Good news and help for your radiation protection file
An updated set of Employer’s Procedure templates has been developed and is now freely available for dental practices to download
More radiographs are taken in dental practices across Scotland every day, than in all the hospital radiology departments added together.
Yet Ionising Radiation (Medical Exposure) Regulations (IR(ME)R 2017) and the Ionising Radiation Regulations (IRR 2017) regulations that underpin patient safety, the safe usage, management of X-ray equipment, and the protection of staff, were primarily written for the teams that work in a hospital environment. This has perhaps contributed to confusion about what should be required of the dental team.
To facilitate dental practices in understanding how to implement the IR(ME)R legislation, an updated set of Employer’s Procedure templates has been developed and is freely available for dental practices to download. To help with the process of how the templates should be completed to reflect the local circumstances in your practice, a set of accompanying videos has also been provided on the National Services Scotland (NSS) YouTube channel, again at no cost. A selection of templates for patient information posters are also included in this package.
This package provides a complete set of resources to help achieve compliance removing many of the irrelevant regulatory hurdles for a dental practice
The creation of these resources is a collaborative process between NSS and the Scottish IR(ME)R regulatory team at Healthcare Improvement Scotland and expertise from the medical
physics community. This ensures that all the templates and supporting material meet all the regulatory requirements.
Employer’s Procedures are deliberately structured to ensure all aspects of the management of radiation usage in a healthcare environment are considered and managed appropriately. So, a dental practice must have all the Employer’s Procedures in their radiation protection file. However, the regulator has identified those Employer’s Procedures which can legitimately labelled as not applicable in this dental practice.
The new templates have removed those documents which are not applicable to the average dental practice, such as a procedure around managing X-rays in a research project, another example being the usage of forensic images to determine age of a person by the home office in asylum applications. This will reduce the document collection and thus reduce the work in compiling and managing this document portfolio, reducing some of the administrative burden, and the resultant documents will be more focused and easier to use.
Another significant change in the Employer’s Procedures relates to where a child may have previously had to be restrained or held by a “carer or comforter” (usually after some form of trauma). The emphasis has moved from trying to minimise the risk of an exposure for the carer or comforter, explaining the risk to this person as it delivers no value to them – to the new position of asking a practice to consider who will be providing the child’s dental care relating to this trauma.
If a patient is going to be referred on to the local public dental service, paediatric specialist or dental hospital then dialogue with this team should start prior to any radiographs being taken. In many instances the decision process about what images may be required and the specialist ability to get these images resides with that specialist team.
Another area where the regulatory framework has not kept pace with developments in a dental practice environment is the requirement of a dental practice to display a pregnancy poster. There has been a significant reduction in the amount of radiation required to take intra oral dental images, and the pathway to digital radiography has also reduced the radiation dose.
These have contributed to a recognition that dentists need not always ask about pregnancy status for the purposes of intra oral dental radiography. As intra oral radiography can be undertaken without risk to a developing child, the new range of posters explain this position and help deliver reassurance and clarity around this subject and keep the practice on the right side of the law by being ableto display one of the range of posters available in this new resource.
This package provides a complete set of resources to help achieve and maintain compliance in an effective and efficient way removing many of the irrelevant regulatory hurdles for a dental practice.
Originally released sequentially to allow dental practice to review and update their radiation protection file in manageable chunks, the complete file is available on the ‘Scottish Dental – Accessible information about Dentistry’ web page (www.scottishdental.nhs.scot). The accompanying videos are now available on the NSS YouTube Channel (www.youtube.com/c/NHSNationalServicesScotland).