Standard

Posted: 03/12/08

R State Standard £ Institutionally Developed College: N/A

RAD 136 - Clinical Radiography V

Course Description

Provides students with continued hospital setting work experience. Students demonstrate increased proficiency levels in skills introduced in Radiographic Procedures and practiced in previous clinical radiography courses. Topics include: advanced radiographic anatomy; equipment utilization; exposure techniques; sterile techniques; participation in and/or observation of angiographic, interventional, minor special, and special genitourinary system procedures; participation in and/or observation of special equipment use; patient care; and behavioral and social competency. Execution of radiographic procedures will be conducted under direct and indirect supervision.

Competency Areas	Hours
Patient Care	Class	0
Behavioral and Social Competency	D. Lab	0
Advanced Radiographic Anatomy	P. Lab/O.B.I.	21
Equipment Utilization	Credit	7
Sterile Techniques
Participation in and/or Observation of Angiographic, Interventional, Minor Special, and Special Genitourinary System Procedures
Participation in and/or Observation of Special Equipment Use

Prerequisite:	RAD 135
Corequisite:

Course Guide

Competency	After completing this section, the student will be able to:	Hours
		Class	D.Lab	P.Lab/ O.B.I.
Patient Care		0	0	25
	Observe and/or participate in manage interactions with the patient and family in a manner that provides the desired psychosocial support.
	Observe and/or participate in evaluating the patient’s status and condition before, during and following the radiologic procedure to demonstrate competence in assessment skills.
	Demonstrate skills in assessment and evaluation of psychological and physical changes in the patient’s condition and carry out appropriate actions.
	Observe and/or participate in assessing the patient and recording patient histories.
	Assess the patient and record patient histories.
	Observe and/or participate in documenting care in the patient’s record.
	Carry out principles of transferring, positioning, immobilizing and restraining of patient.
	Observe and/or participate in assessing patient using the ABC’s of CPR and demonstrate basic life support procedures.
	Observe and/or participate in differentiating between emergency and non-emergency procedures and respond appropriately.
	Observe and/or participate in differentiating between normal ECG rhythms and abnormal ECG tracings.
	Examine procedure orders for accuracy and follow-up to make corrective changes when applicable.
	Observe and/or participate in Integration of the radiographer’s scope of practice and practice standards into clinical practice settings. Observe and/or participate in adhering to national, institutional and/or department standards, policies and procedures regarding care of patients, provision of radiologic procedures and the reduction of medical errors.
Behavioral and Social Competency		0	0	5
Cultural Diversity	Examine gender, cultural, age and socioeconomic factors that influence patient compliance with procedures, diagnosis, treatment and follow-up patients.
	Adapt procedures to meet age-specific, disease-specific and cultural needs of patients.
Ethical Behavior and Moral Reasoning	Demonstrate and support safe, ethical and legal practices
Demonstrate Professional Communication	Integrate the use of appropriate and effective written, oral and nonverbal communication with patients, the public and members of the health care team (peers, physicians, nurses, administration, etc.) in the clinical setting.
Patient Education	Observe and/or Participate in Choosing patient and family education strategies appropriate to the comprehension level of patient/family
Patient Confidentiality	Act consistently to maintain patient confidentiality standards.
Advanced Radiographic Anatomy		0	0	20
Minor and interventional anatomy	Identify the anatomical structures revealed in radiographs of minor radiographic procedures such as angiograms, CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngio- pancreatograms (ERCPs), myelograms, sialograms, and venograms.
	Identify the anatomical structures revealed in radiographs of interventional procedures.
Equipment Utilization		0	0	55
Equipment inspection	Perform safety checks of radiographic equipment and accessories (e.g., lead aprons and gloves, collimator accuracy).
	Recognize malfunctions in the radiographic unit (including table, tube, and accessories).
	Note difficulties experienced which might assist in locating the cause of the malfunction.
	Report malfunctions in the radiographic unit (including table, tube, and accessories).
	Inspect and clean screens and cassettes regularly to identify and remove causes of artifacts.
	Perform "start up" and/or "shutdown" procedures on the automatic processor (e.g., adjust water, removal and cleaning of "cross-over" bars).
	Recognize malfunctions in the automatic processor.
	Note difficulties experienced which might assist in locating the cause of the malfunction.
	Report malfunctions in the automatic processor.
	Monitor the performance of the automatic processor using sensitometry.
