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Ensuring Patient Safety
In Radiology
June 2007 John Thomas
Verification Process - STEP 1
Radiology ‘Request/Consent Form’ Clear & legible
Provision of mandatory information
Patient Details(preferably Addressograph label)
Full Name/ DOB/ MRN
Ward & Date Written
Procedure Requested (including side)
Relevant Clinical History
Referring Doctor Contact Details
Printed Name/ Signature/ Page No.
Incomplete/Incorrect Request Form – Immediately notify Referrer or Ward Nurse
Verification Process – STEP 2
Correct Patient (Identification)
Scope: All radiology procedures
Ask the patient
“What is your FULL NAME?”
“What is your Date of Birth?”
“What is the name of the PROCEDURE you are having today?”. Also ask SITE/SIDE if required
Never state patient’s Name/ DOB/ Site & Side
“Do not tell the patient… the patient tells you”
E.g. Call “Mr. Brown”, then ask the above questions including additional questions related to clinical history as outlined on Request Form
Verification Process - Cont.
Correct Patient (Identification) Cont.
Inpatients
1. Ask patient to state Full Name/ DOB/ Procedure
2. Check responses against Referral Form & Patient ID Band (wrist/ankle) including MRN– MANDATORY
Do Not Proceed if :
Patient ID Band is absent. Call Ward Nurse to personally ID patient and complete Time Out Verification sticker (all personnel sign). Complete online IIMS form & document into Escort Issues book
Patient can not verbalise identity. Nurse Escort must verify patient identity. Complete Time Out Verification sticker (all personnel sign).
Verification Process - Cont.
Outpatients
1.Ask patient to state Full Name/ DOB/ Procedure
2.Check responses against Referral Form
Do Not Proceed if :
Patient can not verbalise identity.
Proceed only after :
Identity is verified by accompanying relative, family member, friend or healthcare interpreter.
Reinforcing the Message
Displayed at all imaging consoles
Have you checked the Patient ID ?- Prior to the Procedure -
Are you sure !
Asked patient their:
• Name
• DOB
• (Procedure)
Checked response & MRN against ID Band & Request Form
Team Time Out – STEP 3
General X-ray
(General, Mobiles, Emergency - Resus, Mammography, Screening)
Confirm before procedure
Correct patient is present (Full Name/DOB/MRN/ID Band)
Clinical history corresponds with Requested exam
Correct site & side is being examined
Correct right & left markers are being used
Perform diagnostic examination (provided no discrepancies exist).
Team Time Out – STEP 3 Cont.
Interventional (invasive) Radiology(All invasive procedures covering CT / Ultrasound / Angiography / Mammography and selective Screening procedures)
In procedure room, with patient present.Confirm patient ID, request/consent forms, image data all correct.Site marked by interventional doctor.
Team Leader (usually Nursing staff) calls Time Out immediately prior to procedure commencement (patient draped) to confirm:
Verification of patient identity (Full Name/DOB/MRN/ID Band)
Agreement on the intended procedure
Verification of correct position i.e level & side
Verification of the visible marked site
Availability of correct implants/equipment/medication
TTO discrepancies – DO NOT proceed until resolved (document)
Team Time Out – STEP 4
Post Procedure (all Radiology procedures)
Ensure that:
Correct details are attached to the image/s
Patient details & side marker/annotations on post-processed image/s are correct
Certified Time Out Verification sticker
Radiographer/s to complete checklist, procedure, date, print name & sign
scanned to PACS, then
placed in patient medical notes.
Time Out Verification sticker Scope: All radiology procedures
General vs. Interventional use
TIME OUT VERIFICATION Patient Identification VerifiedProcedure & Consent Verified Correct Site & Side VerifiedImaging Data Confirmed (priors)Implant/Equipment Confirmed RADIOLOGY St George Hospital
Yes N/A
Procedure : ……………………………Date: …………….Team member :………………………………………………Team member:………………………………………………Team Leader name:………………………………………..Team Leader signature:…………………………………..
SUMMARY
Getting in Right in Radiology
SUMMARY
Getting in Right in Radiology
Staff Related Responsibilities
Patient Transfers
Radiology staff (Front Desk) are required to complete ALL the front section of the Radiology Patient Transfer Slip:
• Check adequacy of Request Form (completion of mandatory information fields). Follow Request Form Completion Policy.
• To transcribe procedure & patient details from Request Form to Patient Transfer Slip.
• Phone Ward Nurse responsible for patient to arrange transfer stating:
• Your name and department (Radiology)
• “I have a Request Form for (Patient Name) to have an (Radiology procedure)”
Patient Transfers Cont.
The following questions should then be asked:
1. What is the patient MRN?
2. Is the patient ready for their procedure?
3. Do they travel in a bed or wheelchair?
4. Do they require a Nurse Escort?
5. What bed number are they?
6. Do they have electrical equipment on the bed e.g..IMED?
7. Do they need oxygen?
8. Does the Orderly need Personal Protective Equipment?
Patient Transfers Cont.
For all procedures, especially CT & Angiography
1. Has the patient consented or are they able to consent?
2. When was the last time the patient had something to eat?
3. Does the patient have a cannula?
4. Is the patient on anticoagulation therapy?
When all necessary information has been established, complete front side of Radiology Patient Transfer Slip.
Radiology Patient Transfer Slip
Front Side
Ward and Bed No. Destination General CT
Family name Screening Angio
Given name Ultrasound MRI
MRN Region
Nurse escort? Yes No Travel Chair Bed
Protective equipment? Yes No Checked by (signature)
Radiology Patient Transfer Slip
Radiology Patient Transfer Slip
When all information fields are completed, patient transfer can proceed. Radiology Orderly is given slip.
Upon arrival on Ward, the Radiology Orderly must:
• Identify themselves to Ward staff and Department (Radiology)
• State name of patient to be transferred & procedure (as outlined on accompanying Transfer Slip).
• Consult Ward Nurse (or NUM) responsible for patient and verify whether:
• patient is ready for transfer?
• needs a Nurse Escort?
• requires oxygen &/or electrical equipment?
• you need to wear PPE?
Radiology Patient Transfer Slip Cont.
Locate patient as directed by Ward Nurse
Radiology Orderly MUST:
• Verify Patient Identification
• Radiology Orderly to ask patient to state Full Name & Date of Birth as outlined on Patient Transfer Slip. Check
• Check response against ID Band (wrist/ankle). This is mandatory. Check MRN against ID Band (Patient is not to be transferred without ID Band or correct identification)
• Ensure all Patient Notes & X-rays accompany patient to Radiology
Radiology Orderly then completes checklist on rear side of slip
Radiology Patient Transfer Slip
Rear Side
Radiology Ph 33565Emergency Ph 666Orderly has confirmed all the following:
All information is recorded on the slip?
Yes The patient is ready for transport Yes No
The patient’s ID indicates the correct patient?
Yes Does the patient need oxygen or electrical equipment?
Yes No
Radiology nursing staff have been informed of the patient’s imminent arrival?
Yes Does the patient need a Nurse Escort? Yes No
All patient notes are with the patient? Yes No
Orderly checklist