CH 12 Patient History - Spring 2024 Patient Care (RADR-1203-22501,22502,22503,22504) (1).pdf

In this video, we're going to look at how to conduct a patient interview prior to an x-ray procedure. When you finish this video, you should be able to describe the role of the RT in taking patient clinical histories, describe the desirable qualities of a good patient interviewer, explain the value...

In this video, we're going to look at how to conduct a patient interview prior to an x-ray procedure. When you finish this video, you should be able to describe the role of the RT in taking patient clinical histories, describe the desirable qualities of a good patient interviewer, explain the value of each of the six categories of questions used in obtaining patient histories, describe the importance of clarifying the chief complaint, detail the components of each of the sacred seven elements of a clinical history. Let's look at our first patient. Mr. Smith arrived for his exam at 745. Now it is 830 and in walks Tech Julie. Julie's had a bad day and she's running 45 minutes behind schedule. She calls for Mr. Smith and asks him to follow her. Once in the room, she confirms Mr. Smith's ID by asking for his name and birthdate. She also asks Mr. Smith to confirm the test that he's having. The only question she asked about his symptoms is whether or not he has reflux. She gives him instructions on how to get dressed and says she's going to finish setting up the room. This is not how to conduct a patient interview. When Mr. Smith leaves his exam, he's feeling very dissatisfied with the care he received. One negative experience like this can have a large impact on the perception of the hospital and the community, as word of it will spread quickly. Another result of Julie's lack of patient care is that the radiologist does not have a full patient history to refer to when reading the images. It can be difficult to ask all of the necessary questions while the exam is already in progress. There is a better way to interview your patient. This is Ms. Johnson. She has been waiting for her exam for 45 minutes. This is Sam. He's had one disaster after another today, but he's managing to keep a smile on his face. He calls for Ms. Johnson and asks her to follow him. In the hallway, Sam takes a quick second to apologize. An apology can go a long way for making a patient feel cared for. Once in the room, Sam identifies his patient with both her full name and her date of birth. This is very important. He also lets her know that he's going to ask her some questions. Sam begins his interview with an open-ended question. You want to let your patient tell their story. As the interview progresses, Sam begins using probing questions. This will allow him to focus the interview and to get more detail from Ms. Johnson. Facilitating questions encourage the patient to elaborate. Sam continues to use a combination of the probing questions and facilitating questions in order to make sure that he has identified all of the sacred seven elements of a clinical history. Sam even uses silence in order to give his patient time to think. Rewording or repeating a patient's answer allows for clarification of the information. During his interview with Ms. Johnson, Sam makes sure that he has identified her chief complaint, noted the onset and chronology of her symptoms, localized the site of her symptoms, as well as their quality and severity. Sam also takes note of any aggravating or alleviating factors, along with any other symptoms Ms. Johnson is experiencing. Sam wraps up the interview by briefly summarizing his notes to make sure he has an accurate patient history. He also thanks Ms. Johnson. Thank yous go a long way in providing great patient care. After her test, Ms. Johnson leaves, feeling that she was given a thorough exam and word of her positive experience at the hospital spreads out into the community. She is confident they will finally figure out what is going on with her. As technologists, we serve as the link between the radiologist and the patient, and we should take this role very seriously. Sam's notes provide a full picture of the problem to the radiologist so that a better diagnosis can be made. Serious conditions may be missed if a radiologist is not aware of all of the symptoms. During his interview, Sam used six types of questions. Open-ended, facilitation, silence, probing, repetition, and summarization. The sacred seven are the localization, chronology, quality, severity, onset of symptoms, aggravating or alleviating factors, and associated manifestations.