NMHS33920

Learning Outcomes:

Utilize evidence-based guidelines (e.g., iRefer Paediatrics) to select the most appropriate radiological imaging procedure based on individual patient characteristics, clinical indicators, and local imaging protocols

Identify situations in which the use of ionizing radiation is justified in the case of a child

Assess the cumulative effective dose for a series of exams for a given individual patient

Apply the principle of justification to the referral of a child for a radiological procedure, including the exposure of asymptomatic individuals (i.e., parents, comforters, and carers)

Explain the benefits and risks of a particular procedure to the child’s parents/guardian at a level they can understand (to include the radiation risks wherever there is a significant deterministic or stochastic effect or when the child/parent(s)/guardian has a question)

Inform the parent(s) of the underlying health problem, the planned procedure and follow up care

Provide the practitioner with necessary referral information to aid in the justification and optimization of an examination

Advise actions in case of adverse incidents, accidents, near misses or inadvertent radiation exposure of a patient

Discuss radiation induced skin injury and other potential radiation effects in patients and worker

Refers within scope of practice and works collegially and collaborative with members of the MDT to support the process of justification and optimization of radiation protection.

Maintain competence in referral practice by engaging in continuous education, clinical self-audit and competence review

Student Effort Hours:

Approaches to Teaching and Learning:

This is a blended learning module. 5% is online and 95% is face-to-face experiential learning in the clinical area in which the nurse-midwife is employed. This module provides students with the opportunity to apply theoretical and empirical knowledge to the practice of referring a patient for a radiological procedure under the supervision of a designated consultant medical practitioner. Students develop the cognitive and practical skill of 'referring for a radiological procedure' using a problem-based approach based on real life clinical case scenarios.

Requirements, Exclusions and Recommendations

Learning Requirements:

Students registered to X905 Professional Certificate Referring for Radiological Procedures (Children) must have successfully completed a minimum NFQ Level 8 Health Assessment module prior to registering to this module.

Module Requisites and Incompatibles

Not applicable to this module.
 

Assessment Strategy

 

Please see Student Jargon Buster for more information about remediation types and timing. 

Feedback Strategy/Strategies

• Feedback individually to students, on an activity or draft prior to summative assessment
• Feedback individually to students, post-assessment
• Self-assessment activities

How will my Feedback be Delivered?

Written and oral feedback and feedforward is given by the consultant medical practitioner to the student after each case (i.e., 1-10). The first seven clinical cases are formative and the last three are summative (i.e., a measure of clinical competence). The consultant medical practitioner and student work together over a period of 100 hours and engage in teaching, learning and shared decision-making while referring children for a radiological procedure. The student records and documents each 'referring' case in their logbook as part of their clinical portfolio. They are required to reflect on the medical practitioner’s feedback and feedforward after each case, write a short personal perspective analysis on strengths and weaknesses, and identify and record learning outcomes for the next clinical case.

Boman, E., Levy-Malmbery, R., Fagerstrom, L. (2019) Differences and similarities in scope of practice between registered nurse-midwifes and nurse-midwife specialist in emergency care: an interview study. Scandinavian Journal of Caring Sciences, 34(2) p.492-500.

Department of Health (2011) Strategic Framework for role expansion for Nurses and Midwives: Promoting quality patient care. Located at: https://assets.gov.ie/40257/352ec24c9710421890a044d676a209a8.pdf. Accessed 13/09/21

Department of Health (2019) A policy on the development of graduate to advanced nursing and midwifery practice. Located at: https://assets.gov.ie/19260/f49c5ea1a19843b0aae20151aeaf694d.pdf. Accessed 13/09/21

Drennan, J., Noughton, C. Griffins, M., Butler, M., Grehan, J., Moughty, A., Kavanagh, I., Hyde, A., Butler, M.L., Sheridan, A., Coughlan, B., Hegarty, J., Savage, E., Coffey, A., O’Connell, R., Creedon, R. (2014) An Evaluation of the HSE Guiding Framework for the Implementation of Nurse Prescribing of Medical Ionising Radiation (X-Ray) in Ireland

European Commission (2014) Guidelines on radiation protection education and training of medical professionals in the European Union. Radiation Protection No. 175. Located at: https://ec.europa.eu/energy/sites/ener/files/documents/175.pdf. Accessed 25th April 2022.

Fealy, G., Casey, M., O’Leary, D., McNamara, M., O’Brien, D., O’Connor, L., Smith, R., Stokes, D. (2018) Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers. Journal of Clinical Nursing, 27, p.3797-3809.

Government of Ireland (2018) European Union (Basic safety standards for protection against dangers arising from medical exposure to ionizing radiation) Regulations 2018. Statutory Instrument No. 256 of 2018. Located at: http://www.irishstatutebook.ie/eli/2018/si/256/. Accessed 13/09/21

Health Information Quality Authority (2019) Guidance on the assessment of compliance in undertakings providing medical exposure to ionizing radiation. Located at: https://www.hiqa.ie/sites/default/files/2019-10/Guidance_assessing-compliance-in-ionising-radiation.pdf. Accessed 25th April 2022.

