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FORM FOR A QA PROGRAMME FOR DENTAL PRACTICES<br />

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

I. General<br />

General condition of equipment and room<br />

Availability of an operator’s manual<br />

Training of personnel to use equipment<br />

Imaging protocols and involvement of medical<br />

physicist in development of protocols<br />

Acceptance testing policies, procedures and/or<br />

manual<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 />

Quality assurance policies, procedures and/or manual <br />

Y NI N NA<br />

II. Quality Assurance (Acceptance Tests, Frequencies, Responsible Persons,<br />

Performance Criteria and Corrective Actions Taken)<br />

Dental system constancy test (intraoral only)<br />

Visual checklist<br />

Repeat analysis<br />

Tube head: boom stability<br />

Panoramic field alignment<br />

Collimation<br />

Half-value layer<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 />

168

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