RPNM Part09 Qa

IAEA Training Material Radiation Protection in Nuclear Medicine
Part 9
Quality Assurance
OBJECTIVE
To become familiar with the concepts of Quality
Assurance in radiation protection in nuclear
medicine and procedures for reviewing and
assessing the overall effectiveness of radiation
protection
Nuclear Medicine Part 9. Quality Assurance 2

Content
 General principles
 Organization of QA
 Administrative routines
 Occupational and Medical exposure
 Instrumentation
 Education and training

IAEA Training Material on Radiation Protection in Nuclear Medicine
Part 9.
Quality Assurance
Module 9.1. General principles

BSS
2.29. Quality assurance programmes shall be established
that provide, as appropriate:
a) adequate assurance that the specified requirements

relating to protection and safety are satisfied; and
`
b) quality control mechanisms and procedures for
reviewing and assessing the overall effectiveness of
protection and safety.

Meaning for medical
exposure that:
II.22. Registrants and licensees shall establish a

comprehensive quality assurance programme
for medical exposures with the participation of
appropriate qualified experts in the relevant
fields, such as radiophysics or radiopharmacy,
taking into account the principles established by
the WHO and the PAHO.

QA-PROGRAMME
OBJECTIVES
• Improvement in the quality of the

diagnostic information.
* Use of minimum amount of radionuclide

activity to ensure the production of the
desired diagnostic information.
* Effective use of available resources

BSS
II.23. Quality assurance programmes for medical exposures
shall include:
a) measurements of the physical parameters of the radiation

generators, imaging devices and irradiation installations at the
time of commissioning and periodically thereafter,
b) verification of the appropriate physical and clinical factors
used in patient diagnosis or treatment;
c) written records of relevant procedures and results
d) verification of the appropriate calibration and conditions of
operation of dosimetry and monitoring equipment; and
e) as far as possible, regular and independent quality audit
review of the quality assurance programme for radiotherapy
procedures.

QUALITY ASSURANCE
(definition)
”all those planned and systematic actions necessary

to provide adequate confidence that a product or
service will satisfy given requirements for quality”
(ISO)

QA and QC
 Quality Assurance is the overall process

which is supported by Quality Control
activities
 Quality Control describes the actual
mechanisms and procedures by which
one can assure quality

QUALITY
Quality of a practice is to fulfil the
expectations and demands from:
Patient Clinician
Yourself

QUALITY ASSURANCE
OVERALL QUALITY
Protection
Diagnostics Safety
Therapy

QUALITY
DEFINE OBJECTIVES
How many times should the nurse What is an acceptable sens-

be allowed to drop the child? itivity and specificity?

NUCLEAR MEDICINE SERVICE
facilities
patient care
waiting time Nuclear
staff Primary medicine
reporting service examination
competence or
experience Secondary treatment
optimisation service
radiopharmaceuticals
methods
examination technique
instrumentation
etc
etc

QUALITY ASSESSMENT
Communication with the

client (patient, clinician).
Expectations
Acceptable level
Reality

NUCLEAR MEDICINE
Diagnosis and therapy with
unsealed sources
Clinical problem
Radiopharmaceutical Instrumentation

QUALITY ASSURANCE PROGRAMME
A quality assurance programme in nuclear medicine should
ideally include:
Procedure (i.e patient history and signs, diagnostic question,

appropriateness of investigation, contraindications)
Planning of procedure (i.e reliable administrative procedures,
patient information, patient preparation)
Clinical procedure (i.e approved suppliers and materials, storage,
preparation, clinical environment, patient handling and preparation,
equipment performance, acquisition protocols, waste disposal)
Training and experience of nuclear medicine specialists, physicists
and technologists and others involved
Data analysis (i.e processing protocol, equipment performance,
data accuracy and integrity)
Report (i.e. data, image review, results and further advice)
General outcomes (i.e clinical outcome, radiation dose, patient
satisfaction, referring physician satisfaction)
Audit
Part 9.
Quality Assurance
Module 9.2. Organization

