engleski

Establishment and implementation of QA / QC programme in diagnostic radiology in the west region of Croatia

Introduction Quality Assurance programme on using ionizing radiation is mandatory in all EU member states. Even though terms of use of ionizing radiation for medical purposes are defined by the Croatian regulatory body since 2009 in diagnostic and interventional radiology this is still not implemented in most facilities. One of the main reasons is a lack of medical physicists in diagnostic radiology departments even at University hospitals. At this moment in Croatia, less than 5 medical physicists are involved in diagnostic and interventional radiology. Materials and methods A medical physicist at radiology department of University Hospital Rijeka is present since 2012 and Quality Assurance programme is implemented. As a result of the efforts of our Medical Physics Department for optimized, responsible and safe use of ionizing radiation in medicine at UH Rijeka, other health institutions in west Croatian region became strongly interested on developing and implementing their own QA programme. As they had no medical physicist and no ability to employ one, a collaboration between UH Rijeka and these institutions was initiated during 2015. It was agreed that medical physicists from UH Rijeka will periodically perform QC controls of higher complexity and provide education of technologists for daily and monthly QC tests. The next step would be the optimization of procedures. This cooperation include one general hospital, one special hospital and 2 public health institutions with 13 facilities. Results96 First results of QC tests showed a lot of problems with technical parameters of the equipment. Mainly, it was because of poorly maintained equipment. The most common problem was the functionality of the automatic exposure control in both, radiography and mammography units. Recommendations were given, some corrective actions have been made and some are still in progress. Next step of our collaboration is the optimization and establishing diagnostic referent levels. So far, the first step has been made which includes collecting data about radiographic practice and calculating entrance skin air kerma (ESAK) in radiography and average glandular dose (AGD) in mammography. First results showed a lot of variety between radiographic techniques and a wide range of patient doses for the same procedure in different facilities even within the same institution. Discussion Results showed that periodical QC is necessary as it is the only method for quantitative evaluation of the X-ray units. Additionally, reports and results from QC measurements upgraded the communication between users and service engineers. First results of the collected data about patient exposures showed that the optimization and also the additional education of technologists is necessary, especially since high patient doses were not generally linked to older equipment as it was expected. All of the mentioned activities lead to the conclusion that departments using ionizing radiation in their clinical practice have a strong benefit of the collaboration with a medical physicist. The main goal of quality assurance programme in diagnostic radiology, giving the adequate diagnostic information with least possible exposure, is now more achievable. For full QA implementation, including the optimization of radiographic practice, medical physicist is needed in radiology departments and therefore it should be a rule rather than the exception. References 1. Zakon o radiološkoj i nuklearnoj sigurnosti, Pravilnik o uvjetima i mjerama zaštite od ionizirajućeg zračenja za obavljanje djelatnosti s električnim uređajima koji proizvode ionizirajuće zračenje (NN 41/13) 2. EUROPEAN COMMISSION - RADIATION PROTECTION N°162. Criteria for Acceptability of Medical Radiological Equipment used in Diagnostic Radiology, Nuclear Medicine and Radiotherapy. Directorate-General for Energy Directorate D — Nuclear Safety & Fuel Cycle Unit D4 — Radiation Protection 2012 3. EUROPEAN COMMISSION - RADIATION PROTECTION N°180. Medical Radiation Exposure of the European Population. Part 2/2. Directorate-General for Energy Directorate D — Nuclear Safety & Fuel Cycle Unit D3 — Radiation Protection 2014

quality assurance, diagnostic radiology

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