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SErIES IAEA HumAn HEAltH SErIES IAEA Hum

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FORM FOR A QA PROGRAMME FOR ULTRASOUND<br />

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

I. General<br />

General condition of equipment and room<br />

Availability of operator’s manual<br />

Training of personnel to use equipment<br />

Imaging protocols and involvement of medical<br />

physics in development of protocols<br />

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

manual report<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 />

Physical and mechanical integrity<br />

Fidelity of display monitor<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

Calliper distance accuracy<br />

Vertical<br />

Horizontal<br />

Depth of penetration/visualization<br />

Dead-zone depth<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 />

171

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