Capital Project I
Capital targeted for technology enables hospitals to move ahead and provide valuable services to customers (Sandrich, 2008). This facility serves veterans and the capital project proposal is for a Magnetic Resonance Imaging (MRI) compatible monitor and a program for sedation services for patients. Nursing support is necessary for monitoring patients during magnetic imaging for patients receiving oral and intravenous conscious sedation or pain management. In some cases anesthesia support may be necessary and a physician or radiologist to provide orders and supervision for needed sedation to complete imaging. Several studies reveal that 14% to 20% adults need sedation to complete this type of procedure successfully (Medical Advisory, 2003). Patients’ inability to maintain the necessary immobility during the diagnostic imaging and distress contributing to adverse health outcomes, cause suboptimal imaging secondary to motion. This causes decreased productivity of the Magnetic Resonance Imaging facility because of delays, repeat imagining, and cancellations. Understanding MRI Imaging
An MRI (or magnetic resonance imaging) scan is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures (MRI, 2010). The imaging scanner is a tube surrounded by a giant circular magnet. The patient is lies on a moveable bed inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons in the tissues (hydrogen atoms), which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal detected by the receiver portion of the scanner. These signals produce diagnostic images by the computer. Magnetic Resonance imaging poses no radiation to the patient. Noise is a big problem for some patients during the procedure even with the use of ear plugs and headphones. This technology takes longer to acquire images, times required between 30 to 50 minutes per procedure. Images obtained by radiograph are very fast and require less patient cooperation to acquire. Magnetic Resonance Imaging poses little risk to the patient, but studies highlight the risk of life-threatening adverse events related to sedation. