2. • Qualifications and Training
• Health and Safety
• Changes in Technology
• Leave Entitlements
• Patient Demographic
• Patient Perception of Healthcare
4. Studying 30 years ago
Nurse
• 3 years
• Hospital based
• Heavy workload and stress
Dental Nurse
• 2 years
• Training schools Wellington, Christchurch and Auckland
• Principal (dentist) dental tutor sisters (dental nurses)
Radiographer
• Hospital based
• Theory and practical study
5. Studying now
Nurse
• 3 year course
• Train in polytechnics
Dental Therapist
• Changes occurring
• Otago and Auckland University now offer dual
qualification
• “phantom heads” , treat pt’s under supervision
Radiographer
• 3 year course
• Train in polytechnics
6. Restrictions 30 years ago
Nurses
• Able to do most things under supervision
• Not involved in childbirth
• Only watch theatre cases
Dental Nurses
• Complete supervision
• Everything checked off
Radiographers
• Watched in theatre until almost fully qualified
• Given a lot of dirty jobs e.g barium enemas
7. Restrictions Now
Nurse
• Supervised with medications, ecg
• Not allowed to give meds to minors
• Can’t carry out any procedures that requires further study
Dental Therapist
• 1st year :work solely on phantom heads,
• 2nd and 3rd year :pt’s under supervision
Radiographer
• Supervised by Qualified
• Films must be checked off
• Not able to do morgue, NAI cases.
8. Effect on Patient Care
Nurses
• Polytechnic training – consistency in training
• More emphasis now on patient rights
• 1970’s - pt’s communal showering
• “Right to be Treated with Respect”
• “Right to Dignity and Independence” (“HDC”, 2009)
9. Effect on Patient Care
Dental Therapists
• Very pt care orientated
• “Need to like and care for people”
• Their role
health promotion in
education, community
development
10. Effect on Patient Care
Radiographer
• Tertiary education
• Big emphasis on patient care
-classes
-tests e.g. CBA
• Restrictions
-supervision ensures positive/safe patient
experience
12. Questions
• What health and safety
issues were considered
important when you entered
your career?
• What changes have there
been in the way infectious
patients are handled?
• Have there been changes to
do with health and safety?
13. Health and Safety issues
• Changing of uniforms
• Wearing of glove/ masks
• Transferring patients
14. Uniforms
• Radiographers wore a uniform
which they could only change
into while they were in the
hospital
• Now everyone is able to
change into their uniforms at
home and wear them into the
hospital
15. Wearing gloves/ masks
• Dental nurses didn’t wear
masks or gloves when they
worked on patients in the 1980’s
• Now they always wear gloves, masks and
protective glasses. Very infectious patients are
now treated at the end of the day and Electrical
safety is also very important
16. Transferring Patients
• Staff often lifted using their back like a crane
instead of using there legs. So a lot of health
care workers often got chronic back
problems.
• Now new lifting techniques are enforced
• Use slippery sams and Pat slides
17. Benefit to Patients
• Health and safety has not only benefited the staff but
the patient also……
• Hoist = moving patients safely onto examination tables
• Wearing gloves/gowns with infectious patients=helps
minimise the risk to the next patient of becoming
infectious
19. 1970’s Radiography
• Film used
• Processed film manually
in theatre
• Automatic Processors
• 3 minutes to develop film
• Single phase generators
with line voltage
compensators that had to
be adjusted manually.
20. 1970’s Radiography
• No other
modalities in
Radiology
Department
• Specialised rooms
• Air
Encepholograms
21. Nuclear Medicine
• 1950’s – first used
• 1970s – visualisation of
organs beside the thyroid i
• 1980s – nuclear medicine
used to diagnose heart
disease
• Now – over 100 types of
different examinations can
be performed.
22. General X-ray
• High frequency and constant
potential generators
• 1973 – phosphor imaging plates
• 1983 – First CR units were
commercialised
• Late 1980’s CR accepted by medical
community
• Latest CR readers take 5 seconds to
read a 35 X 43 imaging plate.
• Equipment generally smaller and
lighter
• DR virtually instant
23. Development of CT
• 1972 – Hounsfield and
Cormack invented CT
• 1974 – first medical
equipment
manufacture of CT
equipment
• 1989 – first spiral CT
machine in routine
operation
24. MRI
• 1946 – Magnetic resonance
phenomenon discovered.