ORGANIZATIONS
International bodies
Recommendations.
Interlaboratory comparison programmes.
Education and training.
National organizations
National guidelines, codes of practice etc.
Interlaboratory comparison programmes.
Education and training.
Industry
Assistance in acceptance tests.
Documentation.
Training.
Maintenance.
Professional associations
Supporting QA-programmes
Establishing working groups
Education and training

LOCAL ORGANIZATION
Hospital manager (licensee)
QA committee
QA-group nuclear medicine

(chief technician, physicist, physician, pharmacist)

QA Committee Membership
 Must represent the many disciplines within the department
 Should be chaired by the Head of Department
 As a minimum must include a medical doctor, a physicist, a
technologist and an engineer responsible for service and
maintenance
 Must be appointed and supported by senior management
 Must have sufficient depth of experience to understand the
implications of the process
 Must have the authority and access to the resources to instigate
and carry out the QA process

Quality Assurance Committee
 Should ‘represent’ the department
 Should be ‘visible’ AND accessible to staff
 Oversees the entire Quality Assurance program
 Writes policies to ensure the quality of patient care
 Assists staff in tailoring the program to meet the
needs of the Department (using published reports as
a guide)
 Monitor and audit the program to ensure that each
component is being performed and documented

Part 9.
Quality Assurance
Module 9.3. Administrative routines

ADMINISTRATIVE ROUTINES
Patient
Patientid
id
Request
Request and
andcare
care
Examination
Examination Method
Method
Computer
Computer Diagnostic
Diagnostic
evaluation
evaluation report
report

REQUEST
It is the responsibility of the nuclear medicine specialist
that the study requested by the referring physician is
justified. Special attention must be paid to studies
requested for children and pregnant women. Are there
alternative methods e.g. ultrasound, MRI etc.?
Communication, on a regular basis, between the

referring clinician and the nuclear medicine specialist
is very important.

PATIENT
• Identification of the patient

• Information about the examination
including premedications
• Waiting for the examination
A fully informed and motivated patient is the

basis for a successful examination as well as
a staff well educated in care of the patient.

YOUNG PATIENTS
..should also be informed and motivated

PATIENT MOVEMENT

PATIENT MOVEMENT
moving
moving
moving

Policies and Procedures Manual
 Reviewed (typically) yearly

 This manual contains clear and concise
statements of all the policies and
procedures carried out in the department
 Updated as procedures change
Policies and Procedures

Manual
 As a minimum, sections should exist for

 Administrative procedures
 Clinical procedures
 Radiation safety

 It must be “signed off” by the Head of

Department and appropriate section heads
 It is important that all staff have “ownership” to
the manual - it should reflect the opinions of all
and be agreed to by all
 A list of all copies of the Manual and their
location must be kept to ensure that each copy is
updated

METHODS
Methods should be in accordance with accepted practices
Study name: Bone scan

Preparation of patient: Empty bladder
Radiopharmaceutical: Tc99m-MDP
Route of administration: IV injection
Activity: 400 MBq
Type of examination: Whole body scan
Views: AP, PA
Scanning speed: 10 cm/minute
Collimator: Scanning
Window setting: 140+/-20% keV
Positioning of patient: Supine
Presentation of result: Images in BW on film.
Original and filtered.

METHODS
Static? Tomographic?
Dynamic?
METHODS
Tl-201 Tc-99m
25 mSv 8 mSv

QUALITY ASSURANCE
COMPUTER EVALUATION
Efficient use of computers can

increase the sensitivity and
specificity of an examination.
•software based on published and
clinically tested methods
•well documented algorithms
•user manuals
•training
•software phantoms

QC Application programmes
 Analysis of the programme code

 Phantom studies
 Simulated examinations
 Reference data (normal material)
 Clinical evaluation

