Topic 1- The Technologist and The Patient.pdf

TOPIC 1: THE PATIENT & THE TECHNOLOGIST  DIAGNOSTIC IMAGING TECHNOLOGY Diagnostic Imaging Technology is a hands-on, multi-faceted health care profession that requires impeccable communication skills Also referred to as “Medical Imaging”, uses specialized equipmen...

TOPIC 1: THE PATIENT & THE TECHNOLOGIST  DIAGNOSTIC IMAGING TECHNOLOGY Diagnostic Imaging Technology is a hands-on, multi-faceted health care profession that requires impeccable communication skills Also referred to as “Medical Imaging”, uses specialized equipment, techniques, and different types of radiation to image the internal structures of the human body for diagnosis and treatment of injury or disease Modalities in Diagnostic Imaging: o Radiography & Radioscopy, Bone Densitometry, Computed Tomography and Angiography uses x-ray radiation o Magnetic Resonance Imaging uses radio waves and a strong magnetic field o Ultrasound uses sound waves (separate program)– only used for vessel localization in DI https://www.britannica.com/science/diagnostic-imaging 2 Many different types of specialists make up the health care team, such as: -nurses -physicians -technologists -therapists -social service counsellors -technicians -technical assistants -chief technologists -clinical instructors -etc 3  THE DIAGNOSTIC IMAGING TECHNOLOGIST The Diagnostic Imaging Technologist or Medical Imaging Technologist (MIT) is a qualified professional who produces diagnostic images of specific internal structures of the patient's body on the order of the requesting physician or other qualified medical professional. In addition to radiography, the MIT or RT is also qualified to work in specialty areas that also use x-rays such as CT, General Radioscopy, Angiography & Interventional Procedures (extra training). They may also be qualified to work in Mammography (extra training and certification) They may also be qualified to work in Magnetic Resonance Imaging (MRI) which uses radio-waves and a magnetic field to produce images Only Radiologists have the mandate to interpret the images produced by the MIT and make a diagnosis *** official order or authority to do something 4  THE DIAGNOSTIC IMAGING TECHNOLOGIST GENERAL REQUIREMENTS (page 21, Torres– 9th edition) demonstrate an understanding of human anatomy, physiology, pathology, and medical terminology maintain a high degree of accuracy in radiographic positioning and exposure technique possess, apply and maintain knowledge of radiation protection and safety independently perform or assist the physician in the completion of radiographic procedures prepare, administer, and document activities related to medications in accordance with provincial and federal regulations or lawful institutional policy are the primary liaison between patients, physicians, and other members of the support team must remain sensitive to the needs of the patient through good communication, patient assessment, patient monitoring, and patient care skills participate in quality improvement and continually assess their professional performance think critically and use independent, professional, ethical judgment in all aspects of their work engage in continuing education to include their area of practice to enhance patient care, public education, and technical competence teach and train student technologists and other technologists 5 The Diagnostic Imaging Technologist scope of practice: (page 21, Torres– 9th edition) Providing optimal patient care Receiving, relaying and documenting verbal, handwritten and electronic orders in the patient’s medical record – HIS & RIS Corroborating a patient’s clinical history with procedure & ensuring information is documented & available for use Verifying informed consent for applicable procedures Preparing patients for procedures Assuming responsibility for patient needs during procedures Applying the radiation protection principles of ALARA (as low as reasonably achievable) to minimize exposure to patient, self and others Optimizing technical exposure factors in accordance with the principles of ALARA Performing venipuncture as prescribed by a physician Starting, maintaining and/or removing intravenous (IV) access as prescribed by a physician Identifying, preparing and/or administering medications as prescribed by a physician Evaluating images for technical quality, ensuring proper identification is recorded Identifying and responding to emergency situations Educating and monitoring students and other health care providers Performing ongoing quality assurance activities – e.g., quality control of equipment Applying the principles of patient safety during all aspects of patient care – “never compromise the well being of the patient” Performing diagnostic radiographic and non-interpretive radioscopic procedures as prescribed by a physician Assisting the radiologist or other specialized physicians with radioscopic and specialized radiologic procedures 6 7  The technologist: (*SoP, Section: Normes de Pratique Générales, pages 7 & 8) https://otimroepmq.ca/wp-content/uploads/2023/07/Normesdepratiquegenerales-Septembre2017.pdf understands and observes the Technology Act in medical imaging, the Code of ethics (RLRQ c. T-5) and other laws and regulations inherent in the exercise of his profession must be a member of the OTIMROEPMQ and annually provide to the employer a proof of the validity of his license to practice Does not tolerate or promote illegal exercise of the profession as it is an act derogatory to the profession May practice in all sectors without discrimination on condition that he is qualified and meets the profession’s Code of ethics. The employer has the privilege to determine the functions of the technologist to the extent permitted by law. *Standards of Practice (SoP): A set of recommendations by the OTIMROEPMQ on the practice of the profession Normes de pratique