It is carried out under the auspices of the Ministry of Health, acting through the Russian Federation Department of Sanitary and Epidemiological Surveillance (DSES). DSES is responsible for a wide range of areas of public health, including radiation protection." (Vincent, 1998)
Quality Assurance is statistically determined and tracked within each department when a radiation emitting device is in use. The Performance Improvement Team has overriding authority in this area as the specialty of that department is to ensure that all departments are removing excess waste within their process operations such that operations are statistically consistent with efficiency and effectiveness. The QA team has the acceptable and unacceptable radiation levels and will monitor the hospital to ensure there is not a breach of these levels.
The compliance department will also be in contact with the QA department to facilitate compliance reporting based on national and state standards and the current statistical information regarding the usage of radiological equipment within designated zones as well as within non-designated departments and non-designated areas. Our standards do require ensuring the level of radiation exposure to the patient, staff and visiting population remains negligible.
The Joint Commission also referred to as JCAHO renders random compliance testing every 18 months (estimated) to determine facility compliance. The radiological measure is a function of the patient safety area and is generally not tested JCAHO. However, such information is tracked by our internal safety program and is therefore subject to internal standards as well as national and state regulations. The equipment in use by our staff also must be in compliance. Compliance is measured by the ability of our radiological emitting equipment including the CT scan, the X-Ray machine, the MRI machine, and the equipment in use within the Nuclear Medicine Department.
The tests are performed by random (pull and testing) of all equipment every 6 months. The equipment is measured using radiation detecting gauges to measure radiation release, and a tag is attached to the equipment with a quality control test date, raw score, and actual radiological release information. The equipment is tested for spikes in the release of radiation as well as other malfunctioning that may cause exposure to high levels of radiation. The purpose of the test is to determine whether the equipment itself is able to maintain levels within the compliance standards. If the equipment fails to remain within one standard deviation of the threshold, it is removed from operations and replaced with a new or refurbished machine that has been tested for compliance. The acceptable range for radiation exposure is between .005 and .05 mrem
Structural Barriers in Facility Design
The facility design has incorporated a framework to limit the exposure of radiation contamination spread risk. The CT and MRI machines are located in a corridor that is on a wing designated for the containment of radiation leaks. The walls are use lead-based paint and include a 2" lead support wall behind the sheetrock. The department is located on the bottom floor to ensure immediate evacuation in case of emergency to ensure human safety whilst the ceilings are reinforced to prevent objects and material from falling onto the machinery and causing exposure of radiological energy. Additionally, the machines are kept in a vault when not in use. The lead vault is designed to prevent any radiation leakage and contains a safety wash station between the outside door and the inside door to enter into the vault. A common design for infection control units.
The most important aspect of drafting an original, well-designed, functional, and compliant radiation manual is to address the specific needs of your clients and to understand what it is specifically is being planned and for what reason. We understand the inherent dangers of excessive radiation exposure to healthy human tissue and cells such as the cells comprising the epidermis layer of human skin. Radiation exposure then becomes a function of the frequency of hospital visits as well as the level of proximity one has to the portable diagnostic equipment.
The transportation of the MRI and CAT scan machines are imperative in a time where perilous disasters are occurring all across the world. Tornadoes and hurricanes can breach the exterior of any hospital and cause the collapse of critical infrastructure that may render any radiological emitting equipment as an immediate danger to society. Indeed, the cost of securing the necessary infrastructure is ostensibly a sunk cost in the planning and development of any medical facility that is going to support an ever increasing amount of equipment with radioactive isotopes.
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