SECTION 310:667-23-2. Radiological, computerized tomography, magnetic resonance imaging services

(a)   Radiology. The hospital shall maintain or have available radiological services according to needs of the hospital.

(1)   Hazards for patients and personnel.

(A)   The radiological department shall be free of health and safety hazards for patients and personnel.

(B)   Proper safety precautions shall be maintained against fire and explosion hazards, electrical hazards, and radiation hazards.

(C)   Inspection of x-ray equipment shall be made once every two (2) years by a certified health physicist or members of the Diagnostic x-ray section of the Department, and hazards so identified shall be promptly corrected.

(D)   The hospital shall identify those employees who are subject to significant occupational exposure to radiation while performing their job duties. All such workers shall be checked periodically for amounts of radiation exposure by the use of exposure meters or badge tests.

(E)   With fluoroscopes, attention shall be paid to modern safety design and good operating procedures; records shall be maintained for the output of all fluoroscopes.

(F)   Regulations based upon medical staff recommendations shall be established as to the administration of the application and removal of radium element, its disintegration products, and other radioactive isotopes.

(G)   If mammography is performed at the facility, the facility shall have a current certificate from the Food and Drug Administration as required by the Mammography Quality Standards Act.

(2)   Personnel.

(A)   Personnel adequate to supervise and conduct the services shall be provided, and the interpretation of radiological examinations shall be made by physicians or licensed independent practitioners competent in the field according to individually granted clinical privileges.

(B)   The hospital shall have a qualified radiologist, either full-time, part-time or on a consulting basis, both to supervise the department and to interpret films and studies that require specialized knowledge for accurate reading.

(C)   If the activities of the radiology department extend to radiotherapy, the physician in charge shall be appropriately qualified.

(D)   The amount of qualified radiologist and technologist time shall be sufficient to meet the hospital's requirements. A technologist shall be on duty or on call at all times.

(E)   The use of all x-ray apparatus shall be limited to personnel designated as qualified by the radiologist or by an appropriately constituted committee of the medical staff. The same limitation shall apply to personnel applying and removing radium element, its disintegration products, and radioactive isotopes. Radiology technologists shall not independently perform fluoroscopic procedures. Fluoroscopic procedures may be performed by radiology technologists only upon the written authorization of a qualified radiologist, and in the presence of a physician or licensed independent practitioner or by real time visualization through electronic means.

(3)   Signed reports.

(A)   Signed reports shall be filed with the patient's medical record and exact duplicates of the signed reports shall be kept in the department.

(B)   Requests by the attending physician or licensed independent practitioner for x-ray examination shall contain a concise statement of reason for the examination.

(C)   Reports of interpretations shall be written or dictated and signed by the radiologist, physician, or licensed independent practitioner making the interpretation.

(D)   X-ray reports shall be preserved or microfilmed in accordance with the statute of limitations and OAC 310:667-19.

(E)   X-rays and other images shall be maintained at least five (5) years. These images may be maintained in a digital or electronic format as long as a duplicate can be reproduced.

(b)   Ultrasound imaging.

(1)   Ultrasound imaging shall be performed only upon order of a physician or licensed independent practitioner.

(2)   Ultrasound imaging shall be performed by a physician or licensed independent practitioner or by a technologist that has specific training in ultrasound imaging and designated as qualified by the radiologist.

(3)   Reports of findings of ultrasound imaging shall be included in the patient's medical record.

(c)   Computerized tomography and magnetic resonance imaging.

(1)   Computerized tomography and magnetic resonance imaging may be provided.

(2)   If used by the facility, all computerized tomography (CT) and magnetic resonance imaging (MRI) examinations shall be authorized by a written and signed order from a physician or licensed independent practitioner.

(3)   CT and MRI examinations shall be performed under the direction of and interpreted by a qualified radiologist who is a member of the hospital active or consulting medical staff.

(4)   CT and MRI examinations shall be performed by a radiology technologist with documented CT or MRI training and experience and designated as qualified by the radiologist.

(5)   A qualified physician or licensed independent practitioner shall be available during the administration of intravenous contrast media.

(6)   Oxygen and emergency medical supplies shall be maintained within the CT/MRI suite or be readily available. If the CT/MRI suite is a mobile unit, the mobile unit shall contain oxygen and emergency medical supplies.

(7)   CT/MRI films and reports shall be maintained at the hospital in the same manner as x-ray films and reports.

(8)   If the CT/MRI is a mobile unit, written infection control policy and procedures and safety plans shall be maintained as part of the overall hospital plans.

[Source: Added at 12 Ok Reg 1555, eff 4-12-95 (emergency); Added at 12 Ok Reg 2429, eff 6-26-95; Amended at 20 Ok Reg 1664, eff 6-12-03; Amended at 21 Ok Reg 2785, eff 7-12-04]