Download the Radiology Department

Student
Learning
Opportunities
Radiology
1
Student Nurses - Welcome to the Radiology Department
We are an extremely busy unit providing an imaging service to Sunderland City and the
surrounding districts. Our service covers a wide range of diagnostic and interventional
procedures to a vast population suffering from various injuries, illnesses and diseases.
The department of Radiology can offer the student nurse a wide range of experience,
knowledge and skills, which can enlighten them towards procedures which patients regularly
undergo as both in-patients and out-patients. There is many opportunities to develop
knowledge and understanding of anatomy and physiology, as well as developing a greater
understanding of disease and disease process.
You will be assigned to a mentor for your time spent in the department. Your learning
outcomes and competencies will provide direction during your placement and be facilitated
where possible by your mentor. Please remember that you are responsible for your own
learning and your mentor/associate mentor is only there to advice and facilitate your learning
(Student/mentor file section 2 Roles & Responsiblities of the Learner).
If you have any queries please feel free to ask your mentor or any other staff member. The
sister is also available to assist you with any difficulties you may experience.
The modalities within the department are:
Computer Tomography (CT)
Fluoroscopy
Ultra Sound
Plain film radiography
Magnetic Renaissance Imaging (MRI)
2
The Directorate
The Directorate of Radiology comes under the Division of Clinical Support
This includes clinical directorates:
Anaesthetics
Pathology
Radiology
Pharmacy
Paramedics
Directorate of Radiology
Clinical Director
Mr G McNab
Directorate Manager / Imaging Service Manager
Mr P Stephenson
Nursing Staff
Matron Anita Hagon
Joy Champion
Barbara O’Shaughnessy
mentor)
Shirley Butler
Catherine Launder
Julie Brown
Margaret Lash
Jean Rogers
Consultants
Dr England
Dr Marsh
Dr Shirbhate
Dr Featherstone
Dr Schierle
Dr Karasek
Dr Bunea
Dr White
Dr Florek
Dr Powaska
Dr Connor
- Sister (mentor, Educational link)
- Staff Nurse (stores & supplies co-ordinator, associate
- Staff Nurse (mentor, infection control link)
- Enrolled Nurse
- Staff Nurse (mentor)
- Staff Nurse Deputy infection control link,)
- Auxiliary Nurse
Fluoroscopy Vascular/ CT
Fluroscopy non vascular/CT
Bariums/CT
MRI/CT
CT/Ultrasound/Bariums
Fluroscopy Vascular/CT
CT/Ultrasound/Bariums
CT/Paediatrics/urology
Ultrasound/ CT
Ultrasound /CT
Ultrasound/ CT
3
Departmental Philosophy
The radiology department aims to provide an efficient and effective diagnostic imaging
and interventional service. We accept referrals from Sunderland City and the
surrounding districts. Our immediate multidisciplinary team consists of:
Clerical staff, Domestic technicians, Nurses
Porters, Radiographers, Radiographic assistants, Radiologists
Furthermore, we strive to work in active partnership with our other colleagues
throughout the trust.
‘We Believe’
The Environment:
Whilst your stay in the department may be short, the atmosphere will be friendly. We
aim to be welcoming and approachable to all visitors. The department will be clean,
comfortable, safe and tidy, catering for your needs.
For our Patients:
Individual choices coupled with privacy, dignity and confidentiality. An identified
practitioner will be responsible for your care during your visit and an explanation of
each procedure undertaken will be offered to ensure you are well informed.
Relatives and Friends:
When a patient chooses to invite a friend or relative to participate in their care, we will
aim to accommodate, support and inform them where appropriate.
How we provide care:
Standards are constantly monitored to meet the changing needs and expectation of our
clients. Education is recognised by all staff as being essential for continuous
professional development and to keep abreast with research based practice.
We respect that all members of our team play a part in the delivery of care and the
maintenance of standards. As a team we strive to supports each other to reach our
goals. In order to improve our standards of care and our service to you we welcome
your constructive comments. Please use the comment boxes located around the
department or speak to a member of staff.
4
GENERAL INFORMATION
Off Duty
The department operates Monday to Friday students are expected to work from 8.30am
until 5pm, with exception of one 2pm early finish.
Uniforms
Uniforms should only be worn within the hospital therefore; changing facilities will be
arranged.
Patient Allocation
Primary nursing is in operation within the Radiology department. The primary nurse
will be responsible for the patient’s total welfare during the stay in the unit.
