-
a degree of excellence
quality
-
Three things quality includes
- -equipment
- -accessories
- -radiography personnel
-
Performs the monitoring and testing of equipment and control of variables in a clinical setting
quality assurance tech
-
Order of the administrative pyramid from bottom to top
patients- radiographer controls 25+ variables- rads equipment with numerous malfunctions- image processing system- acceptable radiograph
-
hospitals' organizationals charts illustrating the errors through the production of a radiograph
administrative pyramid
-
psychological aspects of the patient are evaluated when?
before procedure begins
-
How to treat patients
care, competence, respect, by age
-
-
-
-
-
Three ways for administrative evaluation
- -observations of tech work
- -interview patients
- -interview fellow techs
-
Four good physical conditions for the patient
- -read request for patient name and procedure for correctness
- -set up exam room
- -touch gently to do no more harm
- -provide comfort items like blankets, pillows, sponges
-
most complex and complicating factor in the pyramid
equipment
-
number one problem in most departments
film processing equipment
-
used to expose films precisely so each film will have the same density, processor chemicals, temperature, etc
sensitometer
-
measures amount of light transmitted through the radiograph
densitometer
-
develop latent images into visible images automatically
developer solutions
-
remove unexposed silver bromide crystals from film and hardems film to preserve image
fixer solutions
-
Five things QA techs check
- kV
- mA
- timer settings
- focal spot size
- collimator accuract
-
Radiographers control three factors in producing a radiograph
density, contrast, detail
-
learning the equipemtn and procedures in a department
orientation
-
major cause of excessive exposure of patients to radiation
repeats due to positioning errors
-
photo limiting and terminates exposture when centered over the part
automatic exposure devices
-
adjustment of voltage, amperage, distance, time
exposure factors
-
provides opportunity for techs to stay abreast of advancements
continuing education
-
continuing education is required by two groups
ARRT and state
-
How many CE credits required?
24 every two years
-
most important part of quality control
radiologists
-
only person who may legally make a diagnosis from a radiograph
radiologist
-
expert in production of radiographic image
radiologic technologist
-
determined by radiologists to say if an image in too light or too dark
acceptance limits
-
acceptance limits are wider with..?
digital imaging
-
determined by radiographer or QA tech subjectively to determine image quality
personal standard
-
communication between radiologist and tech includes
explaining to radiologist the circumstance prohibiting an acceptable radiograph
-
communcation between tech and patient includes
duration of pain, intensity, procedure explanations
-
15 ways to maintain an optimal rating in quality
- 1. approach problems directly
- 2. overcome pyramid communication problems
- 3. consider psychologics and emotions of pt
- 4. create good physical conditions
- 5. understand how managers evaluate care
- 6. awareness of importance of film processor to quality film
- 7. awareness of complexity of equipment and minimization of variables
- 8. be familiar with equipment
- 9. develop good positioning skills
- 10. develop good exposure factor skills
- 11. assist managers in determining rating of services
- 12. awareness of each radiologist's acceptance limits
- 13. awareness of department's acceptance limits
- 14. maintain optimal ratings through high personal acceptance limits
- 15. assist radiologist with pathient history and explanations
-
causes damage to living cells
ionizing radiation
-
Three sources of ionizing radiation
- -natural
- -background: airplane, atmosphere
- -manmade: xrays
-
absorbed dose and traditional and SI measurement
rad- gray
-
dose equivalent and Traditional and SI measurement
rem- sievert
-
exposure and traditional and SI measurement
Roentgen (R)- coulomb/kg
-
amount radiation required to turn skin red
erythema dose
-
established in 1964 to control radiation protection and measurements
NCRP
-
Four functins of NCRP
- 1. provide info and recommendations in the public interest
- 2. allow pooling of resources to facilitate studies
- 3. develop basic concepts about radiation protection
- 4. make effort to cooperate with international government and private organizations
-
nucleus surrounded by electrons
atoms
-
packets of energy in xrays
photons
-
created when photons knock electrons out of their orbits
electrically charged ions
-
process of ionization results
transfer of energy
-
Three main types of photon interactions
- absorbed
- scattered
- pass with no interaction
-
most common type of photon interaction
photoelectric effect
-
absorbed photon interaction
photoelectric effect
-
photoelectric effect is an interaction with....?
inner shell electrons
-
photoelectron production occurs with ...?
low energy photons
-
electron that has enough energy to knock other electrons from orbit
photoelectron
-
scattered photon interaction
compton scatter
-
compton scatter is a photon interaction with...?
outer shell electrons
-
During compton scatter, an atom is ___, photons change ___ and ___ energy.
ionized; directions; loses
-
source of most occupational exposure
compton scatter
-
photon interaction where photons pass through with no interaction
pair production
-
Pair production sends electron close to the ___ before disappearing
nucleus
-
Pair production produces what two things?
positron and electron
-
photon must have energy of...?
