MDA Chapter 40

Liable

Accountable or legally responsible under the law

what surfaces must be covered with barriers?

All that aren't easily sanitized

CDC - Transport and handle exposed film in a (BLANK) manner to prevent contamination of the developing equipment.

Aseptic

How can you check the developer strength?

By using a reference radiograph or a stepwedge radiograph.

when should you check a box of film for freshness?

Check each box while opening.

Quality control tests can be used to...

Monitor the strength of the developer and fixer solutions

should you use a film cassette that has scratches?

No. Screens that appear visibly scratched should be replaced.

Can a waiver be signed to release the Dentist from taking x-rays?

No. Such a document would be invalid if an injury would result. It should be stated in the patients record if a patient refuses recommended treatment

No. Screens that appear visibly scratched should be replaced.

Should you use a film cassette that has scratches?

Quality control test

Specific test that are used to ensure quality in dental x-ray equipment supplies and film processing

Sterilized film-holding devices should remain packaged until the patient is seated and can view the opening of the package.

When should the packages containing the film-holding device be opened?

Test each new box for freshness by processing one packet.

When should you check a box of film for freshness?

how can you tell when the fixer loses its strength?

When the fixer solution loses its strength, the film takes a longer time to "CLEAR," or become TRANSPARENT, in unexposed areas.

Dentist. Dental radiographs are a part of the patient's dental records.

Who legally owns patient's dental radiographs?

what federal act requires persons who take radiographs to be trained and certified?

consumer patient radiation health and safety act

Following the exposure of radiographs, a. all contaminated items should be disposed. b. positioning devices should be placed in the designated contaminated items area. c. the lead apron can be removed after hands are washed. d. All of the above e. All of the above, EXCEPT C.

d. All of the above

Which of the following are sources of disease transmission during dental radiography? a. Film packets b. Control panels c. Dental chair controls d. All of the above

d. All of the above

Dental radiographs are owned by the a. insurance company. b. patient. c. physician. d. dentist.

d. dentist.

The American Academy of Dental Radiography recommends annual tests for dental radiograph machines designed to identify minor malfunctions including a. variations in radiation output. b. inadequate collimation. c. tubehead drifting. d. inaccurate kilovoltage and milliamperage readings. e. All of the above

e. All of the above

To determine if dental x-ray film is fresh, a. unwrap one exposed film from a newly opened box. b. process the film using fresh chemicals. c. do not check the results. d. check the expiration date on the box. e. Both B and D.

e. Both B and D.

Inspection of dental x-rays

every 5 years & must be registered & charged a fee for this registration

monthly

how often should intensifying screens be cleaned with a commercial cleaner?

what type of agreement is obtained before radiographs of a patient are taken?

informed consent

Informed Content

permission granted by the patient after being informed about the details, risks, benefits & alternatives of the procedure

Quality assurance (QA)

plan to ensure that the dental office produces consistent, high-quality images with a minimum of exposure to patients and personnel

Disclosure

process of informing the patient about a procedure, for example, the procedure for taking x-rays

image receptor

recording medium for an image - a digital sensor, a phospor storage plate (PSP), or conventional dental x-ray film

PSP (phospor storage plates)

reusable film-sized flexible plate coated with phospor as the image receptor.

CDC - Heat tolerant holding items

should be heat sterilized between patients

The use of dental imaging is now the accepted...

standard of care. Lack of images compromises patients treatment and diagnosis

what are quality control tests?

tests that are used to monitor dental x-ray equipment, supplies, and film processing.

What are quality control tests?

tests that monitor dental x-ray equipment supplies, and image processing.

under state laws, who is allowed to prescribe dental images?

the dentist

who is the legal owner of a patient's dental images?

the dentist

who legally owns a patient's dental images?

the dentist

When giving patients a copy of their dental images..

the request must be written and signed The dentist should be informed Entry should be made (when and for whom they were sent to)

The cassette and screen are safe to use if..

the wire mesh image seen in the film exhibits uniform density, good film-screen contact has taken place

why are the reference radiograph and the step wedge used?

to check the strength of the developer solution

what precautions should be taken when one is handling contaminated film or PSP's?

wearing overgloves

fluorescent bulbs

what kind of light bulb is in the view box?

The Consumer Patient Radiation Health & safety act

what law is a federal law that requires all persons who use x-rays be properly trained & certified?

what precautions must be taken when films are transported to the darkroom?

Don't touch the films inside of the cup

Artifact

A blemish or unintended radiographic image that is not present in the actual structure being imaged. (caused by a technique error)

what is meant by quality assurance?

A way of ensuring that high quality diagnostic radiographs are produced.

How often should you check the processing solution?

Each day before any patient films are processed.

When the FIXER is at full strength the film should...

Clear within 2 minutes

what PPE's should the operator wear while exposing radiographs?

Coat, gloves, mask, eyewear

what unique infection control problems occur in dental imaging?

Constant movement

Dental assistants can still be held liable for their own actions.

DA's May be sued for their actions.

How often must you replenish processing solution?

Daily and change them every 3-4 weeks as recommended by the manufacturer.

Types of quality control tests:

Dental Film Dental x-ray machine Cassettes and Phosphor storage plates (PSPs) Safelighting Automatic Processor Manual Processor

which staff members have to be aware of the quality administration program?

Dentist, Dental Hygienist, Dental Assistant

what is one of the most critical areas in a quality control program?

Film processing is one of the most critical aspects of a quality control program and must be monitored on a daily basis.

If the FIXER loses its strength the..

Film takes longer time to "clear," or become transparent, in exposed areas.

If the DENSITY on the daily radiograph differs from that on the reference radiograph or standard stepwedge radiograph by more than two steps, the developer solution is depleted and must be changed before patient films are processed.

