Who is responsible for establishing standards of practice for the profession

Transcription

1 Mdule 2 Standards f Practice In this mdule yu will learn abut Wh is respnsible fr establishing standards f practice fr the prfessin Hw the CMRTO Standards f Practice set expectatins f prfessinal practice fr members Hw standards f practice are used by managers, educatrs, the public and the CMRTO The standard f practice and examples f sme indicatrs fr each f the fllwing areas Legislatin standards & ethics Equipment & material Diagnstic & therapeutic prcedures Safe practice Relatinship with patients Prfessinal relatinships Recrds & reprting Cntinuing cmpetence Resurces t include with Mdule 2 CMRTO Standards f Practice CMRTO Cde f Ethics 1

2 Mdule 2: Standards f Practice The Cllege f Medical Radiatin Technlgists f Ontari (CMRTO r the Cllege ) is the regulatry bdy fr medical radiatin and imaging technlgists in Ontari. The missin f the CMRTO is t regulate the prfessin f medical radiatin and imaging technlgy t serve and prtect the public interest. One f the ways the CMRTO meets its missin is by establishing and enfrcing standards f practice fr its members. The Standards f Practice set ut the expectatins fr prfessinal practice f members f the CMRTO when practising in Ontari. Please nte that the CMRTO Standards f Practice are different than the Canadian Assciatin f Medical Radiatin Technlgists (CAMRT) r Sngraphy Canada Cmpetency Prfiles. Cmpetency Prfiles describe the cmpetencies required fr entry t practice and prvide the fundatin fr the develpment f the CAMRT and Sngraphy Canada s certificatin examinatins. There are five specialties: radigraphy, nuclear medicine, radiatin therapy, magnetic resnance and diagnstic medical sngraphy, which have several areas f practice. Each specialty and area f practice has its wn Cmpetency Prfile and examinatin. The CMRTO Standards f Practice, n the ther hand, set ut the standards f prfessinal practice and cnduct fr members f the CMRTO. Althugh certain indicatrs within each practice standard may be specific t nly ne f the five specialties, the Standards f Practice apply t the practice f all members. The CMRTO Standards f Practice Set ut minimum standards f prfessinal practice and cnduct fr members; Assist members in understanding the CMRTO s expectatins with respect t the prfessinal practice f medical radiatin and imaging technlgy; Help managers in making apprpriate decisins regarding management f the practice f the members f the CMRTO and in develping suitable plicies and prcedures; Assist educatrs in develping curriculum and in prviding apprpriate instructin; Assist the public in assessing quality f care. The Standards f Practice are used by the CMRTO in determining whether members have maintained apprpriate standards f practice and cnduct. They are used by the Inquiries, Cmplaints and Reprts Cmmittee (ICRC) and the Discipline Cmmittee in making determinatins regarding prfessinal miscnduct and incmpetence. They are als used fr ther CMRTO prcesses such as ascertaining entry-level requirements fr registratin and are the basis fr the Quality Assurance (QA) Prgram. In the event that the Standards f Practice set a standard that is higher than departmental plicy r prcedure, the member must cmply with the standard set by the Standards f Practice. 2

3 Standards f Practice > Departmental Plicy r Prcedure The Standards f Practice reflect the knwledge, skills and judgement that members need in rder t perfrm the services and prcedures that fall within the scpe f practice f the prfessin. The Medical Radiatin Technlgy Act (MRT Act) sets ut the scpe f practice statement fr medical radiatin technlgy, as fllws: The practice f medical radiatin technlgy is the use f inizing radiatin, electrmagnetism and ther prescribed frms f energy fr the purpses f diagnstic and therapeutic prcedures, the evaluatin f images and data relating t the prcedures and the assessment f an individual befre, during and after the prcedures. The Standards f Practice are intended t be generic. Under the CMRTO s Standards f Practice, members are expected t be: Accuntable Cmpetent Cllabrative - Cmpetent means that members must maintain cmpetence in their current area f practice, must refrain frm acting if nt cmpetent, and must take apprpriate actin t address each situatin. - Accuntable means that members must take apprpriate actin if they feel the interests f the patient are being unnecessarily and unacceptably cmprmised. This includes nt implementing rdered prcedures r treatment plans that, frm their perspective, appear t be cntraindicated, and in this event, taking apprpriate actin t address the situatin. - Cllabrative means that members are respnsible fr cmmunicating and crdinating care prvisins with ther members f the health care team, and taking apprpriate actin t address gaps and differences in judgement abut care prvisin. All members are respnsible fr ensuring that they are practising the prfessin f medical radiatin and imaging technlgy in accrdance with the Standards f Practice. Each standard has a number f indicatrs, sme f which apply t all specialties and sme f which are specialty specific. Members shuld be familiar with all f the Standards f Practice and the indicatrs applicable t the specialty in which the member will be practising. Nt maintaining the Standards f Practice is cnsidered t be prfessinal miscnduct under the prfessinal miscnduct regulatin f the MRT Act. 3

