The aim of the RPU is to ensure that Irish legislative requirements of SI 30 (2019) and SI 256 (2018 and 2019) are met in relation to radiation protection for staff and patients. Table 1 is an extract from SI 30 (2019), regulation 34 (3), which describes the tasks of the radiation protection officer, while Table 2 outlines the additional duties delegated to the RPU from the Undertaking to meet the requirements of SI 256 (2018 & 2019).
Table 1. Extracts from SI 30(2019) on the radiation protection requirements to be undertaken by the RPU
Table 1: Extracts from SI 30(2019) on the radiation protection requirements to be undertaken by the RPU
Table 2. Additional radiation protection requirements to be undertaken by the RPU including the requirements set out in SI 256 (2018 & 2019)
Table 2: Additional radiation protection requirements to be undertaken by the RPU including requirements set out in SI 256 (2018 & 2019)
In addition, the RPU is required to communicate with the regulators on behalf of the Undertaking and the hospital. In particular, incidents involving ionising radiation needs to be reviewed and investigated by the RPU and the outcome submitted to the regulators if required. The RPU also will advise on equipment replacement and upgrades to rooms/areas where ionisation radiation is used.
These tasks and duties are undertaken using a multi-disciplinary approach where the members of the RPU share out the requirements (Figure 3).
Fig. 3: Tasks for the various members of the RPU
The clinical specialist radiographer takes on the more regular day to day tasks and audits within the department. Safety and warning systems are assessed with regular checks of the warning lights at the entry to the X-ray rooms and ensuring appropriate shielded personal protective equipment (PPS) are available for staff and carers and comforters when required. The CSR also undertakes regular audits of compliance with the patient identification policy, pregnancy status checks and exposure factors used. Together with the RSM’s, the CSR also ensures dissemination of any relevant policies, procedures, protocols and guidelines (PPPG) to all staff working within the Radiology Dept, as well as appropriate training in radiation protection.
The Consultant Radiologist takes on the role of the QA lead Radiologist (QARad). They undertake clinical audits on the resultant patient images to ensure adequate image quality is being achieved. They also audit the justification of each exam. In conjunction with medical physics and radiography staff, they take part in the optimisation process of the imaging systems.
The Medical Physics Expert and Radiation Protection Adviser (MPE/RPA) take on responsibility for the physical room and imaging equipment. They initially undertake radiation risk assessments on the area where ionising radiation is to be used. They then risk assess the operational aspects of the systems and estimate the potential doses staff may receive in operating the equipment. They advise on any mitigating measures that can help reduce potential doses. Once the system is operational, the MPE/RPA undertake patient dose audits, the outcome of which can be used towards establishing local diagnostic reference levels (LDRLs). Finally the MPE/RPA takes on the responsibility for the regular quality assurance (QA) testing of the imaging equipment and the integrity checks of the shielded PPE.
The radiography services managers (RSMs) are vital in supporting the CSR and the radiography staff. In this RPU there are two RSMs as radiography as staff rotate to the satellite unit from the two base hospitals of CHI. The RSM’s provide a vital management link between the main hospitals and this satellite unit.
The RPU initially met once a fortnight but now, several months on from establishment, meets monthly. Documents, audit results, clinical reviews, etc. are brought to these RPU meetings for discussion. Any radiation incidents or near misses are also dealt with at this forum. This allows actions to be identified and addressed in a concise manner due to the multi-disciplinary representations at the meetings. These meetings are chaired by the RPA and minutes are recorded. A report of the activity of the RPU is submitted to the CHI Radiation Safety Committee which meets twice a year.