Teaching Current Radiography Topics

Transcription

1 Teaching Current Radiography Topics WHAT S NEW TEACHING THE RADIOGRAPHIC SCIENCES? RICH LEHRER, MSRS, RT(R), ARRT, CRT Education is a dynamic process State of CA CDPH / RHB ASRT ARRT JRCERT SRJC State of CA CDPH / RHB Preparation for our October site visit Radiation protection practices, and; Radiation Protection Plans 1

2 CDPH / RHB We will base our preparation on the 2011 site visit as well as guidance from other program directors who have just gone through the process RPP s and statements from S&O s. They will visit 2-3 sites. ASRT Changes in curriculum Film is gone processors are gone Digital has become much more prevalent Direct and Indirect conversion, PSP, CMOS & CCD, DQE, MTF, histogram, ROI, VOI, LUT, RIS, HIS, PACS, DICOM, EMR ASRT Image acquisition now includes pixels, dynamic range as well as film screen characteristics for density, contrast and recorded detail. Digital imaging Processing has evolved with histogram VOI and rescaling, grayscale bit depth and LUT, edge enhancement and smoothing, equalization. electronic masking and more. These were covered in RADT 66 and reviewed in RADT 68. 2

3 Merrill s New kvp ranges all barium is now 120, iodinated conrast Positioning has evolved knees ankles When in Rome Rich, If you look in chapter 1, page 31 under SID we note that an SID of 44 to 48" is better for reducing patient dose and for better detail. The reason 40" was used in the past was due to the fact that generators could not handle the techniques for the longer SID, but with the high frequency generators we now have that is not a problem and it is better to use the longer SID. Barbara Smith, Portland CC ARRT New mandatory and elective comps Clinical Competency changes start January 2017 General Patient Care Procedures i.e. vital signs from 6-10 Will now include Pulse Oximetery We will sign off in patient care lab Imaging Procedures Mandatory was 31 will be 37 Elective was 15 will remain 15 ARRT Some changes in the Comps Clavicle will be mandatory XTL spine is now mandatory (not necessarily C-spine) Some NEW Ones! TMJ s added to head section. We can sign a simulation in lab. HSG is now an elective comp C-Arm more than one projection & C-arm manipulation around a sterile field (mand) Geriatric Patient Physically or cognitively impaired as a result of aging CXR, Upper Extremity & Lower Extremity all mandatory 3

4 ARRT National Board Certifying Exam Radiation Exposure and monitoring NCRP 160 typical effective dose per exam & comparison of doses by modality no longer on the exam. SI Units and traditional units. Dedicated chest unit & conventional tomography unit no longer on exam. LAO Sternum & sternoclavicular joints no longer on the exam. Rheese for Orbits no longer on the exam. ARRT JRCERT Direct Supervision Standard 4.4 Review the procedure in relation to the student s achievement, Evaluates the condition of the patient in relation to the student s knowledge Is physically present during the conduct of the procedure, Reviews and approves the procedure and/or image. Students must be directly supervised until competency is achieved. 4

5 JRCERT Indirect Supervision Standard 4.5 Indirect supervision promotes patient safety and proper educational practices. The JRCERT defines indirect supervision as that supervision provided by a qualified radiographer who is immediately available to assist students regardless of the level of student achievement. Immediately available is interpreted as the physical presence of a qualified radiographer adjacent to the room or location where a radiographic procedure is being performed. This availability applies to all areas where ionizing radiation equipment is in use on patients. JRCERT And the third expectation of the JRCERT for student supervision is: Are we having issues? Collimation Patient Transportation Who are the technologists working with our students? Are they good role models? 5

6 Bi-Weekly Progress Report / CEF A) PATIENT CARE B) COMMUNICATION C) PROFESSIONALISM & ETHICS D) EQUIPENT HANDLING E) POSITIONING SKILLS F) CRITICAL THINKING & ADAPTABILITY G) ACCOUNTABILITY H) RADIATION PROTECTION I) ORGANIZATION J) STUDENT CHALLENGE A) PATIENT CARE Maintains patient modesty, comfort, confidentiality. Behaves in a nonjudgmental, mature and compassionate manner to patients and their families. Properly handles patients and patient devices. Correctly identifies patient per department protocol. Uses a safe approach in transferring patients (must be fully supervised during first semester of training). B) COMMUNICATION SKILLS Practices proper "hand-off" procedures. Shows understanding of instruction and direction. Reads and understands requisitions. Demonstrates clear and complete understanding of all interactions essential to clinical performance. Consistently utilizes AIDET practices when communicating with patients, their families, and caregivers. 6

7 C) PROFESSIONALISM & ETHICS Upholds the principles of the ARRT Code of Ethics. Projects professionalism under stress environment. Cooperates with technologists and demonstrates a team approach. Takes initiative and interest in their clinical education. Demonstrates judicious use of post-processing tools. D) EQUIPMENT HANDLING Practice safe and respectful manipulation of all equipment. Demonstrates accurate use of digital equipment. Consistently aligns the X-ray tube and the IR. E) POSITIONING SKILLS Identifies anatomy seen on the images at appropriate level of training. Marks images correctly according to department standards. Produces images of consistent high quality. Shows competency and proficiency with positioning at appropriate level of training. 7

8 F) CRITICAL THINKING & ADAPTABILITY Identifies and corrects positioning & technique errors at appropriate level of training. Recognizes causes of artifacts and their prevention at appropriate level of training. Adapts to new and changing situations or patient needs and makes reasonable decisions. Adapts and improvises to non-routine situations; ER, OR, Trauma. G) ACCOUNTABILITY Adheres to the college and the department dress code. Demonstrates consistent reliability and punctuality with attendance. Shows consistent compliance to program s and the department s policies. Shows consistent compliance to the instructors suggestions or recommendations. Remains alert and interested in the procedures - asks pertinent questions. H) RADIATION PROTECTION Collimates to the area of interest, and in accordance with the department protocols. Uses shielding on patients when possible. Selects technical factors according to ALARA. Maintains compliance of department protocol with women of childbearing age. Strives to keep repeated images to a minimum. Monitors exposure index (EI) on the initial image to insure appropriate radiation delivery to the patient, and alters technical factors on subsequent images as necessary to minimize radiation exposure whenever possible. 8

9 I) ORGANIZATION Plans and organizes work efficiently anticipation of needs, room and equipment readiness. Demonstrates an organized and efficient work pattern during exams. Work at a pace appropriate for level of training. Demonstrates increased confidence and independence in executing tasks. J) STUDENT CHALLENGE The student seeks input for this goal. SRJC We count on our CI s to advise the students with timely and objective feedback. If students meet expectations, then they are not excellent. 9

10 SRJC New awards are available for our graduating and continuing students. ALARA & Compassion nominations by CI only to program director. We need repairs or replacement of our X-ray room. SRJC THANK YOU for everything that you do on behalf of our students and our program. Brief 10 question Post-Test to meet the annual requirement will be distributed at the conclusion of the last presentation. Hope this was valuable. Thanks for your attention. 10