1. Patient Care In Medical Imaging RAD 233
Abdulrahman Al Sayyari,
PhD, MBA, &MS.c

2. Professional Practice
Lecture One & lecture two

3. Professional Practice of Imaging
Legal Responsibilities And Risk Management.
Privacy And Confidentiality
Consent
Professional Communications

4. Definition
Much of the work defining patient safety and practices that prevent harm have focused on negative outcomes of care, such as mortality and morbidity
The services rendered by members of the health profession and non-professionals under their supervision for the benefit of the patient. (From Dorland, 28th ed, p269)
Fundamentally, patient safety refers to freedom from accidental or preventable injuries produced by medical care. Thus, practices or interventions that improve patient safety are those that reduce the occurrence of preventable adverse events (AHRQ PSNet Patient Safety Network. Patient safety. [Accessed October 20, 2007]. 

5. Legal Responsibility
Departmental policy and procedure DPP provide guidelines for technologist to provide patient with safe, comfortable, fast and efficient health service as well as protect technologist from any allegations.
A tort is a an action that wrongly causes harm to someone but that is not a crime and that is dealt with in a civil court.

6. An unintentional Torts
An unintentional tort is an act not intended to do harm but that still results in damage to person or property
Negligence is an example of unintentional tort
Negligence is the failure to take the care that a responsible person usually takes
For a technologist to be found negligent, the following must be proven:
The patient was in the technologist’s care
The technologist failed in their duty to
provide proper care
The patient suffered an injury
The patient's injury was a result of the
technologist’s failure to provide proper care

7. Intentional Torts
An intentional tort is defined as an act performed with the intention of inflicting harm on another.
Examples of intentional torts include:
assault
battery (a wrongful touching)
false imprisonment
intentional infliction of emotional distress

8. Intentional Torts cont’d
Assault is the crime of trying or threatening to hurt someone physically
A statement such as "I'm going to get this x-ray one way or another,“ could be interpreted by the patient as assault
Battery is the crime of hitting or touching someone without their consent and in a way that is meant to cause harm or injury
Battery may be claimed if a patient is palpated for positioning (i.e. palpating the symphysis pubis or chest)
False imprisonment is the unlawful detention or confinement of a person
The inappropriate and unnecessary use of physical restraints is a common example of false imprisonment

9. Quasi-intentional Torts
Quasi-intentional torts are voluntary acts, without intention to injure or distress a patient, but that still result in injury or damage
Types of quasi-intentional torts are:
–Defamation of character (statement that causes people to have a bad opinion of someone
Slander (making a false spoken statement) Libel (publishing a false statement)
– Invasion of privacy

10. Legal Responsibility Summary of torts Type of tort Definition Example
Unintentional tort
Act not intended to do harm but that still results in damage to person or property
Negligence
Intentional tort
Action performed with the intention of inflicting harm on another
Assault, battery, false imprisonment.
Quasi intentional tort
Action that does not mean to hurt but still cause damage
Defamation of character.
Invasion of privacy.

11. Risk Management
Risk management is the process of identification, analysis and acceptance or mitigation of service in medical imaging.
Risk management aimed to provide patient with safe and efficient imaging service.
Therefore it is crucial for technologists to be aware of risk situations specific to their profession.

12. Risk Situations
Occupational hazards (e.g., accidental radiation exposure, high voltage, chemicals, back injury, repetitive stress injury)
Demands or requests that a technologist engage in tasks or duties that fall outside of his or her job specifications and/or professional qualifications
Inadequate information/documentation to perform the requested task
Demands or requests that the
technologist believes are
inappropriate or “unreasonable”

13. Restraints Restraints are used to control or limit a person’s activity
They can be either physical restraints or chemical restraints
Reasonable judgement should be used to decide whether restraints are necessary
If necessary, the least restrictive restraints that provide adequate safety should be used.
Old fashion of risk
management

14. Restraints Policy
Hospitals, and care facilities such as nursing homes, generally follow a policy of least restraint
This means that all possible interventions must have been tried and been unsuccessful before deciding to use a restraint
It is acceptable to use physical restraints for safety reasons with the patient’s permission
Use of restraints will ensure the patient does not injure themselves or others, or disengage therapeutic lines or devices

15. Physical Chemical Does not need physician order:
Restraints
Physical
Need physician order:
Wrists, ankles, vest
Does not need physician order:
Side rail, wheelchair belt, compression band
Chemical
It always need physician order:
Lorazepam

16. Mandatory Report
Mandatory reporting means that as a health professional, you are required by law to file written reports if you are witness to “unsafe, incompetent or unethical practice”
Issues may include:
Professional malpractice
Professional negligence
Incompetence
Incapacity
Sexual Harassment

17. Privacy and Confidentiality
Privacy act: all patient’s information are considered private.
Confidentiality: is to ensure private, personal information will be withheld from all, except those professionals directly involved in care.
Privacy Act: is a law that regulate disclosing private information.
Consent.
Purpose for collection of personal information.
Any secondary user will be involved.

18. Privacy and Confidentiality in medical imaging
Technologists must practice in a manner that protects patient privacy at all times
This is an important aspect of working in health care as a medical radiation technologist
Privacy can be applied by:
Keep request in private area
Imaging screen should be blank of any
patient images and information if not in use
Discuss patient condition only with relevant
health care provider
Patient medical file is under your custody,
privilege people only could review it

19. Exceptions of Confidentiality
Examples of conditions that may be exceptions to confidentiality include:
Certain wounds (gun shots, sharps)
Suspected abuse
Communicable disease (TB, AIDS)
RTA
Industrial accidents (explosion, chemical spills)
Birth defect
Drug addiction

20. Consent
Before a health care practitioner undertakes any sort of procedure or treatment on a patient, consent must be obtained from that patient
Before the patient gives consent, it is important that the procedure is fully explained to them and their decision to undergo the procedure is an informed decision
The only time a procedure may be
performed without consent is in an
emergency situation where consent
cannot be obtained due to time
constraints or patient condition

21. Types of Consents Consents Expressed Implied Written Oral
presentation at the emergency department or at the hospital for admission implies consent for ordinary diagnostic and treatment measures
Expressed
obtained when any medical procedure is to be undertaken on a patient
Written
authorization for use of drugs, sedation or contrast media
Oral
obtained in the presence of a witness when written consent is not available

22. Validity of the Consent
Age and mental status:
the patient must be old enough and mentally capable of making such a decision
Voluntarily given:
Be given voluntarily without coercion or threat
Right for withdrawal :
any time without any cost or punishment
Considered for explained procedure:
the patient must understand the nature and reason for the treatment, risks and benefit
Be informed
the patient must understand the consequences of not having the procedure or treatment, and must also have received information on alternatives

23. Who should obtain a consent?
Ordering Physician ???!!!
(has the responsibility to explain the procedure and alternatives)
Radiologist
Technologist
(specially in a busy environment)

24. Consent in Emergency Situation
The patient is too ill or too injured to provide a signed informed consent.
No legal relative is available to provide consent on behalf the patient's
Urgent treatment is crucial to prevent the danger to life or serious impairment .
There is obvious risk of serious impairment.
There is obvious danger to the patient's life

25. Refusal of Consent
When a patient refuses treatment, the practitioner may be confused or frustrated
The right to refuse treatment may seem irresponsible or irrational action from the patient
But the practitioner must respect the patient’s decision
It is important to keep in mind that the patient should never be forced or coerced into accepting treatment they are not comfortable with

26. Thank you Questions?