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Clinical Audit in Dental Radiology

Introduction  

legislative background  

ClinicalAuditCover CoverIn 2002, a Statutory Instrument was passed through the Oireachtas (S.I. 478). This piece of legislation directly affected dental practitioners and the practice of dental radiography. It was amended with a further statutory instrument S.I. 303 in 2007 to allow for omissions and clarifications on some of the issues it raised.
Section 15 of S.I. 478 of 2002 introduced legislation that requires each “holder” of a radiographic license/equipment to carry out clinical audit as per the criteria adopted by the Dental Council. In early 2008, the Dental Council published their criteria for clinical audit in dental radiography. 

 

 
 
dental council criteria for clinical audit in dental radiography 

The Dental Council published its criteria for clinical audit in dental radiography. They are: 

Each section of this module will address each of these criteria and suggest methods by which they can be audited. It should be remembered however that many of the criteria for audit overlap, and the areas that can be audited are often the same. 

Dental Practice Radiography File

The concept of the “Dental Practice Radiography File” (DPRF) is to allow the practitioner to hold all the relevant information in one location. This allows for easy reference, the collation of data and facilitates the practice of internal audit. It is also hoped that the file provides the framework to allow internal audit to be a task that does not unduly take the practitioner away from their clinical work and hence does not become an overly onerous task.

This advice sets out to address the Dental Council criteria and should therefore allow the practitioner to fulfil their obligations under S.I. 478 of 2002.

It is intended to provide the materials and methods required to produce a DPRF and address some of the possible areas that can be audited. However, it is not exhaustive and any audit process when carried out, is likely to highlight other areas that can be addressed.

Were possible, templates for data collection are provided at the end of each section and in the Appendix. Practitioners can print off and use these pages as required. An “All in One” template is also provided. This template provides a form on which practitioners can record their audit data in one location to supplement the data recorded on the other templates. At the end of each section the relevant part of the “All in One” template for that section is highlighted.

Materials required:

  1. One lever arch file or ring binder
  2. A second lever arch file if the practitioner wishes to download and print the European Guidelines (EC136) and the current “Code of Practice in Dental Radiography” from the Radiation Protection Institute of Ireland.
  3. One set of file dividers with five tabs

It is suggested that each of the tabs in the dividers be assigned to the following sections:

1. Guidance Notes
This document and templates for the audit process.

2. Official documents
To include documents such as the X-ray license, dosimetry reports, evidence of attendance at radiography / radiology courses, certificates of disposal of lead foil and developer chemistry, and Radiation Protection Advisor (RPA) reports.

3. Quality Assurance Data
This would be where the “raw” data from the practitioner’s audits would be held.

4. Clinical Audit reports
The practitioner can summarize the data held into the form of a report.

5. Correspondence
Any letters relating to the audit process and the radiographic equipment held in the practice.

Statutory Requirements
S.I. 478 of 2002
15.1 "The Medical and Dental Councils shall, within two years of the making of these regulations and in consultation with the Faculty of Radiologists of the Royal College of Surgeons of Ireland (RCSI), adopt criteria for clinical audit."

15.3 "Each holder shall ensure that the clinical practice conducted in his or her installation or installations, is audited in accordance with the criteria adopted under paragraph 15.1 at least once every five years and the first audit under these regulations shall be undertaken not later than three years from the date of adoption of the criteria for clinical audit specified in paragraph 15.1."