DR M SAQIB MUNIR,DY:MS RADIOLOGY Quality Assurance and msds Indicator 10 training Department of radiology,FMU,Faisalabad DR M SAQIB MUNIR,DY:MS RADIOLOGY

MSDS INDICATOR 10 Policies and procedures guide identification and safe transportation of patients to imaging services.

What is Quality Any Planned and Systematic activity directed towards customers ( Patients) providing them appropriate Products, along with confidence that Services meet Consumers(Patients) Requirements. Quality ( Standards & Specifications) can be measured and perceived. Quality Assurance: Associated with some form of measurement & inspection activity for production operation. Quality Assurance is to bridge gaps in the dispersion of quality , aiming to attain expected value.

TRANSFER SUMMARY FORPROCEDURE/RADIOLOGY DEPARTMENT ALLIED HOSPITAL FAISALABAD Patient Identification Sticker TRANSFER SUMMARY FOR PROCEDURE/RADIOLOGY Also applicable for patients admitted from OPD to IPD. Date: Time: Transferred To: __________________________________________________________________ ___________________ Reasons for transfer: __________________________________________________________________ ______________

TRANSFER SUMMARY FORPROCEDURE/RADIOLOGY DEPARTMENT ALLIED HOSPITAL FAISALABAD Category A B C Level of Escort ________________________________________ Diagnosis ____________________________________________________________ ______________________________ Isolation Required Yes No Pulse: bpm Temp C BP mmHg Resp /min Wt kg GCS AEWS Score PEWS Score

POST PROCEDURE TRANSFER SUMMARY Time In : Time Out : TRANSFER SUMMARY FORPROCEDURE/RADIOLOGY DEPARTMENT ALLIED HOSPITAL FAISALABAD Consent : Yes No TRANSFER DOCTOR/NURSE NAME/ID___________________ Time___________ POST PROCEDURE TRANSFER SUMMARY Time In : Time Out : Post Procedures Vitals: (If Applicable) Pulse: bpm Temp oC/F BP mmHg Resp /min AEWS PEWS Total Score __________________ CATEGORY A B C LEVEL OF ESCORT :__________________________

Additional Comments___________________________________ _________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ _____________________

Category Patient: A, B, C. Annexure Category Patient: A, B, C. Category A: • All patients receiving invasive or non-invasive ventilation. • All patients who are hemodynamically unstable, are on inotropic support or have life threatening arrhythmias. During transfer of critical patients for procedures/imaging or to another unit: For SICU: Anesthesia resident, assigned registered nurse, and respiratory therapist, will accompany the patient. For MICU / Step Down: ACLS certified PG, assigned registered nurse and respiratory therapist will accompany the patient. All code blue patients: if revived, must be transferred to the critical care unit by the anesthesia resident/ ALCS certified PG and assigned registered nurse.

Category Patient: A, B, C. Category B: During transfer of patient for procedures/imaging, assigned registered nurse will accompany the patient after assessment has been conducted by ward/floor Resident. For shifting to parallel or low acuity transfer, assigned registered nurse will accompany patient. Category C: During transfer of patient for procedures/imaging, assigned transporter will accompany the patient after assessment has been conducted by ward/floor doctor. For shifting to parallel acuity transfer, assigned Transporter/ Clinical Aide will accompany patient.

Procedure for handling of Radiological Waste Wear Gloves. Take reading at the surface of bags and 1 meter would be noted in radioactive waste storage form.

General safety considerations Radioactive material / waste should be handled and managed within the controlled area. Keep exposure to ionizing radiation as Low as Reasonably Achievable (ALARA). Always wear laboratory coat while working with radioactive material/waste. Always wear gloves before handling any radioactive material Contamination monitoring of extremities must be done in low background area after each procedure or whenever worker has doubt of contamination

General safety considerations No eating, drinking, smoking or cosmetics application should be done in an area where radioactive material is being handled or used. There should be no storage of food, drinks or other items in areas where radioactive material is being handled or stored. All staff (radiation workers) must wear personnel monitoring devices at all times while working in radiation areas. Radioactive waste must be disposed off only in designated, labelled and shielded receptacles.

Radiation Protection: General instructions that should be applied at all times when working with radioactive materials include: Wear a laboratory coat or other protective clothing at all times in areas where licensed materials are used. Wear disposable gloves at all times when handling licensed materials. After each procedure or before leaving the area, monitor hands, shoes, and clothing for contamination in a low-background area. Do not eat, drink, smoke or apply cosmetics in any area where licensed material is stored or used. Do not store food, drink or personal effects in areas where licensed material is stored or used. Wear personnel monitoring devices, if required, at all times while in areas where licensed materials are used or stored.

Dispose off radioactive waste only in designated, labelled and properly shielded receptacles. Never pipette by mouth. Store radioactive solutions in clearly labelled containers. Secure all licensed material when it is not under the constant surveillance and immediate control of the user(s). Counting apparatus should normally be placed away from high background or if not possible covered with lead bricks to minimize the background level for better accuracy. The transfer of radioactive materials from one workplace to another, where necessary, without passing through the surrounding area.

Storage of Biomedical Radioactive Waste: o labelled bin is vacated after one month or when bin is filled 2/3 of its capacity and waste is stored in waste room for 3 months. o waste bin is vacated when it fills 2/3 of its capacity or 3 months and waste is stored in waste room for 6 months.

Patients using toilet at nuclear medicine would be instructed to flush out twice after urination. i. Disposal of Excreta and Urine of Patient Administered High Doses of Radioisotope: Patient administered high therapeutic doses of radioisotopes (e.g; I-131 in thyroid cancer) will be admitted in isolation ward until their radiation emission levels are within the safe limits (3mR/hr at 1 m distance) The excreta and urine of the patient admitted in a high dose isolation ward (e.g. Iodine 131) after getting flushed should passed through the PVC pipes through the shortest route possible into customized storage tanks, called delay tanks for storage before

The delay tank should be in an area where there is minimal movement of public. The tank should be leak proof, corrosion free and should have smooth surface from inside. The capacity of the tank depends on number of patients admitted each day. Liquid radioactive waste with activity less than micro curie level can be disposed off into sanitary sewerage system with adequate flushing system. ii. Waste Management and Disposal of Sealed Radioactive Sources Sealed radioactive sources should be disposed by requesting PINSTCH at their facility. SIH shall seek permission from PNRA before disposal of sealed sources.

Patients using toilet at nuclear medicine would be instructed to flush out twice after urination. i. Disposal of Excreta and Urine of Patient Administered High Doses of Radioisotope: Patient administered high therapeutic doses of radioisotopes (e.g; I-131 in thyroid cancer) will be admitted in isolation ward until their radiation emission levels are within the safe limits (3mR/hr at 1 m distance) The excreta and urine of the patient admitted in a high dose isolation ward (e.g. Iodine 131) after getting flushed should passed through the PVC pipes through the shortest route possible into customized storage tanks, called delay tanks for storage before

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