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Radiology Welcome Pack

WELCOME PACKRADIOLOGY NURSES

Sister E McKnight October 2014 Version 1 1


Contents

Introduction and Overview……………………………………………………………….3Key personnel………………………………………………………….............................6Placement philosophy………………………………………………………………….…7Shift patterns………………………………………………………………………………..8Housekeeping arrangements…………………………………………………………….9Mentoring Arrangements………………………………………………………………....9Dress Code………………………………………………………………………………….9Examples of Pathways of care…………………………………………………………10Spoke Directory and Contact Details…………………………………………………11Learning Opportunities available……………………………………………………...14Resources available to support learning…………………………………………….16Interactive Content………………………………………………………………………17The Placement Charter………………………………………………………………….42



Introduction and Overview

Welcome to the radiology department. We hope you enjoy your learning experience. This booklet has been designed to help orientate you to your new environment. All the staff are dedicated to supporting students and we respect the contribution you can make to the team during your stay. We hope that your time is enjoyable, rewarding and challenging. The department offers a learning environment, which encourages students to ask questions at any time in relation to any aspect of the placement or patient care. You will remain supernumerary at all times.

About the Department

The Radiology Department is divided into several areas

Radiology One is located on Level 1of The Turnberg Building and contains the following areas:-

General X-ray rooms 1-5 Angiography room 6 (Gastro and renal interventions some musculoskeletal injections)Fluoroscopy rooms 7+ 8 (Gastro diagnostics and interventions)Mammography (Biopsies)CT – Neuro (Lung Biopsies)Gamma Camera

Neuro MRI scanner is across the corridor from Radiology 1in The Irving Building

Radiology Two is located on Level 1of the Ladywell Building and contains the following areas:-

General X-ray rooms Body MRI scannerBody CT scanner (Biopsies, drainages)General Ultrasound (Biopsies, drainages)

The Neuro-Angiography suite is located on Level 3 of the Turnberg Building adjacent to theatres and SAL 3 (Neuro-interventions)

Obstetric and gynaecological ultrasound scans are performed in the Ultrasound suite in the Brooke Building, Level 1.

A third CT scanner and plain film x-ray room is located in the Emergency Village, Level 1 of the Hope Building.

Radiology is a very diverse and interesting place to work; changes in methods of diagnosis and treatment are taking place all the time. We care for adult clients who require radiological procedures both diagnostic and therapeutic. We care for out patients and inpatients undergoing procedures including



CT, MRI and Ultrasound scanning. Patients from all specialities require a variety of imaging techniques in their hospital experience.The imaging department can offer you a wide variety of experiences in the management, delivery and evaluation of care to patients requiring investigations and treatments, plus experience in: -

Pre and Post procedure careMonitoring of patients undergoing interventionManagerial experienceScrub technique and asepsisSedation of patientsRadiation Protection – see appendix 1Multi disciplinary team working and meetings

Types of Procedures

This is by no means a comprehensive list of procedures. In patient invasive procedures; -

Biopsy Drainage Stents oesophageal, gastric and rectal Gastrostomy Nephrostomy PICC line insertion Coiling of cerebral aneurysm

Out-patient procedures; - Barium meal Small bowel enema Barium swallow Hysterosalpingogram Change of Nephrostomy or gastrostomy tube Micturating cystogram

Multidisciplinary Team

The Radiology department is a multidisciplinary team with each person within that team bringing their own special knowledge; do not be afraid to ask questions, we are all here to help one another to ensure our patients receive the best possible treatment whilst they are in our care. All student nurses will have the opportunity to rotate between all the individual departments within Radiology.