Daily Routine
Start
8.30
08.30 – 9.00
09.00
13.00 – 13.30
13.30 – 14.00
14.00
Set up rooms
Commence lists
Lunch
Set up rooms
Commence lists
Finish
17.00
5
COMMUNICATION SKILLS
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
Communicating with: Patients and relatives
Members of the multi disciplinary team
The whole departmental team
VERBAL COMMUNICATION:
Telephone skills
The Emergency System (Fire & Cardiac Arrest)
The Bleep System
Giving and receiving information
Observing confidentiality
Answering patient enquires
Patient Transportation
Liaising with the clinical team
Nurse hand over
Nursing staff, radiographers
Nursing staff, radiographers, doctors
Nursing staff, all department staff, patients and relatives.
All departmental staff, CHS polices
Nursing staff, radiographers, doctors, secretarial staff, patients
Ambulance liaison, portering service
Observation of roles
Registered nurses
WRITTEN DOCUMENTATION & COMPUTER SKILLS:
Care plans
Hiss system
Patient information
Investigation results
Daily lists etc.
CHS protocol and policies,
Nursing staff, radiographers, doctors, secretaries, administration
staff.
1
PRACTICAL NURSING SKILLS
LEARNING OPPORTUNITIES
Practical nursing skills:
Recording physiological observations e.g.
Pulse, Blood pressure, Oxygen Saturations, Blood Glucose
Giving medication i.e. Oral/Intravenous/Controlled Drugs
Skin care/pressure area care
IV infusions/Medical devices
Checking equipment/Emergency Crash Trolleys
Risk assessment/Patient safety
Moving and Handling/use of aids and hoists
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCE S.
Books, articles, courses, library resources and various literature,
Registered Nurses.
Books, articles, courses, library resources and various literature
Registered Nurses, Drug Administration Protocols,
Radiographers, Trust Protocols, moving and handling facilitator,
Doctors
Aseptic technique
Setting Trolleys/Preparing for Investigations
Assisting Radiologists with investigation/treatment process eg.
Angiographic catheter and wire manipulation
Cannulation/care of intravenous cannulas
Infection Control issues:
Hand washing technique as part of investigation process giving
barium/water soluble contrast:- orally
intravenously arterially rectally
Infection control link nurse. Registered Nurses. Infection Control
File, Infection Control Link Nurse. Poster Campaigns.
2
ANATOMY, PHYSIOLOGY AND PATHOLOGY
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
PROCEDURES/INVESTIGATIONS:
CT Scan
MRI
Angiography (vascular/coronary)
Angiography for the Biliary and Renal Systems
Angioplasty /Stent insertion/Thrombolysis
Balloon dilatation and stenting of oesophageal strictures
Percutaneous Transhepatic Cholangiogram (PTC)
Ultrasound examinations
Fine needle aspiration (FNA)
Biopsies
Drainages
Intravenous Urograms (IVU)
Micturating Cystograms
Barium Examinations (swallows/meals/enemas/follow-through)
Books, articles, courses, library resources and various literature
Radiologists, Radiographers, Registered Nurses, Ultrasound
Stenographers, Doctors, Radiology Procedure File
INFECTION:
Books, articles, courses, library resources and various literature
Observation of Infection Control Policies i.e. when acting as scrub Registered Nurses, Doctors, Infection Control Nurse Infection
Control Nurse,
nurse. Causes, spread & prevention
3
ANATOMY, PHYSIOLOGY AND PATHOLOGY
LEARNING OPPORTUNITIES
NORMAL ANATOMY AND PHYSIOLOGY
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCE S.
Books, Library Resources, Posters/visual aids, x-rays
ABNORMAL ANATOMY. PHYSIOLOGY AND
PATHOLOGY
(Examples you may encounter on the department)
DISORDERS OF THE CARDIOVASCULAR SYSTEM
Coronary Heart Disease
Congestive Heart Failure
Cardiac Valve Disease
Hypertension
Atherosclerosis/Peripheral Vascular Disease
Aortic Aneurysm
DISORDERS OF THE NERVOUS SYSTEM
Traumatic Brain Injury
Stroke
Subarachnoid Haemorrhage
Brain Tumour
Spinal Injury
Books, articles, courses, library resources and various literature
Radiologists. Cardiologists. Registered Nurses. Specialist
Vascular Nurse. CCU. Literature. Investigations/Diagnostic
Procedures e.g. CT, Angiography, Ultrasound/Doppler,
Electrocardiography (ECG)'
Books, articles, courses, library resources and various literature
Doctors. Registered Nurses. Radiographers. Specialist Nurses,
Literature, Rehabilitation Nurses, Investigations/Diagnostic
Procedures E.g. CT. MRI. X-RAY
4
ANATOMY, PHYSIOLOGY & PATHOLOGY
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
DISORDERS OF THE RESPIRATORY SYSTEM:
Books, articles, courses, library resources and various literature
Chronic Bronchitis/Emphysema
Asthma
Cystic Fibrosis
Lung Cancer
Chest Trauma
Pulmonary Embolism
Pneumothorax
Chest Drainage
Doctors, Registered Nurses, Specialist Respiratory Nurse, Chest
Clinic, Respiratory Ward, laboratory, Macmillan Nurse,
Investigations/Diagnostic Procedures e.g. CT, X-Ray ,
Ultrasound, CT /Ultrasound guided Biopsies, Drainage
DISORDERS OF THE RENAL AND URINARY SYSTEM
Acute/Chronic Renal Failure
Polycystic Kidney Disease
Renal Cancers
Urinary Tract Infections
Bladder Cancers
Acute/Chronic Pyelonephritis
Books, articles, courses, library resources and various literature
Doctors, Registered Nurses, Renal Ward, Renal Dialysis Unit,
Literature, Laboratory , Investigations/Diagnostic Procedures e.g.
