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RDGY30770

Academic Year 2024/2025

RadProc: Ref Adults/Children (RDGY30770)

Subject:
Radiography
College:
Health & Agricultural Sciences
School:
Medicine
Level:
3 (Degree)
Credits:
5
Module Coordinator:
Dr Catherine D'Helft
Trimester:
Autumn
Mode of Delivery:
Online
Internship Module:
No
How will I be graded?
Letter grades

Curricular information is subject to change.

This module offers an introduction to the legal and professional rules, regulations and guidelines that govern safe referral of adult and paediatric patients for diagnostic imaging procedures.

Indicative content in respect of ionizing radiation includes an introduction to ionising radiation, radiation sources, radiation dose, ionising radiation protection, risk of exposure to medical ionising radiation and it biological effects (deterministic vs stochastic).

General principles of radiation protection (i.e., justification, optimisation, and dose limitation) are discussed in the context of roles and responsibilities of the undertaking, practitioner and referrer in line with S.I. No. 256 of 2018 (with amendments SI 332 and SI 413 of 2019), with specific consideration to the area of justification. The role of the referrer in the justification of medical exposure to medical ionising radiation, based on the lowest possible radiation exposure while ensuring the best outcome for the patient is explored. Students critique the use of evidence-based guidelines (e.g., iRefer guidelines), that inform decision making when selecting the most appropriate investigation for a range of clinical problems and when communicating the risks and benefits to the patient. Legal requirements for writing and processing a referral for diagnostic imaging are discussed.

Students are introduced to the most common types of radiologic modalities such as projection radiography, CT scanning, fluoroscopy, DXA imaging, mammography, and radio-nuclide imaging procedures, MRI and US

Referral for radiological practice standards and competencies are explored with reference to the NMBI (2019) Nurse Authority to Refer for Radiological Procedures Standards and Requirements for Education Programmes. Adverse incidents, accidental or unintended exposure to ionising radiation are defined and discussed in the context of role responsibility, common referral errors/ near misses and the reporting and recording of such incidents/accidents to the appropriate local and regulatory authorities (i.e., National Incident Management System, State Claims Agency, HIQA). The importance of ongoing clinical audit as a quality improvement method that assists referrers to monitor and evaluate their performance against agreed practice standards is discussed. Students are introduced to the HSE ONMDS Nurse-Midwife Referrers Clinical Audit Tool Kit as a resource that supports the implementation and auditing of nurse-midwife referral practice.

Clinical governance and quality patient safety issues are explored in the context of the HSE ONMSD (2021) National Nurse and Midwife Authority to Refer for Radiological Procedures Guideline. The role of state regulatory bodies (i.e., HSE ONMSD, HIQA and the NMBI) in ensuring the provision of quality patient centred care and safe referral practice at organisation and practice level is critiqued. Working collegially and collaborative with members of the referring multidisciplinary team is highlighted as a key safety indicator. Issues of personal responsibility and accountability are explored in the context of one’s scope of practice, local PPPG’s, the granting of authority to refer for specific radiologic modalities by the undertaking, clinical indemnity insurance cover, the maintenance of practice competence, and the need for continuous education and ongoing professional development.

About this Module

Learning Outcomes:

On completion of this module, the student should be able to:
Knowledge Outcomes:
• Discuss the different types of radiation encountered in different settings; how x-rays are produced; how they interact with the body; and what is meant by radiation dose.
• Discuss the three principles of ionising radiation protection (i.e., justification, optimisation, dose limitation). Critique their application in the context of nurse-midwife referral practice.
• Critically discuss the impact of ionising radiation exposure for the foetus and the breast feeding infant, including radiological procedures and the use of radiopharmaceuticals.
• Critically discuss the management of women of childbearing age undergoing diagnostic imaging procedures with specific reference to radiation protection protocols.
• Describe the legal standards for writing a referral for a radiological procedure.
• Differentiate roles and responsibilities of the undertaking, practitioner, and referrer.
• Demonstrate an understanding of more commonly used diagnostic radiological procedures and other imaging modalities and their implications for a person’s safety.
• Critique the steps in the justification and optimisation process with reference to evidence-based decision support frameworks (i.e., iRefer Guidelines) based on the lowest possible radiation risk in the context of individual patient characteristics.
• Critique referral for radiological procedures governance structures, guidelines, and policies at national, organisational and practice level.
• Critique the role of the nurse-midwife referrer in the management of adverse events, unintended exposure to ionising radiation or near misses and describe the process of reporting these incidents to the relevant regulatory authority and local management.
• Discuss clinical audit as a quality improvement method to assess and evaluate competence in referral practice. Outline methods and resources for implementing and recording clinical audit of nurse-midwife referral practice.
• Understand why certain groups of patients are more susceptible to harmful effects of ionizing radiation and identify situations in which the use of ionising radiation is justified for these patients.



Professional Skills:
• Demonstrate knowledge of the benefits and risks associated with a variety of radiological procedures, to be able to explain these to the patient at an understandable level.
• Understand how to provide necessary information in referrals for radiological procedures, to aid in optimization of an examination by the practitioner.
• Demonstrate knowledge of effective doses for a variety of common imaging examinations, to be able to assess cumulative dose for a given individual patient.
• Understand how to diagnose radiation induced skin injury and other potential radiation effects in a patient.
• Understand the importance of utilizing clinical and radiological information from previous examinations in the process of justification.
• Understand how to explain the planned procedure to the patient at an understandable level.



Personal / Professional Development:
• Critically explore one’s own scope of referral practice, the granting of authority to refer for specific radiologic modalities by the undertaking, indemnity insurance cove, teamwork and collegiality, maintaining practice competence and the need for continuous education and ongoing professional development

Student Effort Hours:
Student Effort Type Hours
Specified Learning Activities

12

Autonomous Student Learning

93

Lectures

20

Total

125


Approaches to Teaching and Learning:
Lectures - live and online
Lectures - pre-recorded
Class based discussion
Critical evaluation of literature
Self directed learning
Reflective practice

Requirements, Exclusions and Recommendations

Not applicable to this module.


Module Requisites and Incompatibles
Co-requisite:
NMHS33910 - CP Referring RadProc in Ad&Chi


 

Assessment Strategy
Description Timing Component Scale Must Pass Component % of Final Grade In Module Component Repeat Offered
Assignment(Including Essay): An essay based on content delivered in the module and background reading. Week 15 Alternative non-linear conversion grade scale 50% No
60
No
Exam (Online): Multiple choice and multiple select questions based on module content. Week 12 Alternative non-linear conversion grade scale 50% No
40
No

Carry forward of passed components
No
 

Resit In Terminal Exam
Spring No
Please see Student Jargon Buster for more information about remediation types and timing. 

Feedback Strategy/Strategies

• Group/class feedback, post-assessment

How will my Feedback be Delivered?

General feedback on the essay assignment will be posted on BrightSpace once all essays have been graded. Students are welcome to request specific individual feedback via email to the MC.

Name Role
Ms Eileen Bohan Lecturer / Co-Lecturer
Assoc Professor Shane Foley Lecturer / Co-Lecturer
Ms Jennifer Grehan Lecturer / Co-Lecturer
Ms Marion Maher Lecturer / Co-Lecturer
Ms Éilish McDermott Lecturer / Co-Lecturer
Ms Shauna Murphy Lecturer / Co-Lecturer

Timetabling information is displayed only for guidance purposes, relates to the current Academic Year only and is subject to change.
Autumn Lecture Offering 1 Week(s) - 1 Fri 08:00 - 08:50
Autumn Lecture Offering 1 Week(s) - 1 Thurs 08:00 - 08:50