Radiology Nursing Staff



Designation Name Tel NoSenior Sister Elaine McKnight 60077Sister Paula Mitchell-Harper 62547Staff Nurse Elaine Penberthy 65091Staff Nurse Stacey Hull 62206Staff Nurse Le Xu 62206Staff Nurse Helen T-Michael 62206Staff Nurse Michelle Thompson 62206Assistant Practioner Jacqui Greenhalgh 65091Health Care Assistant Kelly Rees 62206Health Care Assistant Emma Power 62206Clinical Support Worker

John Law 62206

Clinical Support Worker

Gail Beaumont 62206

Useful Contact Numbers

X-ray reception Rad 1 64919Room 6 / Angio level 1 62206Angio level 3 65091/2



Key Personnel

The Placement Educational Lead (PEL) helps the development and maintenance of an effective learning environment within the placement area.

The PEL for Radiology is:-

Elaine McKnight (Senior Sister) – [email protected]

Telephone Number – 0161 206 0077.

The Practice Education Facilitators (PEF) aim is to support student learning and assessment whilst on placement.

The PEF for Radiology is:-

Mike Hollinshead – [email protected]

Telephone Number – 0161 206 8223

The Link Lecturer is the link between the University and the placement, their role is to offer advice on any student issues.

The Link Lecturer for Radiology is:-

Mike Lappin – [email protected]

Telephone Number – 0161 295 7288


mailto:[email protected]




Philosophy of the Radiology Department

A philosophy is a set of principles or beliefs, its ideals and its goals (Clodagh Gray 2004). The staff of the radiology department aim to:

View patients, carers and relatives as individuals who have needs which require our help

Care for patients, carers and relatives unconditionally recognising and respecting their individual personal, cultural and religious beliefs

Preserve a patient’s dignity Protect an individual’s right to confidentiality Treat with courtesy patients, carers and relatives as we would want our

families to be treated Support patients, carers and relatives, involving them in decisions about their

treatment and care Provide a high standard of care informed, were possible, by empirical

evidence Promote health education and health promotion Provide a work environment which is safe and supportive to students and all

team members Supervise and teach students, encouraging them to build upon their previous

learning in order to meet the requirements for entry to the professional register

Encourage each staff member to contribute in their own unique way to this philosophy

Promotes a no blame culture but learn together from our mistakes in order to progress

Embrace life long learning principles in order to practice with a sound body of knowledge and competence



Shift Patterns

The routine of the department will be discussed with you when you begin your placement. We are a friendly team, which believe in supporting each other at all times, so that the best possible care can be delivered to our patients.

Our normal hours are from 08.00hrs until 18.00hrs Monday to Friday; however these times may vary to suit the needs of the department.

If you are going to be off for any reason, please ring the department at the earliest possible time, on 0161 206 2206 or 5091. Please inform the staff when you will next contact the department or will be returning to work.

The Off Duty is done six weeks in advance and can be found in the blue folder in Room 6 and Angio Level 3.

Leaving the Department – Under no circumstances should any nurse leave the department without informing a senior member of staff where they are going, this is for Health and Safety reasons.

Clinical Governance – As part of the Clinical Governance Initiative the Trust has set out ‘Protected Time’. This enables the majority of staff to come together every two months and discuss/present issues of relevance to Radiology. It enables all staff to keep up to date with topics that they otherwise would not hear about due to the geographical logistics of Radiology. It also acts as a forum for presentations from staff members of all sub-departments.



Housekeeping Arrangements

On your first day please come to Radiology 1 reception at 8.30am and you will be directed to Room 6.

You will be oriented to the department and introduced to the staff. This will be carried out by one of the nursing team who will be assigned to look after you.

We have very limited locker space so where possible please leave your personal items at home or keep them on your person.

We have a staff room on Level 3 opposite the Neuro angiography suite where there is tea and coffee making facilities and fridges to store you lunch. We will give you the code to the staff room as you are very welcome to use it for your breaks.We also have tea and coffee making facilities in Room 6, Radiology 1 which you are also very welcome to use.

Mentoring Arrangements

On your first day you will meet your mentor who will welcome and orientate you to the department. We are an extremely friendly team so you will be made to feel very welcome. We all meet in Room 6 at 8.30am for Safety Huddle and Team discussion.