4 The Standards f Practice have eight Practice Standards applicable t all f the specialties and are described under eight sectins. They are: Legislatin, Standards and Ethics Equipment and Materials Diagnstic and Therapeutic Prcedures Safe Practice Relatinship with Patients Prfessinal Relatinships Recrds and Reprting Cntinuing Cmpetence Belw, yu will find an explanatin f each f the eight standards f practice. Each Practice Standard includes a statement f the legal and prfessinal bligatins f members under each standard. Each Practice Standard als includes Indicatrs, which describe hw members are expected t apply the standard. These indicatrs can be used t determine if the standards are being maintained. The indicatrs are nt utlined in rder f imprtance, nr are they an allinclusive list f all applicatins f a standard. General indicatrs are applicable t all members, while specific indicatrs apply nly t specific specialties. In this mdule, nly select indicatrs are listed. Fr a cmplete list f indicatrs fr all eight standards f practice, cnsult the CMRTO s Standards f Practice. Fr the full text f the CMRTO s Standards f Practice, please cnsult the CMRTO s website here. Legislatin, Standards and Ethics In rder t be registered as members f the CMRTO, members must meet the prfessinal educatin and ther registratin requirements set by the CMRTO. They must cntinue t educate themselves abut practical, legal, ethical and ther matters pertaining t the prfessin. Members must be cmpetent, accuntable and cllabrative in their practice. Practice Standard: Members must understand, and adhere t, the legislatin gverning the practice f the prfessin, the Standards and Practice set by the Cllege, the Cde f Ethics and the by-laws f the Cllege. Indicatrs Have the knwledge, skills and judgement t perfrm prcedures undertaken in the curse f practising their prfessins 4

5 Take respnsibility fr decisins and actins, including thse undertaken independently and thse undertaken as a member f a team Wrk with ther members f the health care team t achieve the best pssible utcmes fr the patient. Equipment and Materials The practice f members entails the use f a wide range f equipment and materials. Members must knw and understand the functins, capabilities, specificatins and hazards f the equipment and materials they use in the curse f their practice. Practice Standard: Members must have the knwledge, skills and judgment t select the apprpriate equipment and materials fr prcedures rdered by a physician r ther authrized health prfessinal, t make determinatins as t the quality, serviceability and perability f the equipment and materials, and t take any crrective actins required t meet standards set by legislatin, facility plicies and manufacturers guidelines. Members must be skilled in making safe, efficient and effective use f resurces t prduce the desired examinatin infrmatin r deliver safe, effective treatment. Indicatrs Determine the quality, serviceability, and perability f the equipment and materials t be used in the prcedure in accrdance with the standards set by legislatin, facility plicies and manufacturers guidelines, and if the standards are nt met, take crrective actin Determine, set and verify the technique and prtcl t be used in the prcedure Make use f apprpriate shielding devices What are cnsidered apprpriate shielding devices may vary frm facility t facility. Since facility plicy will infrm this decisin, members shuld ensure that they are aware f their facility s plicy n the use f apprpriate shielding devices. Diagnstic and Therapeutic Prcedures Members emply inizing radiatin, radipharmaceuticals, electrmagnetism and sundwaves t create images and data that are part f diagnstic imaging examinatins r that are used fr defining and recrding treatment parameters. These images may be dynamic, n film, digital displays, three-dimensinal mdels r templates. Members in the specialties f radiatin therapy and nuclear medicine administer inizing radiatin t treat cancer and ther diseases. Members wh apply inizing radiatin d s under the authrity f and in accrdance with the Healing Arts Radiatin Prtectin Act (HARP Act) and, where applicable, the Nuclear Safety and Cntrl Act (NSC Act) and their respective regulatins. Members are permitted t apply electrmagnetism fr magnetic resnance imaging under an exemptin set ut in the Cntrlled Acts regulatin made under the Regulated Health Prfessins Act. Members are als permitted 5

