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Chapter002 1

  1. 1. Patient Assessment and Communication in Imaging Chapter 2
  2. 2. Introduction <ul><li>As Radiographers, we must learn to asses the needs of the patient and formulate a plan of care that best fits the individual. </li></ul><ul><ul><li>Assessment </li></ul></ul><ul><ul><li>Critical thinking </li></ul></ul><ul><ul><li>Problem solving </li></ul></ul><ul><ul><li>Therapeutic communication </li></ul></ul><ul><ul><li>Patient education </li></ul></ul>
  3. 3. The Health-Illness Continuum <ul><li>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.” </li></ul><ul><li>Stress </li></ul><ul><li>Basic needs </li></ul>
  4. 4. Basic Human Needs <ul><li>1. Physiological needs </li></ul><ul><li>2. Safety and security </li></ul><ul><li>3. Love and belonging </li></ul><ul><li>4. Self-esteem and esteem of others </li></ul><ul><li>5. Self actualization </li></ul>
  5. 5. Critical Thinking <ul><li>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. </li></ul><ul><ul><li>Cognition </li></ul></ul><ul><ul><li>Effect </li></ul></ul><ul><ul><li>Didactic </li></ul></ul><ul><ul><li>Psychomotor </li></ul></ul><ul><li>Learning requires cognitive, affective and psychomotor skills. </li></ul>
  6. 6. Critical Thinking Requires <ul><li>The ability to interpret </li></ul><ul><li>Analyze </li></ul><ul><li>Evaluate </li></ul><ul><li>Infer </li></ul><ul><li>Explain </li></ul><ul><li>Reflect </li></ul>
  7. 7. Modes of Thinking <ul><li>Recall </li></ul><ul><ul><li>Knowledge of scientific facts that you can recall at a moment’s notice while with patients </li></ul></ul><ul><li>Habit </li></ul><ul><ul><li>You will develop habits that make for the efficient practice of learned skills </li></ul></ul><ul><li>Inquiry </li></ul><ul><ul><li>Using the skills of recall and habit along with higher mode of thinking </li></ul></ul><ul><li>Creativity </li></ul><ul><ul><li>It is used to solve individual problems and to prevent causing the patient discomfort or pain </li></ul></ul>
  8. 8. Problem Solving and Patient Assessment <ul><li>Every patient and every diagnostic procedure presents problems ranging from simple to complex. </li></ul><ul><li>The student radiographer must decide how to perform the assignment quickly, efficiently, and as comfortable as possible for the patient. </li></ul><ul><ul><li>Data collection </li></ul></ul><ul><ul><li>Data analysis </li></ul></ul><ul><ul><li>Implementation </li></ul></ul><ul><ul><li>Evaluation </li></ul></ul>
  9. 9. Data Collection <ul><li>There are 2 types: </li></ul><ul><li>Subjective: Anything that the patient or significant other who accompanies the patient say in regards to their care. </li></ul><ul><li>Objective: Anything you see, hear, feel, or read on the patient’s chart; or, information given by another health care worker. </li></ul>
  10. 10. Data Analysis <ul><li>This part of assessment integrates all segments of critical thinking. </li></ul><ul><li>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. </li></ul><ul><li>This method requires demand recall. </li></ul>
  11. 11. Planning and Implementation <ul><li>Planning requires the use of all modes of thinking. </li></ul><ul><li>Theoretical concepts learned from classroom instruction are recalled. </li></ul><ul><li>Implementation of the plan depends on the patient’s problems and the need for assistance to achieve the desired goal safely. </li></ul>
  12. 12. Evaluation <ul><li>Each patient care situation differs in some way or another. As a student you will observe many approaches to a successful exam. </li></ul><ul><li>One must never cease learning from the patient regardless of how many years of experience he or she possesses. </li></ul><ul><li>Each patient care situation differs in some ways from all others encountered; therefore, all patient care experiences are learning experiences. </li></ul>
  13. 13. Cultural Diversity in Patient Care <ul><li>Culture is defined as: “The socially inherited characteristics of a group of people that are transmitted from one generation to the next” (Fejos, 1959). </li></ul><ul><li>The patient’s culture and ethnicity will play a major role in assessing the patient. </li></ul><ul><ul><li>Culture </li></ul></ul><ul><ul><li>Sociological </li></ul></ul><ul><ul><li>Psychological </li></ul></ul><ul><ul><li>Physiological and Biological </li></ul></ul><ul><li>Cultural and ethnic diversity are a part of the radiographer’s assessment and plan of care. </li></ul>