Bone scan phantom

Thyroid phantom

DIAGNOSTIC REPORT
Patient identification
Date and type of study
Radiopharmaceutical and activity
Study results - e.g. a graph or a series of images
Objective description of findings
Diagnostic conclusion and recommendations
Avoid adjectives like ’possible’, ’probable’, ’likely’

etc. They can never be interpretated by the referring
physician. The diagnostic conclusion should be more
quantitative e.g. by using a probability statement.
QUALITY ASSURANCE
METHOD
Patient follow-up.
Correlation with other available

surgical, pathological, clinical and
anatomic information.
False positives?
False negatives?
The final judge of any analytical method is
a clinical audit:
the correctness and impact of the

decisions made with respect to any
method and process.
Society of Nuclear Medicine

Procedure Guideline for General
Imaging

RECORDS
•Authorization certificate and documentation supporting the
corresponding application, and also any correspondence
between the licensee and Regulatory Authority;
•Name of the person authorized and responsible for the
RPP;
•Individual doses (current and prior work history);
•Results of area surveys;
•Equipment and instrument QC tests and calibration;
•Inventory of unsealed and sealed sources;
•Incident and accident investigation reports;
•Audits and reviews of the radiation safety programme;
•Installation, maintenance and repair work;
•Facility modification;

RECORDS (cont)
•Training provided (initial and continuing), including the following
information:
Name of the person(s) who delivered the instruction or
training;
Name of the person(s) who received the instruction or
training;
Date and duration of the instruction or training;
List of the topics addressed; and
Copy of the certificates of training.
•Evidence of health surveillance of workers;
•Waste disposal;
•Transportation:
Package documentation;
Package surveys;
Transfer/receipt documents; and
Details of shipments dispatched
•Patient records; and
•Patient discharge surveys for patients receiving radionuclide therapy.
Part 9.
Quality Assurance
Module 9.4. Occupational and

medical exposure
EXAMINATION
Patient
Patientid
id
Request
Request and
andcare
care
Examination
Examination Method
Method
Computer
Computer Diagnostic
Diagnostic
Evaluation
Evaluation report
report

The patient shall always be confident
that a nuclear medicine examination
and therapy is performed correctly and
with highest possible quality regarding
both diagnostics/therapy and safety.

Medical exposure
 Choice of examination
 Determination of technical parameters
 Optimization of administered activity
 Methods of reducing the absorbed dose
 Quality control of equipment and
radiopharmaceutical
 Quality assurance of methods
 Safe routines to avoid misadministration

Factors affecting medical and
occupational exposure
Receipt
Receiptand
and Preparation
Preparation
storage
storage
Detection
Detection Administration
Administration
(QC
(QCequipment)
equipment)
Radioactive
Radioactive
Contamination
Contamination waste
waste

QUALITY CONTROL
RADIOPHARMACEUTICALS
• Radionuclide purity (other radionuclides?)

• Radiochemical purity (labelling efficiency)
• Chemical purity (toxic substances?)
• Sterility
• Absence of pyrogens
Responsibility of the approved manufacturer

and supplier

QUALITY ASSURANCE
• Quality control of radiopharmaceuticals.

• Written and trained procedures in preparation and
safe handling of radiopharmaceuticals
• Use of a unique code which guarantee the ability
to trace the origin of all components in the preparation.
• Records of radionuclides, kits etc.
• Labeling of vials and syringes.
• Measurement of activity.

PREPARATION OF
• Use a transparent vial shield Tc99m-MDP

• Put the kit in the shield
• Add Tc99m and finish the 2237 5
preparation 447 SC
• Measure the activity
• Write the label and put it on
1997-09-28 7.40
the vial shield
• Check the kit and the label on
the vial shield. Same radiopharma-
ceutical?

DISPENSING
Tc99m-MDP 400 MBq 1997-09-28 07.45

• Check kit and vial shield label 400928-3336 SC
Correct radiopharmaceutical?
• Draw the required volume
• Measure the activity
• Write the label and put it on
the syringe shield

INJECTING
• Patient name?
• Patient identification number?
• Pregnant?
• Breastfeeding?
• Check the request form
• Check the label of the syringe.
Correct radiopharmaceutical
for the required examination?
Correct activity?
• Inject!