CT, X-RA y , Angiography, Stenting, Ultrasound, Ultrasound
guided biopsies/ drainages
5
ANATOMY, PHYSIOLOGY & PATHOLOGY
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
DISORDERS OF THE GASTROINTESTINAL SYSTEM:
Nausea and Vomiting Dysphasia
Diarrhoea/Constipation
Gastrointestinal Bleeding
Bowel Obstruction/Colorectal Cancer Diverticular Disease
Crohn's Disease/Ulcerative Colitis Eating Disorders/Obesity
Gastric Cancer
Oesophageal Cancer
Books, articles, courses, library resources and various literature
Doctors, Registered Nurses, Specialist Colorectal Nurse, Library
Resources, Surgical Team, Speech Therapist, Dietician,
Investigations/ Diagnostic Procedures e.g. CT, Barium
investigations, Endoscopic Procedures, X-Ray, Angiography,
Stenting
DISORDERS OF THE ENDOCRINE SYSTEM :
Hypo thyroidism/ Hyperthyroidism Goitres
Thyroid Cancer
Diabetes Mellitus Pancreatitis
Pancreatic Cancer
Books, articles, courses, library resources and various literature
Doctors, Registered Nurses, Diabetic Specialist Nurse,
Laboratory, Specialist GI Nurse, Literature,
Investigations/Diagnostic Procedures E.g. Ultrasound, Ultrasound
guided Biopsy/FNA, Angiography, ERCP, Blood Tests
6
ANATOMY, PHYSIOLOGY & PATHOLOGY
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
DISORDERS OF THE LIVER AND BILIARY SYSTEM:
Alcoholic Liver Disease
Cirrhosis
Hepatic Failure
Tumors/Metastatic Liver Cancer Jaundice
Clotting Disorders
Books, articles, courses, library resources and various literature
Doctors, Registered Nurses, Specialist Nurses, Laboratory,
Literature, Investigations/Diagnostic Procedures e.g. CT,
Angiography, Stenting, Ultrasound, Ultrasound Guided Biopsies,
Blood Tests i.e. Clotting Studies
DISORDERS OF THE REPRODUCTIVE SYSTEM:
Testicular/Prostate Cancer
Ovarian Cysts/Ovarian Cancer
Cervical Cancer
Breast Cancer
Books, articles, courses, library resources and various literature
Doctors, Registered Nurses, Oncology Team. Breast Care Nurse.
Screening Clinics, Literature. Library Resources. Investigations!
Diagnostic Procedures e.g. CT, MRI. Ultrasound. Ultrasound
Guided Biopsy Fine Needle Aspiration (FNA)
DISORDERS OF THE SKELETAL SYSTEM :
Osteoarthritis/Osteoporosis
Trauma/fractures
Metastatic Bone Disease
Books, articles, courses, library resources and various literature
Doctors. Nurses, Radiographers, Accident and Emergency Dept.,
Literature. Investigations/Diagnostic Procedures e.g. CT. MRI, XRay
7
HEALTH EDUCATION AND PROMOTION
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
LIFESTYLE ISSUES IN RELATION TO COMMONLY
PRESENTED CONDITIONS:
Smoking
Obesity
Alcoholic Liver Disease
Diabetes
Heart Disease
Peripheral Vascular Disease
Accidental Injury
Gastrointestinal Disorders
Books, articles, courses, library resources and various literature
Registered Nurses, Mentor, Library Resources, Department of
Health Document, Government Target Initiatives. Health Action
Zones. Trust Strategies and Documents
INFLUENCED BY:
Government Target Initiatives
The role of the X-Ray Department e.g. Fast-Track Services
The Nurses Role in Health Education/Promotion
Giving Appropriate Advice
Leaflets/Poster Displays
Books, articles, courses, library resources and various literature
Mentor. Registered Nurses. Trust Strategies and Documents
Health Promotion and Health Education Literature, Specialist
Nurses
8
THE PATIENT JOURNEY AND THE NURSING PROCESS
LEARNING OPPORTUNITIES
Many of the procedures and investigations within radiology
involve nursing care. On the patient ‘s journey through Radiology
nurse contact may be brief but this should never interfere with the
standard of care given.