1.02 meV
-
Pair production rarely occurs in ___ range and mainly occurs in ___.
diagnostic; radiation therapy
-
Four possible results of radiation on a cell
- 1. pass through with no damage
- 2. temporarily damage
- 3. permanently damage
- 4. kill the cell
-
two sources of medical radiation exposure
xray and radionuclides
-
external course of medical radiation exposure
xrays
-
internal source of medical radiation exposure
radionuclides
-
contains half life of radiation, but patients are radioactive until it dies out
radionuclides injected tests
-
produced when a stream of electrons hits the atoms of a target in the tube
xrays
-
applied to accelerate electrons
kilovoltage
-
controls quality of beam
kV
-
controls quantity or amount of radiation produced
mA
-
xrays produced from the tube
primary radiation
-
primary radiation interacting with matter produces what two types of radiation
secondary or scattered
-
Three methods of protection:
- - less time
- - farther distance
- - shields
-
most sensitve mature cells
gonadal sex cells
-
used for treatment of cancer patients in radiation therapy or oncology and in nuclear medicine
radionuclides
-
Good housekeeping for protection from radionuclides is important because they can be ___, ___, and ____ to enter the body.
ingested, inhaled, absorbed through skin
-
related to rate of exposure as function of inverse square law
distance
-
intensity of beam is inversely proportional to square of the distance
inverse square law
-
aluminum used to absorb harmful soft radiation
filtration
-
inside the tube should be 0.5- 0.9 mm aluminum
inherent filtration
-
as high as possible to decrease skin dose
kV
-
Total filtration of what should be equal to 2.5 mm Al?
primary beam
-
automatic or manual restriction of primary radiation to a limited area located on tube housing
collimation
-
Three methods to minimize repeat exposures
- - restraining devices
- - technique charts
- - quality control programs
-
Best projection method for shielding
PA
-
Three shielding devices
lead aprons, gloves, gonad shields
-
measure exposure to radiation and is to be worn at all times by employers
film badge/ radiation dosimeter
-
How often should film badges be turned in and reported?
once a month
-
provides certification and registrations for RT profession
American Registry of Radiologic Technologists- ARRT
-
established in 1992 in St. Paul, Minnesota to organize who is registered in RT
ARRT
-
Primary certification exams
- radiography
- radiation therapy
- nuclear medicine
-
advanced level exams
- cardiovascular-intervention
- mammography
- CT
- MRI
- quality management
- sonography
-
ARRT board of trustees
5 RTs; 4 physicians
-
ARRT consultants
one from each discipline
-
ARRT publication saying who lost licenses, test stats, etc.
Annual Report to RTs Journal
-
Eight steps of procedures to take certification exams
- 1. general qualifications: good moral character
- 2. education
- 3. military
- 4. competency exams
- 5. application
- 6. aggrement of applicants
- 7. registry exam
- 8. score report
-
Five areas of content on registry exams in greatest to least order
- - radiographic procedures
- - image production and evaluation
- - radiation protection
- - patient care
- - equipment operation and maintenance
-
-
Name, RT (N)
nuclear medicine
-
Name, RT (T)
radiation therapy
-
makes sure RT programs are teaching students correctly to ensure an accredited program
Joint Review Committee on Education in Radiologic Technology- JRCERT
-
goes into hospital to ensure quality
joint commission
-
establisted in 1969 by ASRT and ACR
JRCERT
-
what year did JRCERT become free standing?
1992
-
national accrediting agency
JRCERT
-
JRCERT Board of directions
- -RTs
- -radiologists
- -oncologists
- -public
-
Five functions of JRCERT
- -documentation of programs
- - peer review
- -educational standards
- - respond to student allegations
- - enforce compliance with national education standards
-
JRCERT deems program in order to be "good enough" for certification
accreditation
-
Nine areas of program standards
- -mission and goals
- -integrity
- -organization and administration
- -curriculum practices
- -resources
- -students
- -radiation safety
- -effectiveness
- -satisfaction
-
Steps of the accreditation process
- -self study
- -set site visit date
- -site visit
- -JRCERT members give an exit interview
- -JRCERT reports to program on what was seen and what to fix
- -program responds with what has been fixed and how
- -accreditation is rewarded
-
When does self study occur?