• 1973 – MRI of test tube
• 1977 – first MRI of entire
human body
• 1980 - First commercial
scanner developed
• 1993 – functional MRI
developed
25. Other Changes...
• Computers now used to quickly access and share
patient information and radiological images.
• Local anesthesia and high speed drills introduced
into dental nursing since 1970’s
• Electronic monitoring of blood pressure, pulse,
oxygen levels adopted.
26. Impact of changes on staff
• Still require the same background
knowledge
• New knowledge is required to
operate machinery
• Loss of some skills as some
processes become automated.
27. Impact of changes on staff
• Changes in exposure factors
are not as evident in CR
systems
• Pre-set exposures also
reduce need to thoroughly
understand exposures.
• Exposure creep
28. Benefits of technology to patients
• Technology should ensure patients
receive better care
• Advances in medical imaging provides
more accurate diagnoses faster
• Better pain relief
• Increased accuracy of monitoring
equipment
• Staff have access to more knowledge,
easily and quickly
• Simple procedures can be performed
faster
29. Disadvantages to patients
• Less understanding,
procedures more foreign and
confusing to the public
• Dehumanization
• Monitoring done by
interacting with machines,
not patient
• Equipment can seem
intimidating, claustrophobic
and isolating.
• May have elevated
expectations
30. “They strapped me into
this machine, I didn’t like
it. It was really close to
my face. I was alone, I
did not know where they
(the radiographers) had
gone. It was noisy. I
wouldn’t want another
one.”
31. Technology and Patient Care
• With support and
education technology can
be beneficial patients.
• Need to remember that
they don’t understand
what is happening.
• Risk of losing basic patient
care skills and getting
caught up in technology
• Technology makes patient
care more essential
32. Future of Technology
• Advances being made
in making medical
imaging more patient
friendly.
• “Ambient Experience”
technology for CT/MRI
rooms
• Patient controls
surroundings
35. Leave Entitlements 30 years ago
• 2 weeks of sick days
• Maternity leave available:
-not well promoted
-smaller hospitals tended to accommodate
for this more
36. Leave Entitlements Now
• Long service leave introduced in private practices
• Parental Leave (1987)
• Paid parental leave (2002)
• Minimum Annual Leave Entitlements (2007)
37. Leaves’ effect on Patient Care
• Annual Leave
“maintain health and well
being and to achieve a
work/life balance” (“Staff annual
leave”, 2007)
• Positive effect patient
experience
• Motivation
• Higher quality performance
39. Reasons for hospital admissions have not changed
dramatically, however……
The public’s perception of certain jobs,
The demographic of patients treated and
What a staff member can/can not do has changed.
40. Hospital Admissions
• Late 1980’s:
• Accidents e.g. MVA,
• arthritis, and rheumatism.
• Followed by hearing and
• eyesight difficulties.
In 2002/2003:
MVA were still one of the major
causes of hospital admissions
along with:
-alcohol admissions,
-strokes and arthritis
41. DEMOGRAPHIC OF PATIENTS
TREATED
Late 1980’s
• Patients predominantly white
• Trauma = young adults
• Strokes = older people
2002/2003
• Females = 57.2% of hospital discharges,
• 27.8% of patients discharged were 65years +
• Maori accounted for 16% of total discharges
42. PUBLIC PERCEPTION TO DENTISTS
Dental clinics were commonly
called the murder house
• Now parents now see them
as being an important part
of their child’s school life
43. WHAT STAFF CAN/CAN’T DO
20years ago
MRTs were allowed to:
•smoke in the staff rooms
•read books or knit while they
were on the job
Now
MRT’s are more focused on their
career paths and have
responsibilities
44. PATIENT CARE
• Has changed for the better over the last few
years.
• Now treat a lot more Maori people
• This has lead to continuing education on how
to deal with different cultures
45. References
FujiFilm Corporation. (2009). Innovation History. Retrieved June 01, 2009, from http://www.fujifilm.com/about/history/innovation_history/#content5c
Health and Disability Commissioner. (2009). The HDC Code of Health and DisabilityServices Consumer’s Rights Regulation 1996. Retrieved June 4 2009, from
http://www.hdc.org.nz/theact/theact-thecodesummary
• History of Nuclear Medicine. (2008, June 10). Retrieved June 01, 2009, from http://www.imaginis.com/nuclear-medicine/nuc_history.asp
Kodak. (2005, August). Kodak Continues With It’s Computed Radiography Innovation [PDF]. Available from
http://www.shawinspectionsystems.com/products/kodak/datasheets/CR_history.pdf
Medical Imaging Technology and Innovative Tools Improve Patient Experience. (2006, September 13). Retrieved June 01, 2009, from
http://www.jobwerx.com/news/phg_medical_biz-id=948453_843.html
Nagasaki University School of Medicine. (n.d.). Introduction to MRI – History. Retrieved June 01, 2009 from http://www.med.nagasaki-
u.ac.jp/radiolgy/MRI%20of%20the%20FOOT/MRI-CDNUH/nf-history.html
NDT Resource Centre. (n.d.). Present State of Radiography. Retrieved June 01, 2009 from http://www.ndt-
ed.org/EducationResources/CommunityCollege/Radiography/Introduction/presentstate.htm
Priority Improvements to Parental Leave (2007). Retrieved June 4, 2009, from
http://74.125.155.132/search?q=cache:sXMHpYcCXBcJ:www.nacew.govt.nz/publications/files/parental-
leave.doc+leave+entitlements+1980%27s&cd=2&hl=en&ct=clnk&gl=nz
Santacroce, L. (2005, October 27). Mammogram. Retrieved June 01, 2009, from http://www.emedicinehealth.com/mammogram/article_em.htm
Siemens Medical. (n.d.). Computed Tomography – It’s History and Technology [PDF]. Available from
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History_and_Technology.pdf
Staff Annual Leave Balances (2007). Retrieved June 6 2009, from
services.eng.uts.edu.au/StaffandAlumni/secure/StaffAnnualLeaveBalances.doc
Notas del editor
There have been huge technological developments in the healthcare system between the 1970’s and now. We’re going to look at some of these changes, how they have effected the role and knowledge of staff as well as the impact of technological changes on the patient.
Film usedProcessed film manually in theatreHad automatic processors but often had problems with machines jammingTook approximately 3 minutes to develop a filmSingle phase generators with line voltage compensators that had to be adjusted manually.
No other modalities in Radiology DepartmentSpecialised rooms for angriography ( Carotid, Renal, Aortic, Femoral,etc).Room for Air Enceplograms was (air was injected through a lumbar puncture needle into the ventricles of the brain).Air encephalograms now defunct due to introduction of CT
Nuclear medicine first used in 1950’s to demonstrate thyroid function.1970s – visualisation of organs beside the thyroid including the liver, spleen and brain tumour localization.1980s – nuclear medicine used to diagnose heart diseaseNow – over 100 types of different examinations can be performed.
High frequency and constant potential generators in common usage. 1973 – George Luckey invented phosphor imaging plates1983 – First CR units were commercialised by KodakLate 1980’s CR accepted by medical communityLatest CR readers take 5 seconds to read a 35 X 43 imaging plate. Equipment generally smaller and lighterDR virtually instant
1972 – Hounsfield and Cormack invented CT (awarded Nobel prize in 1979 for invention)1974 – first medical equipment manufacture of CT equipment1989 – first spiral CT machine in routine operation
1946 – Bloch & Purcell independently discovered the magnetic resonance phenomenon. 1973 – MRI of test tube1977 – first MRI of entire human body1980 - First commercial scanner developed1993 – functional MRI developed
Still require the same background knowledge to perform most tasksNew knowledge is required to operate machinery Loss of some skills as some processes become automated. E.g. When not taking blood pressure manually become less proficient.
Changes in exposure factors are not as evident in CR systems so MRTs loose understanding of the affect of changing exposure settings. Pre-set exposures also reduce need to thoroughly understand exposures. Not as obvious when consistently overexposing films. Exposure creep not good practice.
Technology should ensure patients receive better careAdvances in medical imaging provides more accurate diagnoses fasterBetter pain relief (local anaesthetic in dentistry)Increased accuracy of monitoring equipmentStaff have access to more knowledge, easily and quicklySimple procedures can be performed faster
Less understanding, procedures more foreign and confusing to the publicIncreased efficiency can make experience dehumanising.Monitoring done by interacting with machines, not patientEquipment can seem intimidating, claustrophobic and isolating. May have elevated expectations of what equipment is capable of
Advances being made in making medical imaging more patient friendly. Phillips has developed “Ambient Experience” technology for CT/MRI rooms Patient controls surroundings. E.g. the lighting, projected images and other elements of the exam room, giving them a greater sense of comfort and control over their experience