The worker should always feel confident
that he/she has the necessary training
in order to perform his/her duty.
The worker should feel that he/she gets the

necessary support from the licensee in
matters concerning working situation and
safety.

FACTORS AFFECTING
QUALITY
•Design of facility
•Safe receipt and storage of unsealed sources
•Safe handling of unsealed sources
•Management of radioactive waste
•Safety equipment
•Personal monitoring
•Health surveillance
•Workplace monitoring
•Emergency procedures
•Local rules
•Training and experience of staff

EDUCATION OF STAFF
Correct use of equipment
Close 15 cm Wrong setting

of energy window

Part 9.
Quality Assurance
Module 9.5. Instrumentation

How to get a new
Gamma camera?

PURCHASE GROUP
•Nuclear medicine specialist
•Nuclear medicine technologist
•Medical physicist
•Medical engineer
•Person from the hospital administration

How to open the safe?
Careful analysis of the need and state the reasons for
the purchase of the gamma camera
•Establishment of a nuclear medicine service

•Increased volume of patients
•The technical performance is not good enough
for new methods
•No spare parts available
•Unrepairable

How many cameras?
As an example, let us assume that in a certain
region of a country having a stable population of
150000 there are plans to establish a nuclear
medicine facility. The mean number of
examinations in the country is 15 per 1000
population and year but the new department should
be designed to fulfil a future need of 20 per 1000
population, which means that the total number of
examinations will be 3000 per year or 60 per week

Basic calculation
Type of examination Examinations per Time (h) per Total time (h) per
week examination *) week
Bone 20 1 20
Lungs 6 0.5 3
Liver 2 0.8 2
CBF 5 1 5
Myocard 10 2 20
Kidneys 8 0.75 6
Thyroid 5 0.5 3
Others 4 1 4
Quality control 1 3 3
Total 61 66
*) depends on the type of camera

Result
Number of cameras
If we assume that the number of hours per week a

gammacamera can be effectively used for patient
examinations to be 28 (70% of 40) then the number
of cameras should be 66/28=2.4. This figure should
be further corrected by taking into account the time
needed for regular maintenance of the equipment as
well as unplanned stops due to different failures.

End of step 1

Let the vendor Write a tender
define Your needs and document and distribute
make the selection it to the vendors

Choice of equipment
•Type of procedure to be undertaken
•Technical specifications
•Manufacturer
Spare parts
Service and maintenance
User and service manuals
•Local user
Education and experience of staff
Siting of the instrument
•Ease, reliability and safety in operation
•Cost

Siting of equipment
•Sufficient space
•Electrical power
•Environmental factors (temperature,
humidity, air pollution)
•Structural shielding
•Background radiation

MAINTENANCE
Regular maintenance will result in:

•Increased availability of equipment
•Increased quality by better performance
•Increased safety
•Increased lifetime of equipment

Maintenance procedures
should include consideration of the following:
• Overall management of the maintenance programme. This is often

provided by the medical physicist in co-operation with the RPO;
• Measures to prevent the use of equipment during periods of
maintenance;
• Notification of the medical physicist whenever there is a repair,
regardless of its importance. The physicist must assess whether any
tests or measurements are to be made and whether the equipment is
operating satisfactorily before it is used with patients;
• Provision of a service contract covering preventative maintenance,
particularly when equipment parts and expertise are provided by the
manufacturer;
• Maintenance of a service record during the lifetime of the equipment
or for a duration specified by the Regulatory Authority.

EQUIPMENT
EQUIPMENT
NEEDS FOR EFFICIENT USE
••Well
Welltrained
trainedstaff
staffwith
withaccess
accessto
tomanuals
manuals
and
andother
otherdocumentation.
documentation.
••Quality
Qualitycontrol
controlprogram.
program.
••Regular
Regularmaintenance.
maintenance.

Purpose of tendering
The purpose of tendering for gamma cameras is to assess

the best match between the requirements of the clinical
department and the equipment available and not necessarily
to buy the 'best camera’.

