Establishing Nursing Staffing Requirements in an Imaging Environment

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Frank Overfelt
Delta Healthcare Consulting Group

Joanna Po
Director Clinical Nursing
MD Anderson Cancer Center

The MD Anderson Cancer Center in Houston, TX consists of 22 Imaging locations, covering all modalities; PET, CT, Nuclear Medicine, Mammography, MRI, Rad/Fluoro, Diagnostics, and Interventional. Nursing plays a major role in preparing the patients for exams. How to effectively staff nursing in all these modalities became the major challenge.

In most Imaging departments, the technologist is the key to handling and processing patients. At MD Anderson Cancer Center the Nurse (RN, LPN, or Clinical Care Assistant)is the first caregiver the patient encounters in all modalities: Pet, CT, Nuclear Medicine, Mammography, MRI, Rad/Fluoro, Diagnostics, and Interventional. With medication reconciliation becoming a major consideration in healthcare, the management of MD Anderson Cancer Center have identified the Nurse as a critical player in this process. Nurses assess and evaluate the patient, administer IVs, prepare the patient for the exam (which could include weights, fall precautions, allergic reactions and the like). Pre- and post care, where required, are all responsibilities of the Nurse. Indirectly the nurse affects the efficient utilization of technologist staff and equipment. Applying similar tools used in the inpatient nursing environment, Delta Healthcare consultants adapted tools to fit the outpatient and inpatient imaging environment. Protocols were established for each individual exam, which defined precisely how nursing was going to be involved in each exam process. Utilizing the hospital's Radiology Information System (RIS) mapping was done to tie all exams to nursing protocols. Arrival rates by hour of day were determined so that the final product identified nurse staffing requirements by hour of day by day of week.