How can you tell when the developer loses its strength?

When the fixer solution loses its strength, the film takes a longer time to "CLEAR," or become TRANSPARENT, in unexposed areas.

How can you tell when the fixer loses its strength?

Replenish the processing solutions daily and change them every 3 to 4 weeks, as recommended by the manufacturer.

How often should the processing solutions be replenished?

why should you never give original films to a patient?

If a lawsuit should occur, no defense is possible without the dental images.

when should the packages that contain positioning instruments be opened?

In front of the patient

How long should dental images be retained?

Indefinitely.

what type of consent is necessary before a patient is exposed for dental images?

Informed consent

Patient records - Documentation of all imaging must include what information?

Informed consent Number and type of images Rationale for requiring images Diagnostic interpretation

how often should processing solutions be replenished?

Replenish the processing solutions daily and change them every 3 to 4 weeks, as recommended by the manufacturer.

what is the purpose of the coin test?

Test the effectiveness of the safelight.

what federal act requires persons who take radiographs to be trained and certified?

The Consumer-Patient Radiation Health and Safety Act

what federal act requires persons who take radiographs to be trained and certified?

The Consumer-Patient Radiation Health and Safety Act Requirements for Certification in Radiography for dental assisting vary from state to state.

under state laws, who is allowed to prescribe dental images?

The dentist

Who owns dental images

The dentist. However, it is reasonable for pts to have a copy of their records.

What is the most critical component in the quality control of film processing?

The processing solution.

Who is legally responsible or LIABLE for the actions of denta auxiliary personnel?

The supervising dentist AKA the resoindeat superior doctrine.

If the developer loses its strength the..

Time temperature chart is no longer accurate

what is the purpose of a quality administration program?

To ensure the highest quality for radiographs and the least risk for exposure to patients and personnel. To ensure compliance with state and federal regulations.

Dentist

Under the state laws, who is allowed to prescribe dental radiographs?

CDC - Digital Radiography sensors:

Use FDA- cleared barriers Clean & heat or high lvl disinfectant sterilze between pts. At Minimum use hospital disinfectant (with Tuberculocidal claim) between pts.

what type of gloves should be worn while one is disinfecting the radiography operator?

Utility gloves

To ensure the highest quality for radiographs and the least risk for exposure to patients and personnel. To ensure compliance with state and federal regulations.

What are the purposes of quality administration program?

A plan to ensure that the dental office produces consistent high-quality images with a minimum of exposure to patients and personnel.

What is it meant by quality assurance?

Film processing is one of the most critical aspects of a quality control program and must be monitored on a daily basis.

What is one of the most critical areas of a quality control program?

Test the effectiveness of the safelight.

What is the purpose of the coin test?

Always wear gloves and protective clothing while exposing radiographs and handling contaminated films. You should also wear a mask and eyewear if there is a likelihood that blood or other body fluids may spatter. Masks also are indicated if you or the patient has a cough or a cold.

What personal protective equipment (PPE) should the operator wear while exposing radiographs?

Once the film has dried, place it into a disposable container (plastic bag or paper cup) that is labeled with the patient's name. This container will be used to transport films to the darkroom. Be careful not to touch the outside surface of this container.

What precautions must be taken when transporting the films to the darkroom?

Once films are removed from the mouth, they are obviously contaminated and should be handled only with gloved hands. One technique that can be used to minimize contamination of the film packet by saliva is to place a clear-plastic barrier envelope over the film packet.

What precautions should be taken when handling contaminated film?

Surfaces that cannot be easily cleaned and disinfected should be protected by barriers, usually plastic or foil.

What surfaces must be covered with barriers?

informed consent

What type of consent is necessary before exposing radiographs on a patient?

Be sure to wear utility gloves while disinfecting the surfaces.

What type of gloves should be worn while disinfecting the radiography operatory?

Dental radiography presents unique infection control problems because of the potential for cross-contamination of equipment and environmental surfaces with blood and saliva.

What unique infection control problems occur in dental radiography?

Stepwedge

a device constructed of layered aluminum steps used to demonstrate film densities and contrast scales

What is meant by quality assurance?

a way of insuring the everything possible is being done to produce high quality diagnostic images

After exposure, each mount should be labeled with the patient's name and the date. a. True b. False

a. True

Disinfecting solutions may cause damage to the electrical connections of the radiographic equipment. a. True b. False

a. True

Film-holding instruments and bite-blocks that are placed in the patient's mouth are considered semicritical items and must be sterilized or high-level disinfected before reuse. a. True b. False

a. True

Documentation of all dental imaging must include all of the following information EXCEPT the a. date the film processing solutions were changed. b. informed consent. c. tooth number. d. diagnostic interpretation.

a. date the film processing solutions were changed.

Dental radiographic equipment that should receive a protective barrier includes the a. x-ray machine. b. lead apron. c. dental chair. d. All of the above

a. x-ray machine.

Viewbox

an illuminated boxlike device used to view radiographs

Positioning device

an instrument used to hold the film, phospr storage plate (PSP), or digital sensor in the proper position.

Fresh fixer film at full strength should produce a clear film within a. 30 seconds. b. 2 minutes. c. 4 minutes. d. 6 minutes.

b. 2 minutes.

A patient's signing of an x-ray refusal releases the dentist from liability. a. True b. False

b. False

A properly functioning view box is not necessary for the interpretation of dental radiographs. a. True b. False

b. False

The dental film packet should be sterilized after wiping the saliva off of it. a. True b. False

b. False

The lead apron is considered a low-contamination item and should be disinfected weekly. a. True b. False

b. False