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
Policies and procedure files.
Sister, Mentor, Registered Nurses Sister, Mentor,
At all times the following things should be unheld:
Philosophy of care
Nursing models
Nursing policies
Standards
Protocols
Documentation
Books, articles, courses, library resources and various literature
Policies and procedure files.
Registered Nurses, Specialised Nurses, Sister, Mentor.
Managing Patient Care:
Prioritising
The nursing process – assessment, planning implementation &
evaluation.
Nurse handovers/discharge home.
Books, articles, courses, library resources and various literature
Policies and procedure files.
Sister, Mentor. Registered Nurses.
9
MANAGERIAL AND ORGANISATIONAL SKILLS
LEARNING OPPORTUNITIES
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
ORGANISATIONAL SKILLS
RESOURCE PERSONNEL~INFORMATION SOURCE
Prioritising
Time Management
Organising Procedure Lists
Organising Patient Transportation/Portering Services
Team Preparation
Organising Appropriate Skill Mix
Patient Preparation for Procedures e.g. Clotting Studies
Leadership Skills
Books, articles, courses, library resources and various literature.
Registered Nurses, Sister, Mentor, Radiographers, Doctors, etc
QUALITY ISSUES
Policies
Clinical Governance
Standards of Practice
Clinical Audit
Changing Practice
Handling Complaints
Research
Books, articles, courses, library resources and various literature.
Registered Nurses, Policy File, Performance and Governance
Dept, Library Resources, Mentor, Sister
10
MANAGERIAL AND ORGANISATIONAL SKILLS
LEARNING OPPORTUNITIES
RESOURCE MANAGEMENT
Stock Control
Ordering Pharmacy
Budget Management
RISK MANAGEMENT
Standards, Policies and Procedures
Infection Control
Clinical Supervision
Moving and Handling
Equipment/Environment Safety Check
HANDLING EMERGENCY SITUATIONS
Fire
Cardiac Arrest
Security Incidents
Accidents/Near Miss Register
SUGGESTIONS OF RESOURCE PERSONNEL&
INFORMATION SOURCES.
Books, articles, courses, library resources and various literature
Policy and Procedure Files
Sister, Mentor, Registered Nurses
Books, articles, courses, library resources and various literature
Registered Nurses. Policy Files, Infection Control Link Nurse,
Moving and Handling Facilitator, Radiographers,
Relevant literature
Fire Officer/Safety Department, Mentor, Registered Nurses
Security Officer, IM&T Security Officer. Sister, Senior
Radiographers
11
FAST –TRACK
BREAST ASSESSMENT
CLINIC
BREAST CARE
SPECIALIST NURSE
CORONARY CARE
UNIT
MRI
SURGICAL
DAY CASE UNIT
BARIUM
EXAMINATIONS
RADIOLOGY
DEPARTMENT
LEARNING
ZONE
ADMISSION
UNIT
CT SCANNERS
SPECIALIST
VASCULAR NURSE
ULTRASOUND
INTERVENTIONAL
PROCEDURES
ANGIOGRAPHIC
PROCEDURES
RENAL UNIT
MEDICAL DAY-CASE
UNIT
COLORECTAL
SPECIALIST NURSE
12
Terminology
Abscess
Localised collection of pus.
Aneurysm
A sac formed by local enlargement of a weakened artery wall.
Angiography
The radiographic study of vessels.
Angioma
A benign tumour associated with blood vessels.
Angioplasty
An angiographic procedure where a balloon is passed into a stenosed artery
And inflated with contrast medium; it presses the artheroma against the
Vessel wall, thereby increasing the lumen.
Anterior
Forward part of the body or organ.
Artefact
An area of information on a reconstructed image that does not exist in reality. It may be
caused by operator, patient motion or equipment peculiarities.
Artheriography
The radiographic examination of arteries after the injection of a radiopaque contrast
medium.
