Instructions. Print out all three tabs of the guide to be used as a reference.

Transcription

1 Instructions For the Learner 1) The purpose of the observation checklist is to help evaluate the skills obtained from the course. It is also a reference and reminder for what was learned in this course. 2) It can be used to identify areas of in-hospital training. 3) This tool can also help to show an increase in skills obtained and dedication to job performance improvement. For the Evaluator 1) The purpose of this observation checklist is to understand the content and materials discussed during the 2) It can be used to identify areas where in-hospital training is needed and utilization of hospital specific 3) It allows the evaluator to observe and rate employee performance based on consistent and specific criteria. It 4) This can be incorporated into performance evaluations. It can also be included as part of the employee's Instructions Print out all three tabs of the guide to be used as a reference. 1) The observation checklist is : *Divided into sections consistent with course content *Provides an outline of skills and information to be obtained from the course *Allows for notes, comments and guidance from the evaluator on how to best develop skills 2) The evaluator's reference is: *Divided into sections consistent with course content *Provides an outline of skills and information to be obtained from the course *Is to be used to assist in consistent evaluation of skills performed and to give guidance and mentoring for Evaluator Scale 1) To show that if expectations are met, the learner recalls the information from training on a basic level 2) If the learner does not recall the information, the scale will reflect that the learner does not meet this expectation. Further development and additional demonstration of skills are needed; retaking the course may be suggested for development as well 3) If the learner does recall the information and is able to explain and apply the skills with a level of problem solving and comprehension, the scale will reflect that they have exceeded expectation. Further development and skill advancement can be recommended. Rating Scale Exceptional = Course content mastered Exceeds Expectations = Course content executed well Meets Expectations = Course content demonstrated Needs Improvement = Course content demonstrated with guidance Unsatisfactory = Course content not demonstrated

2 Observation Checklist Employee Name Position in Hospital Hire Date Competency Radiology Learning Module Radiographic Positioning of the Dog - Shoulder Radiographic Recommendations, Anatomy and Landmarks for Collimation Skills By Date Rating Observation Notes Development Recommendation Located MSDS forms in the hospital Review current hospital standard operating procedure on how to handle Example Locate hospital MSDS forms Csmith 7/31/2013 Exceeds Expectations and was able to explain the importance of the form chemical spills or reactions based off of the guidance of the MSDS form 1) Identify two views discussed for a shoulder radiographic study 2) Identify the anatomy needed when obtaining a shoulder radiograph 3) Identify the skeletal landmarks to ensure appropriate anatomy is included in the shoulder Patient Positioning Preparation Skills By Date Rating Observation Notes Development Recommendation 4) Identify where caliper measurements are needed to be obtained and how to read the calipers if applicable to your practice 5) Demonstrate the knowledge of how to obtain an accurate weight to utilize for determining appropriate settings for digital radiographs

3 Observation Checklist 6) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - the foam wedge 7) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - the v-trough 8) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - tape, sandbags and ties Lateral View- Patient Positioning; Quality Image Skills By Date Rating Observation Notes Development Recommendation 9) Demonstrate the knowledge of proper patient positioning 10) Demonstrate the knowledge of proper collimation 11) Demonstrate the knowledge of appropriate marker placement 12) Demonstrate the knowledge of verification of position prior to image capture 13) Demonstrate quality image review system 14) Demonstrate knowledge to perform technique evaluation 15) Demonstrate knowledge on how to adjust patient positioning or technique to obtain an diagnostic quality image

4 Observation Checklist Caudocranial - Patient Positioning; Quality Image Skills By Date Rating Observation Notes Development Recommendation 16) Demonstrate the knowledge of proper patient positioning 17) Demonstrate the knowledge of proper collimation 18) Demonstrate the knowledge of appropriate marker placement 19) Demonstrate the knowledge of verification of position prior to image capture 20) Demonstrate quality image review system 21) Demonstrate knowledge to perform technique evaluation 22) Demonstrate knowledge on how to adjust patient positioning or technique to obtain an diagnostic quality image Helpful Hints Skills By Date Rating Observation Notes Development Recommendation 23) Demonstrate knowledge of why sedation is recommended 24) Demonstrate the knowledge of how to obtain images of obese dogs 25) Osteochondrosis Positioning 26) Demonstrate knowledge of how to submit studies to AIS

