Assessment of radiographers' competences from the perspectives of radiographers and radiologists: a cross-sectional survey in Lithuania.

BACKGROUND: Assessing radiographers' clinical competence is of major importance in all medical imaging departments, and is a fundamental prerequisite for guaranteeing professional standards in both nursing care and radiography. Despite the fact that self-assessment has been reported to be the most common form of competence evaluation only several studies defining the radiographers' self-assessment of clinical competencies were identified. The aim of the study was to evaluate radiographers' professional competence from the perspectives of radiographers and radiologists by applying the Radiographers' Competence Scale (RCS). METHODS: The study was conducted in university hospitals of Lithuania. We used the original instrument designed by Swedish researchers - the Radiographers' Competence Scale (RCS) consisting of two domains: A "Nurse-initiated care" and B "Technical and radiographic processes". The study involved in all 397 respondents; radiographers (250) and radiologists (147) working in departments of diagnostic radiology. Each competence was evaluated twice - the level on a 10-point scale, and the frequency of practical application on a 6-point scale. RESULTS: The overall level of the radiographers' competence and the frequency of its use in practice were evaluated high or very high by both respondent groups. The radiographers attributed the highest evaluations to such competences as "Encouraging and supporting the patient" and "Collaborating with other radiographers", while the lowest evaluations were attributed to "Guiding the patient's relatives" and "Empowering the patient by involving him/her in the examination and treatment" competences. The radiologists attributed the highest evaluations to such competences as "Collaborating with radiologists" and "Independent carrying out of the radiologist's prescriptions", while the lowest evaluations - to the same competences as the radiographers did. Irrespectively of the work experience and age, the radiographers gave significantly higher ratings to all competences that the radiologists did (p < 0.001). CONCLUSIONS: Both groups of the respondents attributed high or very high evaluations to the competences in both the "Nurse-initiated care" and the "Technical and radiographic processes" domains.

[Telemedicine in current nursing practices]. / La télémédecine dans les pratiques de soins aujourd'hui.

The first priority telemedicine programme focused, from 2011, on five areas, with the aim of guaranteeing equal access to care to everybody across a healthcare region. Experiments were financed by public authorities. These practices are now integrated into the organisation of healthcare.

The effect of new clinical pathways on the outcome of vascular access surgery.

PURPOSE: Prior to 2007, the waiting time for vascular access surgery at our center was approximately 107 days compared to a UK average of 45 days. Two new pathways were developed; the rapid and super-rapid pathways incorporating an access liaison nurse who organized vessel mapping and referred patients for surgery. This audit was to determine whether the pathways were effective in reducing the waiting times and improving vascular accesses outcomes. METHODS: All 210 patients with established renal failure undergoing 232 vascular access procedures between January 2008 and March 2011 were studied. Detailed patient information including type of procedure and cause of access failure were stored in an Excel spreadsheet and analyzed using SPSS for Windows. RESULTS: One hundred and twenty patients had a brachiocephalic fistula, 61 a radiocephalic fistula, 39 an access using the basilic vein ± transposition, and 11 a transposition of the long saphenous vein and one a brachio-axillary graft. Overall median waiting time from referral to access surgery was 23 days. Patients were followed up for a median of 248 days after surgery. The overall primary failure rate was 9.1% and 25 of 27 accesses failed because of thrombosis. The overall cumulative survival probability of accesses at one year was 61.4% with a mean survival of 621.2 days (SEM = 34.8). CONCLUSION: The clinical pathways have improved VA service to patients with a drastic reduction in waiting times, elimination of synthetic access, and maintenance of satisfactory results.

[Promoting "well-treatment" in medical imaging]. / Promotion de la bientraitance en imagerie médicale.

A project to promote "well-treatment" has been initiated in the medical imaging department of a Parisian hospital. With the aim of promoting the well-being of the patient and developing shared values of empathy and respect, the members of this medico-technical team have undertaken to build a culture of "well-treatment" which respects the patient's dignity and rights.

New covalent capture probes for imaging and therapy, based on a combination of binding affinity and disulfide bond formation.

We describe the synthesis and development of new reactive DOTA-metal complexes for covalently targeting engineered receptors in vivo, which have superior tumor uptake and clearance properties for biomedical applications. These probes are found to clear efficiently through the kidneys and minimally through other routes, but bind persistently in the tumor target. We also explore the new technique of Cerenkov luminescence imaging to optically monitor radiolabeled probe distribution and kinetics in vivo. Cerenkov luminescence imaging uniquely enables sensitive noninvasive in vivo imaging of a ß(-) emitter such as (90)Y with an optical imager.

