COURSEWORK: SCENARIO AND ASSESSMENT
You are required to read and analyse the following scenario and answer the questions at the end. While your answers should be based around the scenario provided, any details given are obviously limited in scope. You are actively encouraged to review the supporting materials provided on study space and research any additional information to support your arguments. You should therefore read widely, in order to underpin your answers with supporting evidence from current practice, articles, research on contemporary issues, and theoretical models and concepts, which have been covered during the integrated module. Marks will be allocated for such evidence, and references are expected as in other work using the Harvard method.
It is anticipated that you will discuss the main issues arising in the scenario with other members of your group or cohort, module leaders and others. However your work must be presented and researched as an individual piece of work and you are advised that the rules relating to academic misconduct including plagiarism and cheating apply.
SCENARIO
Mr and Mrs Doff live in the village of Slowdown on the outskirts of Prosperham city. Stan Doff is 78 years old and a retired factory worker. Wanda Doff is 70 years old and has always been a housewife. Originally from Eastern Europe they moved to England 20 years ago, as a result of civil unrest. Although Mr Doff has mastered the English language Mrs Doff’s English is not that good. They have two children who work abroad. Unfortunately Stan was diagnosed with Alzheimer’s disease 4 years ago. Wanda is his sole carer, although from time to time the local health authority provides respite care, giving Wanda a much needed break. Apart from attending church on Sundays and a weekly visit to the supermarket she has little contact with friends or family as her sister died 12 months ago.
For sometime now Wanda’s health has also been deteriorating. She still smokes, and although she sees this as a comfort she is attempting to cut down her 20 a day habit since last year she was diagnosed with maturity onset diabetes for which she takes Metformin. More recently she has developed pain in her right hip and has put on a considerable amount of weight as she is eating more. She gets little exercise as she finds it difficult to walk and easily gets out of breath. Looking after Stan has become quite a struggle and she is very tired as the pain in her right hip is keeping her awake at night.
One Sunday, friends at her local church comment on how tired she is looking. Wanda tells them about the problems with her hip. Everyone urges her to contact her GP, which she does the next day. Wanda’s GP, Dr Getwell arranges to visit her at home knowing that it is difficult for her to arrange care for Stan.
Dr Getwell is concerned about Wanda’s breathing and that she has put on a lot of weight and is still smoking. He examines her hip and prescribes some non steroidal anti-inflammatory drugs. He writes a request for a Pelvis and Chest X-ray, and in order to allow Wanda the opportunity to visit the hospital and to get some rest, he arranges for Stan to go into care for a fortnight.
A friend agrees to accompany her for her x-rays. A few weeks later Dr Getwell telephones Wanda to inform her that she has been diagnosed with emphysema and has severe osteoarthritis in her right hip. He arranges for her to see an orthopaedic consultant at Karemore NHS Trust, but she has a wait of at least 6 months. During this time Mr Doff’s condition worsens and he requires almost 24 hour care.
When Wanda eventually gets to see the orthopaedic consultant, Dr May Trix. Dr Trix informs Wanda that she will need a hip replacement. However Dr Trix considers that in Wanda’s current state that she is unfit for surgery and indicates that the situation is complicated by her osteoporotic bones. Dr Trix urges her to loose weight and advises that she stops smoking. Mrs Doff leaves disappointed and is unable to understand why the operation could not be undertaken. This was particularly since an article in a local newspaper claimed that the Government had set up an initiative to carry out more hip replacements. Wanda is finding it hard to cope with her husband’s illness and this is causing her further anxiety.
A few days later Wanda takes a walk to the local Kwik-Stop-One-Shop to buy her 40 Bunsen and Fudges cigarettes. She is however feeling very hot. Whilst on her way there a group of teenagers on skateboards ride past and knock her to the ground. Apologetic they phone for an ambulance when it becomes clear that Wanda is unable to stand. The ambulance promptly takes her to Karemore NHS Trust.
The doctor in casualty examines her and requests an ‘X-ray’ as he suspects she has a fractured neck of femur. At the hospital she is imaged by Karl Amity a grade 6 radiographer. Using the new DDR system which has recently been installed. He images Wanda’s pelvis and right hip. Due to inappropriate centring for the lateral hip Karl has to repeat the examination several times and thereby giving an unreasonable dose of radiation. It is evident that Wanda has a sub-capital fracture of the right neck of femur. Karl marked the image as part of the ‘red dot’ process relating to the department’s pathological recognition scheme.