6 t apply sundwaves fr diagnstic ultrasund under an exemptin set ut in the Cntrlled Acts regulatin made under the Regulated Health Prfessins Act Members perfrm five cntrlled acts, which they are authrized t perfrm under the MRT Act. These authrized acts are: 1. Administering substances by injectin r inhalatin; 2. Tracheal suctining f a trachestmy; 3. Administering cntrast media r putting an instrument, hand r finger, a. Beynd the pening f the urethra, b. Beynd the labia majra, c. Beynd the anal verge, r d. Int an artificial pening f the bdy; 4. Perfrming a prcedure n tissue belw the dermis; and 5. Applying a prescribed frm f energy. Practice Standard: Members must be able t create images and data that are sufficiently accurate and clear fr the diagnstic r therapeutic prcedures that are rdered by a physician r ther authrized health prfessinal. In the case f prcedures that use inizing radiatin, members use nly the minimum amunt f radiatin necessary during the curse f the prcedure. Members perfrming prcedures using sundwaves fr diagnstic medical ultrasund use the minimum acustic pwer utput and minimum expsure time. Members must be prficient in evaluating the images, data and tests relating t the prcedures t ensure that the images, data and tests are satisfactry. Members must be able t administer inizing radiatin, radipharmaceuticals, electrmagnetism fr magnetic resnance imaging and sundwaves fr diagnstic ultrasund accurately and in accrdance with the rder f the physician r ther authrized health prfessinal fr the diagnstic r therapeutic prcedure and the applicable legislatin (including withut limitatin, the Healing Arts Radiatin Prtectin Act its regulatins and the Nuclear Safety and Cntrl Act and its regulatins and licences issued thereunder). Members must nt apply r administer inizing radiatin r radipharmaceuticals unless the cnditins under the applicable legislatin have been met. Under the MRT Act, members are authrized t perfrm five cntrlled acts ( authrized acts ) as required in the curse f engaging in the practice f the prfessin. They must nt perfrm the authrized acts r any exempted cntrlled act unless the cnditins under the RHPA, MRT Act and their respective regulatins, and the Standards f Practice have been met. Indicatrs Perfrm prcedures, including authrized acts, nly in the curse f engaging in the practice f the prfessin 6

7 Safe Practice Have and apply the necessary knwledge, skills and judgment t perfrm and manage the utcmes f perfrming the prcedure safely, effectively and ethically. Members perate equipment, apply inizing radiatin, electrmagnetism fr magnetic resnance imaging, sundwaves fr diagnstic ultrasund and administer radipharmaceuticals. All f these culd be dangerus if used incrrectly. Members endeavur, at all times and in every aspect f their practice, t reduce the risk f harm t their patients, t themselves, t their clleagues and t any ther individuals wh may be present in the practice envirnment. Practice Standard: Members must have and maintain the knwledge, skills and judgement t practise safely by adhering t all relevant prvincial and federal legislatin and guidelines, departmental prtcls and plicies and manufacturers directins pertaining t health and safety. In the event f any unexpected prblems r emergencies, members must be cmpetent and prepared t handle r t assist in the management f the situatin. Indicatrs Verify the patient s identity fr all diagnstic r therapeutic prcedures Assess the patient s physical and emtinal limitatins and ensure that the patient will nt be expected t perfrm any task r mvement that wuld cause physical harm Use the ALARA principle t minimize patient expsure t radiatin and sundwaves fr the prcedure Use apprpriate aseptic techniques and infectin cntrl prcedures in the curse f the diagnstic r therapeutic prcedure The third indicatr utlined abve engages the ALARA principle. Guided by the As Lw As Reasnably Achievable (ALARA) principle, members apply their knwledge f radiatin and r sundwaves effects and risks t minimize the expsure t radiatin r sundwaves fr their patients, ther healthcare clleagues and the public. Relatinship with Patients Members have patient care as their main cncern. Practice Standard: Members must maintain clear and prfessinal bundaries in relatinships with patients and treat all patients with dignity and respect. Members must have the knwledge, skills and judgment t avid placing patients at unnecessary risk f harm, pain r distress. Members must be able t prvide apprpriate respnses t patient inquiries abut prcedures and related issues, and accept the patient s autnmy and the right f the patient r the patient s substitute decisin maker t cnsent t r refuse service. Members must understand hw and act t prtect the cnfidentiality f all prfessinally acquired infrmatin abut patients 7