Atuação de enfermeiros em um Centro de Diagnóstico por Imagem / Practice nurses in Center of Image Diagnosis

Objetivo - Buscou-se conhecer a atuação das enfermeiras que trabalham no Centro de Diagnóstico por Imagem. Método - Estudo descritivo de abordagem qualitativa aprovada pelo protocolo n. 463/2009. Resultados - No Brasil as radiações ionizantes e materiais radioativos são regulamentados pela Comissão Nacional de Energia Nuclear. A competência do enfermeiro em radioterapia, medicina nuclear e serviços por imagem foi estabelecido na Resolução nº 211/98 que destaca as funções: planejar, organizar, supervisionar, executar e avaliar todas as atividades de enfermagem em clientes submetidas à radiação ionizante. Conclusão - Ressalta-se a escassez de trabalhos publicados sobre o tema na enfermagem, por isso novos estudos devem ser realizados para contribuir como fonte de conhecimento e informação aos enfermeiros e profissionais da área de saúde.

Objective - Our goal was to get familiar with the performance of the nurses that work in the Center of Image Diagnosis. Method - Descriptive study of qualitative approach approved by protocol number 463/2009. Results - In Brazil, ionizing radiation and radioactive material areregulated by the "Comissão Nacional de Energia Nuclear" (National Commission of Nuclear Energy). The competence of a nurse in radiotherapy, nuclear medicine and imaging services was established by resolution number 211/98, which emphasizes the following functions:plan, organize, supervise, execute and evaluate all the nursing activities involving clients exposed to ionizing radiation. Conclusion - We want to point out the lack of published articles about this topic in nursing. Thus, new studies must be carried out to contribute to nurses and professionals of the health area, as a source of information and knowledge.

Educación sanitaria al paciente sometido a pruebas diagnósticas osteoarticulares / Healthcare education for the patient undergoing osteoarticular testing

En los últimos años las exploraciones de diagnóstico por la imagen han experimentado una importante transformación que las ha consolidado como una herramienta básica para el diagnóstico de la patología osteoarticular. En este contexto el papel de los enfermeros/as, como referente más próximo del paciente es básico para resolver las necesidades de información, consentimiento informado, preparación y posibles cuidados posteriores al procedimiento diagnóstico. El objetivo del presente artículo es proporcionar las herramientas para que los enfermeros/as conozcan las pruebas diagnósticas en la enfermedad osteoarticular y puedan responder a las demandas de los pacientes. Esto facilitará una correcta preparación del paciente y permitirá conocer y prevenir las complicaciones posteriores derivadas de la técnica. Por una parte se recorren las pruebas diagnósticas: radiografía convencional, tomografía computarizada, resonancia magnética y ecografía; y además se abordan las técnicas en función de la zona corporal explorada: hueso, articulación y partes blandas (AU)

In the past few years diagnostic imaging techniques have experienced an important transformation that has consolidated their role as a basic tool for the diagnosis of osteoarticular pathology. In this context the role of nurses, who are the reference point closest to the patient, is paramount to resolve information needs, informed consent, preparation and possible care following the diagnostic procedure. The objective of this article is to provide the tools for nurses to learn about diagnostic tests in osteoarticular disease and to respond patient needs. This will aid in the correct preparation of the patient and will also help them learn about and prevent subsequent technique-related complications. First, a general overview of diagnostic imaging technique is presented, followed by a description of particular techniques depending on the body area to be examined: bone, joint, or soft tissue (AU)

Diagnostic tools and therapeutic interventions that may influence the integrity of vascular and nonvascular access devices.

Current technology introduces many new vascular and nonvascular devices to the medical field. With the assistance of these devices, patients can be offered many more diagnostic tests and therapeutic treatments that aid in the diagnosis and treatment of diseases. As with any new infusion technology, these devices can be associated with complications attributable to the rapid rate of infusion. This article defines vascular and nonvascular devices; describes diagnostic medication, tests, and treatments that may have an impact on outcome or compromise vascular access; and describes the role of nurses and radiologic technicians in preventing complications related to vascular access.

Understanding contrast media.

More than 10 million radiologic examinations requiring intravascular injection of iodinated contrast media are performed in the United States each year. Iodinated contrast media are considered to be safe diagnostic drugs, and the incidence of adverse reaction is low. However, as with any drug, the administration of contrast media is not without risk. Nurses involved in patient care should have some understanding of the properties and potential effects of iodinated contrast media.