Order No (1) for 1995 On the Regulation of Practicing The Profession of Radiology (Examination and Treatment)

Transcription

1 Kingdom of Bahrain Ministry of Health Office of Licensure and Registration Order No (1) for 1995 On the Regulation of Practicing The Profession of Radiology (Examination and Treatment) 1

2 Order No (1) for 1995 On the Regulation of Practicing The Profession of Radiology (Examination and Treatment) Minister of Health: After full consideration of Legislative Decree No (2) for 1987 on the practice of non-doctors and pharmacists as paramedics, in particular articles (1,3,), and attached table, Legislative Decree No (7) for 1989 on the practice of Human Medicine and Dentistry, And upon the submission of Health Undersecretary, Hereby Ordered the Following: Article (1) In implementation of this Order, the following words and terms shall have the meanings assigned opposite each: The profession of Radiology Examination and Radiology Treatment: Is the radiography and treatment of people by means of radiology and waves or any other mean with the objective to help in diagnoses of diseases and excluding the retraction thereof. Radiology and Waves: X Ray, Ultrasound waves, MRI, and radioisotopes Article (2) Without prejudice to the provision of article (2) of legislative decree No (2) for 1987 on the practice of non doctors and pharmacists as paramedics, the profession of radiology and treatment may not be practiced without obtaining a license from the Ministry of Health according to the manner provided for in this Order. Article (3) The categories of the license to practice the profession of radiology shall be divided to the following categories according to the qualifications assigned opposite each: 2

3 (a) Radiology Technician: Shall have the certificate of associate diploma in radiography or its equivalent from one of the accredited colleges or institutions. (b) Radiologist: Shall have a Bachelor degree in radiography or equivalent from one of the accredited college universities. (c) Specialist Radiologist: Shall have post graduate studies degrees or training in one of the specializations of radiology examinations after completion of university studies from one of the accredited universities in addition to practical experience of no less than 3 years in the field of specialization from an accredited hospital. Article (4) A licensee to practice the profession of radiology may not take radiographs, examine or treat any person without instructions from a doctor licensed to practice human medicine or dentistry in Bahrain. Article (5) Any person desirous of obtaining a license to practice the profession of radiology must submit an application thereof to the Licensure Office at the Ministry accompanied with the following documents: 1- Birth certificate or an official extract thereof or a certificate stating the age, issued by a competent authority in the respective country. 2- A certificate proving the nationality of applicant or a passport copy with 3 4x6 photographs. 3- Academic qualifications and experience certificates obtained by the applicant authenticated from competent authorities. 4- A certificate proving the health fitness of the applicant to practice the profession issued by the medical committee prescribed by the Minister of Health. 3

4 5- A Certificate proving that no criminal judgments have been passed against applicant prejudicing his integrity and honour unless he has been forgiven by competent authorities. 6- Names of three superiors/supervisors/managers whom the applicant have worked with in order to obtain from them information or statements as regards the professional level and personal details of the applicant. 7- Receipt evidencing payment of prescribed fees for new or renewals of licenses. Article (6) In case of approving the license application, licensee s name shall be registered in a special register for the practice of radiology. The licensee shall be given an identical copy of this entry attached with licensee s photo. The license shall be for two years renewable for the same period and according to the same terms and conditions. Article (7) The Ministry of Health shall maintain a special register for entering names of licensees for the practice of radiology which shall include the following information: 1- Licensee s registration number in the register. 2- Full name, title, nationality and age. 3- The medical profession the applicant is licensed to practice. 4- Academic certificates and qualifications and date of obtaining thereof. 5- The category of the license. 6- Details on previous experience. 7- Date and number of the decision of the Committee on authorizing the licensee to practice the profession. 8- The premises at which the licensee will practice. Licensee s domicile and address. A personal photo shall be affixed opposite licensee s name in the register. 4

5 Article (8) Any person licensed to practice the profession of radiology must notify the Ministry of Health by a registered letter on any change that may take place on licensee s domicile or the place at which he practices the profession within one month from the date of such change or the Ministry may cross out licensee s name from the register. The Ministry shall only re-enter licensee s name in the register if he shall notify it on the new address provided that he shall pay new registration fees. Article (9) A licensee authorized to practice radiology shall carry out his duties with due honesty, integrity and confidentiality and shall not carry out any action prejudicing the rules and morals of the profession. He shall also comply with the duties of the profession shown in Table (1) attached to this Order. Article (10) A licensee authorized to practice radiology shall indicate in all his correspondents, books or signboards, the category and type of license. License category may not be changed without an approval from the Ministry of Health Article (11) Any person, public or private institution may mot open a center or a radiology department for the practice of radiology without obtaining a license from the Ministry of Health. Article (12) Radiology centers and departments licensed to practice in Bahrain shall be divided into three categories: (a) Primary Radiology Units: 1- Carry out radiology examinations that do not require use of colored medical materials or sonar. 2- Use of ultra sound radiography equipment. (b) Specialized Radiology Units: 5