Atherosclerosis
Fibrous and fatty deposits on the luminal wall of an artery that may cause an obstruction
of the vessel.
Benign
Non malignant, simple tumour.
Bifurcation
The place where an artery divides into two branches.
Calculus
A stone.
Carcinogen
Any cancer producing substance or material such as nicotine, radiation, ingested
uranium.
Cerebrovascular
Pertaining to the blood vessels of the brain.
Crohn’s Disease
Chronic non-specific inflammation of any part of the intestine.
CT
Computed Tomography – computer constructed imaging technique of thin slices through
the body, derived from x-ray absorption data collected during a circular scanning
motion.
Cyst
Hollow sac containing fluid or semi-solid material.
Distal
Refers to parts of the body farthest from the centre, midline or trunk.
Diverticulitis
Inflammation of the diverticulae of the bowel.
Dysphasia
Difficulty in swallowing.
Despoil
Difficulty in breathing.
Embolus
Thrombus that detaches and moves freely in the bloodstream.
13
Extravasation
The escape of fluid from a vessel into the surrounding tissue.
Film Badge
A piece of photographic film in a lightproof holder worn to measure the amount of
radiation to which an individual is exposed.
Fistula
Abnormal communication between organs.
Haematemesis
Vomiting of blood.
Haematology
The science of dealing with the formation, composition, functions and diseases of the
blood.
Haematoma
A local swelling filled with blood.
Haematuria
Blood in the urine.
Haemoptysis
The coughing up of blood.
Haemorrhage
The escape of blood from a vessel.
Hydronephrosis
Distension of the kidney pelvis with urine caused by urethral obstruction.
Hypertension
Abnormally high blood pressure.
Hypotension
Abnormally low blood pressure.
Hysterosalpingogram Radiological examination of the uterus and the uterine tubes used to investigate the
patency of fallopian tubes.
IVU
Intravenous urography – radiographic visualisation of the renal pelvis and ureter by
injection of a radiopaque liquid into the blood stream.
Leaded Apron
Protective apron worn to shield the trunk of the wearer from scattered radiation.
Laryngoscope
Instrument for exposure and visualisation of the larynx.
Lateral
At or belonging to the side away from the median line.
Malignant
Life threatening tumour producing secondary effects.
Mastectomy
Surgical removal of the breast.
Medial
Pertaining to or near the middle.
Metastasis
The spread of tumour cells from one part of the body to another.
MRI
Magnetic Resonance imaging – a technique of imaging by computer using a strong
magnetic field and radiofrequency signals to examine thin slices through the body.
Nephrostomy
Surgical drainage of the kidney.
Pancreatitis
Inflammation of the pancreas.
Percutaneous
Effected or introduced through the skin.
14
Pneumothorax
The presence of air in the pleural cavity.
Proximal
Refers to a part closest to the centre, midline or trunk.
Radiograph
A photographic image formed by exposure to x-rays. (The correct term for a x-ray).
Radiographer
A person qualified in the techniques of diagnostic or therapeutic radiography.
Radiography
The use of x – radiation to create images of the body from which medical diagnosis can
be made (diagnostic), or to treat a person suffering from a malignant disease, according
to a prescribed regime (therapeutic).
Radiologist
A medical specialist in diagnosis by using x-rays and other allied imaging techniques.
Radiopaque
Having the property of significantly absorbing x-rays, therefore becoming visible on a
radiograph. Barium and iodine compounds are used as a contrast media to produce
artificial radiopacity.
Stenosis
Constriction or narrowing of a passage or orifice.
Thrombosis
Formation of a clot within a blood vessel.
U.S.
Ultrasonography – production of a visible image from the use of ultrasound. A
controlled beam is directed into the body. The echoes of reflected ultrasound are used to
build up an electronic image of various structures in the body.
Varices
Dilated veins.
Venogram
The radiographic study of veins after the injection of radiopaque contrast medium.
References
Ballinger, P.W. (1986) Merrill’s Atlas of Radiographic positions and Radiological Procedures. 6th ed.
The C.V. Mosby Company.
Brown, G. (1998) A Radiographer’s Handbook. W.B. Saunders Company Ltd.
Roper, N. Ed. (1987) Pocket Medical Dictionary. 14th ed. Churchill Livingstone
VERSION HISTORY
Version
Date
Issued
Brief Summary of Change
Owner’s Name
Live
2001
First Version
Judy Smith Staff Nurse Radiology
Live
Jan 2004
Revised Version
Claire Elwell Staff Nurse Radiology
Updated
Aug 2005
In line with Ed audit
Joy Champion sister Radiology
15