et lignes directrices | OTIMROEPMQ 8  OTIMROEPMQ Mission de l'Ordre | OTIMROEPMQ L’Ordre a pour mission de protéger le public dans les domaines de l’imagerie médicale, de la radio-oncologie et de l’électrophysiologie médicale. Registre des étudiants | OTIMROEPMQ T-5, r. 1 - Regulation respecting the professional activities that may be engaged in by persons other than medical imaging technologists, radiation oncology technologists or medical electrophysiology technologists (gouv.qc.ca) 9 The technologist in his/her practice: (SoP, Section: Normes de Pratique Générales, pages 7 & 8) Adopts a professional attitude towards the patient Respects the autonomy and the rights of the patient Has the qualities essential to good human relationships (e.g., empathy, calm, care) Continues a permanent professional development process (DPP), technically & in human relations Masters all the specific knowledge relating to the examinations, treatments and intervention procedures performed (e.g., anatomy, physiology, pathology, pharmacology, medical terminology) Is concerned about the conditions in which he/she performs examinations to avoid compromising the quality of services and patient safety (e.g., State of equipment, materials, organization of work) Contributes in the development new techniques or practices Participates in scientific research in their area of ​practice Actively participates in continuous improvement activities Promotes and participates in education and information measures in the field of practice Applies to each examination the specified protocol which is determined by a specialized physician or the department depending on the procedure. Protocols can be transmitted to the technologist in writing, verbally or via a document endorsed by the relevant body. 10  PERSONAL CHARACTERISTICS & SKILLS Strong problem-solving skills Strong technical skills Excellent critical thinking and judgment Empathy and compassion towards patients Excellent communication and interpersonal skills Ability to adapt to challenging and stressful situations Ability to work autonomously & collaboratively on a team 11  TECHNOLOGIST VERSUS TECHNICIAN (Adler page 11) A Technologist refers to an individual who is competent in a technology and has higher level problem-solving skills than a technician does in that particular field. Technician refers to an individual who performs tasks requiring attention to technical detail. Technicians work under the direction of the technologist. Unfortunately, technologist and technician are often used interchangeably, but the responsibility, scope of practice as well as mandate is much different. A technologist has more responsibility and requires a higher level of education. A technician may have more of a supporting role 12  CRITICAL THINKING SKILLS from Adler Textbook - page 30 to 37 Objective and unbiased analysis and reflective evaluation of facts leading to a decision (judgement) Professional judgement and unique decision-making - Every patient situation & challenge is different A patient’s condition may require quick-thinking and a creative response and should be performed appropriately and professionally with utmost patient care. Critical thinking also involves that these decisions are taken with integrity, professional judgment, and high ethical standards. Challenges with communication, modifying procedures or treatments based on the patient’s condition, and solving unexpected equipment technical problems are just a few examples of situations that involve problem solving and critical thinking 13  Critical thinking involves learning beyond memorization of the concepts of the profession It requires that students pursue a profound long-term conceptualization of the professional protocols and standards In school, the student adapts the course material and processes it for utilization in the clinical setting Each examination may require a different application of skills and knowledge A technologist’s responsibility involves meeting the exclusive needs of the patient while completing the exam effectively and efficiently 14  Identify and Interpret Patient behaviour and capacity to determine what action is required Investigate and Evaluate patient’s cooperation and compliance with instructions to determine the next step to take. Consider all solutions and pick the best one Infer/conclude: based on the interpretation and evaluation, what was concluded regarding the patient’s abilities and level of cooperation Ability to explain Explain to the patient in terms that are understood to obtain the patient’s cooperation Reflect on the outcome Was the outcome acceptable? What could have been done better? 15 When applying critical thinking, the student technologist must: Review past experiences Examine past methods without bias (fairly) Inquisitive thinking and open minded Professional maturity and technical skill 16 RADIOLOGIST VERSUS MEDICAL IMAGING TECHNOLOGIST (MIT) Radiologists are physicians who specialize in medical imaging to diagnose and treat patients Radiologists do not perform the imaging examinations with the exception of some interventional procedures They review and interpret the medical images in making a diagnosis 17  THE PATIENT What is a patient? A person receiving or registered to receive medical treatment and health care services, (in Quebec also referred to as the client) A patient must be clinically assessed by a physician before receiving any type of diagnostic examination 18  TYPES OF PATIENTS Age Groups Pediatric o Neonates (0 to 4 weeks) o Infants (1 to 12 months) o Toddlers (1 to 3 years) o Preschoolers (3 to 6 years) o School children (6 to 12 years) Adolescent o Adolescents (12 to 19 years) Adult o Young adults (19 to 25 years) o Adults (25 to 45 years) o Middle age (45 to 65 years) Geriatric o Mature (65 years and older) 19  PEDIATRIC PATIENTS Require special attention A