Patient and Patient Care LM PDF

HSMI 1211 Introduction to Medical Imaging Patient and Patient Care in Medical Imaging Learning Objectives 1. Define “Patient” and “Patient Care”. 2. List and discuss the “Rights of the patient”. 3. Identify the various types of patients that require radiograp...

HSMI 1211 Introduction to Medical Imaging Patient and Patient Care in Medical Imaging Learning Objectives 1. Define “Patient” and “Patient Care”. 2. List and discuss the “Rights of the patient”. 3. Identify the various types of patients that require radiographic examinations. 4. Discuss factors related to patients undergoing radiological examinations. 5. Define the terminologies associated with the type of patient. 6. Discuss the common problems related to the different types of patients. 7. Identify ways to overcome the problems related to the different types of patients. 8. Identify patients who need special attention. 9. Understand the needs of the patient. 10. Relate the basic aspects of patient care in relation to the Islamic perspective. 11. Summarize the overall role of the radiographer with respect to patient care in medical imaging. Introduction Patient A person who requires, seeks, or receives medical attention, treatment or care to be provided for or provided by a healthcare provider, facility or agency. For medical imaging radiographer, the first encounter is when he identifies the patient from the request form. Introduction Patient Care The service (attention, treatment, care) provided by a healthcare practitioner or a healthcare institution to any patient for a given medical condition. Type of services and promptness may differ, depending on the patient’s needs. In-patient Patients that need hospitalization Out-patient Patient that does not need hospitalisation THE DIFFERENCE BETWEEN INPATIENT AND OUTPATIENT SERVICES Introduction In medical imaging, patient care also varies depending on the following: the condition of the patient. the type of examination that the patient needs to undergo. As a radiographer, how do you fulfil the patient’s expectations and improve the patient’s experience? The Rights of A Patient In 1948, the Universal Declaration of Human Rights was declared by the General Assembly of the United Nations. All human beings are born free and equal in dignity and rights without distinction of any kind race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. In medical field, the Universal Declaration of Human Rights is translated into “Rights of the patient”. The Rights of A Patient Malaysian Medical Association “Every individual shall have access to competent health care and treatment regardless of age, sex, ethnic origin, religion, political affiliation, economic status or social class.” Outlines what the patient can expect from the institution or service provider attending to his medical situation. The rights of patients may defer from institution to institution or department to department. Depending on the nature of their services The rights of patients are now presented in “Patient Charter”. Patient Charter Adopted by the United Kingdom in 1991. A government document that outlines several National Health Service (NHS) patient rights. Outlines patient’s rights with respect to hospital treatment, community treatment, ambulance, dental, optical, pharmaceutical and maternity.  Patient Charter (Malaysia) https://jknselangor.moh.gov.my/htar/en/about- https://sasmec.iium.edu.my/v2/images/sasmec/Patient/SAS us/client-charter MEC_PATIENT_RIGHT.pdf Similarities of the right’s of patients between countries and institutions: Have access to competent health care and treatment regardless of age, sex, ethnic origin, religion, political affiliation, economic status or social class and expect considerate and respectful care. “..patient has the right to a care that is Be given high-quality and safe care. free from biases, sexual and religious discrimination. ……taking into consideration his privacy and Have his privacy and confidentiality protected. confidentiality”.. -Zainul Ibrahim Zainuddin, 2014- Receive informed consent from the attending physician before any procedure or treatment. Refuse to participate in research. Privacy The healthcare provider’s obligation is Changing room/space (with curtain) to ensure that the patient is secluded - open in the examination room not from the presence or view of others in in the public waiting area. certain situations. In medical imaging department, some procedure requires the patient to change to a hospital garment. Removal of radiopaque materials that can cause artefacts and misdiagnosis. Ease the positioning of patients and give comfort to patients. For patient safety (MRI), ferromagnetic materials need to be removed. Confidentiality The obligation to keep details of a patient only to those authorised to have access to the information. The confidential details of patients are not allowed to be disclosed to those with no professional obligation to the patient. Medical condition The reason for undergoing the radiological examination Medical images Informed Consent The signed agreement of the patient to undergo a certain medical procedure (including medical imaging) after the patient understands the implications or risks involved in the procedure. For medical imaging: Patient can be assumed agree to undergo radiological examination after consultation with doctor. However, radiographer is still expected to brief patient about the examination before the start of the procedure. Other specific right of patient Determine the patient’s waiting time. Example in medical imaging: patient will not be made to wait for more than 45 minutes for the completion of an x-ray examination. To provide the chaperon if a female patient is attended by a male radiographer.  Aurah in Medical Imaging? If the patient is a woman, priority should be given first to a Muslim woman doctor, then to a non- "Harm necessitates the unlawful" Muslim woman doctor, then to a Muslim male doctor and finally to a non-Muslim male doctor. This is because (being forced) to see the aurat of the same gender is lighter (safer). "Harm (taken only) is sufficient only as necessary" [See: al-Mausu'ah al-Fiqhiyyah al-Kuwaitiyyah (12/136)] https://www.muftiwp.gov.my/ms/artikel/irsyad-hukum/umum/3835-irsyad-al-fatwa-siri-ke-337-siapakah-yang-lebih-didahulukan-antara-doktor-lelaki-muslim-dengan-doktor-perempuan-bukan-muslim-bagi- menyambut-kelahiran-bayi Patient Responsibilities The responsibility to maintain one’s health through a healthy lifestyle. not to interfere with the well-being or rights of other patients or health care providers. Shall accept all the consequences of the patient's own informed decisions. To take necessary preventive measures in case of infectious diseases as per the doctor’s instructions. Violations of patient’s right - Radiographer Did not identify the patient correctly. Fail