	Clean, wash, disinfect, and/or sterilize facilities and equipment (e.g., cassettes, tabletops) and dispose of contaminated items in preparation for the next examination.
X-ray tube warm-up	Warm-up the x-ray tube to achieve proper operating conditions by following the manufacturer's prescribed sequence of steps.
Exposure Techniques		0	0	25
Film storage and processing	Store film/cassette in a manner which will reduce the possibility of accidentally exposing or re-exposing the film.
	Imprint proper identification information onto the film using either the radiographic, photographic, or light imprinter method.
	Process exposed film by unloading the cassette and feeding it into the automatic processor.
	Reload cassettes by selecting film of proper size and type.
	Record required information on the request form following performance of examination (may include technologist identification, patient data, billing codes, number and size of films, technique, or other information as required by department protocol).
	Combine radiographic requisition and radiographs for interpretation and filing.
Technique development	Determine appropriate exposure factors using calipers, technique charts, and tube rating charts for guidance.
	Modify exposure factors for circumstances such as voluntary and involuntary motion, plaster casts, pathological conditions, and/or patient's inability to cooperate.
	Restrict beam to limit exposure to area of interest and to improve image quality.
	Set kVp, mA, and time or automated exposure system to achieve optimum image quality, safe operating conditions, and to minimize radiation exposure.
Technique evaluation	Evaluate radiographs using a view box to make certain that radiographs contain proper identification and are of diagnostic quality.
	Determine corrective measures if the radiograph is not of diagnostic quality.
Sterile Techniques		0	0	5
Sterilization	Observe and/or participate in methods of sterilizing radiographic equipment and examination rooms.
	Observe and/or participate in methods of sterilizing radiographic equipment and examination rooms. Observe and/or participate in the sterilization processes preparatory to catheterization.
Gowning and gloving	Observe and/or participate in the use of "open" and "closed" gowning and gloving methods.
Sterile procedures	Observe and/or participate in applying the standard and transmission-based precautions.
	Observe and/or participate in applying the appropriate medical asepsis and sterile technique.
	Identify the sterile techniques required for specific minor and interventional radiographic/ fluoroscopic procedures.
	Observe and/or participate in the use of techniques to open sterile packages where the person opening the package is either sterile or non-sterile.
	Observe and/or participate in "scrubbing in" a patient.
	Observe and/or participate in creating a sterile field, gowning and gloving oneself, and assisting a radiologist and/or physician.
Participation in and/or Observation of Angiographic, Interventional, Minor Special, and Special Genitourinary System Procedures		0	0	50
Angiography	Observe and/or participate in special radiographic procedures such as cerebral, visceral, peripheral, and digital subtraction angiograms.
	Observe catheterization techniques.
	Observe the Seldinger technique.
Interventional procedures	Observe and/or participate in interventional techniques such as infusion therapy, extractions, embolizations, PTA/PTLAs, and percutaneous needle studies.
Minor special procedures	Observe and/or participate in angiographic, interventional, minor special, and special genitourinary system procedures.
	Observe and/or participate in special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngio- pancreatograms (ERCPs), myelograms, sialograms, and venograms.
	Observe and/or participate in the preparation for use, operation, and maintenance of equipment used to perform special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngiopancreatograms (ERCPs), myelograms, sialograms, and venograms.
	Observe and/or participate in the use and maintenance of special radiographic equipment such as image intensifiers, magnification radiographic equipment, biplane equipment, recording equipment, rapid film changers, injectors, program selectors, and other miscellaneous radiographic equipment.
	Observe and/or participate in the preparation of patients undergoing special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngiopancreatograms (ERCPs), myelograms, sialograms, and venograms.
Patient preparation	Observe and/or participate in the preparation of patients undergoing special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholangio-pancreatograms (ECRPs), myelograms, sialograms, and venograms.
Post-procedural techniques	Observe and/or participate in the post-procedural care of patients who have undergone special minor radiographic procedures.
Evaluation	Observe and/or participate in the evaluation of special minor procedure radiographs in terms of anatomy visualized and pathologies revealed.
Contrast media	Observe and/or participate in the selection and administration of contrast media used for special radiographic procedures.
