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Form FIF — Items to be reviewed by auditor Adequacy Comments<br />

Accuracy and reproducibility of kVp<br />

Beam quality (HVL) assessment<br />

Radiation output rate<br />

Performance of image display monitor<br />

Technique charts<br />

Repeat analysis<br />

Visual checklist<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

III. Radiation Protection and Safety<br />

Radiation protection equipment available, accepted,<br />

calibrated and passed QC test<br />

Room shielding checked<br />

Quality control of immobilization devices: storage<br />

and replacement<br />

Control of X ray room access<br />

Checks of warning lights/signs<br />

Checks of door interlocks<br />

Radiation protection surveys (e.g. what is done,<br />

including frequency, methods, records and actions<br />

taken as a result)<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

153

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