to obtain a proper history from the patient It’s all about before contrast media administration. communication No explanation of procedure. skills. Informed consent from women of childbearing age. Not observing patient’s privacy at all times. Did not apply optimisation in producing radiographic images. Acting beyond the jurisdiction of a radiographer. The clinician should convey the patient’s result. Characteristics of Patients for radiological procedures Characteristics of Patients: Gender Might not influence the technical aspects. Has implications on safety considerations in examinations using ionising radiation. Female need more time to change to hospital gown. Characteristics of Patients: Age Experience changes to physical, physiological & psychological characteristics. Level: Neonate/newborn (1 month old) Infant ( 1 month to 12 months old) Toddler (12 months to 4 years) Adolescent/teenager Adult Geriatric Influence: Technical (eg: osteoporosis) Safety measures (young, geriatrics) Characteristics of Patients: Race Differentiated by: Physical appearance: skin color, cranial or facial features, hair texture Language & dialects; communication barrier Culture & belief Characteristics of Patients: Religion A person who submits himself to a particular religion must follow certain obligations as outlined by the religion. Examples: A married Hindu woman shall not remove her wedding necklace (thalli) for it is forbidden by her beliefs. Only the husband can remove the thalli without serious consequences to their marriage. A Buddhist monk will not take off his saffron robes for an X-ray examination involving the abdomen. A Muslim woman usually will not take off her headscarf in front of men other than her immediate family members. Radiographer: Accommodate to religious beliefs by applying modifications to the procedure. Characteristics of Patients: Body Habitus Different variations in body shape or the type of physique of a particular person. Attenuation concept Influence: Technique Contrast media considerations Characteristics of Patients: Physical Aspects “Anything pertaining to the body”, distinguished from the mind or spirit. Term related to physical” Disability - condition or function judged to be significantly impaired functioning of an individual that include, physical impairment, sensory impairment, cognitive impairment, intellectual impairment, mental illness, and various types of chronic disease. Mobility- movement pf patient Level of consciousness-conscious, semi-conscious, unconscious. Radiographer: Restore confidence to patient, inform current status of the procedure again and again. Communication (Reassurance) Monitoring, assisting Characteristics of Patients: Physiological/Pathological Aspects Physiology: refers to the functions of the various body systems in the body. Pathological: the changes in functional of the system as a consequence to a disease. Radiographer Aware of the various pathologies that can influence their technical considerations. Osteoporosis: reduce radiation exposure Ascites: increase radiation exposure Characteristics of Patients: Psychological Aspect Defined as “the science that deals with mental processes and behaviour” – relate to the mind or emotion. Radiographer Observation Should show high level of understanding, compassion, empathy Special Imaging Considerations: Traumatic Injuries Definition: serious injury or shock to Classifications of injuries the body, as from violence or an accident. Head Considerations: Spinal cord Level of pain acceptance Fracture Signs of shock observation Modification to the technical aspects; positioning techniques Minimize patient’s movement, pain & discomfort Use of accessories & positioning aids Preventive measures against risk of cross-infection Special Imaging Considerations: Traumatic Injuries Special Imaging Considerations: Traumatic Injuries Special Imaging Considerations: Bedside Radiography Radiological examinations on patients who’s conditions does not permit them to be sent to the Radiology department. Radiographs are needed to be used as a baseline reference before start of treatment and to assess progress of treatment. Mobile unit has limited capabilities. Radiographer: Modification of techniques Considerations: Cross infection Radiation safety; other patients, staff, public Patient with mechanical ventilators & tracheostomy tubes Post Procedural Care Objective To educate the patient on what to expect after the procedure. Example: Examination involving the use of contrast media. Radiographers needs to inform patient: The symptoms or effects of the contrast media. The necessary action should be taken if those effects happen. On when to present himself for the outcome of the radiological examination. Islamic Inputs in Patient Care To be fair to everyone. The existence of various races is to encourage people to know each other better. Islam detests those who do injustice to others and champions its followers to do good deeds for the young and the elderly. The thought of bringing harm to others should not be in the mind of any Muslim. Islam expects its followers to respect the beliefs of others, and this is evident in the last verse of Surah Al-Kaafirun. Sayyidina Umar Ibnu Khattab also demonstrated this respect when he prayed outside the building once used by the Christians during the liberation of Jerusalem during his reign, although prompted by his generals to pray inside the building. Summary of Radiographer’s Responsibility Assessing the patient before the radiological procedure. Must consider the purpose of the examination, the patient’s condition, equipment and safety. Must assess the patient’s ability to cooperate and comply with the needs of the examination. Patient’s consciousness level, mobility and communication capabilities would be the essential considerations. Identify possible restrictions, precautions or situations that can influence the results. Presence of respiratory tubes, drainage tubes or contraindications to contrast media. Summary of Radiographer’s Responsibility Planning for the examination To formulate the best technical approach given the initial patient assessment. To ensure all safety aspects are to be observed. To see that patient comfort should be addressed most appropriately. To decide the most appropriate communication method with patients with vision or speech impairment. To ensure patient’s privacy and confidentiality are not compromised in any way. Latest update on Malaysian healthcare system. Health White Paper (2023) One of the aspirations: An equitable and person-centred health system The population has reasonably easy access to good quality and affordable health services. Service delivery would need to be transformed to be closer to the community and designed to be more in keeping with the individual’s convenience and limitations, including geographical constraints. End