What do we want?
Hardware
One, two or three detector heads?

Round, square or rectangular detector?
Crystal thickness?
Collimators?
Whole body scanning?
PET-option?
Transmission source?

What do we want?
Computer & software
Acquisition modes?
Application programmes?
Network?
Storage capacity?
Backup?

What do we want?
More...

Payment
Warranty
Reliability
List of users
Manuals and other documentation
Time of delivery
Upgradability
Quality control equipment
Acceptance test
The tender document should
therefore include:
•System overview
•Contact persons
•Commercial specifications
•Technical specifications
•Data acquisition and processing
•Electrical and mechanical safety (national regulations)
•Education and training
•Documentation
•Service organization
•Installation and acceptance testing

What shall the vendor specify?
Commercial specifications:
•Price
•Payment
•Warranty
•Liability insurance for installers
•Right to refuse or remove equipment
•Value of the old camera

Hardware:
•Crystal size and shape
•PM-tubes
•Gantry dimension and weight
•Gantry movements, including auto-
contour
•Electrical power requirements
•Imaging table
•Collimators and method of change
•Shielding of detector
•Operating console
•Energy windows
•Energy range
•Safety features
•Motion control
Technical performance:
•Linearity
•Uniformity (different energies, different angles)
•Energy resolution
•Spatial resolution (intrinsic and system, planar
and tomographic)
•Count rate performance
•Center of rotation
•Multiple window spatial positioning
•System sensitivity (planar and tomographic)
•Point source sensitivity

Computer system:
•Acquisition modes
•Basic application programmes
•Clinical application programmes
•Quality control programmes
•DICOM-standard
•Network and communication
•Printers
•Storage and backup of patient data

…..and more:
•User lists and site visits

•Reliability (e.g. 95%)
•Service response time and follow up
•Training now and later
•Service manuals
•Upgradability
•Delivery, setup and installation date
•Floor loading, elevators and doors
•Electrical requirements

End of step 2
Distribute the tender documents to the vendors
RELAX!

The decision:
Which camera fulfills our
requirements?

The decision
• Can the camera and the computer software be used

efficiently for all types of intended examinations?
• Are the technical specifications satisfactory?
• Is the camera easy to handle?
• Is the price reasonable?
• Is the manufacturers service organization satisfactory?
• Is the required training OK?

Site visits

The decision- End of step 3
Manufacturer 1 Manufacturer 2
+ price + price
+ technical parameters - technical parameters
- service + service
- computer system - computer system
We want that one!!

Make a clear and detailed specification of the implemen-
tation agreement.
• Which are the users responsibilities?
• Which are the vendors responsibilities?
• Which documents are valid?
• Date of delivery?
• Mode of payment?
• Warranty?
Sign the contract
Make the installation
Perform an acceptance test
QUALITY CONTROL
EQUIPMENT
Acceptance / reference testing.
Measurements to assess whether
instrumentation comply with its
specifications. Manual available.
Routine testing.
Performed to maintain high quality and
standard of the equipment.
Analysis of results.
Is the observed result significantly
different from the reference testing?
Is the observed result due to errors in
the QC procedure?
Records.

Acceptance tests
X-ray installations 171
Passed 10
Passed after minor corrections 123
Not passed 38
(SSI 1992)

QC GAMMA CAMERA
Acceptance Daily Weekly Yearly
Uniformity P T T P
Uniformity, tomography P P
Spectrum display P T T P
Energy resolution P P
Sensitivity P T P
Pixel size P T P
Center of rotation P T P
Linearity P P
Resolution P P
Count losses P P
Multiple window pos P P
Total performance phantom P P
P: physicist, T: technician

Part 9.
Quality Assurance
Module 9.6. Education and training

How to achieve a high standard
of safety in a hospital?
•Safety culture
•Support from the hospital management
•Well educated staff
•Local radiation protection organization
•Quality assurance programme
•Use of authorized services
•Continuing education and training
•Arrangements for individual
monitoring and health surveillance
•Records
•Documented local rules and procedures
Education and Training
are essential for a
radiation protection programme
 As part of a the implementation of a Radiation

Protection Programme (IAEA TECDOC 1040,
2.2.1): “Early in the process a decision should
be made about additional training required for
the hospital staff…”
 The relevant plan should include who, where
and when shall be trained.

