CI.I Perform image guided procedures and/or interventions

Overview

This standard is about undertaking image guided interventional procedures. It covers invasive procedures and/or interventions performed under image guidance. This standard is relevant to various imaging modalities and should be used in your area of practice. Key people are those involved in the individual's care and others involved in provision of services. It is essential that any person undertaking this procedure be currently competent in appropriate life support and cardio-pulmonary resuscitation. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

legal, organisational and policy requirements relevant to your role, the role of others in your organisation and the activities being carried out
the relevant national and local standards, guidelines, policies and procedures that are available and how and when they should be accessed
the national and local guidelines for acceptance of requests for image guided interventional procedures in your area of practice
the importance of obtaining valid consent in line with national and local guidelines
the principles and role of image guidance in your area of practice
the use of pre-intervention checklists and how they should be used according to local and national policies and procedures
how to keep full, accurate and clear records in line with organisational procedures
the limitations of your own knowledge and experience and the importance of operating within your scope of practice
the benefits and limitations of image guided interventional procedures in your area of practice
the role and importance of alternative, additional and complementary imaging techniques and investigations
clinical appropriateness of the examination request and the action to take when the request is not appropriate
how to undertake risk assessments for individuals prior to the procedure
the contraindications associated with each investigation and the implications of proceeding with due consideration of related risks
the preparation of the individual, environment and equipment for image guided interventional procedures in your area of practice
the importance of respecting individuals' culture, privacy, dignity, wishes and beliefs and decisions and how to do so
the roles and responsibilities of other team members
how to adapt communication styles, ask questions, and listen carefully in ways which are appropriate for the needs of the individual
methods of communicating difficult and complex information to individuals and key people
the importance of providing individuals and key people with opportunities to ask questions and increase their understanding
the information that should be given to individuals before, during and on completion of the examination
debrief procedures and how these should be used to ensure that any problems encountered during the procedure are recorded to inform future interventions
the anatomy, physiology and pathology of the anatomical structures under investigation
the pathophysiology of relevant disease processes
the clinical findings and imaging appearances associated with normal and abnormal anatomical structures
the safe use of local anaesthesia and other medicines used during the procedure or intervention
aseptic techniques and the potential consequences of poor practice
the importance of minimising any unnecessary discomfort of individuals undergoing interventional procedures, and how to do so
the management of emergency/acute complications that occur during the procedure
the safe use and manipulation of non-imaging equipment used during the procedure
the management, storage and transport of tissue samples where relevant
local procedures for image acquisition, storage and retrieval
the annotation and interpretation of relevant images and information to confirm the location of the region/structure(s) under investigation
procedures relating to recording, collating and preparing appropriate documentation and images for transfer or storage according to local protocols
how changes to image findings as a result of intervention may affect interpretation of future imaging procedures and decisions by others
safe operation of imaging equipment in your area of practice
the risks of work-related disorders and how to minimise the risks
machine settings and methods available to optimise the image in your area of practice

Performance Criteria

You must be able to do the following:

apply standard precautions for infection prevention and control, and other appropriate health and safety measures
check and prepare the equipment required for the procedure
ensure all necessary preparations have been made by the individual and staff before starting the procedure
ensure the environment is conducive to maintaining the privacy and dignity of the individual
introduce yourself and other members of staff present during the examination
check the identification details before commencing the interventional procedure in accordance with local policies and procedures
obtain valid consent for the procedure in accordance with national and local guidelines and protocols
communicate with the individual / key people to facilitate their understanding of and co-operation with the examination
establish the individual's capacity to understand the procedure with the help of key people if necessary
clearly explain the procedure and possible outcomes, including risk, benefits, limitations and alternatives
respect the individual's privacy, dignity, beliefs and decisions
review the clinical history for factors which might contraindicate the procedure
assess the individual for contra-indications to any medicines to be used in the examination and for any relevant allergies, and take appropriate action
ensure appropriate and recent imaging is available and assess relevant images and information prior to performing the procedure to confirm the location of the region/structure(s) of interest
make an assessment of the individual's emotional needs and respond appropriately
ensure that relevant checklists are completed prior to the procedure in line with local and national policies to highlight any potential problems before the procedure begins
select the correct equipment for the procedure according to national and local guidelines and protocols
take appropriate precautions to ensure a clean or aseptic technique as required
ensure the individual is in an appropriate position and is as comfortable as possible for the procedure
administer local anaesthetic if required according to national and local guidelines
take appropriate steps to minimise the risk of work-related disorders
ensure the procedure is carried out correctly and in accordance with local policies and procedures
where required by the procedure, obtain any samples and label containers according to local guidelines and protocols
ensure all images are acquired, store and transferred in line with local guidelines and protocols
ensure dressings are applied where appropriate after the procedure
ensure immediate post-procedure observations are carried out according to national and local guidelines and protocols
recognise and respond to a deterioration in the individual's clinical condition in line with relevant national and local guidelines and protocols
provide the individual with information relating to the procedure and aftercare where necessary
explain the process for obtaining results
document the procedure according to national and local guidelines and protocols and make arrangements for results review
debrief the team according to local guidelines
communicate information to other members of the team as necessary

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: HWB7 Interventions and treatments