PATIENTS IN RADIOLOGY DEPARTMENTS

Patients in Radiology Departments

Patient’s rights

1. Patient’s bill of rights from the  Hospital Association

provides for patient consent or refusal of any

procedure; the patient has the right to the following:

a. Respectful care

b. Obtain up-to-date and understandable medical

information regarding diagnosis, treatment, and

likely outcomes

c. Be involved in the decision-making process

throughout diagnosis and treatment

d. Have an advance directive (living will, health care

proxy, durable power of attorney) on file

e. Privacy in all aspects of diagnosis and treatment

f. Complete confidentiality

g. View medical records of the case

h. Expect that a hospital will respond to a request for

needed care and services

i. Be informed of business or educational relationships

that may affect treatment and carej.

Consent to or decline participation in research

studies

k. Continuity of care and other options for care

beyond the hospital

l. Be informed of hospital policies and procedures

related to diagnosis and treatment

m. Be informed of all resources available for resolving

disputes

n. Be informed of charges for services and payment

options

I. Radiographic images

1. Radiographic images are legal documents, whether

electronic or on film

2. Images must include the following information:

a. Patient identification

b. Anatomic markings, including left and right

markers

c. Carefully placed markings on each radiograph

using lead markers

d. Date of exposure

e. Markings placed on the image following exposure

may not be legally admissible

Scheduling of Radiographic Examinations

A. General considerations

1. Schedule in an appropriate and timely sequence to

ensure patient comfort and fiscal responsibility

2. Sequence so that examinations do not interfere with

one another

3. Schedule barium studies last

4. Schedule several examinations in a single day if the

patient is able to tolerate them

5. Seriously ill or weak patients may be able to tolerate

only one examination per day or must have a rest

between examinations

6. If sedation is used, patient must be given time to

recover from sedation before beginning fluoroscopic

studies

7. Thyroid assessment must precede any examinations

involving iodinated contrast media

8. Schedule radiographic examinations not requiring

contrast agents first

9. Total doses of iodinated contrast media should

be calculated if they are to be used in a series of

examinations

10. Schedule patients who have been held NPO (nothing

by mouth) first

11. Schedule pediatric and elderly patients early

12. Schedule diabetic patients early because of their

need for insulin

B. Sequence of examinations

1. Fiberoptic (endoscopy) studies are conducted first in

a series

2. Radiography of the urinary tract

3. Radiography of the biliary system

4. CT studies should be scheduled before examinations

involving the use of barium sulfate

5. Lower gastrointestinal (GI) series (check for residual

contrast material from previous examinations before

proceeding)

6. Upper GI series

Patient Preparation

A. GI system or urinary system

1. Low-residue diet (e.g., low fiber) or clear liquid diet

(e.g., tea, gelatin, bouillon)

2. NPO for 8 to 12 hours before procedure

3. Cathartics and enemas are used to cleanse the GI system

4. If scheduled as an outpatient

a. Patient must clearly understand the routine for

proper preparation

b. Patient should be asked to explain the procedure

back to the radiographer to verify understanding

B. All procedures

1. Clothing is removed from area to be radiographed

and replaced by patient gown when appropriate

2. All radiopaque objects are removed from area of

Interest

Patient History

A. Provides information for the radiographer about the

extent of the patient’s injury and the range of motion

the patient can tolerate

B. Assists the radiologist during interpretation of the

radiographs

C. History should begin with the radiographer introducing

himself or herself and verifying the patient’s name
D. Types of questions asked to obtain a patient’s history

(depending on type and site of injury)

1. How did your injury occur?

2. When did your injury occur?

3. Where is your pain?

4. Do you have tingling or numbness?

5. Do you have any weakness?

6. Were you unconscious after your injury?

7. Why did your physician order this examination?

8. Have you experienced shortness of breath or been

coughing?

9. Have you experienced a fever or heart problems?

10. Have you experienced any nausea, vomiting, or

diarrhea?

11. Have you had previous surgery on this area?

12. Is there any family history of problems in this area?

Patients in Radiology Departments

A. Identify precaution and follow guidelines

B. Isolation patients should never spend time waiting in the

hallway

C. Carefully cover x-ray table with a sheet

D. Work in pairs so that only one radiographer is in contact

with the patient (dirty) while the other radiographer

manipulates the equipment (clean); both wash

hands

E. Carefully cover patient with protective sheets and

blankets when returning patient to the wheelchair or

cart

F. All contaminated materials must be placed in an appropriate

discard bag

G. Carefully clean off x-ray table and any other equipment

with which the patient came in contact

H. Remove gloves and carefully wash hands