Policy and Procedure?

  1. Hi everyone.

    I'm new to Rad nursing and am the first nurse in the Rad department. My hospital has no policies to cover what I do except for conscious sedation. Does anyone have some they can share?

    I am particularly interested in the requirement for vitals during angios that don't require sedation, med administration (like glucagon for MRIs or contrast for CT's on those rare occasions when it's given by hand.) I am also interested in policies for transferring post angio patients to floors- how long do they stay in the Rad department? And what are your contrast reaction treatment protocols/discharge criteria?

    If anyone has online policies, a link would be great, otherwise please feel free to email them to me at ratchit@angelfire.com .

    Thanks in advance!

    Ratchit
    •  
  2. 4 Comments

  3. by   morgain
    Dear Ratchit,

    I was in your very position once! I found it quite challenging and rewarding at the same time! Don't try to reinvent the wheel. Some of the answers depend on whether you are considered part of the nursing department or the radiology department. We found that NOT being part of the nursing department was to our advantage. (But, that was just OUR facility and probably another discussion altogether.) I have attempted to answer your questions as follows:

    I am particularly interested in the requirement for vitals during angios that don't require sedation
    * We generally adopted/followed existing policy used by cardiac cath and outpatient surgery.

    . . . med administration, like glucagon for MRIs or contrast for CT's on those rare occasions when it's given by hand . . .
    * Your rads probably already have some sort of protocol they use to determine when they give glucagon and how much. If not, check out the standards set by American College of Radiology at www.acr.org/. Another great resource I strongly recommend you join and certify if you're going to be in IR long is American Radiology Nurses Association at www.arna.net/. Membership DOES have its rewards. I imagine that you could call or e-mail and they could give you more specific answers to your questions.

    I am also interested in policies for transferring post angio patients to floors- how long do they stay in the Rad department?
    * We generally kept angio patients in radiology long enough to hold pressure and assure there would be no bleeding from the insertion site. If we did some other procedure, we sent them to the floor or out-pt pacu as soon as the dressing was on and report could be called to the receiving unit. Again, check to see what your cardiac cath or outpt surgery departments are doing. It's easier and faster to adopt/adapt a policy that is already in place than to try to pass "new legislation."

    And what are your contrast reaction treatment protocols/discharge criteria?
    * Again, check with the cardiac cath department.
    * This is just one of several web pages describing possible treatment for contrast reaction: http://www.ohsu.edu/ps-DiagRadiol/kojima/rxn.htm/.

    Remember, the 'net is your friend. Surf for answers to your questions. The answers are out there if you look for them!

    Another suggestion would be to call the nearest hospital doing IR and see if they could share some of their informatin with you. The worst they'll do is say "no."

    Good luck!
  4. by   ratchit
    .
    Last edit by ratchit on Feb 21, '03
  5. by   smittybike
    I am a cath lab nurse transitioning into radilogy, I've worked in IR for 3 1/2 years, and now I am assisting in CT, ultrasound, xray. nuc med. I don't have much to go on as far as policy and procedure, documentation of my time etc. Any resources you could recommend would be great!
  6. by   dianah
    ARNA (American Radiological Nurses Association) should have Radiology-specific guidelines/helps. We had a large binder (department purchased it for us from ARNA) for reference. Also ARNA's Core Curriculum is wonderful resource. Call around to local hospitals for what they do (the "community standard"). Know your conscious sedation policy and what it requires. Ours required a two-hour stay in PACU after conscious sedation or angio(to observe for bleeding), as the floor nurses maintained they couldn't do q-15 min vitals/check for bleeding, so couldn't receive fresh angios/caths. We also didn't have a dedicated post-procedure recovery area, so the pts went to PACU. Some facilities have that dedicated area for both post and pre-procedure. Do what you feel in your gut is safe for the pt. Hope you have supportive Rads, too. Good luck!

close