6 Its scope of work shall be restricted to one specialization of radiology examinations as shown in article (1) of this Order. (C) Comprehensive Radiology Units: 1- Carry out all radiology examinations including that which require use of colored medical materials. 2- Use ultra sound, MRI and radioisotopes. Article (13) Individuals who shall be licensed to open primary radiology unit must fulfill the following: (a) A Bahraini doctor licensed to practice the profession in Bahrain who obtained associate degree or the American Board certificate, or the Arab associate degree in radiology examination sciences or equivalent diplomas with experience not less than 2 years after obtaining the required academic qualifications in one of the specializations accredited by the Ministry of Health. (b) Or a Bahraini radiology technician licensed to practice the profession in Bahrain who has obtained the bachelor degree in radiology examination sciences or an equivalent degree with practical experience of not than 3 years after obtaining the required academic qualifications in one of the accredited hospitals. Services of radiology doctor must be available for writing of reports and quality control. Article (14) A person licensed to open a specialized radiology unit or comprehensive radiology center must be a Bahraini doctor licensed to practice the profession in Bahrain who obtained associate degree or the American Board certificate, or equivalent degree in radiology examination sciences with practical experience not less than 2 years in his field of specialization. Article (15) Applications for opening private radiology centers or units shall be submitted to the Ministry of Health (Licensure Department) on prescribed form and shall be accompanied with the following documents: 6

7 1- Site and building layout of the center. 2- Applicant s passport photocopy. 3- ID card or CPR copy. 4- Copy of academic qualifications of the applicant. 5- Copy of experience certificates and certificate of good conduct. 6- List of equipments provided for the center. 7- Copy of the license to practice the profession in Bahrain. Article (16) A person licensed to open a radiology center or unit shall manage the center or the unit by himself. The center or the unit may not be operated in case of his leave for more than one week, unless the licensee shall appoint another authorized technical manager in his absence period after the approval of the Ministry and for a period not exceeding three months. Article (17) In case of death of a person licensed to open a radiology center or unit, the heirs or their legal representative may operate the center or the unit provided that a manager who is authorized to practice the profession shall be appointed to manage the center or the unit according to the conditions stipulated in articles 13 and 14 of this Order. Article (18) Radiology examination centers must comply with health, safety and technical requirements provided for in appendix (2) and (3) attached to this Order within a period of six months commencing from the date this Order becomes effective. Article (19) A person licensed to open a Radiology examination center may not open more than one center at the same time. Number of staff working at the center shall be proportionate to work volume in the center. They shall be individuals licensed to practice the profession according to the provisions of this Order. All categories of technicians must fulfill the requirements shown in appendix 4 attached to this order including the qualifications, experience and job requirements. 7

8 Article (20) Fees for issuance of licenses to open radiology centers and units shall be as follows: (a) Primary Radiology Unit: (b) Specialized Radiology Unit: (c) Comprehensive Radiology Center 100/- B.D. for each year. 200/- B.D. for each year. 300/- B.D. for each year. Article (21) Any person licensed to open a radiography unit or center shall maintain a special serially numbered register to enter the following data for examination as follows: 1- Serial number. 2- Date of examination. 3- Full name of patient, title, nationality, age and CPR number. 4- Name of doctor who has sent the patient and his address. 5- Type of examination required. 6- Date of sending the report to the doctor. 7- Copy of the approved examination report by the radiology doctor. Article (22) Any person who violates the provisions of this Order and attached appendixes shall be punishable with punishments stipulated in legislative decree No (2) for 1987 on the practice of non doctors and pharmacists as paramedics. Article (23) Health Undersecretary shall implement this order, which shall be effective from the date of its publication in the Official Gazette. Minister of Health Jawad Salim Al Urayyed Issued on: 1 st Sha ban 1415 A.H. Corresponding to: 2 nd January

9 Appendix No (1) Services Provided by a Radiology Center 1- Receiving patients referred by doctors licensed to practice the profession in Bahrain. 2- Entering patients data in a special register which shall include the following details: Name, age, sex, type of examination and referral party according to the provision of article (13) of this Order. 3- in case of special radiology which needs prior preparations, radiology technicians shall explain in details the preparation method in clear written language. 4- Printing patient s details on all the radiographs that belong to him including: name of the center, full name of patient, examination date and register number. 5- Carrying out radiology examination by one of the means stipulated in article (1) with consideration to the quality and laws on protection against radiology hazards mentioned in appendix (2) of this Order. 6- Writing the medical report by a specialist radiology doctor. 7- Reports shall be sent after approval by radiology doctor to the referral doctor and a copy of which shall be kept at the radiology center. 8- Hospitals must maintain films and reports for a period not less than 5 years as of the last radiograph done for the patient. 9- Carrying out first aid for patients who may become exhausted during radiology examination and in case of using colored medical drugs the first aid must be carried out under the supervision of radiology doctor or first aid specialist. 9