Responsibility of the licensee
 BSS 2.30.: “Provision shall be made for
reducing as far as practicable the contribution of
human error to accidents and other events that
could give rise to exposures, by ensuring that:
(a) all personnel on whom protection and safety
depend be appropriately trained and qualified so that
they understand their responsibilities and perform
their duties with appropriate judgement and
according to defined procedures;”

Education
 All staff in nuclear medicine must have
appropriate education to perform their
duties…
 For radiation protection purposes this affects
particularly:
 Radiation Protection Officer
 Physician
 Qualified Expert (Medical Physicist)
 Nuclear Medicine Technician
 ….

Personnel shall be instructed in radiation protection before
assuming duties:
•the conditions of the licence;
•safe use and operation of equipment;
•instructions that should be provided to patients and patient
helpers;
•institutional radiation protection policies and procedures
(including emergency practice drills);
•the local QA programme and QC procedures;
•the results of review and analysis of incidents and accidents
that have occurred in the institution or elsewhere.

A note of qualifications of others
 There should also be a process in place

which ensures that outside contractors
on whom radiation protection may
depend (e.g. service engineers) are
appropriately trained and qualified.

EDUCATION AND TRAINING
In addition to the staff working within the nuclear medicine department,
the following staff should receive instruction from the RPO: nurses in
wards with radioactive patients; staff who do not belong to the nuclear
medicine practice but need to enter controlled areas; and staff who
transport radioactive patients or radioactive materials within the
institution.

* Basic and continuing training for those who

have responsibilities for the operation of the
equipment or for preparations of radio-
pharmaceuticals.
* Advanced training for physicians, physicists
and radiochemists.
* Continuing education for those who have
operational responsibilities in a nuclear
medicine facility.

Continuing Education
 It is essential for all staff to have

regular updates on radiation
protection aspects
 Continuing education must be
documented

Education and Training
 If the number of professionals is too small

to justify setting up a training course, then
international co-operation programs may
be used
 Distance learning programs may be useful
 A course such as the present may play an
important role...

Continuing education in annual refresher training courses, and
whenever there is a significant change in duties, regulations,
terms of the license, or type of radioactive material or
instruments used. Topics should be selected from a syllabus
which has been approved by the RPC.
Today we will
talk about
Patient safety

Radiation protection training
programme
• Basic radiation physics.
• Biological effects of radiation.
• International standards in Radiation Protection
• Responsibility and duties.
• Safe handling of radioactive materials.
• Occupational radiation protection.
• Medical exposure.
• Management of radioactive waste.
• Protection of the public.
• Emergency preparedness.
• Organization of radiation protection

Training Record
The records should include the following information:
(a) Name of the person(s) who delivered the
instruction or training;
(b) Name of the person(s) who received the instruction
or training;
(c) Date and duration of the instruction or training;
(d) List of the topics addressed;
(e) Copy of the certificates of training

Education & Training
 The Regulatory Authority should
establish training curricula for (for
example) :
 RPOs
 members of the RPC
 relevant physicians
 medical physicists
 laboratory staff

The role of Regulatory Authority
 Require key personnel (named in RPP) to be duly

accredited/qualified and to have adequate training
in radiation protection.
 Specify/approve minimum training
standards/syllabus content for radiation protection
training courses.
 Provide training courses, perhaps in conjunction
with other contributors, if courses are otherwise
unavailable in the country.