four years after initial accreditation
-
longest possible accreditation award
8 years
-
Three things to happen if program is not up to par
- -probation
- -accreditation revoked
- -program withdraws
-
classroom instruction
didactic
-
hospital, RTs, professors, students evaluation
clinical instruction
-
safety and efficiency evaluation
lab instruction
-
Three areas of evaluation by JRCERT
didactic- clinical- lab
-
Allegation process
- -allegation made in writing
- -JRCERT alerts program
- -program responds
- -board decides
- -program submits report
-
Five values of accreditation
- -assure public RT is qualified
- -assures quality of service
- -on going assessment
- -self evaluation of programs
- -assures educational standards
-
Four services of JRCERT
- consultation
- educational presentations
- resources
- review
-
founded in 1920 as a national professional society to build up RTs as a profession
American Society of Radiologic Technologists - ASRT
-
ASRT House of Delegates
- -2 reps from each state
- -10 regional delegates
- -10 radiation therapists
- -10 nuclear medicinist
- -10 radiographers
- -speaker
- -vice speaker
-
ASRT board of directors
- president
- vice president
- president elect
- secretary-treasurer
- immediate past president
-
Four purposed of ASRT
- -continuing education
- -establish guidelines for CE programs
- -publications
- -position descriptions and Scopes
-
ASRT peer reviewed journal
Radiologic Technology
-
socioeconomics regarding technologists set by ASRT
wage and salary survey
-
state society that tracks continuing education credits and student involvement
Louisiana Society of Radiologic Technologists- LSRT
-
how many conferences held by LSRT and when?
two per year- one summer, one spring
-
society to give skills for leading people and dealing with changing health care environment
American Healthcare Radiology Administrators- AHRA
-
Three goals of AHRA
- -education and training of administrators
- -maintenance of high ethical standards
- -communication among members
-
publication of AHRA published quarterly
Radiology Management
-
publication of AHRA published monthly
AHRA Link
-
Two services of AHRA
- sponsor meetings for continuing education
- conduct surveys
-
Three purposed of the AERS
- -strives to advance the profession and support high standards of education
- -promotes exchange of information through communication channels
- -promotes research
-
AERS
Association of Educators in Rad Sciences
-
ARTS
Association of Radiologic Technology Students
-
Above average pay for RTs
$16-18/ hr for RT; $20/ hr for special
-
Four jobs of an RT
- -provide radiologist with images to assist diagnosis
- -provide patient care
- -positioning skills
- -selection of exposure factors
-
RT facts:
- -nationwide shortage
- -one of 10 occupations for new jobs
- -demanding field
- -hours depend on area
- -described by ASRT
-
education required for RT
higher level
-
Specialty areas of RT
- -diagnostic
- -fluoroscopy
- -radiation therapy
- -nuclear medicine
- -ultrasound
- -mammography
- -CT
- -MRI
- -bone densitometry
-
routine xrays, portable, orthopedics, trauma, surgery
diagnostics
-
administer targeted doses of radiation to a patient's body to treat cancer and other diseases
radiation therapy
-
gradually shrink and destroy the nucleus of malignant tumor cells
highly energized ions
-
determine how much radiation will be delivered to a tumor site by calculations from the oncologist's plan
medical dosimetrists
-
radioactive material introduced into the body to produce images of major organs
nuclear medicine
-
two procedures of nuc med
-
ultrasound in invasive procedures
sonography
-
Heart cath, myelogram, stents, angiography
cardiovascular interventional
-
contrast into spine to look for bulging discs
myelogram
-
contrast into veins
angiography
-
radiography of breast for breast cancer awareness and education
mammography
-
sectional imaging that used radiation to slice axial images for several different views to improve diagnosis in emergency situation
computed tomography
-
uses magnetic fields and radio waves to see sectional views
magnetic resonance imaging
-
measures indications of strength to determine osteoporosis
bone densitometry
-
advanced level RT
radiologist assistant
-
What can an RA do?
- -patient assessment, education, and management
- -fluoroscopy and radiography procedures
- -make initial image observations
-
Four opportunities for RTs out of the medical setting
- -education
- -administration
- -quality management
- -sales
-
radiaton therapist, nuclear medicine, ultrasound, special procedures
short term postgraduate education
-
master of science in rad science
masters in healthcare administration
doctorate in education
long term postgraduate education
-
radiologic and management expertise involved in purchasing, personnel management, budget preparation, regulatory specifications, decision making, and planning
administrative radiology
-
formal training recognized in 1933
radiographer educator
-
qualifications for radiographer educator
baccalaureate degree and 2 years clinicals
-
oversee the equipment in the department and guarantee that the equipment meets standards set by JCAHO, federal, state, and local agencies
quality assurance
-
ensures radiation producing machinery are properly handled and monitors radiation exposure of staff with film badges
radiation safety officer
-
preventative and non-preventative maintenance and repair of equipment
biomedical technicians
-
have a background in electronics and a high mechanical aptitude
equipment specialists
-
train technologists on equipment on site to establish protocols and procedures
applications specialists
-
has a business background and involved in equipment, film, supplies
sales reps
-
Bacelor of science is required for what two jobs?