10 Appendix (2) Health Requirements at Radiology Examinations centers A radiology examinations center shall fulfill the following health requirements: First: The Building and its facilities and installations: 1- The building must be independent and not connected to any residence or any other premises. It must be designed in a manner that allows the carrying out of all works in a sound, comfortable and safe way. Radiology room must not be crowded with installations. 2- Radiology rooms must be designed to accommodate all the various equipment with sufficient space for movement of staff, patients stretchers. The area of the radiology room must not be less than 4-6 meters for normal radiology machine. 3- Walls, floors and ceilings of the center must be lined with easy to clean smooth tiles. Floors must be nonskid. 4- Walls of radiology rooms must be lined with protective materials against radiation in order not to allow any infiltration of radiology dose according to the Ministry s laws and the regulation on the practice of the profession issued from the Directorate of Health and British Social Insurance for The center must have tools for fixation of patients in particular the children during the radiography process in order to avoid carrying out the radiography again for movement reasons. 6- The center must be equipped with modern technology tools and equipment mainly those which ensure using least amounts of radiology in order to protect patients and staff against radiology hazards. 7- Control machine must be placed in a place protected against radiology with a glass window from which the technician can watch the patient clearly. 8- In case the radiology center is not located on the ground floor, the floors of the rooms must be covered with materials protective against radiology. 9- Powerful electricity source must be provided for the center. Lighting must be controllable. 10- Healthy methods for air-conditions must be provided and sufficient number of exhaust fans must be available. 11- Sufficient supply of pure water must be provided and there must be no contact between water used for film developing and drinking water. 10

11 12- The furniture of the center must be strong and stable, there must be also enough space between and under tables, closets and other installations in order to make them easy to reach and clean. 13- Table surfaces in film developing rooms must be non porous (do not absorb water), resistant to the effects of antiseptics, acids, alkalescents, biosolvents and moderate heat. 14- Suitable storage closets for radiographs and medicaments used in the department must be provided. 15- Wash basins shall be installed in each of the radiation and film developing rooms if possible. It is recommended that they are fixed near exist door. 16- Fire-protection equipment must be available. Electricity connections must be safe to use. Lavatories for patients and staff must be available. 17- First aid equipment must be available. Second+: Discarding of Wastes: Syringes, plastic injections, gloves, and other waste must be kept in special red bags and sent for discard according to the instructions of Ministry of Health. 11

12 Safety Requirements in Radiology Examination Centers Any Radiology Examination Center shall have a general policy for safety. This responsibility shall be undertaken by the manager or chairman or whoever acts on his behalf. Safety in the center is also the responsibility of each employee working in the lab. Each employee shall report to the head of the center any action or situation violating safety rules. Safety Precautions for Staff Working in Radiology Examination Center: 1- All the staff working at the center shall undergo medical check up to decide on their fitness for work. Special register shall be maintained for this purpose. 2- Individuals suffering from diseases which cause natural immune deficiency or those who take medicines that cause this deficiency shall not be allowed to work in a radiology center. 3- Staff shall be given vaccinations against infectious diseases. 4- Specialist radiology doctors and technicians shall abide by safety rules and regulations in order to protect the patients, other visitors and themselves against radiology overdose and they shall comply with safety rules according to the regulation on practicing the profession issued by Health Directorate and British Social Insurance for Radiology machines must contain all required safety equipment and tools to enable staff to determine the amount needed for the radiography and highlighting the part that needs radiography only such as: radiometer apparatus, filters etc. 6- Any radiology center must subscribe in a regular basis in one of the international radiometry services in order not to exceed the standard dose. A file must be maintained to register radiation dose for each employee. 7- The responsibility of providing the radiometer for registering the dosage employees are exposed to as well as maintaining files for dose results, is carried out by the concerned center. 8- Head of the center shall apply safety laws and takes necessary action when one of the staff is exposed to overdose. 9- In case an employee is transferred to another center, details on radiology dosages he has received must be sent to that center. 10- Any patients must not be exposed to radiation without a request from a medical doctor or a dentist. Redoing of radiology must be avoided. 12