positive relationship must be established Get down to a child’s level physically, verbally and in demeanor Pediatric patients can present a challenge The technologist should have patience, understanding, proper communication skills & effective immobilization devices 20 Communication with pediatric patients is not limited to just words... o Touch o Physical proximity o Environment o Listening with impartiality o Visual communication o Tone of voice o Body language o Timing o Have rapport with family o Open to questions 21  ADOLESCENT Focuses on body awareness Special consideration to avoid embarrassment when changing clothes and during examinations Becoming independent and often appreciate being treated like an adult, (conversation, preferences, and consultations) 22  ADULT When poor health or a threat of poor health occurs, the concern and focus is on how to maintain responsibilities rather than health and wellness Effective communication 23  GERIATRIC ID arm band Important to interact and treat them like mature adults Accommodate them with gentle handling and extra time for positioning & movements Respectful and patient verbal responses 24  Effective communication requires understanding emotions o Patients demonstrate a wide range of emotions, and the way technologists handle those emotions relies on how well they understand not only the emotions exhibited by their patients but also how well they understand their own Understanding is one of the concepts involved in emotional intelligence (EI) o Emotional Intelligence: The capacity to be aware of, express one’s emotions and handle interpersonal relationships empathetically and carefully 25  HOSPITAL STATUS: INPATIENT Someone admitted into the hospital for treatment Important to gain their confidence May be agitated or confused Previous experiences may have shaped the way they respond 26  HOSPITAL STATUS: OUTPATIENT A patient who has come to the hospital for diagnosis or treatment but does not occupy a bed They often expect to be seen immediately because they have an appointment As a professional you should provide the same care to all patients 27  HOSPITAL STATUS: EMERGENCY A seriously ill or trauma patient may act differently because of pain, stress, confusion or anxiety Try to determine the patient’s coherence level o It is important that the patient understands instructions if possible o Letting patient know what is going on is reassuring Important to work quickly and efficiently while continuing to communicate Watch for visual indications of changes in vital signs 28 PATIENT WITH SPECIAL NEEDS: LEARNING DISABILITIES Important interaction skills and immobilization techniques strong reassuring voice 29  PATIENT WITH SPECIAL NEEDS: PHYSICAL DISABILITIES Communicate o patient can inform the technologist of his/her abilities to help o the technologist should adapt to the patient’s specific needs o Reassure the patient with gentle touch if possible Impaired Vision/Blind Patient o Gain the patient’s confidence by giving clear instructions o Reassure the patient with gentle touch if possible Speech and Hearing Impaired o Pantomime and demonstration work well o Writing the instructions o Reassure the patient with gentle touch if possible Amputee o Treat like other patients 30  CONFIDENTIALITY AND ETHICS Health related information about the patient should not be revealed to others Code of Ethics (OTIMROEPMQ and CAMRT) 31  PATIENT CARE patient care refers to: Illness prevention treatment management of illness preservation of physical and mental well-being through medical services 32  GENERAL PATIENT CARE Hospital Environment Conditions: Temperature: Average 18.3 to 20C (65 to 68F) Humidity: 40-60% Light: o too low - patients become drowsy o too high - patients will suffer fatigue Ventilation: o cross ventilation using fans or air conditioning in the summer and heating in the winter o Air should be changed at least five times per hour 33 Colour of Surroundings: preferably not a dark colour as this can be depressing as well as unnecessary. Cream or pastel colors are more restful. Noise Control: Medical monitoring devices used for the patients' well-being are necessary; however unnecessary shouting and other loud noises should be avoided. 34  COMFORT Comfort and security are very important to the patient. Patients are not in the comfort of their home and may often feel afraid and anxious (This is true of the elderly patients and children). Pillows, padding, sponges, blankets should be used to make the patient feel comfortable. This will provide confidence in the patient and therefore will be more cooperative during the examinations. The unknown can be fearful  COURTESY AND RESPECT The patient has the right to considerate and respectful care. In the moment of contact, when the first impression is to be made upon the patient, he/she must be greeted by name (double-identification) and with a smile. An accurate, lucid, adequate explanation should be given to the patient of the procedure in which he is to play so important a part. This explanation will enable the technologist to identify the patients’ level of cooperation and reassure them and make them cooperation easier and more certain. Remember that being courteous means being polite and considerate in manner and action. When patients are taken to the examination room, all must be ready to receive them, and the room must have been tidied after the previous examination. Patients MUST be treated with respect regardless of their race, age, sex, gender, religion, social or economical status, handicap, personal attributes, or the nature of the health problem.  The patient is the MOST IMPORTANT person in the hospital, unfortunately he/she will seldom look and feel as if he/she were Medical Imaging Technologists are members of a team of health care professionals who work together to maximize patient wellness and provide care 37