Your mentor will carry out your preliminary assessment, book dates for your initial, mid-point and final assessments and assist you with identifying the appropriate learning opportunities available to you. They will also facilitate helping you in meeting your learning needs.You will work at least 40% of your time with your mentor and work their shift pattern. The majority of staff work 08.00-18.00 four days per week and have half an hour for lunch.

Dress Code

Please come to work wearing your student uniform which you must wear at all times except when you are in the angiography department when you will wear theatre blue scrub suits which are provided in the department as are changing facilities.



Examples of Pathways of Care (Patient Journeys)

The Radiology Department takes patients form across the hospital including all wards and many departments. We also have a very large number of patients who attend from home (Out patients). Therefore we can be caring for patients of all ages, some are very well while others are on a ventilator and are from Intensive Care.

The radiology nurse team is part of a large multidisciplinary team that all work within the Radiology Department. This team includes radiographers, radiologists and clerical staff. For any interventional procedure there will always be a radiology nurse, a radiographer and a radiologist.

We constantly communicate with nurses on the wards on how to prepare their patients for an interventional radiology procedure, and how to care for that patient post procedure. We also liaise with medical staff and specialist nurses.

Spoke Directory and Contact Details

Students are encouraged to spend time on spoke placements with the specialist nurses and other members of the multidisciplinary team to enhance their learning. This will allow the students to see patients in a different healthcare setting and gain an insight to the many facets of patient care. The following spoke placements are available providing a range of learning experiences:

We have divided our placement into 2 rings and a central hub. The central hub being those rooms and lists that we cover regularly. The 1st ring shows those areas within radiology that we do not cover regularly but will give our students an opportunity for multidisciplinary working and the ability to follow a patient experience through radiology. Many of these areas are where the patients undergo investigation before they come to us for therapeutic intervention. The outer ring is generally where our patients come from and go back to such as outpatient clinics and wards.

.



Spoke placements within radiology

Obstetrics and Gynaecology Ultrasound Contact: Sharon Crawford 0161 206 5470Learning outcomes availableUltrasound imaging of obstetrics and gynaecology patients

Computerised Tomography (CT)Contact: Mrudula Thaker 0161 206 7689Learning outcomes availableCT imaging. Biopsies, drainages and aspirations under CT guidance.

Magnetic Resonance Imaging (MRI)Contact: Suzanne Phenna 0161 206 7689/0511Learning outcomes availableMR imaging. Sedation/GA of patients for scans.

MammographyContact: Catherine Hanna 0161 206 0320Learning outcomes availableImaging of patients with suspected breast carcinomas

Gamma Camera Contact: Wendy Johns 0161 206 4872Learning outcomes available Observation of investigations including renogram, bone density scans, skeletal survey for carcinoma, VQ scans breath tests for helicobacter

Fluoroscopy Room 7/8Contact: Lisa Lyon 0161 206 5739/4941Learning outcomes availableBarium meals and swallows. Complex bowel imaging. Micturating cystograms. ERCPs. Colonic stents.



Spoke Placements outside radiology

Vascular Access Nurse Contact: Ali Pondor 0161 206 61333Learning outcomes availableCare of patients with who need renal vascular access

Renal UnitContact Janet DunnLearning outcomes availableObserving and caring for patients undergoing haemdialysis.

Level 1 TheatresContact: Linda Weir 0161 206 5734Learning outcomes availableObservation of patients having fistula formation, ante grade renal stents and percutaneous nephrolithotomy

H4 - Urology Contact: Matron Charlotte Barrett 0161 206 5866Learning outcomes availableImmediate post care of nephrostomy patients

Endoscopy Unit Contact: Elaine Dyson 0161 206 1277Learning outcomes availableCare of patients undergoing Percutaneous endoscopic gastrostomies, endoscopic retrograde chloangio-pancreatography

C1 – Investigation Unit Contact: 62300Learning outcomes availablePre and post care of radiologically inserted gastrostomies

Motor Neurone Disease Specialist Nurse Contact: Sam Holden-SmithLearning outcomes availableCare of motor neurone disease patients

