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 - Pelvis 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 three views discussed for a pelvic radiographic study 2) Identify the anatomy needed when obtaining an pelvic radiograph 3) Identify the skeletal landmarks to ensure appropriate anatomy is included in the pelvic radiograph 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

4 Observation Checklist 15) Demonstrate knowledge on how to adjust patient positioning or technique to obtain an diagnostic quality image Ventrodorsal View - 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 Ventrodorsal View (Frog-leg) - Patient Positioning; Quality Image Skills By Date Rating Observation Notes Development Recommendation 23) Demonstrate the knowledge of proper patient positioning 24) Demonstrate the knowledge of proper collimation

5 Observation Checklist 25) Demonstrate the knowledge of appropriate marker placement 26) Demonstrate the knowledge of verification of position prior to image capture 27) Demonstrate quality image review system 28) Demonstrate knowledge to perform technique evaluation 29) 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 30) Demonstrate knowledge of why sedation is recommended 31) Demonstrate the knowledge of how to obtain images of obese dogs 32) Demonstrate knowledge of centering beam on the greater trochanter 33) Demonstrate the knowledge of how to troubleshoot an image using the size of the obturator foramina 34) Demonstrate knowledge of how to submit studies to AIS

6 Radiographic Recommendations, Anatomy and Landmarks for Collimation Skills Guidelines given for Meets Expectations Reference 1) Identify three views discussed for a pelvic radiograph study 2) Identify the anatomy needed when obtaining an pelvic radiograph 3) Identify the skeletal landmarks to ensure appropriate anatomy is included in the pelvic radiograph Lateral, Ventrodorsal and Frog-leg Ventrodorsal The desired anatomy to be visualized include the ilium and ischium of the pelvis and the femur (LAT) or stifles (VD) depending on view. The stifles are needed in the image to show that the legs are straight. Landmarks to be used for the lateral view collimation are: the cranial edge of wing of the ilium, the caudal edge of ischium and the dorsal edge of wing of the ilium. If dorsal margin is ok and beam is centered on the greater trochanter, ventral margin should be fine. For the VD and VD frog legged views the collimation landmarks include the x-ray beam centered on pubis to start. Open collimator just enough to include cranial edge of wing of the ilium and entire femur. The extended limb VD view should include the stifle. May move center distally as needed (depending on the conformation of the patient) 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 pelvis near greater trochanter. 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.

7 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 legs on the lateral view A V-trough can also be used to keep the head and spine straight for the VD 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 femurs for the VD view Lateral View- Patient Positioning; Quality Image Skills Guidelines given for Meets Expectations Reference 9) Demonstrate the knowledge of proper patient positioning The patient is placed with the most affected side down on the radiology table. Do not rotate the patient. Be sure to keep them in a lateral position. Gently pull the bottom limb cranially and the top limb caudally to slightly separate the femurs. Depending on the patient s conformation, place a small foam wedge between the femurs to keep each femur parallel to the table. The doctor will determine if he or she prefers the legs to be kept parallel to one another or if the legs should be staggered. Place the limbs accordingly.

8 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 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 flat to the table with the pelvis being square. Place marker so that it is in the collimated field but not obscuring any anatomy Verify landmarks, anatomy and collimation are appropriate When performing quality control radiographs for the lateral pelvic view: 1. Check the anatomical boundaries Verify that the area just cranial to the ilium, just caudal to the ischium and the proximal femurs are included 2. Is the patient straight? Verify that the femoral heads are centered on top of each other 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? 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? Verify anatomy; Landmarks; Collimation, Marker and make needed adjustments to capture in case it is needed

9 Ventrodorsal View - Patient Positioning; Quality Image Skills Guidelines given for Meets Expectations Reference 16) Demonstrate the knowledge of proper patient positioning The patient is placed on his or her back/dorsal recumbency. Place reasonable but not extreme traction on the pelvic limbs. Ensure that the pelvis and back are straight (not rotated) and the pelvis is level. Palpate the greater trochanters as each should be the same distance above the table. The long axis of the femurs should be parallel to the table and the long axis of each femur should be parallel to each other. Palpate the patella's to ensure they are on the center or top of the femur assuming patellar luxation is not present. Palpate and visually check to ensure that the pelvis is straight and level. As you maintain internal rotation and parallel status of the pelvic limbs, gently extend the pelvis and stifles by placing traction on the pelvic limbs. It is necessary to hold or anchor the thoracic limbs at this time. 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 pelvis. 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 VD pelvic view: 1. Check the anatomical boundaries The area cranial to the ilium and the area just to the level of the stifles should be included. 2. Is the patient straight? Verify that the wings of the ilium and obturator foramen are symmetrical 3. Is the technique appropriate? You should see all 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? Verify anatomy; Landmarks; Collimation, Marker and make needed adjustments to capture in case it is needed Ventrodorsal View (Frog-leg) - Patient Positioning; Quality Image Skills Guidelines given for Meets Expectations Reference 23) Demonstrate the knowledge of proper patient positioning For the VD frog-legged view, the patient is placed on his/her back. Allow the pelvic limbs to fall naturally; Femurs will be approximately 45 degrees to the pelvis. The positioner can lightly hold pelvic limbs to ensure the pelvis remains symmetrical but many times this restraint is not necessary.

11 24) Demonstrate the knowledge of proper collimation 25) Demonstrate the knowledge of appropriate marker placement 26) Demonstrate the knowledge of verification of position prior to image capture 27) Demonstrate quality image review system 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 When performing quality control radiographs for the VD frog-leg pelvic view: 1. Check the anatomical boundaries The area cranial to the ilium and the entire ischium should be included. 2. Is the patient straight? Verify that the wings of the ilium and obturator foramen are symmetrical 3. Is the technique appropriate? You should see all 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? 28) Demonstrate knowledge to perform technique evaluation 29) 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? Verify anatomy; Landmarks; Collimation, Marker and make needed adjustments to capture in case it is needed

12 Helpful Hints Skills Guidelines given for Meets Expectations Reference 30) Demonstrate knowledge of why sedation is recommended 31) Demonstrate the knowledge of how to obtain images of obese dogs 32) Demonstrate knowledge of centering beam on the greater trochanter 33) Demonstrate the knowledge of how to troubleshoot an image using the size of the obturator foramina 34) Demonstrate knowledge of how to submit studies to AIS 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 (especially the VD view). Radiographs made without sedation are often suboptimally 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. It is not necessary to include the fat dorsal to the spine in the image However you want to include the entire spine including the spinous processes If you are having difficulty centering the x-ray beam on greater trochanter you can gently flex and extend the pelvic limbs while palpating to locate The obturator foramina should be equal in size and shape on the VD views. A smaller obturator foramen indicates the side that is closest to the table (less magnification). All fields must be completed to the best of your 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. AIS Handout