5 Radiographic Recommendations, Anatomy and Landmarks for Collimation Skills Guidelines given for Meets Expectations Reference 1) Identify two views discussed for a shoulder radiographic study 2) Identify the anatomy needed when obtaining a shoulder radiograph 3) Identify the skeletal landmarks to ensure appropriate anatomy is included in the shoulder radiograph Lateral and Caudocranial View When obtaining a shoulder radiograph, the desired anatomy to be visualized includes the humerus, (humeral head, greater tubercle, bicipital groove) and scapula. The shoulder joint, a small portion of the distal scapula and a small portion of the proximal humerus are needed for all views. For the lateral view, include the shoulder joint and a small portion of the distal scapula. For the craniocaudal view, center x-ray beam on joint space/proximal humerus. Patient Positioning Preparation Skills Guidelines given for Meets Expectations Reference 4) Identify where caliper measurements are needed to be obtained and how to read the calipers if applicable to your practice For film radiographs, caliper measurements are to be taken at the widest portion of the shoulder. For an accurate measurement to be obtained, the bottom and moveable portion of calipers should be parallel to each other. The anatomy should not be compressed by the calipers in any way. The measurement reading is taken at the bottom of the moveable bar and is usually read in centimeters.

6 5) Demonstrate the knowledge of how to obtain an accurate weight to utilize for determining appropriate settings for digital radiographs 6) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - the foam wedge 7) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - the v-trough 8) Demonstrate the knowledge to utilize appropriate positioning devices and what they can assist with achieving - tape, sandbags and ties Obtain current and accurate weight of patient; enter information into computer/software to determine appropriate settings for radiographs If the patient is has a narrow chest cavity, a foam wedge can be placed under the sternum to help the patient to remain parallel to the table and not allow them to rotate and distort the image; these can also be used to separate the limbs A V-trough can also be used to keep the head and spine straight for the CdCr view Sandbags of appropriate weight relative to the patient size can be used to keep the patients forelimbs and hindlimbs into position. Ties can also help to achieve this. Tape can be used to maintain the positioning of the limbs on the lateral view.

7 Lateral View- Patient Positioning; Quality Image Skills Guidelines given for Meets Expectations Reference 9) Demonstrate the knowledge of proper patient positioning 10) Demonstrate the knowledge of proper collimation 11) Demonstrate the knowledge of appropriate marker placement 12) Demonstrate the knowledge of verification of position prior to image capture Sedation recommended; For the Lateral View of the shoulder, place the patient with the affected limb down on the x-ray table. Be sure to keep the patient in the lateral position parallel to the table and do not rotate the patient or the affected limb. Gently pull the top limb towards the hind toes. Place traction on the down limb in a cranioventral direction Pull the head dorsally to remove superimposition of the soft tissues of the neck. Center the x-ray beam over the shoulder. Verify the landmarks and anatomy needed are in the collimated area and that the patient is in the proper position with shoulder joint and a small portion of the distal scapula. Center x-ray beam on the joint space Place marker so that it is in the collimated field but not obscuring any anatomy Verify landmarks, anatomy and collimation are appropriate

