Department of Radiology

1
Role of a Radiology Nurse

• Department of Radiology
• Royal Adelaide Hospital
• Rhys Ellison RN BN
• July 2007

2
The Goal of Nursing

• ...is to promote, restore, maintain and enhance
  the health of individuals and groups in the
  community.
• The Nurses Board of South Australia (2006)

3
Nursing is . . .

• ... a science and an art.
• The Nurses Board of South Australia (2006)

4
The Science is . . .

• . . . the body of nursing knowledge and the
  technical aspects of clinical practice.
• The Nurses Board of South Australia (2006)

5
The Art is . . .

• . . . the establishment of a caring relationship
  through which the nurse applies nursing knowledge
  and skill.
• The Nurses Board of South Australia (2006)

6
Nurses are

• Registered
• Three-year University Degree Course
• Enrolled
• Eighteen-month Diploma Course

7
Nurses are

• - Care Givers
• - Advocates

8
Care Givers

• Assist in the Imaging Process
• Ensure the correct person receives the correct
  image
• Ensure the patient/client is safe and able to
  undertake to procedure
• Monitor the patient/client through out the
  procedure
• Report additional precautions the person may
  require to the imaging personnel
• Hand over the outcome and ongoing requirements
  to the wards, emergency department or other
  health care team

9
Care Givers

• - Ensure that Additional Precautions are adhered
  to
• Maintain a safe work environment for themselves,
  the other staff and the patient/client
• Hazards are identified, reported and rectified
• Triage the clientele into an order of priority,
  when necessary

10
Advocates

• Ensure that patients/clients
• Understand the need for the Imaging that is
  requested
• Are informed and that if necessary a Consent is
  obtained
• Liaise between patient/client and
  Radiographer/Radiologist
• Arrange for continuing treatment/monitoring
  after interventional imaging and/or procedures

11
Modalities

• General X-ray
• Angiography and Vascular Access (PICC lines
  etc.)
• Ultrasound
• CT (Computerised Tomography)
• MRI (Magnetic Resonance Imaging)
• Screening
• Nuclear Medicine
• Radiotherapy

12
General X-ray

• Nurses
• Assist in the positioning of people for their
  imaging, including when sliding people onto the
  X-ray table
• Changing people when necessary for the imaging,
  or if they are soiled (blood, incontinence etc.)
• Utilising lifting machines to transfer people
  from wheelchair to the X-ray table

13
General X-ray

• General X-ray Room 5

14
Chest X-ray

• Normal Chest
• (Oldnall 2007)

15
Angiography (Non-Cardiac)

• - Scrub to assist Radiologist/Radiology Registrar
  with the interventional procedures
• Monitor patient/client throughout the procedure
  (Pulse, Blood Pressure, Intravenous Therapy etc.)
• Ensure documentation is completed by all staff
  where required
• Hand over to the following health care team the
  requirement of the patient after an
  interventional procedure

16
Angiography (Non Cardiac)

• Normal Angiography
• (Oldnall 2007)

17
Angiography Suite

• Specials Room

18
Angiography Suite

• Angiography Room

19
PICC line insertion

• Nurse position
• Peripherally Inserted Central Catheter (PICC)
• Utilised for long term venous access
• Reduces the need for multiple Intravenous (IV)
  Cannula
• Often for Haematology, Intensive Care and Cancer
  Services patients
• Also for those people with Cystic Fibrosis

20
PICC Line

• PICC Line on X-ray
• chris-says (2006)

21
PICC Line

• Various PICC Lines
• Massachusetts General Hospital (2007)

22
Ultrasound

• Currently there is not a permanent position for a
  nurse in the Ultrasound area at the Royal
  Adelaide Hospital, though we are available when
  required to
• Assist in the positioning of patients
• Assist with interventional procedures
• - Biopsies
• - Drainage of Fluid Collections
• - Chaperone when intimate examinations are
  performed
• (Testes and Trans-vaginal Ultrasound procedures)

23
Ultrasound

• Normal
• Hepatic (Liver) and Renal (Kidney) Ultrasound
• (Oldnall 2007)

24
Ultrasound Room

• Room 1

25
CT Scan(Computerised Tomography)

• Ensure the person understands the need for the
  CT Scan
• Assist in the positioning of the patient for the
  CT Scan
• Ensure an intravenous (IV) cannula is inserted
  and patent (working)
• Ensure an Intravenous Contrast Checklist is
  completed and reviewed by a Radiologist/Radiology
  Registrar

26
CT Scan(Computerised Tomography)

• Draw up and administer Intravenous Contrast if
  required for the CT Scan
• Assist in the treatment of Reactions to the
  Intravenous Contrast
• Ensure Documentation is completed by the relevant
  staff
• Assist with interventional procedures
• - Biopsies
• - Drainages of fluid collections
• - Myelograms, Facet joint Injections etc.

27
CT Scan (Computerised Tomography)

• Normal
• Upper Abdomen CT
• (Oldnall 2007)

28
CT Scan Rooms

• CT 1

29
CT Scan Rooms

• CT 2

30
MRI(Magnetic Resonance Imaging)

• Currently there is not a permanent position for a
  nurse in the MRI Unit at the Royal Adelaide
  Hospital, though we are available when required
  to
• Assist in administering Patient care (Bed pans,
  Suction etc.)
• Transferring patients onto/off of the MRI Scan
  table

31
MRI (Magnetic Resonance Imaging)

• Normal
• Upper Abdomen MRI
• (Oldnall 2007)

32
MR Scan Room

• MR Scanner Level 2

33
Screening

• Ensure the person understands the need for the
  Procedure
• Ensure they have completed a preparation
  procedure if it was required (e.g. bowel
  cleansing preparations)
• Assist in the positioning of the person
• Assist in the preparation of solutions, contrast
  media that may be required for the procedure

34
Screening

• Procedures include
• - Barium Studies (Swallows and Enemas)
• - Fluoroscopy of the Knee (or another joint)
• - Tubograms and Sinograms

35
Screening

• Normal Barium Studies
• Small Intestine Large Intestine
• (Oldnall 2007)

36
Screening

• Knee Imaging
• Post-Knee Reconstruction
• (Oldnall 2007)

37
Screening

• Screening Room

38
Nuclear Medicine

• - Assist the Nuclear Medicine Technicians and the
  Radiologists
• Prepare the patient for procedures
• Insert, or arrange, for the insertion of
  intravenous (IV) cannula
• Take blood
• Administer medications
• Continue nursing care
• Ensure documentation is completed by the
  relevant staff
• Arrange for the transportation from the
  department

39
Nuclear Medicine

• PET Scan
• (Positron Emission Tomography)
• Whole Body
• Advanced Diagnostic Radiology (2006)

40
Nuclear Medicine

• PET Scanner
• (Philips Gemini)
• Koninklijke Philips Electronics (2004-2007)

41
Radiotherapy

• Assist the Radiotherapy Technicians and the
  Medical Officers
• Prepare the patient for procedures
• Insert, or arrange, for the insertion of
  intravenous (IV) cannula
• Administer medications
• Continue nursing care
• Ensure documentation is completed by the
  relevant staff
• Arrange for the transportation from the
  department

42
Radiotherapy

• Chest CT Scan
• Tumour Identified
• (Pre-Radiotherapy)
• Twelve months after
• Treatment
• Bush, D., Slater, J., Bonnet, R., Cheek, G.,
• Dunbar, R., Moyers, M., and Slater, J. (1999)