MR Safety Self-Audit Checklist: ACR/MHRA Aligned

A structured self-assessment for MRI departments, aligned with the ACR Manual on MR Safety (2026), MHRA Safety Guidelines for MRI Equipment in Clinical Use, 5th edition (2026), and RANZCR guidance. Work through each section with your MRSO; anything left unticked is your corrective-action list. Pairs with our generic departmental protocols.

Updated September 2026

On this page

1 · Zoning, Signage & Access Control 2 · Screening 3 · Personnel, Training & Roles 4 · Equipment & Ferromagnetic Control 5 · Emergency Preparedness 6 · Quality Assurance & Maintenance 7 · Contrast & Renal/Pregnancy Policies 8 · Governance, Documentation & Incidents

On this page

How to use: tick items as you verify them (ticks are not saved between visits; print the completed page, or print blank and complete on paper for the safety file). Suggested frequency: full audit annually, spot-check quarterly.

1 · Zoning, Signage & Access Control

Four zones defined on a site plan; Zone III/IV physically restricted (lock or badge) at all times, 24/7.
Zone IV door has lighted “Magnet On” / “The magnet is always on” signage, visible and functioning.
Door interlock/self-closing mechanism working; door not propped open unattended.
Fringe-field contour mapped, marked, and contained within Zone IV / the controlled access area. Record which contour the site plan uses: 0.9 mT (9 G) per IEC 60601-2-33 Ed 4.0 (2022), endorsed by the ACR 2026 Manual, or the older and more conservative 0.5 mT (5 G). A site drawn at 5 G needs no adjustment.
Access-holder list current; leavers removed; out-of-hours access documented.
Zone IV never occupied by an unscreened person without Level 2 supervision (spot-check logs).

ACR MR Safety 2026: zoning; MHRA 5th ed. (2026): MR Environment, ACR-equivalent controlled access; IEC 60601-2-33 Ed 4.0 (2022) fringe-field limit

2 · Screening

Written patient screening form in use, signed by patient and countersigned by Level 2 staff (sample 10 records for completeness).
Final verbal check at the Zone IV threshold is routine practice (observe).
Documented pathway for unconscious/non-communicative patients.
Implant verification against manufacturer labelling documented, including all MR Conditional conditions checked on this scanner.
Staff screening on appointment + annual re-attestation, records current for all MR personnel.
Visitors, contractors, and service engineers screened and escorted; permit-to-work in place.
Metal-free gowning policy in use; ferromagnetic detector (if fitted) used as adjunct only.

ACR MR Safety 2026: screening; MHRA 5th ed. (2026)

3 · Personnel, Training & Roles

MRMD, MRSO, and MRSE (or access to one) formally appointed in writing, with named deputies.
Level 1 / Level 2 personnel register current; training within the last 12 months for everyone on it.
Ancillary staff (cleaners, orderlies, security, biomed) inducted annually; records kept.
Annual drills completed: Zone IV arrest evacuation (with code team), fire response, quench tabletop.
New starters supervised until competency sign-off; evidence on file.
Pregnant-staff policy documented and communicated.

ACR MR Safety 2026: personnel; MHRA 5th ed. (2026): roles incl. MR Responsible Person, MRSE

4 · Equipment & Ferromagnetic Control

All Zone IV equipment labelled MR Safe / MR Conditional (with conditions available) / MR Unsafe excluded.
Unlabelled items treated as MR Unsafe; quarantine process exists.
Quarterly Zone IV equipment inventory audit up to date.
MR Conditional trolley, wheelchair, IV pole, and aluminium O2 cylinder available and identifiable.
MR Conditional physiological monitoring available for sedated/anaesthetised patients and used within its conditions.
MR Conditional (CO2, non-ferromagnetic) fire extinguisher present; no steel extinguishers in Zone IV.

ASTM F2503 labelling; ACR MR Safety 2026; MHRA 5th ed. (2026)

5 · Emergency Preparedness

Staff can state the difference between table stop, emergency (electrical) stop, and quench button, and locate all three (spot-quiz).
Cardiac-arrest-in-Zone-IV procedure posted; designated resuscitation point in Zone II/III; door-guard role assigned.
Code team knows not to enter the magnet room; joint drill within the last 12 months.
Quench criteria and post-quench actions documented; quench pipe inspection in maintenance records.
O2 depletion monitor fitted, alarming to control room, in test schedule.
Contrast reaction algorithm, drugs, and documentation form immediately available; observation policy defined.
Fire service pre-plan on file: MR briefing, familiarisation visit, and quench-before-entry rule agreed.
Power-failure procedure covers manual table release and door failsafe behaviour (staff know which way it fails).

ACR MR Safety 2026: emergencies; MHRA 5th ed. (2026)

6 · Quality Assurance & Maintenance

Daily start-of-day checklist in use and initialled (sample the last month).
Weekly phantom QC performed, trended, with defined action limits.
Annual medical physics performance survey completed and actioned.
Vendor planned preventive maintenance up to date; reports filed.
Coil and cable condition checks documented; damaged items withdrawn.
RF shield integrity checked after any building work near the magnet room.

ACR MRI QC Manual; MHRA 5th ed. (2026)

7 · Contrast & Renal/Pregnancy Policies

Gadolinium policy current: agent selection (macrocyclic preference), dosing, renal function pathway, NSF risk groups.
Pregnancy policies (patients and staff) documented and consistent with current ACR guidance.
Extravasation and reaction management pathways posted; adrenaline and emergency drugs in date.
Adverse reactions reported to the national pharmacovigilance scheme (check the last event was reported).

ACR Manual on Contrast Media (current); ESUR Contrast Media Safety Committee Guidelines 2025

8 · Governance, Documentation & Incidents

All MR safety policies version-controlled with author, approver, and review date; none overdue.
MR safety file complete: policies, training records, maintenance, QA logs, incident log, previous audits.
Incidents AND near-misses being reported (a register with zero near-misses is a red flag, not a good sign).
Corrective actions from previous incidents/audits closed out.
MR safety meeting held at least quarterly with minutes.
Device-related harm reported to the national regulator (Medsafe / MHRA / TGA / FDA) where required.

ACR MR Safety 2026: governance; MHRA 5th ed. (2026)

Scoring guide: every unticked box is a corrective action. Prioritise anything in sections 1, 2, and 5 (zoning, screening, emergencies). These are where serious MR accidents originate. Re-audit after corrective actions and file both versions.

MR safety

Guidelines comparison Implant & device checkers SAR reduction Clinical safety & care Gadolinium guide Reaction card MRSO/MRMD/MRSE

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Educational reference for imaging professionals. It does not replace local policy, manufacturer labelling or clinical judgement.

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