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ASSESSMENT OF THE ADOPTION OF QUALITY ASSURANCE POLICY IN RADIOLOGY DEPARTMENT (A CASE STUDY OF THE TERTIARY HOSPITAL IN ENUGU)

Dept: MEDICAL RADIOGRAPHY AND RADIOLOGICAL SCIENCE File: Word(doc) Chapters: 1-5 Views:

Abstract

Presently, radiological workers appreciate the concept of quality assurance in theory due to its multi-faceted benefit especially on the economy when considering the overall cost of imaging equipment and the low cost of testing apparatus. However, they tend to neglect the practical aspect of the topic, thus leading to high rate of break down and faulty equipment. This work is therefore geared towards determining if there is any laid down policy in the radiology department in the tertiary hospital in Enugu.The survey revealed that only 42.9% of the respondents claim that there is an agreement on the servicing of the x-ray equipment in the radiological department and a greater percentage disagrees to that fact. 66.7% of the 42.9% affirmed that this servicing is only applied during repairs.It was observed during the survey that in 66.7% of the scope of the study; the operation and circuit manuals had been misplaced, lost, not supplied or taken away by service technicians during repair mi

• BACKGROUND OF THE STUDY

Quality assurance is an internationally established concept recommended for practice in radiological equipment and accessories for optimum performance and high quality output of x-ray machine

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. In 1990, a recommendation by International Radiological Protection Board (IRPB) was pronounced: this recommends that all x-ray equipment should be subjected to regular performance checks and if necessary corrective or replacement action must be taken

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Medical imaging demands precision in the production of high quality diagnostics images while restricting the amount of radiation administered to patients. Proper quality assurance (QA) Programs optimizes the caliber of radiographic images, protect patients and personnel from unnecessary exposure to radiation and reduce the occurrence of misdiagnosis caused by failures in all phases of imaging procedures.

So, there is a need to maintain a level of performance which will produce radiographic and fluoroscopic image with the maximum diagnostic information possible within the capacity of the equipment available

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. This can be achieved through proper quality assurance practice

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. This quality assurance practice can be achieved in radiology departments only if there is a laid down quality assurance policy

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. A quality assurance policy that will serve as a rule or routine that every worker must follow so that if there is a change in personnel; the policy is still maintained.

Quality assurance may easily be divided into a number of levels, each requiring a different type of scientific/technical surveillance. In the case of equipment whose status has been established by rigorous acceptance testing the requirement of a quality assurance program; in practice, is to ensure that the installation has not departed from this acceptance level

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. Thus, on a day to day basis quality assurance programs may be reduced to having a simple set of tests, or constancy checks to ensure that the status of equipment has not changed since it was established to be acceptable

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.Quality assurance is the planned and organized efforts by staff to ensure the consistent production of adequate diagnostic information at the lowest possible cost with minimum exposure to both patients and personnel to radiation

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.In addition, Susan

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 defines quality assurance as the planned and systematic actions that provide adequate confidence that a diagnostic x-ray facility will produce consistently high quality images with minimum exposure of the patients and personnel. Susan

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 added that quality assurance actions include both quality control (QC) and quality administration (QAd) procedures.

The definition above helps to highlight the practical implications of the term as QA=QC + QAd that is, quality assurance equal to quality control plus quality administration or management.

Dr.S.O.I.Ogbu (in one of his unpublished lectures in UNEC) defined quality assurance as “all those plans and systematic actions necessary to provide adequate confidence that our system is working satisfactorily in its day to day services”. Satisfactory performance implies optimum quality of the whole diagnostic procedures. It must be in line with a consistent production of adequate diagnostic information with minimum exposure to both patient and personnel.

Quality control involves the measurement of performance characteristics (tests) and the recording of the results of those characteristics, while quality administration is the evaluation of the results, the coordination and liaison between the groups involved and the organization of corrective measures in response to monitoring results

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.Presently, radiological workers appreciate the concept of quality assurance in theory due to its multi-faceted benefit especially on the economy when considering the overall cost of imaging equipment and the low cost of testing apparatus. However, they tend to neglect the practical aspect of the topic with reasons ranging from lack of time to carry out such procedures to lack or inadequate fund to buy test kits or employ quality assurance trainers

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In the course of the researcher’s clinical experience; the researcher has observed that quality assurance in the department of radiology is making only slow progress in practical terms. Many radiographers and radiologists are yet to be convinced of the need for involvement in the subject matter

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. Others whilst appreciative of the value of quality assurance at least in theory protest that they have neither the money to buy test equipments nor the time to perform the tests

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.Even though, the greater part of radiological practice continues to depend heavily on subjectivity, quality assurance provides the means of introducing objectivity, and even if we cannot actually measure the quality of our work; it is possible by quality assurance to quantity the performance of the x-ray equipment in the endeavor to improve that quality and hopefully improve our overall efficiency

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In this study, the radiological department in the tertiary hospitals in Enugu will be assessed if there is any laid down quality assurance policy that will serve as a rule or routine that every worker must follow so that if there is a change in personnel; the policy will still be maintained.

 

1.1     STATEMENT OF PROBLEM

In the course of the researcher’s clinical experience, the researcher observed that:

• There is frequent breakdown of equipment which may be due to lack of equipment care.
• Equipment has been found to shock.
• Interns and radiographers in the radiological department in the tertiary hospitals have no laid down departmental policy for carrying out their duty on both patient safety and equipment maintenance.

 

1.2     PURPOSE OF THE STUDY

The aims of this study are:

• To determine whether there is any quality assurance policy in the radiology department in the tertiary hospitals.
• To determine whether there is an objective way for measuring the performance of the x-ray equipment in the radiology department in the tertiary hospitals in Enugu.
• To determine if radiographs pass through quality controls before dispatch before it is sent for interpretation.
• To determine whether radiographers make input on the choice of equipment before it is purchase.
• To determine whether regular servicing of equipment is part of purchase or acquisition agreement.

 

1.3     SIGNIFICANT OF THE STUDY

• This study will reveal whether there is any laid down quality assurance policy in the radiology department in the tertiary hospitals in Enugu..
• This study will reveal whether the performance of the x-ray equipment is objectively monitored in the radiology department in the tertiary hospitals in Enugu.
• This study will reveal whether radiographers make input on the choice of equipment before it is purchase in the radiology department in the tertiary hospitals.
• This study will reveal whether the regular servicing of equipment is part of purchase or acquisition agreement.

 

1.4     SCOPE OF THE STUDY

This study will be conducted in the radiological department in the tertiary hospitals in Enugu. These radiology departments include: University of Nigeria Teaching Hospital Ituku Ozalla (UNTH), National Orthopedic Hospital Enugu (NOHE), and Enugu State University Teaching Hospital (ESUTH).

It is designed to cover all the Deputy Directors of radiology, the chief radiographers, and the Assistant radiographers in the radiology departments in the tertiary hospitals in Enugu. The assessment will be on if there is an establishment of a quality assurance policy in the radiology departments in the tertiary hospitals. A quality assurance policy that will serve as a rule or routine that every worker must follow so that if there is a change in personnel; the policy will still be maintained.