13 11- Radiology technician shall take all necessary actions to reduce redoing the radiography for the patient. 12- Dosage of radiology examination must be suitable to show the radiography film readable and it is recommended to use safety tools in the radiography process. 13- In case of radiography on women it is recommended that they are in the first ten days of menstruation except for cases where otherwise required by the doctor. 14- Pregnant women especially in the first three months of pregnancy should not be exposed to ionizing radiation unless in necessary cases and after consultation of the doctor. 15- Fixed and rubber lead shields must be used to protect the staff and visitors during radiography. 16- Genital organs must be protected during radiography in particular with children by using protection tools. 17- Safety equipment must be checked regularly to ensure their effectiveness by safety officers. Reports on this check up must be maintained at the radiology center. 18- Staff shall directly submit a report to the radiation safety officer at the Ministry of Health in the event that any malfunction of the radiology machine in order to receive the required advice. 19- Use of mobile radiation machines shall be at hospitals only and for cases where the patient can not come to the center with consideration to safety laws and radiation hazards. 20- Safety systems on using dental radiology machines must be applied to reduce radiology dose on the skin of the patient. The technician must stand 2 meters far at least from the radiology pipe with the use of lead apron. 21- All TV radiography must be conducted by a radiation specialist doctor with the registration of time of radiography and use of required safety tools. 22- Mobile TV radiography machines must be operated by a well trained radiation technician. Time of radiography shall be registered in addition to the following information: Name of patient, date, age, name of surgeon and name of radiology technician. 23- Any radiology center must apply laws on storing, using and discarding of radioactive substances according to the rules enshrined by WHO and laws issued by the Ministry of Health in Bahrain regarding handling radioactive materials. 13

14 24- All exits of the center must be free from any obstacles and lead directly to an open area or path. Each exist must have suitable illuminated sign. 25- A filled fire extinguisher must be available at the center in an accessible place. 26- Signs on protection against radiology hazards must be fixed in a visible place for visitors in addition to the no smoking sign. 27- New electrical fittings or alternations or repairs shall be designed according to the specifications prescribed by the Ministry of Works, Electricity and Water. 28- Order of the Minister of State for Cabinet Affairs No (3) for 1981 on occupational safety must be visible to be viewed by all parties. 14

15 Appendix No (4) Occupational Titles, Academic Qualification And Job Duties for the Practice of the Profession of Radiography According to article (9) of this Order, various technician categories must be licensed to work in radiology departments and they should possess the following qualifications and experience: 1- Head of the Technicians: Shall have an academic degree in radiology examination or equivalent from an accredited institution after a study period not less than 4 years after the secondary school. He shall also have an experience not less than 5 years in his field of specialization. In addition to carrying out all types of radiography he shall be responsible for the following: 1- Regulation of work to ensure the good progress of services at a high level of efficiency in all units 2- Guiding senior technicians in all the departments of the center. 3- Ensuring the carrying out of maintenance work for equipment used in radiology examination. 4- Ensuring the carrying out of required maintenance work in all the units of the center. 5- Launching and supervising the quality control program in all the units to ensure the quality and effectiveness of radiology examination by using standard methods, which lead to accurate and valid results. 6- Ensuring that safety systems against radiation hazards to protect the staff, the patients and visitors. 7- In case of unavailability of direct safety officer against radiation hazards, the head of the technicians shall carry out the duties of safety supervisor against radiation hazards. 8- Helping in training of technicians within the program of continuous learning. 9- Might be called at any time to help in solving technical problems that may face the technician on duty. 10- Shall help the radiology doctor in some of the particular examinations which need specific technical skill. 15

16 2- First Radiology Technician: Must fulfill the same qualifications required for the head of the technicians and shall have an experience period not less than 3 years in his field of specialization. In addition to carrying out all types of radiology examinations he shall be responsible for the following: 1- Regulating and running the daily technical aspects in the center such as work distribution among technicians and ensuring that they carry out their duties. He shall report to head of the technicians. 2- Supervising and guiding technicians. 3- Training technicians on new radiology examination methods in the lab and ensuring that they have understood them before conducting these examinations. 4- Ensuring the quality and supervising radiology examination procedures by technicians. 5- Ensuring safety procedures followed in the unit. 6- Maintenance of equipment and ensuring their cleanliness and sound use by technicians. 7- Ensuring the ability of the new technicians to use the equipment and tools in a proper manner. 3- Radiology Technician: Shall have an academic degree in radiology examination sciences from an accredited institution after a study period not less than 2 years after the secondary school. In addition to carrying out radiology examinations he shall be responsible for the following: 1- Receive patients referred by the various clinics. 2- Fix appointments for patients of special examination and explain the preparation process for them. 3- Registering patients details in the register according to article (21) of this Order. 4- Carry out radiography for the required part only with consideration to safety rules during the process to protect the staff, patients and visitors under the supervision of first radiology technician. 5- Develop radiographs by means of development machines. 6- Ensure that the radiograph is readable and sign on the completion of the radiography process as well as arranging films to be read by radiology doctor. 16