applications specialists and sales reps
-
Six reasons continuing education is required
- 1. bridge gap between formalized education and advanced needs
- 2. prevent obsolescence in the profession
- 3. assure the public that all techs are competent
- 4. advance profession through growth of all techs
- 5. provide oppotunities for advanced preparation
- 6. reinforce code of ethics for all practices
-
required in order for a tech to use RT*(R) credentials adn be placed on registry
national certification exam of ARRT
-
How often must tech renew certification?
annually
-
unit of measurement based on a 50-minute contact hour
continuing education credit
-
Three things to be knowledgable about for CE
- ARRT
- state licenses
- institution specific requirements
-
When are CE credits and documentation due?
every two years at end of the month before the birth month
-
Seven CE documentation requirements
- -dates
- -topic
- -content
- -number of contact hours
- -speaker name
- -authorized rep name
- -reference number
-
Passing an advanced level exam (ie. mammo, CV, CT, MRI, nuc med, rad therapy, ultrasound, etc) gives how many CE credits?
24
-
What happens when an RT does not comply with ARRT?
probation for 6 months or loss of registration
-
How many states require full or limited licensure?
39
-
How many states require CE?
30
-
Does the ARRT require CE from ALL states?
yes
-
approved programs for CE by ARRT
Recognized Continuing Education Evaluation Mechanisms - RCEEMs
-
Five examples of RCEEMs
- -ASRT
- -Society of Nuc Med Techs Section (VOICE)
- -SDMS
- -AHRA
- -ACR
-
provides 24 journals with tests approved for CE credits
ASRT
-
Four most effective means of CE
- -professional societies
- -in service education
- -seminars
- -academic courses
-
How many credits given for academic courses?
16 per semester hour; 12 per quarter hour
-
designed to ensure that qualified personnel perform medical imaging and radiation therapy procedures and that state licensures are required to be covered by Medicare
Consumer Assure of Radiologic Excellence (CARE) Bill
-
Quality assurance is the responsibility of
- -the chief radiologist
- -the chief tech
- -each rad employee
-
Quality assurance does not involve
the ethnic origin of employees
-
What is the advantage of the pyramidal arrangement for departmental administration?
economy in personnel cost
-
What is the disadvantage of the pyramidal administrative arrangement?
communication from the base to the upper level is difficult
-
Evluating quality in the radiology department may not include
checking the patient's code of ethics
-
Troubleshooting is an activity for
equipment testing after malfunction occurs
-
Equipment monitoring is an activity involving
periodic routine equipment testing
-
The radiographic latent image is made visible by
- chemical processing
- computer image processing
- automatic processing
-
Checking the equipment is the most logical place to start when
several images were too light for interpretation
-
The acceptance level of a radiograph should be determing by the
person who can legally make a radiographic diagnosis
-
The roentgen unit is a measure of
the number of ions created in the air
-
What is the filtration manufactured into the xray tube called?
inherent filtration
-
What do the letters rad stand for?
radiation absorbed dose
-
When radiation interacts with matter and changes direction, it is called
scatter radiation
-
What will affect patient dose?
filtration, distance, time
-
Which exam will give the patient the highest gonadal dose?
lumber spine
-
The law of Bergonie and Tribondeau implies that sensitivity is greatest in
rapidly dividing cells with shortest life spans at the youngest stage of the organism
-
The basis for the NCRP policies and regulations for personnel and patients is the
ALARA
-
The general population is allowed what fraction of the dose allowed for occupationally exposed people?
one tenth
-
The dosimeter worn by most radiologic technologists measures
the amount of total body radiation
-
What cells of the body are most sensitive?
white blood cells
-
During portable xray exams, the tech's best protection is
distance
-
The primary concern in radiation to the gonads is to prevent
genetic effects
-
Sensitivity to radiation in humans is greatest when?
during the embryonic stage
-
The ARRT offered its first certificate in
1906
-
The ARRT does what?
examines technologists for advanced level specialties and surveys programs in rad educ for accreditation
-
The ARRT exams consist of
200 questions computerized test plus pilot questions
-
A score is defined as passing when
a composite score of 75
-
The ARRT is the national organization for
the certifying of qualified technologists
-
Eligibility to sit for the ARRT exam in radiography requires
completion of an ARRT recognized accredited program in rad, baccalaureate in radiation physics, and masters in radiation biology
-
In 1997, what became a requirement for registration for ARRT exam?
