V4_09.02.15

NHS Western Isles

WesternIslesHospital, Stornoway

RADIOLOGY DEPARTMENT

JOB DESCRIPTION

1.JOB IDENTIFICATION

Job Title: Clinical Support Worker Higher Level (CSW Radiography)
Responsible to: Radiology Manager
Department(s): Radiology
No of Job Holders: 2
Job Holder Reference:
Last Update: 18th November 2014

2. JOB PURPOSE

To assist Consultant Radiologists and Radiographers during specialist procedures, radiographic and ultrasound examinations, providing direct patient care and maintenance of equipment in order to ensure a high quality of service to patients.
To facilitate the delivery of local and national screening programmes by acting as chaperone and data entry.
To carry out general duties such as reception desk duties, booking patients into RIS and patient chaperoning.
The post holder will comply with the IR(ME)R 2000 (Ionising radiation [medical exposure] regulations) at all times.
The post holder maybe required to work in any of the departments associated with Radiology.
3. DIMENSIONS
Clinical Areas: Radiology Departments in Western Isles Hospital and Uist and Barra Hospital
Clinical Activity: 13,000 examinations per annum
Clinical Provision: 24 hours a day, 365 days a year.
Staff Responsibility: Radiologist, Radiographersand system administrators will direct the workload of the post holder depending on service needs. The post holder will assist in the training and induction of new members of staff.

4. ORGANISATIONAL POSITION

NHS WI Radiology Directorate












5. ROLE OF DEPARTMENT

  1. To provide a high quality, efficient and effective Radiology services to the population of the Western Isles.
  2. Diagnostic imaging equipment is used to carry out radiological examinations on patients and reports are provided to referring clinicians. The report assists the referrer in providing a diagnosis of the patient’s condition in order to decide on an effective course of treatment and care.
  3. The departmental procedures and practices ensure a high standard of care for patients undergoing radiological examination and promotes multidisciplinary team working.
  4. Provide an environment suitable for the training and education of student Radiographers and work experience students on clinical placements.
  5. To work according to the IR(ME)R regulations at all times

6. KEY RESULT AREAS

Clinical
  1. Have knowledge of and work within the strict guidelines for radiation protection at all times including IR(ME)R 2000. Ensuring patient, staff and own safety whilst observing NHSWI policies in respect of patient care, Health and Safety and Radiation Protection.
  2. Maintain a clean and safe working environment for both patients and staff in accordance with infection control guidelines and ensure all cleaning schedules are up to date. On rotation, daily cleaning and monthly deep clean of all clinical rooms and daily cleaning of non clinical areas e.g. waiting room, front office, staff room and changing room. Undertake cleaning of Radiology rooms after imaging of infectious patients.
  3. Liaise with ward staff prior to patient leaving the ward, with reference to infection control/patient’s needs, to ensure patients are not sent to the department inappropriately.
  4. On a rotational basis,act as a chaperone for patients and clinicians benefit, including during examinations of an intimate or personal nature such as transvaginal ultrasound scanning.
  5. Preparation & administration of oral contrast medium for screening room lists (barium swallow/follow through) as directed by Radiographers/Radiologists. Preparation and administration of Gastrografin for CT patients as directed by Radiographers/Radiologists. Administration of water to patients as directed by Radiographers/Radiologists in preparation for CT, US and/or fluoroscopy.
  6. Prepare for and assist with a range of specialist examinations some of which are non-routine including Sterile Hysterosalpingograms (female reproductive organ imaging) and non-sterile Barium Enemas (Large bowel imaging) ensuring rooms are kept clean and tidy and stocked with supplies. Each examination has different preparation needs and expectations of the CSW.
  7. Assisting with Barium enema procedures including insertion of rectal balloon catheter.
  8. Prepare sterile trolleys unsupervised, in accordance with infection control protocols and local rules, clearing up after the procedure and ensuring equipment is cleaned appropriately.
  9. Dispose of sterile instruments, used sharps and clinical waste to appropriate areas as per department protocols and infection control guidelines.
  10. Ensure appropriate care of patients post administration of IV contrast medium as per department protocol.
  11. Appropriate removal of IV cannula as directed by the Radiographers in line with department protocols, Health & Safety and Infection Control guidelines.
  12. Check containers i.e. sharps temporary closure, pharmibin etc daily and ensure the safe disposal of final closure containers from within the Radiology Department.
  13. Support the department workflow by assisting radiographic staff during busy periods as and when required, e.g. preparing patients for their examinations, assisting patients to dress and undress.
  14. Have an understanding of patient’s physical condition that may have an effect on their behavior, and reacting appropriately
  15. Adapt and respond appropriately to changes in patient’s condition requiring additional nursing/radiographic support.
  16. Maintain high standards of cleanliness of equipment and accessories including lead aprons and trolleys and ensure waiting area is kept tidy and stocked.
  17. Daily monitor stock levels (consumables/laundry/stationary) and replenish/order as required. Maintain the cleanliness and order of the stock room adhering to the stock control system at all times.
  18. Ensure sufficient supply of clean gowns are available for patients at all times including collecting gowns from laundry if necessary.
  19. Assist Radiographers in escorting patients and relatives and in the moving and handling of difficult and/ or complex patients. Assist with portering if required. Ensure a safe environment with competent use of hoists, pat-slides and all other manual handling equipment when needed.
  20. Occasionally provide reassurance to patients by way of clear explanation as to the nature of an examination, where there may be barriers to understanding i.e. patients with learning difficulties.
  21. Facilitate the delivery of local screening programmes which are run to National Protocols under the supervision of clinical staff. This includes chaperoning of patients and accurate recording of patient data and data entry into a national database e.g. AAA National screening programme. Imparting outcomes to patients with information in relation to further follow up or immediate action depending on the findings from the ultrasound examination.
  22. Regularly handle patient’s valuables when removed for a Radiology examination, and make sure that they are returned to the patient after the examination.
  23. Complies with all approved NHSWI Policies, procedures, protocols and guidance.
Reception Duties
  1. Administrative and clerical duties includeperforming reception duties on a rotational basis, answering the telephone,filing, mail handling,scheduling appointments and booking in patients on attendance, photocopying and assisting theother administrative staff when required.
  2. Organise attendance of inpatients and outpatients, depending on x-ray room use, priority of examination and staff availability. Work as part of a team to ensure effective communication and delivery of care.
  3. Competent in the use of RISV11 (Radiology Information System). Competent to input new Radiology request on the system, search patient history, update patient demographics, book current and future patient appointments, scanning and emailing of request cards to offsite Radiologists, emailing reports to referrers and printing of patient reports.Anticipate problems e.g. clashing appointments and take appropriate remedial action.
  4. Competent in the use of PACS V11. Competent to search local and national archives and access Radiology reports to address queries from stakeholders from within and outwith the organisation. Competent to deal with general PACS queries e.g. password expired /incorrect and to know when to escalate queries to PACS administrators.
  5. Competent in the use of SCi store to look up Radiology reports and blood results for patients awaiting CT scans.
  6. Ensure referrers are notified when results are available, which includesdaily maintenance of the completed examination box and distributing clinical reports where necessary.
  7. Maintain patient confidentiality and adhere to Data Protection policies at all times.
  8. Assist in gathering information for audit.
Educational
  1. Participate in mandatory training and seek personal development under the guidance of the Radiology Manager. All areas of competency will be signed off by a line manager when a satisfactory level of working is achieved.
  2. Gain knowledge and undergo training in relation to a wide variety of radiological procedures, some of which are non-routine e.g. Hysterosalpingogram and Barium enemas concentrating on initial set up of equipment, patient care during examination and assistance of Radiographer /Radiologist.
  3. In house training will be provided to enhance skills in health care and IT.
  4. Keep up to date with any policy changes especially with regards to the strict guidelines for radiation protection including IR(ME)R 2000.

7a. EQUIPMENT AND MACHINERY

All imaging equipment requires a great deal of accuracy and precision. It is to be used under strict
operator and manufacturers guidelines and in compliance with statutory regulations.
  1. X-ray tube/table – To aid patients on and off of the x-ray table before and after examination. Move
the x-ray tube when cleaning the x-ray room or in case of an emergency.
  1. Fluoroscopic X-ray machine/table– To aid on and off of the fluoroscopic table before and after examination. Move the fluoroscopic machine when cleaning the x-ray room or in case of an emergency.
  2. Ultrasound couches
  3. Competent in the use of patient hoists, Pat-Slides and all other manual handling equipment used in the department
  4. Patient trolleys and wheelchairs.
  5. Portable oxygen.
  6. Personal Computer
  7. Office Equipment (Printer, photocopier, fax machine, shredder, etc)

7b. SYSTEMS
  1. Input Patient information onto paper records and computerised Clinical systems to ensure compliance with statutory guidelines.
  2. Competent in the use of RIS V11 (Radiology Information System). Competent to input new Radiology request on the system, search patient history, update patient demographics, book current and future patient appointments, scanning and emailing of request cards to offsite Radiologists, emailing reports to referrers and printing of patient reports. Anticipate problems e.g. clashing appointments and take appropriate remedial action.
  3. Competent in the use of PACS V11. Competent to search local and national archives and access Radiology reports to address queries from stakeholders from within and outwith the organisation. Competent to deal with general PACS queries e.g. password expired /incorrect and to know when to escalate queries to PACS administrators.
  4. Competent in the use of SCi store to look up Radiology reports and blood results for patients awaiting CT scans.
  5. Competent to record patient data and data entry into a national databasee.g. AAA National screening programmes.
  6. Competent in the use of software programs such as Microsoft Word and Excel to create documents and tables.
  7. Access the Internet and Board Intranet for relevant information for personal and professional development within statutory guidelines.
  8. Undertake user training to gain competency in future system developments which are essential to the CSW role.

8. ASSIGNMENT AND REVIEW OF WORK

  1. The Radiology Manager will undertake appraisal in order to agree an annual performance development plan.
  2. Demands for diagnostic imaging are generated by the specific service needs of each clinical area from within and out with Western Isles Hospital and associated Hospital sites. Radiologists and Radiographers will be available to consult on a daily basis and provide direct supervision and training when required.
  3. The Radiology Manager, senior Radiographer’s and System Administrator will delegate other non-clinical tasks on a daily basis.

9. DECISIONS AND JUDGEMENTS
  1. To use initiative and work independently when dealing with routine matters in area of work e.g. answering telephone enquires and directing patients. Radiographers will be available for consultation when required to deal with matters that are not routine.
  2. Knowledge & understanding of the radiation protection guidelines ensuring patient, staff and own safety at all times.
  3. To be alert to patient’s comfort/condition and act appropriately, ensuring that appropriate staff are
informed & available to assist if required.
  1. Occasionally patients are taken ill in the care of the CSW; a decision must be made whether it is necessary to call for immediate assistance.
  2. To be accountable for own actions.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

  1. Ensuring personal safety and that of the patient with regards to radiation protection.
  2. Ensuring personal safety and that of the patient during lifting and handling procedures.
  3. Understanding the needs of individual members of staff and patients who may have communication, cognitive or mobility issues.
  4. Prioritising workload with demands coming from many areas of the department.
  5. Clear and precise explanation of procedures to patients prior to specialist examinations

11. COMMUNICATIONS AND RELATIONSHIPS
Patients
  1. Provide routine information by explanation of procedures and listening to the patient’s requirements in order to encourage compliance with the imaging process, using tact and persuasive skills where appropriate.
  2. Imparting outcomes to patients participating in the AAA screening programme with information in relation to further follow up or immediate action.
  3. Provide assistance and reassurance to patients awaiting examinations.
  4. Often first line for dealing with frightened patients or patient complaints at the reception desk or on the telephone.
  5. Ensure that the system of how results are obtained is fully understood by patients.

