CI.D.2019 Produce Computed Tomography (CT) scanning images for diagnostic purposes

Overview

This standard is concerned with the use of computed tomography (CT) equipment and procedures to produce images for diagnostic purposes. It includes selecting the most appropriate scan protocol depending on the individual's condition and clinical history. Key people are those involved in the individual's care and others involved in provision of services. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You will need to know and understand:

1. legal, organisational and policy requirements relevant to your role, the role of others in your organisation and the activities being carried out
2. the relevant national and local standards, guidelines, policies and procedures that are available and how and when they should be accessed
3. the importance of respecting individuals' culture, privacy, dignity, wishes, beliefs and decisions
4. the limitations of your own knowledge and experience and the importance of operating within your scope of practice
5. the roles and responsibilities of other team members
6. the importance of obtaining valid consent in line with national and local guidelines
7. clinical appropriateness of the examination request and the action to take when the request is not appropriate
8. the gross surface and cross-sectional anatomy of the areas to be scanned
9. the relevant physiology of the areas to be scanned
10. the common normal variants and their appearance on CT images
11. common pathologies of the areas to be scanned and their appearance on CT images
12. the medical terminology relevant to the examination including abbreviations
13. contra-indications to CT scanning including the clinical implications of any allergy relevant to the examination
14. manifestations of individuals' physical and emotional status
15. when additional images are required to aid diagnosis and to enhance the examination and the process for justification
16. production, interactions and properties of x-rays
17. the physical processes involved in the production of CT images, optimisation, scanning techniques and protocols
18. the harmful effects of radiation to the human body and use of radiation protection equipment
19. the ways in which CT images can be captured, processed and permanently stored
20. how to adapt communication styles, ask questions, and listen carefully in ways which are appropriate for the needs of the individual
21. methods of communicating difficult and complex information to individuals and key people
22. the importance of providing individuals and key people with opportunities to ask questions and increase their understanding
23. the information that should be given to individuals before, during and on completion of the examination
24. the physical principles of CT scanning
25. alternative imaging examinations that may be employed alongside CT scanning
26. the technical and diagnostic quality requirements of the image
27. artefacts on images - their causes and avoidance strategies
28. factors which influence the decision to repeat images or take additional CT images
29. the operation, safe use and positioning of equipment that supports, works or links with the CT scan protocol
30. the use of quality assurance equipment, recording results and taking appropriate action
31. equipment capabilities, limitations and routine maintenance including the quality control processes required by the operator
32. the importance of timely equipment fault recognition and local procedures for reporting these
33. preparation of the environment, individual and equipment for CT Scanning
34. positioning of the individual and equipment relevant to examination being performed
35. procedures relating to recording, collating and preparing appropriate information, documentation and images for transfer or storage according to local protocols
36. how to keep full, accurate and clear records in line with organisational procedures

Performance Criteria

You must be able to do the following:

1. apply standard precautions for infection control and other appropriate health and safety measures
2. ensure all necessary preparations have been made by the individual and staff before starting the procedure
3. check and prepare the equipment required for the examination
4. ensure the environment is conducive to maintaining the privacy and dignity of the individual
5. check the identification details before commencing the procedure in accordance with local policies and procedures
6. introduce yourself and other members of staff present during the examination
7. communicate with the individual / key people to facilitate their understanding of and co-operation with the examination
8. establish the individual's capacity to understand the procedure with the help of key people if necessary
9. obtain valid consent for the procedure in accordance with national and local guidelines
10. respect the individual's privacy, dignity, beliefs and decisions
11. clearly explain the procedure and possible outcomes, including risk, benefits and limitations
12. check individuals of child-bearing potential for pregnancy or possible pregnancy, if appropriate to the examination, and take action in accordance with local protocols
13. confirm the status of key people before the examination and, where their presence is required, adhering to local guidelines
14. enter the identification details of the individual into the CT scanner or, if previously entered, check for accuracy
15. accurately select all parameters required for the scan according to local scan protocols for the procedure, assess any required modifications and take appropriate action
16. position the individual and adjust their clothing according to the protocols for the examination to be performed in a manner which allows an optimal outcome to be achieved while:
1. recognising the individual's need to retain their dignity and self respect
2. ensuring their comfort as far as possible
3. preventing the appearance of artefacts
17. check the room prior to making the exposure to ensure that only essential, protected persons remain with the individual, that all local protocols have been adhered to and take appropriate action if this does not occur
18. commence the scan and monitor the individual's condition, compliance and well-being throughout the procedure and take action appropriate to their needs
19. view the images on completion of the scan to ensure they are technically acceptable and suitable for diagnostic purposes
20. create multi-planar reformats (MPR) from the relevant datasets as appropriate
21. review images for clinical acceptability, take appropriate action, including further imaging if required
22. monitor and record the individual's exposure to ionising radiation throughout the procedure according to local protocols
23. following the preliminary imaging examination, inform the appropriate person if an abnormality is observed on the image which is likely to require further investigation or treatment
24. provide the individual with information relating to the procedure and aftercare where necessary
25. explain the process for obtaining results
26. optimise, record, collate and prepare appropriate information, documentation and images for transfer or storage according to local protocols
27. verify that the images have arrived/been stored according to local protocols
28. recognise where help or advice is required and obtain this from appropriate sources

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning