General guidance applicable to all examinations

Examinations should only be carried out by qualified and licensed Radiology staff.

•         The Radiographic request form is a legal documentation and should only be completed by a referring clinician.

•         All patients must be given X-Ray or Scan number for proper documentation of the request in the departmental register

•          Patient demographics must be checked and updated at every point of the patient's journey in the departmental register if necessary.

•          All requested investigations must be entered in the Departmental register.

•          All handwritten requests must be signed by the referring Doctor.

•          Check and ensure that the patient has not already been scanned or has an appointment already booked (i.e., avoid the investigation being repeated).

•          If the referrer or referring location cannot be identified, contact the

 

Director of Radiography

•         For plain film radiography, the Radiographer as a Practitioner must check that the examination is justified and that the clinical details match the request. The request form must be signed and dated to confirm this.

•          The patient should be positively identified with the three-point identity check; Patient's Name, Address, DOB. The request form must be signed and dated to confirm this.

•          Further questions/checks should also be undertaken as appropriate and documented e.g., is the Patient Pregnant or Breast Feeding? Is the patient diabetic or asthmatic etc.

•          Check if the Patient has followed the preparation instructions appropriately.

•          Radiographers take ownership of producing good diagnostic radiographs of their patients.

•          All patients for scan (except emergency cases) must be scheduled for scanning close to their next appointment day, or if possible, on their appointment day.

•          No request form without proper patient's history should be attended to.

•          Except otherwise indicated, evidence of correct payment must be attached to each request form before any patient is attended to.

•          Patients' consent must be obtained before any contrast-based investigation and augmented breast mammography is done.

 

General guidance applicable to all examinations

Examinations should only be carried out by qualified and licensed Radio-diagnostic staff.

•          The Radiographic request form is a legal documentation and should only be completed by a referring clinician.

•          All patients must be given X-Ray or Scan number for proper documentation of the request in the departmental register

•          Patient demographics must be checked and updated at every point of the patient's journey in the departmental register if necessary.

•          All requested investigations must be entered in the Departmental register.

•          All handwritten requests must be signed by the referring Doctor.

•          Check and ensure that the patient has not already been scanned or has an appointment already booked (i.e., avoid the investigation being repeated).

•          If the referrer or referring location cannot be identified, contact the Director of Radiography

•          For plain film radiography, the Radiographer as a Practitioner must check that the examination is justified and that the clinical details match the request. The request form must be signed and dated to confirm this.

•          The patient should be positively identified with the three-point identity check; Patient's Name, Address, DOB. The request form must be signed and dated to confirm this.

•          Further questions/checks should also be undertaken as appropriate and documented e.g., is the Patient Pregnant or Breast Feeding? Is the patient diabetic or asthmatic etc.

•          Check if the Patient has followed the preparation instructions appropriately.

•          Radiographers take ownership of producing good diagnostic radiographs of their patients.

•          All patients for scan (except emergency cases) must be scheduled for scanning close to their next appointment day, or if possible, on their appointment day.

•          No request form without proper patient's history should be attended to.

•          Except otherwise indicated, evidence of correct payment must be attached to each request form before any patient is attended to.

•         Patients' consent must be obtained before any contrast-based investigation and augmented breast mammography is done.  Prior to the Investigation

 

In addition to the General Guidelines above,

•          All patients must have the UCTH hospital number before putting the request on the departmental register.

•          Any patient without an UCTH hospital number must be vetted by the Director of Radiography before it's entered into the Departmental register.

•          Patient demographics must be update if necessary.

Patients for each modality are given appointments according to each modality booking rules.

Appropriate preparation/documentation should be posted or verbally communicated as necessary. The appropriate vetting pathway must be followed prior to booking/ attendance.

•          All request cards and supporting documentation must be checked and put on the Waiting list or Request List in the folder as soon as it is received in the Department.

•          All requests must be assigned the correct  X-ray number.

•          For appointments, the Radiographer must check that the examination is justified and that the clinical details match the request.

•          All paper requests must be filled in the correct form.

•          Request forms must be attached to the modality appointment lists for the day's appointments.

•          All modality appointment lists and request forms must be distributed to each modality area and put in an agreed confidential area ready for appointment/examination.

•          If the incoming request is not on the booking register, the department must be contacted before the examination can be undertaken (for Scan, Echo and special Radiological investigations).

•          Patient must only be 'Attended to' if request form is presented.

•          If the request form cannot be found, check the booking register to see if it had been cancelled before rebooking.

•          All in-patient and out-patient requests should come through the consultant managing the patient.

•         Urgent in-patient requests must be discussed with the radiographer on duty with the appropriate modality clearly indicated.

 

Cancellations

•          The patient must be contacted as soon as possible when cancellation is known.

•          The appointment should be rescheduled (where possible) at time of cancellation, and another appointment sent by post or text message.

•          Reschedule with the first appropriate/ available appointment date for the specific modality

 

Upon Attendance

•          For plain film radiography, the Radiographer must check that the examination is justified and that the clinical details match the request. The request form must be signed and dated to confirm this.

•          For other examinations, this would have been undertaken by the relevant Practitioner

•          In addition to the above Guidelines, the reason why the test is being carried out should be explained to the patient.

•          A description of what to expect should be given and patient's fears allayed.

•         A brief clinical history should be obtained if appropriate and necessary to examination.

•          The patient should verbally or otherwise consent where necessary, to undertake investigation.

•          Infection risks should be identified and managed in accordance with Infection Control Policies.

•          Radiographers must ensure that the correct patient details are on the imaging device before starting the examination.

•          Radiographers must check that the examination/order details are correct and correspond with the order line currently being dealt with (there may be occasions where there is more than one order placed, generating multiple lines)

 

During the examination

•          Radiographers take ownership of ensuring that good diagnostic images are produced.

•          Patients change into the departmental gown.

•          The X-Ray equipment should be optimized for each examination and controls continually adjusted to ensure image optimization.

•         Images must be viewed on the appropriate monitors to ensure that the images are of diagnostic quality before the patient leaves the department.

 

Following the examination (patient information & post-processing)

•          The patient should be informed when the result will be ready, who will receive the results and what they should do next.

•          Radiographers need to accept the image/ close patient episode on the imaging device to be

•          able to post process at the work station

•          Request forms must be modified by

Radiographers at the work station if a different examination is undertaken/added.

•          The necessary modifications must be done at the work station.

•          Ensure that all information from the request form is transcribed at the work station i.e., examination, room, exposure factors, Contrast media, etc.

 

Following the examination (reporting)

•          Images must be reported on a PACS monitor to ensure high resolution.

•          The report should be verified or sent for review as appropriate.

•          Relevant reports are batched printed where appropriate

•          Urgent information should be verbally communicated to referrer or referring team.

•          Any inconclusive results should be discussed with the referring clinician.

 

Did Not Attend

•          The status of patients who do not show up for their investigations automatically changes to a rebooked case.

•          The patient is allowed 3 appointments (DNA or cancellations) or 3 months to be seen from referral before they are returned to the referrer.

TIMING All patients for Booking - 20mins Routine Radiological investigations - < Ihr Special Radiological investigations - Ihr and up to 24hrs Scan - Starts by 9am and dependent on Patients readiness. Report - Ready in 24hrs