  14. 14. Patient Expectations <ul><li>The patient also has expectations of health care professionals. </li></ul><ul><li>The patient expects professionals to be: </li></ul><ul><ul><li>Concerned </li></ul></ul><ul><ul><li>Clean </li></ul></ul><ul><ul><li>Well groomed </li></ul></ul><ul><ul><li>Professional </li></ul></ul><ul><ul><li>Deliver quality patient care </li></ul></ul>
  15. 15. Communication <ul><li>All members of the health care team must learn to communicate clearly and therapeutically with the patients. </li></ul><ul><li>Any problem of communication, whether major or minor, has an impact on the patient’s health care. </li></ul><ul><li>To become a successful communicator you must develop skills: </li></ul><ul><ul><li>Listening </li></ul></ul><ul><ul><li>Observing </li></ul></ul><ul><ul><li>Speaking </li></ul></ul><ul><ul><li>Writing </li></ul></ul>
  16. 16. Non Verbal Communication <ul><li>There is more to communicate than the spoken word. </li></ul><ul><li>The unspoken or nonverbal aspects of communication can be defined as all stimuli other than the spoken word involved in communication. </li></ul><ul><li>Non-Verbal communication functions in the following ways: </li></ul><ul><ul><li>It may repeat or stress the spoken messages </li></ul></ul><ul><ul><li>It may accent the spoken word </li></ul></ul><ul><ul><li>It may regulate the spoken word </li></ul></ul><ul><ul><li>It may substitute for verbal communication </li></ul></ul>
  17. 17. Gender Factors <ul><li>The radiographer must be aware that the manner of communication will vary depending upon the sex of the patient. </li></ul><ul><li>The possibility of a patient requesting a technologist of the opposite gender. </li></ul><ul><li>The radiographer must also be sensitive to the issue of gender in his or her professional interactions with co-workers. </li></ul><ul><li>Avoid sexual innuendoes. </li></ul>
  18. 18. Other Factors that Affect Communication <ul><li>Paralanguage – has to do with the sounds of the speech, rather than the content. </li></ul><ul><li>A patient who has difficulty standing, sit the patient and make them comfortable. </li></ul><ul><li>If the patient has difficulty hearing, speak louder. </li></ul><ul><li>Speak to the patient. </li></ul>
  19. 19. Establishing Communication Guidelines <ul><li>Many relationships between the radiographer and patient are brief and it is essential to make the best use of the time. </li></ul><ul><li>Establishing guidelines for interaction is essential. </li></ul><ul><ul><li>Introducing oneself to the patient </li></ul></ul><ul><ul><li>Give an explanation of the exam </li></ul></ul><ul><ul><li>Give an explanation of what is expected of the patient and what the patient can expect from the imaging staff </li></ul></ul>
  20. 20. Obtaining a Patient History <ul><li>The goal of a patient history is to obtain necessary information to perform a safe and comfortable examination. </li></ul><ul><li>Obtaining the information accurately demands sensitivity and critical thinking on the radiographer’s part. </li></ul><ul><li>During the history taking process, the radiographer must convey a professional image to ensure the patient’s confidence. </li></ul>
  21. 21. Patient Education <ul><li>A patient who comes to the imaging department has a right to expect that he or she will be instructed as to the exam. </li></ul><ul><ul><li>A detailed description of the procedure. </li></ul></ul><ul><ul><li>A description of the purpose of the exam. </li></ul></ul><ul><ul><li>Approximate amount of time. </li></ul></ul><ul><ul><li>An explanation of any unusual equipment. </li></ul></ul><ul><ul><li>Follow up care/results after procedure is complete. </li></ul></ul><ul><ul><li>If the patient questions the exam, do not begin until the problem is resolved. </li></ul></ul>
  22. 22. Loss and Grief <ul><li>Phase I – Denial </li></ul><ul><li>Phase II – Anger </li></ul><ul><li>Phase III – Bargaining </li></ul><ul><li>Phase IV – Depression </li></ul><ul><li>Phase V – Acceptance </li></ul>
  23. 23. Patients Rights Related to End of Life Issues <ul><li>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. </li></ul><ul><li>Advanced Directive </li></ul><ul><ul><li>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. </li></ul></ul>
  24. 24. Cont. <ul><li>Living will </li></ul><ul><li>Directive to Physician </li></ul><ul><li>Durable Power of Attorney for Health Care (DPAHC) </li></ul><ul><li>DNR </li></ul><ul><li>NO CODE </li></ul>