Upper Gastrointestinal (GI) Specialist Nurse Contact: Jenny StocktonLearning outcomes availableSupport of patients with upper GI carcinomas

Colorectal Specialist NursesContact: Amanda OgdenLearning outcomes availableSupport of patients with colorectal carcinomas

DieticianSister E McKnight October 2014 Version 1 12


Contact: Kirstine Ferrar Learning outcomes availableNutritional support of patients with oesophageal stents and RIG’s

Speech therapyContact: Laura DaviesLearning outcomes availableAssessment of patients with swallowing difficulties using Videofluroscopy Neuro - Theatres Contact: Vicky GibbonsLearning outcomes availableClipping of cerebral aneurysm

Subarachnoid Specialist NurseContact: Louise DulhantyLearning outcomes availableCare of patient post subarachnoid haemorrhage



Learning opportunities available

The imaging department offers a wide variety of learning opportunities including:

Contribution to the care pathway of a patient requiring imaging intervention.

Team working

Enhancement of your communication skills

Preparation of the clinical environment for the procedures

Assisting with the safe transfer of patients to and from the department

Observing new and innovative practices in diagnostic and therapeutic techniques.

Gaining an understanding of the physical and psychological aspects and needs of patients undergoing procedures. Also including the level of support required by relatives and significant others.

Development of your IT skills by using electronic patient records. Access to intranet and Internet with hyperlinks to the student nurse website and student notice board on the radiology website.

Interpretation of blood results, this will include understanding the relevance of blood clotting results and the anti coagulation requirements of vascular patients.

Developing an understanding of the most common medicines used in this area.

Monitoring of patients under conscious sedation.

Learning the importance of using aseptic technique when preparing and working close to a sterile field

Managing lists that include patients with MRSA and other infectious conditions.

Training in radiation awareness and MR safety.

Access to practice placement policies and professional codes.

Access to resource and competency packs for all hub placements.

Access to a range of spoke placements.



There are many opportunities for the Student to assist with the Health education of the patient.

Assisting with the after care of radiologically inserted gastrostomy tubes, for patients, carers and nursing staff.

Advising new oesophageal stent patients and their carers regarding diet. Advising patients with regard to a variety of imaging techniques

Links to useful websites

http://www.nmc-uk.org/Students/Guidance-for-students/

. https://www.surveymonkey.com/s/RTRZNVF


https://www.surveymonkey.com/s/RTRZNVF

http://www.nmc-uk.org/Students/Guidance-for-students/


Senior Sister Elaine McKnight

Department Management, Gastroenterology, Renal and Vascular. Practice education lead

Sister Paula Mitchell-Harper

Neuro – angiography Male catheterisation lead

Staff Nurse Le Xu

Neuro, Renal, vascular and gastro angiography.Infection control link. Mentor

Staff Nurse Elaine Wilkins

Neuro – angiography. Male/Female catheterisation

Staff NurseHelen T-Michael

Neuro, Renal, vascular and gastro angiography.Mentor. ANTT and IV link.

Staff Nurse Michelle Thompson

Diabetic link nurse, Female catheterisation.

Staff Nurse Stacey Hull

Neuro, Renal, vascular and gastro angiography.Mentor.

Assistant Practioner Jacqueline Greenhalgh

Neuro – angiography. Female catheterisation

Health Care AssistantKelly Green

Patient preparation, drainages/biopsies, stock co-ordinator. Female catheterisation. Dementia link.

Health Care AssistantEmma Power

Patient preparation, drainages/biopsies, gastroenterology. Female catheterisation. Resuscitation link

Support WorkerJohn Law

Portering, Circulating assistant

Support WorkerGail Beaumont

Portering, Circulating assistant

Staff Profile and Expertise

Mentor Development

All staff require education training updates annually and this will become part of the development of mentors program along with regular feedback meetings. All mentors are registered on the database.



Can you label all the parts of the Stomach?

1. Rugae2. Body3. Cardiac Sphincter4. Duodenum5. Pyloric Sphincter6. Oesophagus7. Fundus8. Pyloric Antrum



Gastrointestinal System – Can you identify all the parts of the GI system?



