Patient Care and Management

CHAPTER 13


Patient Care and Management





Objectives


On completion of this chapter, you should be able to:


• Prevent injury to the patient during a radiographic examination.


• Protect the patient, yourself, and others from contagious diseases by practicing proper isolation, sterile, and aseptic techniques.


• Reassure and comfort, within the limits of your training, the anxious or fearful patient.


• Use proper body mechanics when moving and transferring patients.


• Discuss the importance of maintaining the existing status of indwelling catheters and other patient attachments.


• Explain what is meant by monitoring vital signs, and describe the radiologic technologist’s role in this aspect of patient care.


• Discuss the significance of requiring clinical information when radiographic service is requested.


• Explain the importance of recording or charting patient information.



Key terms



Prevention is always better than treatment for the patient with injury or illness, but no one is immune to illness, natural disasters, or human error. Care must be taken to ensure that good patient care and management are provided. Although we know that different measures will be required for varying circumstances, the principles of care and protection are constant and cannot be overemphasized. The following requirements are required for optimal patient care:



To ensure that these five requirements are met, certain policies and procedures are necessary. These may be written in detail in the hospital or department policy manual and will serve as the basis for performing certain patient care functions.



Verification of patient identification and procedures requested


The information on the examination request form must be immediately verified or matched to the patient’s wristband on the patient’s arrival to the radiographic room. In the event that the patient has not been identified or is unable to give identification, an emergency control number should be assigned with hospital chart verification so that a cross-reference can be made at the time of identification.


To assist further with properly identifying a patient, many imaging departments require that the patient’s name, date of birth, facility identification number, and date of the examination be photographed on the images.


The radiology physician director, hospital administrator, and radiology administrator share the responsibility for establishing procedures for requesting radiographic service and for maintaining radiographic films, tapes, and other records of the patient’s medical history.


The radiology physician director maintains the responsibility and final approval of the examination requested and can cancel or terminate the procedure at any point. Clinical information about pregnancy or possible pregnancy or precautions to be observed because of special conditions such as deafness, blindness, diabetes, heart problems, and allergies are required in most departments.



Patient transfer


Often a medical emergency occurs when a patient is transported to or from the radiographic suite or in the radiographic area. Therefore all students or any radiology staff involved in patient care must be qualified in cardiopulmonary resuscitation (CPR), which is the restoration of function of the heart and lungs after apparent death. Transport equipment such as wheelchairs, stretchers, and beds should be kept in proper working order. Ancillary equipment such as step stools and intravenous stands must also be maintained, and preventive maintenance safety checks should be conducted often. On arrival at the patient area, an assessment of the patient’s condition and wristband identification should be made. The ability of the patient to help him- or herself, the patient’s injury, and the auxiliary equipment necessary for the patient’s condition must be observed, as well as any further precautions noted on the requisition.


Patients must be informed as to where they are to be transported, and assistance must be given when necessary to ensure safe and comfortable transport. The responsible unit personnel should be advised of the patient’s destination. Care should be taken to ensure safety to both the patient and the employee. Should the transporter need assistance, the patient should not be moved until such time that sufficient trained staff is available.


Proper body mechanics (i.e., the action of muscles in producing motion or posture) can best be practiced by employees who have been trained in such techniques. Although a detailed discussion is not appropriate in this text, a few salient points may be helpful. The most important point to keep in mind is that, at all times, human action is influenced by gravity. The center of gravity in the standing human being is at the center of the pelvis. Equilibrium or balance is maintained when the gravity line passes through the base support; the gravity line is an imaginary vertical line that passes through the center of gravity. Stability of a body is increased by broadening the base support. Therefore balance is maintained more easily with the feet spread apart than when they are positioned close together. When lifting or moving a patient, you will want to use this advantage and spread your feet slightly to maintain your balance and stability. Lowering the center of gravity also increases stability. The amount of muscular effort required to maintain stability is directly related to the height of the center of gravity and to the breadth of the base support. Therefore to conserve energy and to reduce the strain on your muscles when lifting or moving patients, lower your body’s center of gravity and broaden your base of support. When lifting an object from the floor, you should bend your knees because this serves as a shock absorber; do not bend from your waist. When lifting a patient, spread your feet slightly to increase your base support, and hold the patient close to your body so that the center of gravity is balanced over both of your feet. Protect your spine by using your arm and leg muscles (Fig. 13-1).


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Mar 2, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Patient Care and Management
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