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Patient monitoring and physical assessment

 

MRTs monitor all patients in their care by maintaining communication and visual contact (to the greatest extent possible) throughout the procedure or treatment, and respond to changes in patient condition

 

+ Importance of patient monitoring

  • Monitoring allows healthcare professionals to detect changes in patient condition, and take action to prevent potential adverse events.1
  • CAMRT Competency Profiles for MRTs cite monitoring as a core expectation of the profession.2-5
  • Patient monitoring encompasses an MRT's responsibility to take an active role in patient care and assessment, including:
    • Initial assessment
    • Monitoring and responding to changes in physical status
    • Assessing and responding to a patient's psychological and emotional status
    • Monitoring and responding to patients’ therapeutic and supportive devices

+ Monitoring during procedure/treatment

  • A patient's condition is monitored throughout their procedures/treatments.
  • The extent of monitoring and assessment depends on patient condition, type of procedure or treatment, facility policy, and the order from the patient's physician.
    • Monitoring may include visual, auditory, and physiological assessments
    • Some patients require constant monitoring with electronic and physiologic equipment
    • Others are only assessed physiologically at initiation of the procedure or treatment and monitored visually and through direct communication thereafter

  • Normal physiological signs, symptoms and ranges and the significance of abnormalities are fully understood by MRTs.
  • MRTs are aware of and monitor patients for possible adverse reactions (e.g., contrast reactions)
  • MRTs use visual assessment and skills to observe the patient under their care and take note of physical characteristics such as:6
    • Skin colour (e.g., pale, flushed, cyanotic)
    • Level of consciousness
    • Breathing (e.g., rate, depth, effort)

  • MRTs monitor a patient’s vital signs when necessary and recognizes changes in patient condition if they occur.7
  • MRTs maintain communication with a patient throughout a procedure or treatment, where possible, to monitor both their physical and emotional state:
    • Assess and respond to physical discomfort
    • Assess consciousness
    • Maintain emotional support and guidance
    • Recognize patient distress and act by comforting, assessing, and/or escalating the response as needed

+ Responding to change in status

  • MRTs are aware of the emergency processes and protocols and take steps to be prepared to respond at any time.
  • MRTs understand what emergency situations may arise in the workplace and in their discipline.
    • MRTs have the skills, knowledge and competency to assess patients and initiate emergency care response when and if the circumstances arise
    • MRTs work with leadership to ensure processes and protocols are in place to address emergency situations
    • MRTs obtain the assistance of other healthcare professionals when required

  • MRTs also understand when a change in status requires a delay or adaptation to the procedure and/or treatment.
  • Significant changes in patient status during the course of the procedure or treatment are documented in the patient records and reported to a physician if necessary/appropriate.

+ References

  1. Davies MA, Tales H. Enhancing Patient Safety Through a Standardized Model of Physiologic Monitoring. Healthcare Quarterly 2005;8(Sp):49-52.
  2. Canadian Association of Medical Radiation Technologists. Magnetic Resonance Competency Profile. Revised January 2011. Available at: http://www.camrt.ca/wp-content/uploads/2014/12/MR-Comp-Prof-2006.pdf. Accessed June 9, 2015.
  3. Canadian Association of Medical Radiation Technologists. Nuclear Medicine Competency Profile. Revised January 2011. Available at: http://www.camrt.ca/wp-content/uploads/2014/12/NM-Comp-Prof-2006.pdf. Accessed June 9, 2015.
  4. Canadian Association of Medical Radiation Technologists. Radiation Therapy Competency Profile. Revised January 2011. Available at: http://www.camrt.ca/wp-content/uploads/2014/12/TH-Comp-Prof-2006.pdf. Accessed June 9, 2015.
  5. Canadian Association of Medical Radiation Technologists. Radiological Technology Competency Profile. Revised January 2011. Available at: http://www.camrt.ca/wp-content/uploads/2014/12/RA-Comp-Prof-2006.pdf. Accessed June 9, 2015.
  6. Ehrlich RA, Daly JA. Patient Care in Radiography. With an Introduction to Medical Imaging. 8th Ed. St. Louis, MO: Mosby; 2013.
  7. Adler AM, Carlton RR. Introduction to radiologic sciences and patient care. 5th Ed. St. Louis, MO: Saunders; 2011.

 

Validation

November 2015

 

 
Canadian Association of Medical Radiation Technologists
85 Albert St, Suite 1000, Ottawa, ON, K1P 6A4
phone: 613 234-0012 / 800 463-9729
fax: 613 234-1097
www.camrt.ca