Mrs Doff is transferred from A & E to the ward, and is due to go to theatre that evening. During pre- theatre assessment, the anaesthetist Dr Penny Drops becomes concerned that Wanda is struggling to breathe and her temperature seems high. Wanda says nothing of the fact that she has recently attended St Patchup’s hospital for a ‘chest X-ray’. Dr Drops requests a chest x-ray to establish any cause for Mrs Doff’s breathlessness. Karl happens to be the radiographer on-call that evening and so meets Mrs Doff again. He is very busy and he images several patients in a row before naming and processing the images. Karl inadvertently marks another patient’s chest image with Mrs Doff’s name and vice versa. He has made several similar mistakes in the past.
Dr Drops is surprised that Mrs Doff’s chest image appears normal. Nevertheless she agrees that Wanda can go to theatre. Half way through the operation, complications arise as Wanda goes into respiratory and then cardiac arrest. Resuscitation procedures were commenced but unsuccessful and Wanda unfortunately dies.
The next day Wanda’s images are reported on by Sue Perrad a radiology registrar. Sue’s report identifies the fractured right neck of femur and reports the chest as normal. She doesn’t however take the time to look at Mrs Doff’s previous chest image undertaking at St Patchup’s and available on PACS.
At the same time an investigation is being launched into Mrs Doff’s death. Prompt action is needed as the press have got hold of the information and are questioning staff. The post mortem reveals that Mrs Doff had emphysema and had developed a chest infection. A Consultant radiologist is asked to review the films and compares the chest x-ray to previous images. It is obvious that the recent chest images are not of the same person. On hearing about the death of Mrs doff and the circumstance surrounding the mix up of images Noelle Plates a grade 6 radiographer feels it is her duty to inform Ms Gravity of a number of errors she has witnessed Karl making with regard to the naming of images and his poor imaging technique. The Radiology Service Manager, Laura Gravity has no option but to suspend Karl. Karl is angered by this and seeks advice from the Society of Radiographers, as he feels he has:
- Been inadequately trained to use the new digital imaging and PACS.
- That the out of hours services are poorly managed with insufficient staff to cope with the increasing workload.
- That management are failing in their responsibility to facilitate mandatory updates in other areas of practice such as moving and handling and CPR training.
In the meantime Ms Gravity drafts an apologetic letter with her excuses to the patient who appears to have been diagnosed incorrectly as having a chest infection.
It is not long before the local press pick up on the story, with a headline in the Hearsay Express which reads ‘ NHS bungle blamed on new technology.’ A week later the story appears in the Daily Blab (a national newspaper) under the headline ‘Inadequate training leads to X-ray errors.’
Following these publications a press release is made by Edna Cloud, the Chief Executive of Karemore NHS Trust. Further articles are published in the national press, and the issue is reported on Prosper Network Television.
Noelle Plates has gone off with stress related to the stigma of being labelled a whistle blower with some staff calling her a ‘mole’ and a ‘snitch’. She no longer feels secure in her job and on contemplating her future as a radiographer decides to take positive steps to educate her radiography colleagues on ‘whistle-blowing’. Mrs Doff’s children have returned from abroad are planning to sue the Hospital for negligence in order to pay for Stan’s long term care.
All institutions and characters depicted within this scenario are fictitious and there is no intention to make any factual reference or implication to any in current or previous existence. The scenario is created purely to simulate potential situations that might impact on the working lives of radiographers with the intention for radiography students to demonstrate key and critical skills in its analysis and response to questions.
QUESTION
The question relate to the issues raised in the scenario. You should ensure that you approach the analysis and conclusions in your response from the perspective given; being innovative and taking into account some of the wider issues that might surround the facts. In constructing your responses, you should also be aware of the intended audience identified within the questions and direct the level of your answers accordingly. The questions are designed to give a focus to the sub- themes of the integrative module. However in the spirit of integration there might be some overlapping of the themes in each question
- Produce a health promotion poster which is designed to educate the public on emphysema and lung disease related to smoking.
The Radiology Service manager has delegated the following task to you in your role as an advanced practitioner at Karemore Hospital. In keeping with the recent government no-smoking campaign you are asked to produce a poster to be displayed in the imaging department.
Content to consider;
The poster should strive to educate the public and improve their understanding of emphysema and the link to smoking. You should outline the aetiology, risk factor, signs and symptoms, complications, imaging and management. This should all be framed within the context of smoking.
GUIDELINES FOR THE POSTER
- The poster may be produced using PowerPoint or Publisher
- Print on A4 paper
- Font size should be readable on A4 size
- Candidate number in the top right hand corner
- The Vancouver style of referencing must be used. If in doubt ask.
- Layout and presentation is imperative, attention to detail is important; marks will be lost for incorrect spelling and grammar.
- All diagrams if incorporated must be adequately and correctly labelled and relevant to the assignment.
- Marks will be awarded for original thought, supplementary and relevant information
- An electronic submission of your work must be submitted via the canvas module.
