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Chapter002 1 Chapter002 1 Presentation Transcript

  • Patient Assessment and Communication in Imaging Chapter 2
  • Introduction
    • As Radiographers, we must learn to asses the needs of the patient and formulate a plan of care that best fits the individual.
      • Assessment
      • Critical thinking
      • Problem solving
      • Therapeutic communication
      • Patient education
  • The Health-Illness Continuum
    • All persons seek to maintain a high level of well-being. Health can be defined as the status of an organism functioning without any evidence of disease or disfigurement. Unfortunately a perfect state of health is rarely achieved; therefore, health is seen as on a “continuum.”
    • Stress
    • Basic needs
  • Basic Human Needs
    • 1. Physiological needs
    • 2. Safety and security
    • 3. Love and belonging
    • 4. Self-esteem and esteem of others
    • 5. Self actualization
  • Critical Thinking
    • The hallmark of an excellent radiographer is the ability to achieve a positive diagnostic or treatment result in a timely, efficient manner while meeting the unique needs of the individual patient.
      • Cognition
      • Effect
      • Didactic
      • Psychomotor
    • Learning requires cognitive, affective and psychomotor skills.
  • Critical Thinking Requires
    • The ability to interpret
    • Analyze
    • Evaluate
    • Infer
    • Explain
    • Reflect
  • Modes of Thinking
    • Recall
      • Knowledge of scientific facts that you can recall at a moment’s notice while with patients
    • Habit
      • You will develop habits that make for the efficient practice of learned skills
    • Inquiry
      • Using the skills of recall and habit along with higher mode of thinking
    • Creativity
      • It is used to solve individual problems and to prevent causing the patient discomfort or pain
  • Problem Solving and Patient Assessment
    • Every patient and every diagnostic procedure presents problems ranging from simple to complex.
    • The student radiographer must decide how to perform the assignment quickly, efficiently, and as comfortable as possible for the patient.
      • Data collection
      • Data analysis
      • Implementation
      • Evaluation
  • Data Collection
    • There are 2 types:
    • Subjective: Anything that the patient or significant other who accompanies the patient say in regards to their care.
    • Objective: Anything you see, hear, feel, or read on the patient’s chart; or, information given by another health care worker.
  • Data Analysis
    • This part of assessment integrates all segments of critical thinking.
    • Once all the data has been collected, you must decide how will you achieve your goal to perform this exam with quality images, patient comfort, and efficiency.
    • This method requires demand recall.
  • Planning and Implementation
    • Planning requires the use of all modes of thinking.
    • Theoretical concepts learned from classroom instruction are recalled.
    • Implementation of the plan depends on the patient’s problems and the need for assistance to achieve the desired goal safely.
  • Evaluation
    • Each patient care situation differs in some way or another. As a student you will observe many approaches to a successful exam.
    • One must never cease learning from the patient regardless of how many years of experience he or she possesses.
    • Each patient care situation differs in some ways from all others encountered; therefore, all patient care experiences are learning experiences.
  • Cultural Diversity in Patient Care
    • Culture is defined as: “The socially inherited characteristics of a group of people that are transmitted from one generation to the next” (Fejos, 1959).
    • The patient’s culture and ethnicity will play a major role in assessing the patient.
      • Culture
      • Sociological
      • Psychological
      • Physiological and Biological
    • Cultural and ethnic diversity are a part of the radiographer’s assessment and plan of care.
  • Patient Expectations
    • The patient also has expectations of health care professionals.
    • The patient expects professionals to be:
      • Concerned
      • Clean
      • Well groomed
      • Professional
      • Deliver quality patient care
  • Communication
    • All members of the health care team must learn to communicate clearly and therapeutically with the patients.
    • Any problem of communication, whether major or minor, has an impact on the patient’s health care.
    • To become a successful communicator you must develop skills:
      • Listening
      • Observing
      • Speaking
      • Writing
  • Non Verbal Communication
    • There is more to communicate than the spoken word.
    • The unspoken or nonverbal aspects of communication can be defined as all stimuli other than the spoken word involved in communication.
    • Non-Verbal communication functions in the following ways:
      • It may repeat or stress the spoken messages
      • It may accent the spoken word
      • It may regulate the spoken word
      • It may substitute for verbal communication
  • Gender Factors
    • The radiographer must be aware that the manner of communication will vary depending upon the sex of the patient.
    • The possibility of a patient requesting a technologist of the opposite gender.
    • The radiographer must also be sensitive to the issue of gender in his or her professional interactions with co-workers.
    • Avoid sexual innuendoes.
  • Other Factors that Affect Communication
    • Paralanguage – has to do with the sounds of the speech, rather than the content.
    • A patient who has difficulty standing, sit the patient and make them comfortable.
    • If the patient has difficulty hearing, speak louder.
    • Speak to the patient.
  • Establishing Communication Guidelines
    • Many relationships between the radiographer and patient are brief and it is essential to make the best use of the time.
    • Establishing guidelines for interaction is essential.
      • Introducing oneself to the patient
      • Give an explanation of the exam
      • Give an explanation of what is expected of the patient and what the patient can expect from the imaging staff
  • Obtaining a Patient History
    • The goal of a patient history is to obtain necessary information to perform a safe and comfortable examination.
    • Obtaining the information accurately demands sensitivity and critical thinking on the radiographer’s part.
    • During the history taking process, the radiographer must convey a professional image to ensure the patient’s confidence.
  • Patient Education
    • A patient who comes to the imaging department has a right to expect that he or she will be instructed as to the exam.
      • A detailed description of the procedure.
      • A description of the purpose of the exam.
      • Approximate amount of time.
      • An explanation of any unusual equipment.
      • Follow up care/results after procedure is complete.
      • If the patient questions the exam, do not begin until the problem is resolved.
  • Loss and Grief
    • Phase I – Denial
    • Phase II – Anger
    • Phase III – Bargaining
    • Phase IV – Depression
    • Phase V – Acceptance
  • Patients Rights Related to End of Life Issues
    • The public’s wishes to make their own determination in this matter was resolved when the PATIENT SELF DETERMINATION ACT (PSDA) was made law in 1990.
    • Advanced Directive
      • They are legal documents that are formulated by a competent person that provides written information concerning the patient’s desire if they are unable to make the decision on their own.
  • Cont.
    • Living will
    • Directive to Physician
    • Durable Power of Attorney for Health Care (DPAHC)
    • DNR
    • NO CODE