showing evidence of CE
-
The ARRT is one of the oldest certifying agencies in heal professions and is also the
second largest
-
The purpose of the ARRT is to
encourage education, elevate standards of rad techs, and examine and certify eligible techs
-
What governmental agency is responsible for the oversight of institutional and programatic accreditation?
united states department of education
-
In what way does the JRCERT accreditation benefit students?
ensures that a program meets national established professional standards
-
Site visitors' responsibilites include
evaluating a program through on site visits and developing a report of findings
-
What is likely when a program's deficiencies threaten the capability of a program to provide acceptable education?
program awarded probationary accreditation
-
Educational standards address
program effectiveness, curriculum, and radiation safety
-
THE JRCERT is
a non profit accreditation authority of educational programs
-
The JRCERT board of directors includes
radiologic techs, physicians, and rep of the public
-
The JRCERT investigates complaints that
relate to program's compliance with educational standards
-
What is a responsbility of the JRCERT?
evaluation of educational programs
-
The accreditation process includes
submit documentations, peer site visit, and JRCERT action
-
JRCERT accredited programs may exist in what settings?
health care facilities, colleges, proprietary schools
-
Responsibilites of JRCERT board of directors include
accreditation, corporate, policy development
-
Services offered by the JRCERT include
identification of accredited programs for prospective students
-
What is true of accreditation?
peer reviewed, voluntary, conducted by nongovernmental agency
-
What is true of a program's self study report?
evaluation of the program by personnel including information about outcomes in relation to mission and goals
-
What individuals may serve as site visitors?
rad tec educators and radiologists and oncologists
-
Radiologic sciences education has evolved from the ___ to the __ model.
apprentice; academic
-
A national organization primarily for radiologic technology educators is the
ACERT
-
A national organization primarily for radiologic technology managers is
AHRA
-
A national organization for all radiologic technologists is
ASRT
-
What was the primary reason that the ASRT was formed?
education
-
Today, the ASRT serves its members with
CE and scholar publications, professional reps, education program curricula
-
The ASRT holds continuing education opportunities in conjunction with the annual meeting of
radiological society of north america
-
The professional jounral published by the ASRT is called
radiologic technology
-
The ASRT currently represents how many rad techs?
more than 100,000
-
Other professionals who work in diagnostic imaging and therapy include
radiolgoists, physicists, nurses
-
The ASRT was founded in
1920
-
coalition of organization to communicate and plan for issues that affect diagnostics
summit on rad sciences
-
Which procedure is not an xray exam?
MRI
-
The distinguishing difference between CT and MRI
magnetic field vs radiation
-
Which imaging modality is most useful in studying the brain and spinal cord through visualization of soft tissue?
MRI
-
The formulation of radiopharmaceuticals and localization of each within the body are unique to what discipline?
nuc med
-
The speacialty that allows the most patient contact is
radiation therapy
-
Which subject in the curriculum is not common to all disciplines?
treatment planning
-
Which specialty is involved in the treatment of disease rather than diagnosis?
radiation therapy
-
Which specialty may national certification be obtained through an organization rather than the ARRT?
ultrasound
-
An advantage of ultrasound over other imaging modalities
no radiation is used and it can monitor fetal development
-
Upward and lateral mobility depends primarily on what?
education
-
Personnel management, budget preparation, union negotiations, and purchasing are a few areas of involvement of
deparment administrator
-
The formal training of xray techs in the US began in
1933
-
Formal training of xray tech in Europe was undertaken by
Marie Curie
-
The ASRT was established in
1920
-
Qualifications for rad science program director, faculty, clinical coordinator, and clinical instructor are addressed by
JRCERT
-
The Joint Commission requires that rad departments establish
quality assurance or quality control program
-
What is of utmost importance in quality assurance or quality control program?
proceessor monitoring
-
The monitoring of personnel radiation exposure is the responsbility of the
radiation safety officer
-
Minor radiographic and fluoroscopic equipment problems are often serviced by the
equipment specialist
-
CE for radiologic technologists is
mandatory for all registered techs
-
What is not acceptable for CE credit
registry review seminars
-
The organization requiring CE for renewal of certification is the
ARRT
-
What organization is not responsbile for approving education activities for CE credit
ASRT
-
CE credits may be obtained from an accredited postsecondary educational institution in
courses in disciplines specified by the ARRT
-
For an academic course to be acceptable for CE credit, the learner must receive at least
Pass
-
The ASRT established the ECE program in
1978
-
The main objective for CE is to
provide efficient care for patients
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