	Observe and/or participate in the diagnosis of and treatment for adverse reactions to contrast media.
Genitourinary procedures	Participate in and/or observe patient preparation procedures for radiographic/fluoroscopic examinations of the genitourinary system.
	Observe and/or participate in the positioning of patients undergoing radiographic/fluoroscopic procedures involving the genitourinary system.
	Observe and/or participate in routine radiographic/fluoroscopic procedures involving the genitourinary system.
	Evaluate the quality of radiographs and photospots of the genitourinary system in terms of positioning accuracy, image quality, and anatomical structures revealed.
	Identify the special considerations for genitourinary procedures relating to the avoidance of repeated procedures.
	Observe and/or participate in the identification of and care for acute reactions to contrast media.
Participation in and/or Observation of Special Equipment Use		0	0	25
Special minor procedures	Observe and/or participate in special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngio- pancreatograms (ERCPs), myelograms, sialograms, and venograms.
	Observe and/or participate in the preparation for use, operation, and maintenance of equipment used to perform special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngiopancreatograms (ERCPs), myelograms, sialograms, and venograms.
	Observe and/or participate in the use and maintenance of special radiographic equipment such as image intensifiers, magnification radiographic equipment, bi-plane equipment, recording equipment, rapid film changers, injectors, program selectors, and other miscellaneous radiographic equipment.
Patient preparation	Observe and/or participate in the preparation of patients undergoing special minor radiographic procedures such as CT of head, thorax, abdomen and pelvis, arthrograms, endoscopic retrograde cholagngiopancreatograms (ERCPs), myelograms, sialograms, and venograms.
Post-procedural care techniques	Observe and/or participate in the post-procedural care of patients who have undergone special minor radiographic procedures.
Evaluation	Observe and/or participate in the evaluation of special minor procedure radiographs in terms of anatomy visualized and pathologies revealed.
Contrast media	Observe and/or participate in the selection and administration of contrast media used for special radiographic procedures.
	Observe and/or participate in the diagnosis of and treatment for adverse reactions to contrast media.
Angiographic and interventional procedures	Observe and/or participate in special radiographic procedures such as cerebral, visceral, peripheral, and digital subtraction angiograms.
	Observe catheterization techniques.
	Observe the Seldinger technique.
	Observe and/or participate in interventional techniques such as infusion therapy, extractions, embolizations, PTA/PTLAs, and percutaneous needle studies.
Genitourinary procedures	Participate in and/or observe patient preparation procedures for radiographic/fluoroscopic examinations of the genitourinary system.
	Observe and/or participate in the positioning of patients undergoing radiographic/fluoroscopic procedures involving the genitourinary system.
	Observe and/or participate in routine radiographic/fluoroscopic procedures involving the genitourinary system.
	Evaluate the quality of radiographs and photospots of the genitourinary system in terms of positioning accuracy, image quality, and anatomical structures revealed.
	Identify the special considerations for genitourinary procedures relating to the avoidance of repeated procedures.
	Observe and/or participate in the identification of and care for acute reactions to contrast media.
Competency completion evaluation	Evaluate the number, types, and degree to which clinical competencies have been completed and mastered.
Competency completion planning	Develop a plan in conjunction with on-site clinical supervisors and technical institute faculty to outline future completion and mastery of clinical competencies contained in this course.
Continuing education/ independent study	Identify an area of concern or interest related to the content of this clinical experience, and research, review a publication, or otherwise explore this topic to personal satisfaction.

Suggested Resources

Adler, Arlene and Carlton, Richard. (2007).Introduction to Radiography and Patient Care. (4^th ed.) Philadelphia: W.B.Saunders/Elsevier.

Frank, Eugene, Long, Bruce, Smith, Barbara (2007). Merrill's Atlas of Radiographic Positions and Radiographic Procedures. (11^th ed.). Mosby/Elsevier

Bontrager, Kenneth., Lampignano, John (2005). Textbook of Radiographic Positioning and Related Anatomy. (6^th Ed.). St. Louis: Mosby.

Ehrlich, R. A., & McCloskey, Ellen, Daly, Joan. (2004) Patient Care in Radiography (6^th ed.). St. Louis: Mosby.

Greathouse, Joanne. (2006) Delmar’s Radiographic Positioning and Procedures. Albany, NY: Delmar.

Gurley, LaVerne, Callway, William. (2006). Introduction to Radiologic Technology. (6^th ed) Mosby, Elsevier

Torres, L. S., & Morrill, C. (1997). Basic medical Techniques and Patient Care for Radiologic Technologists. (5^th Ed.). Philadelphia: Lippincott.