Continuous Quality Improvement
 CQI - many other acronyms are available for this
 Part of virtually all QA systems
 Improved methods are documented in clinical trial
reports.
 Quality assurance protocols are continuously under
development in many countries
 Regular Quality Assurance meeting for all members
of a Section
 Continuing education - lectures, workshops, journal
clubs and must be available for all staff

And finally: QA is not a threat, it is
an opportunity
 It is essential in a QA program that all
staff feel free to report errors
 A non threatening environment must
exist
 Reward honesty with encouragement
 Education is the key, not punishment

What is this?
Communication!

Questions?

DISCUSSION
How should the quality of a nuclear medicine practice

be measured?

DISCUSSION
Discuss the responsibilities in QA for the different

members of the nuclear medicine staff.

DISCUSSION
Which one of the following practices has the

highest quality of the practice:
1. The most modern equipment and unqualified persons

running it.
2. Old equipment and qualified people running it.

Where to Get More
Information
 Further readings
 IAEA TECDOC 602
 Basic Safety Standards
 WHO publications
 ISO publications

RPNM Part09 Qa

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

RPNM Part09 Qa

Uploaded by

Copyright:

Available Formats

IAEA Training Material Radiation Protection in Nuclear Medicine

Nuclear Medicine Part 9. Quality Assurance 2

Nuclear Medicine Part 9. Quality Assurance 3

Module 9.1. General principles

a) adequate assurance that the specified requirements

Nuclear Medicine Part 9. Quality Assurance 5

II.22. Registrants and licensees shall establish a

Nuclear Medicine Part 9. Quality Assurance 6

• Improvement in the quality of the

* Use of minimum amount of radionuclide

* Effective use of available resources

Nuclear Medicine Part 9. Quality Assurance 7

a) measurements of the physical parameters of the radiation

Nuclear Medicine Part 9. Quality Assurance 8

”all those planned and systematic actions necessary

Nuclear Medicine Part 9. Quality Assurance 9

 Quality Assurance is the overall process

Nuclear Medicine Part 9. Quality Assurance 10

Nuclear Medicine Part 9. Quality Assurance 11

Nuclear Medicine Part 9. Quality Assurance 12

How many times should the nurse What is an acceptable sens-

Nuclear Medicine Part 9. Quality Assurance 13

Nuclear Medicine Part 9. Quality Assurance 14

Communication with the

Nuclear Medicine Part 9. Quality Assurance 15

Nuclear Medicine Part 9. Quality Assurance 16

Procedure (i.e patient history and signs, diagnostic question,

Module 9.2. Organization

Nuclear Medicine Part 9. Quality Assurance 19

QA-group nuclear medicine

Nuclear Medicine Part 9. Quality Assurance 20

Nuclear Medicine Part 9. Quality Assurance 21

Nuclear Medicine Part 9. Quality Assurance 22

Module 9.3. Administrative routines

Nuclear Medicine Part 9. Quality Assurance 24

Communication, on a regular basis, between the

Nuclear Medicine Part 9. Quality Assurance 25

• Identification of the patient

A fully informed and motivated patient is the

Nuclear Medicine Part 9. Quality Assurance 26

Nuclear Medicine Part 9. Quality Assurance 27

Nuclear Medicine Part 9. Quality Assurance 28

Nuclear Medicine Part 9. Quality Assurance 29

 Reviewed (typically) yearly

Policies and Procedures

 As a minimum, sections should exist for

Nuclear Medicine Part 9. Quality Assurance 31

 It must be “signed off” by the Head of

Nuclear Medicine Part 9. Quality Assurance 32

Study name: Bone scan

Nuclear Medicine Part 9. Quality Assurance 33

Nuclear Medicine Part 9. Quality Assurance 35

Efficient use of computers can

Nuclear Medicine Part 9. Quality Assurance 36

 Analysis of the programme code

Nuclear Medicine Part 9. Quality Assurance 37

Nuclear Medicine Part 9. Quality Assurance 38

Nuclear Medicine Part 9. Quality Assurance 39

Avoid adjectives like ’possible’, ’probable’, ’likely’

Correlation with other available

the correctness and impact of the

Society of Nuclear Medicine

Nuclear Medicine Part 9. Quality Assurance 43