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CI.I Perform image guided procedures and/or interventions


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

Performance Criteria

You must be able to do the following:
  1. apply standard precautions for infection prevention and control, and other appropriate health and safety measures
  2. check and prepare the equipment required for the procedure
  3. ensure all necessary preparations have been made by the individual and staff before starting the procedure
  4. ensure the environment is conducive to maintaining the privacy and dignity of the individual
  5. introduce yourself and other members of staff present during the examination
  6. check the identification details before commencing the interventional procedure in accordance with local policies and procedures
  7. obtain valid consent for the procedure in accordance with national and local guidelines and protocols
  8. communicate with the individual / key people to facilitate their understanding of and co-operation with the examination
  9. establish the individual's capacity to understand the procedure with the help of key people if necessary
  10. clearly explain the procedure and possible outcomes, including risk, benefits, limitations and alternatives
  11. respect the individual's privacy, dignity, beliefs and decisions
  12. review the clinical history for factors which might contraindicate the procedure
  13. assess the individual for contra-indications to any medicines to be used in the examination and for any relevant allergies, and take appropriate action
  14. 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
  15. make an assessment of the individual's emotional needs and respond appropriately
  16. 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
  17. select the correct equipment for the procedure according to national and local guidelines and protocols
  18. take appropriate precautions to ensure a clean or aseptic technique as required
  19. ensure the individual is in an appropriate position and is as comfortable as possible for the procedure
  20. administer local anaesthetic if required according to national and local guidelines
  21. take appropriate steps to minimise the risk of work-related disorders
  22. ensure the procedure is carried out correctly and in accordance with local policies and procedures
  23. where required by the procedure, obtain any samples and label containers according to local guidelines and protocols
  24. ensure all images are acquired, store and transferred in line with local guidelines and protocols
  25. ensure dressings are applied where appropriate after the procedure
  26. ensure immediate post-procedure observations are carried out according to national and local guidelines and protocols
  27. recognise and respond to a deterioration in the individual's clinical condition in line with relevant national and local guidelines and protocols
  28. provide the individual with information relating to the procedure and aftercare where necessary
  29. explain the process for obtaining results
  30. document the procedure according to national and local guidelines and protocols and make arrangements for results review
  31. debrief the team according to local guidelines
  32. 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
CI.I Perform image guided procedures and/or interventions
Final version approved January 2019 © copyright Skills For Health,
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