8 13) Demonstrate quality image review system When performing quality control radiographs for the lateral shoulder view: 1. Check the anatomical boundaries Verify that the area just proximal and distal to the shoulder joint is included 2. Is the patient straight? You will verify that the shoulder is not superimposed with the trachea or spine. 3. Is the technique appropriate? Is the background black? You should see the needed anatomy including soft tissues 4. Is there a marker present? Verify that the positioning marker and patient ID are present and correct 5. Do you have all the necessary views? 14) Demonstrate knowledge to perform technique evaluation 15) Demonstrate knowledge on how to adjust patient positioning or technique to obtain an diagnostic quality image Is the anatomy needed captured? Was the correct collimation used? Is the patient rotated? Is there a positioning marker present? Is it the correct technique? Underexposed? Overexposed? Verify anatomy; Landmarks; Collimation, Marker and make needed adjustments to capture in case it is needed

9 Caudocranial - Patient Positioning; Quality Image Skills Guidelines given for Meets Expectations Reference 16) Demonstrate the knowledge of proper patient positioning view, adequate sedation or anesthesia is needed to obtain quality images. Place the patient in dorsal recumbency. Place traction upon the limbs (thoracic limbs cranially and pelvic limbs caudally). The thorax may be slightly oblique/rotated, but the limb should not be rotated. The limb can be slightly abducted (pulled away from midline), however, make sure the long axis of the scapula and humerus are parallel to one another (that is, the limb is in a straight line). This is similar to the positioning for the VD view of the thorax, with the x-ray beam centered over the shoulder joint. 17) Demonstrate the knowledge of proper collimation 18) Demonstrate the knowledge of appropriate marker placement 19) Demonstrate the knowledge of verification of position prior to image capture Verify the landmarks and anatomy needed are in the collimated area and that the patient is in the proper position with a straight spine and square hips. Place marker so that it is in the collimated field but not obscuring any anatomy Verify landmarks, anatomy and collimation are appropriate

10 20) Demonstrate quality image review system When performing quality control radiographs for the Caudocranial shoulder view: 1. Check the anatomical boundaries Verify that the area just proximal and distal to the shoulder joint is included 2. Is the patient straight? Check to make sure that the humerus and scapula are aligned and parallel to the x-ray table 3. Is the technique appropriate? You should see the needed anatomy including soft tissues 4. Is there a marker present? Verify that the positioning marker and patient ID are present and correct 5. Do you have all the necessary views? 21) Demonstrate knowledge to perform technique evaluation 22) Demonstrate knowledge on how to adjust patient positioning or technique to obtain an diagnostic quality image Is the anatomy needed captured? Was the correct collimation used? Is the patient rotated? Is there a positioning marker present? Is it the correct technique? Underexposed? Overexposed? Verify anatomy; Landmarks; Collimation, Marker and make needed adjustments to capture in case it is needed

11 Helpful Hints Skills Guidelines given for Meets Expectations Reference 23) Demonstrate knowledge of why sedation is recommended Patients are typically sedated or anesthetized for these views. Even in non-painful patients, it is difficult to get adequately positioned radiographs in awake patients. Radiographs made without sedation are often sub-optimally positioned. Even in cooperative patient s muscular tension may obscure subtle details that are revealed when the muscles are relaxed. Proper monitoring, thermal support and documentation are recommended for these patients. 24) Demonstrate the knowledge of how It is not necessary to include the fat dorsal to the to obtain images of obese dogs spine in the image However you want to include the entire spine including the spinous processes; use of wooden spoon to push away access excess skin on the lateral view 25) Osteochondrosis Positioning The Pronated/Supinated Lateral which is specifically used for the diagnosis of Osteochondrosis, the technique is exactly the same as for a lateral view, but the limb to be examined is held in pronation (internal rotation) or supination (external rotation) while making additional lateral radiographs. Place traction on the down limb in a cranioventral direction and then turn the limb inward toward the table (or outward away from the table)

12 26) Demonstrate knowledge of how to submit studies to AIS All fields must be completed to the best of your AIS Handout ability. The more details on the patient the better! Include the history, signalment and if the patient was sedated or anesthetized Images need to be sent ASAP after approval. Don't wait to send. The quicker they are sent and with the most complete information possible, the faster the doctor will have the needed information to help the patient.