8 and the privacy f patients with respect t that infrmatin, while facilitating the effective delivery f health care. Indicatrs Instruct the patient t remve nly the clthing and items that will interfere with the diagnstic r therapeutic prcedures Prvide the patient with a gwn r sheet t cver areas where clthing was remved Explain t the patient when and where the member may tuch them and why Tuch the patient nly in thse areas needed t facilitate carrying ut the prcedure Keep all patient infrmatin cnfidential except when necessary t facilitate diagnsis r treatment f the patient, r when legally bliged r allwed t disclse such infrmatin Cmply with any applicable privacy legislatin such as the Persnal Health Infrmatin Prtectin Act (PHIPA) and its regulatins. Prfessinal Relatinships Prfessinal relatinships in health care settings are based n mutual trust and respect, and result in imprved patient care. Practice Standard: Members must be able t practise effectively within interprfessinal care teams t achieve the best pssible utcmes fr the patient. Members are respnsible fr cmmunicating abut and crdinating care prvisin with ther members f the team, and must be able t take the apprpriate actin t address gaps and differences in judgment abut care prvisin. CMRTO members may accept the delegatin f cntrlled acts under the RHPA nt authrized t members under the MRT Act, prvided they cmply with the RHPA and the Standards f Practice. CMRTO members cannt delegate cntrlled acts authrized t CMRTO members under the MRT Act t ther individuals. Indicatrs Use a wide range f cmmunicatin and interpersnal skills t effectively establish and maintain prfessinal relatinships Reslve cncerns abut an rder r treatment plan by: Discussing the cncern directly with the respnsible health prfessinal Prviding a ratinale and best practice evidence in supprt f the cncern Identifying utcmes desired fr reslutin Dcumenting the cncern and steps taken t reslve it in the apprpriate recrd. 8

9 Recrds and Reprting Creating and maintaining recrds and reprts are essential cmpnents f the prfessinal practice f members. Members recrds and reprts prvide infrmatin t ther health care prfessinals abut relevant aspects f patient care, treatment and assessment. Practice Standard: Members must be prficient in creating recrds, charts, incident and ther reprts that attest t the diagnstic, treatment, quality assurance, wrkplace and patient safety prcedures that have been carried ut. Members must have the knwledge, skills and judgment t recrd infrmatin that will adequately identify the subjects f all the images and data they create and treatments they administer. Members must prduce recrds and reprts that are accurate, cmplete, legible and timely. Indicatrs Recrd and reprt any equipment faults r prblems Mark all images and data with the patient s identity. Cntinuing Cmpetence Members must maintain cmpetence in their current area f practice and cntinually imprve their cmpetence in rder t respnd t changes in their practice envirnments, advances in technlgy and the changing health care envirnment. Practice Standard: Members must have, maintain and apply the necessary knwledge, skills and judgment t ensure safe, effective and ethical utcmes fr the patient. Members must maintain cmpetence in their current area f practice and must refrain frm acting if nt cmpetent. Members must btain and maintain the necessary knwledge, skills and judgment t respnd t changes in practice envirnments, advances in technlgy and ther emerging issues. Members must participate in the Cllege s Quality Assurance prgram as part f maintaining and imprving their cmpetence. Indicatrs Obtain and maintain the necessary knwledge, skills and judgment t respnd t changes in practice envirnments, advances in technlgy and ther emerging issues Participate in the Cllege s Quality Assurance Prgram. 9