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private out(OP)/ outpatient
can have a scheduled appointment or be a walk in
walk in- no appointment scheduled
sent in from physician’s office with an order from a physician
could result in need for a verbal report/image check
inpatient
nursing floors
intensive care units
SICU
MICU
NICU
PACU
pre-admission testing
procedural routine pre-procedure
review request/control sheet
identify the radiographic procedure requested by the physician
review order to evaluate for accuracy
physician order
a certain x-ray for a patient(left hand, right foot, lumbar spine)
the physician will(for physician order)
order radiographic procedure
order may arrive with the patient(on order slip/script), be faxed to the facility or electronic
RH- all radiographic orders expire after 14 months after prescribed
electronically ordered in EPIC
all inpatients will have orders placed electronically in EPIC
CPT code- current procedural terminology(AMA)
codes that are assigned to every task and service that can be provided to a patient
must be correct for insurance reimbursement/payments
ICD-10 codes- international statistical classifications of diseases
alphanumeric assignments given to diagnosis and symptoms
very detailed and specific
requests list what
patient name, address, MRN, ordering doctor and phone number, study, codes for charging, numbers to track study in computer(accession number), list of most recent studies performed
control sheet
requisition
who enters requests?
clerical staff
intake specialist
unit clerks
equipment prep for procedural routine
radiographic room is prepared, with necessary supplies in place before patient arrives in room(sheet placed on table, shield, sponges)
x-ray tube in position with applicable equipment readily available
operating console prep procedural routine
verify correct selection of patient name/ MRN/accession #
enter user code if # applicable
select proper study/view within operation console
select and verify appropriate kVp, mAs, mA and time, ionization chambers
Retrieving patient from waiting area
introduce self
verify patient ID
address footwear and question pain meds/ stability if applicable
after waiting room and escorting patient into the room,
introduce yourself to the patient as a student as well as introduction of your tech
reconfirm patient identification
after introducing tech and reconfirming patient identification,
obtain LMP/ pregnancy status
8-55 years old
FIRST day of last menstrual period/cycle
assess for chance of pregnancy
obtain history
localization
chronology(period of time)
quality
severity
onset(what caused symptom)
aggravating/ alleviating factors
associated manifestations(other symptoms)
how to get an effective history
open ended questions
probing questions to focus on details
encourage elaboration
give patient time to collect their thoughts
repetition/ rewording
summarize to verify history
after LMP and pregnancy is obtained,
explain procedure to patient
take precautionary measures to ensure safety
radiation protection practices applied(shielding)
assistance provided to patient during positioning
collimation appropriate for view
correctly manipulate equipment for centering and projection
communicate breathing/movement instructions
post-procedure
correctly dismiss patient from procedure(verbal report, image check)
verify images sent to PACS with tech approval
complete EPIC documentation