EVALUATION OF RADIOLOGICAL EQUIPMENT MANAGEMENT IN A TERTIARY INSTITUTION IN NIGERIA

ABSTRACT Radiological Equipment Maintenance (REM) has been described as an integral component of Quality Assurance (QA) for the Radiological Equipments (REs). This is vital as it keeps the RE in optimum condition to aid clinicians in diagnosis. The University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, which is a tertiary health institution centrally located to attend to the health needs of the masses especially in the South-East and South-South regions of Nigeria was understudied as a result of the reports of equipment malfunction and frequent breakdown. Questionnaire was constructed in line with the objectives of this work, and distributed to radiographers in the institute under study. The findings of this research reveals the total absence of a Quality Assurance Committee (QAC), 90.1% of the respondents reported that the only kind of technical attention given to the REs is repair, only 18.2% of the respondents hold themselves responsible for REM while others believe it is the duty of other hospital personnel. 54.5% of the respondents reported that their REs break down seldom while 45.5% of the respondents reports a quite often break down of the REs. The research also observed that the main reason for the procurement of a RE is break down of that RE. The findings of this study reveals the awareness of the end user to REM, the pattern of REM applied in the institution and other contributory factors to the occurrence of broken down REs.   LIST OF TABLES
Table 1----------33 Table 2----------33 Table 3----------34 Table 4----------35 Table 5----------36 Table 6----------38 Table 7----------40   LIST OF FIGURES
Fig i-----------34 Fig ii-----------37 Fig iii----------38 Fig iv----------39 Fig v-----------41 Fig vi----------42 Fig vii----------43   TABLE OF CONTENTS Title page-----------i Certification page----------ii Approval page----------iii Dedication-----------iv Acknowledgement----------v Abstract-----------vi List of tables----------vii List of figures----------viii Table of content----------ix Chapter one Background of study---------1 1.0 Introduction----------1 1.1 Statement of problem---------2 1.2 General objective of study--------2 1.2.1 Specific objectives of study-------2 1.3 Significance of study---------3 1.4 Scope of study----------3 Chapter two 2.0 Review of related literature--------4 2.1 Theoretical background--------12 2.1.1 Quality assurance programs for diagnostic radiology facilities--12 2.2 Maintenance procedures for radiological equipment----23 2.2.1. Plan the tasks---------23 2.2.2. Display the lists---------23 2.2.3. Record the work---------23 2.3 Types and approaches to the maintenance of medical equipment--26 2.3.1 Levels of maintenance--------26 2.3.2 Planned maintenance of medical equipment-----27 2.4  Roles and responsibilities--------28 2.4.1 Involve users----------28 2.5 Roles of a Quality Assurance Committee (QAC)----29 Chapter three; Research methodology 3.0 Research design---------32 3.1 Target population---------32 3.2 Data collection and the tool used-------32 3.3 Analysis and presentation of data-------32 Chapter four; results and discussion of findings-----44 Chapter five; Summary, conclusion, recommendation, limitations and area of further study. 5.0 Summary of findings---------47 5.1 Conclusion----------48 5.2 Recommendations---------48 5.3 Limitations of the study--------49 5.4 Area of further study---------50 References-----------51 Appendix-----------54
INTRODUCTION
Radiology according to Dryo1 is the branch of medicine that uses ionizing radiation for diagnosis and theraupy. These forms of radiation are produced by specific radiological equipment which can be grouped into ionizing radiation and non-ionizing radiation producing equipment. The first group includes the conventional x-ray equipment, fluoroscopy, computed tomography, mammography etc. The second group includes ultrasonography, magnetic resonance imaging, etc. Today, all healthcare delivery systems are very much technology dependent and virtually no medical intervention can take place without recourse to technology or precisely medical equipments and devices.2 With the rapid change in technology, radiological equipments mentioned above are witnessing advancement in trend. This has led to an increased demand for the modern equipments which provides a more appropriate diagnostic and therapeutic quality1. The sophistication in radiological equipment has brought with it difficulty in acquisition and maintenance. Radiographers take it for granted that someone else checks imaging equipment to ensure it’s in good working order. However, checking equipment safety is a task that all radiographers should pay attention to because it relates directly to patient care and risk management.3 When health care givers understand that the primary role of their being in the hospital is to take care of life, perhaps we may start seeing our equipments as vital tools for the sustenance of that life. The frequent down time of equipments due to poor management of those equipments or nonchalancy of attitude is a huge risk to efficient health care delivery. A visit to most of our tertiary institutions reveals for itself the countless numbers of equipments that lie idle majorly as a result of breakdown. In the Sub-Saharan Africa region, for example, a large proportion (up to 70 per cent) of equipment lies idle due to mismanagement of the technology acquisition process, lack of user-training and lack of effective technical support4 . A number of previous studies, conducted in low- and medium-income economies, indicate that as much as half of the equipment in urban and rural medical institutions is inoperable and not in use. As a result the efforts of medical and para-medical personnel are seriously impaired.5 It is against the above background that the need for the evaluation of the management of radiological equipment was hatched, because of its pivotal role in patients’ diagnosis and treatment.