Ward Staff Knowledge [QSI Ref: XR-304]

Ward staff knowledge of Imaging Procedures. The understanding of imaging procedures and related patient care by ward nurses.

• Undergoing medical investigation is a stressful and anxious time for patients [1]

• Patients benefit from and are reassured by advance information on procedures that they are to undergo. Better understanding of imaging procedures by ward staff can be of help to patients. It can reduce anxiety and confusion and potentially improve image quality [2-4]

• Knowledge of the procedure is important to ensure adequate patient preparation, to avoid unnecessary aspects of preparation, e.g. fasting for all CT scans and avoid wasted appointments through improper patient preparation. It may also help with identification and monitoring of any complications, e.g. identifying prior contrast reactions.

The standard: 

A locally agreed standard should be decided. However, virtually all trained nursing staff on the ward should have adequate knowledge of common imaging procedures relevant to their patient population and any preparatory requirements for the investigation such as cannulation, fasting, eGFR, etc.

Target: 

Starting with the most relevant clinical areas that utilise these imaging procedures the most such as Medical Admissions Unit (MAU) and Surgical Assessment (SAU) maybe most appropriate.

Indicators: 

Percentage of permanent trained nursing staff who demonstrate sufficient understanding of current imaging procedures.

Data items to be collected: 

- Use the questionnaire in Resources and tailor it to the specialty being audited

- Score as 1 point per correct answer and no negative marking

Suggested number: 

All permanent trained nursing staff in the specialty of interest.

• Ensure any local resources such as intranet pages are up-to-date

• Consider distributing an explanatory leaflet toward staffConsider providing patient leaflets to the ward giving brief information about the imaging procedure which can be administered at the discretion of the ward staff

• Encourage nurses to accompany patients to the radiology department and observe the procedures

• Arrange educational talks for nurses and nurses-in-training. Given the dynamic evolving nature of radiology as a specialty, there may be benefit from an on-going programme of education [5]

• If these other interventions fail to improve audit outcomes, consider reinforcing the information through a basic check-list which is completed prior to patient attendance for the imaging procedure

• Involve the Director of Nursing in any changes

• Highlight useful educational resources [6,7]

- Download questionnaire below

- Co-operation of ward staff and approximately 10 minutes per member completing the questionnaire

- Radiology Staff member:

   • 8 hours to modify the questionnaire

   • Liaise with the ward sister

   • To analysis data from the preliminary audit. Longer will be required to complete the cycle

1. Flory N, Lang EV. Distress in the Radiology Waiting Room. Radiology 260: 166-173.

2. Clark CR, Gregor FM. Developing a sensation information message for femoral arteriography. J Adv Nursing 1988;13:237–44.

3. Hjelm Karlesson K. Effects of information to patients undergoing intravenous pyelography. An intervention study. J Adv Nursing 1989;14:853–62.

4. Tornqvist E, Mansson A, Larsson E.-M, Hallstrom I. Impact of extended written information on patient anxiety and image motion artefacts during magnetic resonance imaging. Acta Radiol 2006;47:474–480.

5. Majeed MA, Nayeemuddin M, Christie M. Ward nurses' knowledge of computed tomography scanning. Br J Nurs. 2006 Aug 10-Sep 13;15(15):825-7.

6. Nurs Stand. 2006 Jun 21-27;20(41):46-51.Medical imaging techniques: implications for nursing care. Malcolm A.

7. http://www.goingfora.com/radiology/index.html 

A Beattie on behalf of CRAC. Updated by Ravivarma Balasubramaniam 2021