Health Information Quality Authority (2019) Statutory notifications for accidental or unintended exposure to ionizing radiation: Guidance for undertakings carrying out medical exposures to ionizing radiation on the statutory requirement to notify significant accidental or unintended exposure events to HIQA. Located at: https://www.hiqa.ie/sites/default/files/2019-10/Guidance-notification-of-significant-events.pdf. Accessed 25th April 2022.

Health Service Executive (2014) An evaluation of the HSE guiding framework for the implementation of nurse prescribing of medical ionizing radiation (X-Ray) in Ireland. Located at: https://healthservice.hse.ie/filelibrary/onmsd/an-evaluation-of-the-hse-guiding-framework-for-the-implementation-of-nurse-prescribing-of-medical-ionising-radiation-x-ray-in-ireland.pdf. Accessed 25th April 2022.

Health Service Executive ONMSD (2021) Site Declaration Form: Referring for radiological procedures. Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/final-site-declaration-form-nurse-midwife-referrers.pdf. Accessed 25th April 2022.

Health Service Executive ONMSD (2022) How to register on the HSE National Database for Nurse and Midwife Referrers of Radiological Procedures. Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/referral-medical-ionising-radiation-procedures.html. Accessed 25th April 2022.

Health Service Executive ONMSD (2022) Clinical audit toolkit for Nurse and Midwife referrers for radiological procedures. Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/clinical-audit-guidance-toolkit-for-nm-referrers-of-radiological-procedures.pdf. Accessed 25th April 2022.

Health Service Executive ONMSD (2022) Sample audit tool for Nurse Midwife referrers for radiological procedures (Excel spreadsheet). Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/referral-medical-ionising-radiation-procedures.html. Accessed 25th April 2022.

Health Service Executive ONMSD (2022) Sample audit data collection tool for Nurse-Midwife referral for radiological procedures. Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/referral-medical-ionising-radiation-procedures.html. Accessed 25th April 2022.

Health Services Executive (2021) National Nurse and Midwife authority to refer for a radiological procedure guideline. Located at: https://healthservice.hse.ie/about-us/onmsd/onmsd/specific-programmes/national-nurse-and-midwife-authority-to-refer-for-radiological-procedures-guideline.pdf. Accessed 25th April 2022.

Nursing and Midwifery Board of Ireland (2015) Scope of practice. Located at: https://www.nmbi.ie/nmbi/media/NMBI/Publications/Scope-of-Nursing-Midwifery-Practice-Framework.pdf?ext=.pdf. Accessed 13/09/21.

Nursing and Midwifery Board of Ireland (2020) Code of professional conduct and ethics for Registered nurse-midwifes and Registered Midwives. Located at: https://www.nmbi.ie/NMBI/media/NMBI/Code-of-Professional-Conduct-and-Ethics.pdf?ext=.pdf. Accessed 13/09/21

Nursing and Midwifery Board of Ireland (2020) Nurse authority to refer for radiological procedure’s standards and requirements for education programmes. Located at: https://www.nmbi.ie/NMBI/media/NMBI/Publications/NMBI_Radiological-Procedures_AK-06-03-2020.pdf?ext=.pdf. Accessed 25th April 2022.

Stasa, H., Cashin, A., Buckley, T., Donoghue, T. (2014) Advancing advanced practice: Clarifying the conceptual confusion. cited in Fealy, G., Casey, M., O’Leary, D., McNamara, M., O’Brien, D., O’Connor, L., Smith, R., Stokes, D. (2018) Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers. Journal of Clinical Nursing, 27, p.3797-3809.

State Claims Agency (2018) Nurse and Midwife Authority to Refer for Radiological Procedures. Located at: https://stateclaims.ie/uploads/publications/nurse-midwife-and-Midwife-Medicinal-Product-Prescribing-Jan-18.pdf. Accessed 18th September 2021.

The Royal College of Radiologists (2017) iRefer guidelines: Making the best use of clinical radiology, 8th edn. London: The Royal College of Radiologists.

The Royal College of Nursing (2021) Clinical imaging requests from non-medically qualified professionals, 3rd edn. Located at: https://www.rcn.org.uk/professional-development/publications/rcn-clinical-imaging-requests-uk-pub-009-108. Accessed 25th April 2022.
The British Institute of Radiology (2019) Position statement: Training and governance requirements for non-medical refers to Radiology. Located at: https://www.bir.org.uk/media-centre/position-statements-and-responses/guidance-for-non-medical-referrers-to-radiology/. Accessed 25th April 2022.

The Royal College of Radiologists (2020) A guide to understanding the implications of the Ionising Radiation (Medical Exposure) Regulations in diagnostic and interventional radiology. Located at: https://www.rcr.ac.uk/publication/irmer-implications-diagnostic-imaging-interventional-radiology-diagnostic-nuclear-medicine. Accessed 25th April 2022.

Timetabling information is displayed only for guidance purposes, relates to the current Academic Year only and is subject to change.