Can you label all the parts of the kidney?

(Use the labels below)



Can you label the Nephron?



Can you label all the parts of the Urinary System?

(Use the labels below)

1. Adrenal Gland 6. Renal Vein 11. Urethra

2. Right Kidney 7. Left Kidney

3. Ureter 8. Abdominal Aorta

4. Urinary Bladder 9. Inferior Vena Cava

5. Renal Artery 10. Common iliac artery and vein



Quiz for student nurse at the end of placement in Radiology

1. What is the GI tract?

2. What reasons may an individual needs an oesophageal stent?

3. What are the risks and complications relate to RIG(radiologically inserted gastrostomy)

4. What is aneurysm? What are the possible contributing factors?

5. What are complications of endovascular coiling?

6. What is a nephrostomy and what’s the common reason it is performed?

7. What is fistular angioplasty and why it is performed?



8. What is IVC filter and why it is inserted ?

9. Why is infection control so important in radiology?

10.What is the medication used in radiology for sedation ,and what are the side-effects?



1 - Midazolam

Indications:

Cautions:

Contraindications:

Side effects:

Dose:

Route of administration:



2 –Oxycodone

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




3 – Fentanyl

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




4 – Gentamycin

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




5 – Co-amoxiclav

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




6 – Buscopan

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




7 – Nimodipine

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




8 – Sodium Amytal

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




9 – Aspirin

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




10 – Warfarin

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




11 – Heparin

Indications:

Cautions:

Contraindications:

Side effects:

Dose:




12 – Tinzaparin

Indications:

Cautions:

Contraindications:

Side effects:



Dose:


13 – Lidocaine

Indications:

Cautions:

Contraindications:

Side effects:



Dose:


14 – Omnipaque

Indications:

Cautions:

Contraindications:

Side effects:



Dose:


15 – Optiray

Indications:

Cautions:

Contraindications:

Side effects:



Dose:


Useful Facts

Controlled drugs (CD‟s) defined in this policy are those substances contained within Schedules 1 and 2 of the Misuse of Drugs Act 1971. The Trust, however, has extended this term to include other substances that are open to abuse, or are high risk medicines or „controlled‟ for other reasons. These substances include oral morphine solution 10mg/5ml, Temazepam, Midazolam, Ketamine, mifepristone and strong potassium chloride injection/solutions.

Controlled drugs held in the Radiology department, this MUST be requisitioned by Radiologists, registered nurses working in the radiology department or operating department practitioners. Registered radiographers may receive and perform daily balance checks on the stock held but are not allowed to requisition.

Medicines must be stored in the containers in which they are supplied by the Pharmacy department. They must never be transferred to another container. The only approved exception is for ampoules of sodium chloride 0.9% and water for injection (WFI).

The stock balance of CDs entered in the ward or department CD record book against stocks held in the cupboard MUST be checked every 24 hours as a minimum. This MUST be carried out by registered nurses, midwives or registered health care



professionals. The details of the check carried out should be recorded with the date and time of reconciliation and signature of the nurse, midwife or ODP and the witness.

There MUST be two members of staff involved in the administration of a controlled drug one of whom MUST be a registered general nurse (RGN) or midwife, doctor or ODP. The second person (the witness) can be an RGN, midwife, doctor, and pharmacist or registered ODP. In community hospitals an appropriately trained nursing auxiliary may be appropriate but only where one registered nurse is on duty and a doctor is unavailable.

Student nurses may be the witness for a qualified nurse but this will depend on experience and the complexity of the controlled drug that is being administered.

RememberThe Five R’s

When administering medication the:

Right patient should get the

Right medication at the

Right time at the

Right dose, by the

Right route



Along with this workbook read the Trust policies for the administration of

medicine.

This is available on synapse.



Achieving excellence in learning and care...

