules and radiation protection supervisors

A

Must have local rules if there is a controlled area
Must contain
• Name of RPS/RPA
• Details and designation of area
• Summary of working procedures (including any ‘special
procedures’ for entry)
• Investigation dose level
• Contingency plans
RPS needs to be appointed to ensure adherence to LRs

20
Q

Referrer

A

Registered health care professional entitled in accordance with employers procedure to refer individuals for medical exposure to practitioner

21
Q

Practitioner

A

Registered health care professional entitled in accordance with employers procedures to take responsibility for an individual medical exposure

22
Q

Operator

A

An person entitled, in accordance with employers procedures, to carry out practical aspects of exposure
Can include radiographs, medical physics experts, engineers, dark room technicians or staff asking px identification questions

23
Q

Reg 15: co-operation between employers

A

Working for multiple trusts or private clinics, take care of combined dose

24
Q

IRMER 2000 - Employer’s duties

A

Written procedures:
– How is px identified?
– Enquiring if female pxs pregnant/ breastfeeding
– Reducing risk of accidental or unintended doses
as much as reasonably practicable
– Establishing ‘Reference Levels’ for diagnostic exams
Naming of Referrer, Practitioner and Operators and ensuring they have appropriate training
Establish a Quality Assurance programme

25
Q

Referrer duties

A
Shall supply practitioner with
sufficient medical data relevant to
medical exposure to enable practitioner
to decide on whether medical exposure
is justified
26
Q

Practitioner duties

A
Responsible for process of justification
of medical exposure
– Is there net benefit to px?
Must comply with employers procedures
Shall co-operate with other specialists and
staff involved in medical exposure
regarding practical aspects
27
Q

Operator duties

A
Operator who personally carries out any
practical aspect shall be responsible for
that aspect
Shall comply with employer’s
procedures
Shall co-operate with other specialists and
staff involved in medical exposure
regarding practical aspects
28
Q

Justification of medical exposures

A

Every exposure must be justified
• Does the benefit to the patient/society
outweigh the costs?
• Exposure objectives
• Individual detriment
• Alternative techniques
-if for research, must be approved by ethics committee

29
Q

Optimisation through

A

QA program
Assessment of px dose
Diagnostic reference levels (DRLs)

30
Q

DRLs

A

Ball park dose figure for typical
examinations for standard sized pxs for broadly defined types of equipment
• To be established by employer
• To be set in units directly applicable to exam to enable px dose to be calculated,
e.g. exposure time.
• National group including RCR, CoR, IPEM &
PHE collate data to set guideline figures

31
Q

Reporting incidents

A

Radiation incidents more common than you think
– Accidental exposures
– Wrong Exam/ Wrong Px
– Equipment faults
Care Quality Commission responsible for
enforcing IR(ME)R and incidents with a dose “much greater than intended” or unjustified must
be reported to them
Immediately inform your RPS, Consult your RPA, inform CQC if appropriate.

32
Q

PM 77

A

HSE guidance document

This is where dose ‘much greater than intended’ definitions come from