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15. Staffing of MRI units

The SCoR receives many enquiries regarding the staffing of MR units, primarily relating to the suitable skill mix and minimum staffing levels.  Generally, the SCoR tends not to be prescriptive about staffing levels as configurations will very much vary to meet local circumstances and service delivery model; rather we would suggest an approach that considers certain principles in order to provide a quality, safe and effective service for patients and staff.  Under the Health and Safety at Work Act,21 employers have a general duty to ensure the health, safety and welfare at work of all employees.  Employers are also obliged to carry out risk assessments into all aspects of working including systems and patterns of work.  When considering the staffing requirements of an MR unit, managers should take into account the following:

15.1  Safety of patients and staff

Patient safety is paramount, particularly regarding the hazards associated with the strong magnetic fields utilised in clinical MRI.  Staffing levels and competences should be such that there are no compromises to patient safety.

The MHRA advises that staff should not work alone, especially out of hours.  Where it is considered essential that staff do work alone, the Lone Worker Policy of the Trust should be considered.2

15.1.1 MR safety knowledge

The high static magnetic field strengths used in clinical magnetic resonance imaging pose additional safety consideration for departments.  It is recommended that all staff working in MR units should have as a minimum:

  • knowledge and understanding of the threats posed by the static magnetic field;
  • understanding of the environment and controlled area;
  • awareness of MR authorised personnel;
  • understanding of the screening process and access rights;
  • knowledge and understanding  of emergency procedures within the scan room;
  • understanding of the nature of a magnet quench and when a system may need to be quenched by the operator;
  • understanding of the labelling system for MR equipment;
  • understanding of the requirement for hearing protection and correct positioning;
  • understanding of the correct use and positioning of the coils and cables and ancillary equipment.

Radiographers require further post registration knowledge and understanding in the following areas:

  • Bio effects of the static magnetic field
  • Projectile and attractive forces
  • Bio effects of time varying gradient magnetic fields
  • Bio effects of RF radiation
  • Recommended exposure value limits
  • Sequence selection and parameter manipulation to minimise all of the above
  • Conditional implants and devices
  • Contrast agents and other drugs

15.1.2

All staff should have adequate training in departmental emergency procedures.

15.1.3

When considering staffing using a radiographer working alongside a non- clinically trained helper then provision must be made for adequate rest periods for the radiographer.

15.2  Equitable service provision

Managers should consider if the service being offered is of the same quality and safety for the patients and staff throughout the whole day i.e. will there be any difference in the service delivered to a patient attending at 9am than one attending at 9pm?

15.3  Skills, experience and knowledge of staff

When considering staffing using radiographers working with either a non-clinical helper or an assistant practitioner grade then the radiographer should be appropriately experienced with:

  • post registration skills and knowledge in MR
  • skills in clinical decision making eg taking appropriate action for incidental findings
  • taking responsibility for the episode of care, particularly in the absence of other staff trained in MRI.

15.4  Assistant Practitioners in MR Units

The role of an assistant practitioner in magnetic resonance imaging (MRI) is related to providing support for other registered healthcare practitioners eg radiographers and radiologists, and for aspects of patient care.22

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