Placement CharterThis Charter demonstrates the Placement’s commitment to provide a safe and high quality learning environment for all learners to prepare them for their future roles working collaboratively in multi-professional teams. The ‘Placement Pledges’ and the ‘Rights, Roles and

Responsibilities of learners’ instil the values embedded within the NHS Constitution (DH 2013) and Health Education England’s NHS Education Outcomes Framework (DH 2012).

Placement Pledges Rights, Roles and Responsibilities of learners

Ensure all learners are welcomed, valued and provided with an inclusive, safe, stimulating and supportive learning experience.

Prepare adequately for the placement, including contact with the placement in advance. Disclose any health or learning needs that may impact on the placement, or the achievement of learning outcomes.

Promote a healthy and ‘just’ workplace culture built on openness and accountability, encouraging all learners to raise any concerns they may have about poor practice or ‘risk’, including unacceptable behaviours and attitudes they observe at the earliest reasonable opportunity. Respond appropriately when concerns are raised.

Raise any serious concerns about poor practice or ‘risk’, including unacceptable behaviours and attitudes observed at the earliest opportunity. Be clear who to report any concerns to in order to ensure that high quality, safe care to patients /service users and carers is delivered by all staff.

Provide all learners with a named and appropriately qualified / suitably prepared mentor / placement educator to supervise support and assess all learners during their placement experience.

Actively engage as an independent learner, discuss learning outcomes with an identified named mentor / placement educator, and maximise all available learning opportunities.



Provide role modelling and leadership in learning and working, including the demonstration of core NHS ‘values and behaviours’ of care and compassion, equality, respect and dignity, promoting and fostering those values in others.

Observe effective leadership behaviour of healthcare workers, and learn the required NHS ‘values and behaviours’ of care and compassion, equality, respect and dignity, promoting and fostering those values in others.

Facilitate a learner’s development, including respect for diversity of culture and values around collaborative planning, prioritisation and delivery of care, with the learner as an integral part of the multi-disciplinary team.

Be proactive and willing to learn with, from and about other professions, other learners and with service users and carers in the placement. Demonstrate respect for diversity of culture and values, learning and working as part of the multi-disciplinary team.

Facilitate breadth of experience and inter-professional learning in placements, structured with the patient, service user and carer at the centre of care delivery, e.g. patient care pathways and commissioning frameworks.

Maximise the opportunity to experience the delivery of care in a variety of practice settings, and seek opportunities to learn with and from patients, service users and carers.



Adopt a flexible approach, utilising generic models of learner support, information, guidance, feedback and assessment across the placement circuit in order to support the achievement of placement learning outcomes for all learners.

Ensure effective use of available support, information and guidance, reflect on all learning experiences, including feedback given, and be open and willing to change and develop on a personal and professional level.

Offer a learning infrastructure and resources to meet the needs of all learners, ensuring that all staff who supervise learners undertake their responsibilities with the due care and diligence expected by their respective professional and regulatory body and organisation

Comply with placement policies, guidelines and procedures, and uphold the standards of conduct, performance and ethics expected by respective professional and regulatory bodies and organisations.

Respond to feedback from all learners on the quality of the placement experience to make improvements for all learners.

Evaluate the placement to inform realistic improvements, ensuring that informal and formal feedback is provided in an open and constructive manner.

• ‘Learner’ refers to all health, education and social care students, trainees, hosted learners.

• ‘Placement’ relates to all learning environments / work based learning experiences.

• ‘Mentor’/ ‘placement educator’ relates to all trainers / supervisors / coordinators appropriately qualified / suitably prepared to support learners.

• ‘Professional and regulatory body and organisation’ relates to standards required to ensure patient and public safety, and professional behaviours.

Developed in the North West by healthcare learners, service users, carers, and health and social care staff from all professions in the North West region.

Health Education North West


http://nw.hee.nhs.uk/%00%E5%A1%B9%EF%92%81%E1%B4%BB%E4%A1%BF%E2%B2%AF%E5%B6%82%E8%97%84%E6%8C%A7%00%00%EA%AE%A5

welcome to the radiology department€¦ · web viewgamma camera . contact: wendy johns 0161 206...

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