Relatives/Carers

  1. Provide reassurance, support and receive information
  2. Ask for assistance with, and instruct in methods of immobilisation, maintaining Radiation Protection.
Radiography Staff (internal/external)
  1. Consult Radiography Staff for advice
  2. Pass on information relating to patient transfer to colleagues
  3. Liaise with multi disciplinary team to ensure procedures are followed safely and effectively.

Medical Staff/Nurse Practitioners

  1. Seek help and advice with patients in pain or who are immobile
  2. Assist nurses who are attending the X-Ray department with patients if required.
External
  1. Deal with telephone queries from external sources – other hospitals, other companies.
  2. Direct any person who presents at reception to the appropriate place.

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
Physical Skills:
  1. Assist Radiographers when needed in the manipulation and positioning of patients, providing immobilisation when required.
  2. Possess standard keyboard skills for the entry of data into the RIS, PACS, AAA database
  3. Use dexterity and coordination when assisting the Radiologist undertaking biopsies, FNA’s and drainages. Use dexterity when placing rectal catheters, assisting patients to drink barium and remove IV cannula post CT scan.
Physical Demands:
  1. Move/manipulate the three-dimensional ceiling suspended x-ray tubes when machine has to be moved for cleaning of the room. The average starting and continuous pulling forces required are 6.79kg, as measured and confirmed by manual handling assessment.
  2. Carrying CR cassette, detector, grid, Perspex positioning aids and foot rests, which weigh up to 4.5kg during all shifts.
  3. The majority of the working day is spent standing and walking and bending to position patients with little opportunity for resting.
  4. Frequent transfer of patients from trolleys, beds and chairs onto X-Ray tables, using mechanical aids when required e.g. pat-slide/patient hoists.
  5. Manoeuvring patients on trolleys and chairs from waiting area to x-ray room and back, frequently during all shifts.
  6. Frequent periods of sitting undertaking reception duties and inputting data into RIS and AAA databases.
  7. Weekly storing stationary and pharmacy stores involving lifting packages to shelf heights – varied size, weight and height, but not usually heavy objects.
Mental Demands:
  1. Frequent requirement for periods of concentration and accuracy while operating equipment, during procedures and undertaking reception duties.
  2. Frequent requirement for periods of concentration and accuracy whilst inputting AAA screening data onto database.
  3. Environment without natural light. 50% daily shift
  4. Long periods of sitting at a VDU 30%of daily shift.
Emotional Demands:
  1. Assist the Radiographer where needed, when performing radiographic examinations and help care for ill patients.
  2. Assist the Radiographer where needed, when providing examinations that involve direct contact.
  3. Requirement to use diplomatic and persuasive skills when dealing with some patients/ complaints.
  4. Occasional exposure to distressing circumstances i.e. dealing with terminally ill patients, patients who need immediate treatment after ultrasound (AAA screening) or patients with severe learning difficulties.
Working Conditions:
  1. Frequent exposure to highly unpleasant working conditions. The CSW will have direct contact and need to deal withuncontrolled bodily fluids/foul linen regularly throughout all shifts.
  2. Risk of exposure to scattered Ionising Radiation particularly during fluoroscopic procedures.
  3. Be required to wear heavy lead rubber aprons during fluoroscopy procedures sometimes in a hot environment on a daily basis.
  4. Working constantly in artificial lighting with little or no natural daylight.
  5. Possible exposure to verbal abuse from some patients.
  6. A risk of physical abuse from patients, who may be confused, disorientated and/or intoxicated.
  7. Possible exposure to patients which may have infectious diseases e.g. HIV, Hepatitis, MRSA, c/Diff
  8. Frequent dealings with clinical waste and soiled linen.
  9. Frequent use of VDU.

13. JOB DESCRIPTION AGREEMENT
Job Holder’s Signature:
Head of Department Signature: / Date:
Date:

V4_09.02.15

Person Specification

Clinical Support Worker Higher Level (CSW Radiography)