SONOGRAPHERS’ COMMUNICATION

Lest we forget the patients!

James L Teixeira,BA, RDCS (AE, PE), RCS

Patient safety is such an important topic that when I receivedan e-mail from James Teixeira, a sonographer from Tennessee,asking to submit an editorial on the topic; I honestly wished Ihad thought of it myself. The truth is, many laboratories areworking extensively to incorporate a culture that embracesthe patients safety above all else. Please enjoy the followingeditorial by James Teixeira, BA, RDCS, (AE, PE), RCS.

–Marti L. McCollough, BS, MBA, RDCS, FASE

More often than not, sonographers are inundated with literatureregarding their safety and the measures that must be taken to stay pro-tected. Both the Society of Diagnostic Medical Sonographers (SDMS)and the American Institute of Ultrasound Medicine (AIUM) providedocuments which describe the topic of sonographer safety: wearingprotective gear, ensuring proper ergonomics, and even tasks such aswashing your hands. Obviously, appropriate hand hygiene benefitsthe sonographer as well as the patients. While protecting oneself isnecessary and in most cases mandatory, it is also the responsibilityof all caretakers, including sonographers, to properly care for ourpatients and their safety.

Debatably, one of the most important features of an echocardio-gram is answering clinical questions, thereby confirming a diagnosisor managing the progression of a prior diagnosis. The ASE has pub-lished a plethora of guidelines with respect to appropriateness criteria.The creation of appropriateness criteria is an effort to reduce unnec-essary examinations, thereby minimizing costly medical bills and im-proving efficiency. It is the duty of each and every sonographer toensure that the proper diagnosis is presented, but also that the criteriafor each examination, whether it is a TEE, contrast study, or routineechocardiogram, have been met.

Regardless of the setting (inpatient vs. outpatient), the care we giveour patients extends beyond the realm of scanning and broadens intothe daily management of patient care. Sonographers are faced with pa-tient safety in both outpatient laboratories and inpatient settings. As-sessing two patient identifiers (i.e. arm band, driver’s license, orverbal confirmation), as well as confirming the order and indicationfor the test, is mandatory. In addition, in the inpatient setting, loweringthe bed, raising the side rails, removing obstacles, and leaving a patient

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with a call bell are all sim-ple measures a sonogra-pher can take to keep hisor her patients free ofharm. The facility where Iwork gives each new em-ployee a thorough orienta-tion which goes over thecare a practitioner mustfollow in order to remaincompetent. Proper educa-tionandorientation is excel-lent practice and reiteratesthe fact that patient safetyis a top priority, as well asthe vision for providing thehighest quality of care.

Patient safety issues are challenging in any setting but are particu-larly so when working in a large general hospital. The sonographerworking in a hospital facility has to be especially adaptable as he/she applies patient safety measures to circumstances that vary accord-ing to each patient. For instance, a premature infant is significantly dif-ferent from a full-term infant. The complexity of care then continuesthrough pediatrics, adults, and into geriatric patients.

Pediatric echocardiography has a myriad of technical challenges.The physical pressure applied during scanning can cause problemssuch as a pneumothorax, bruising, dyspnea and even, in extremecases, cardiorespiratory arrest. In addition, neonates are extremelyvulnerable to handling and sonographers/echocardiographers mustalways be aware of how firmly pressure is applied with our probesonto the patients’ chest walls.

Sonographers, nurses, and physicians all become health care pro-viders to positively impact the lives of others. We need to be the frontline that protects and guards the safetyof thepatients so that their healthconditions can be accurately diagnosed and their care properly deliv-ered. By spending a few moments before each exam to tidy a room, re-movehazards, or arrange patients so that they are out of harm’sway,wecan greatly decrease the chances of an untoward incident. Always keepin the mind the motto of health care: ‘‘Primum non nocere.’’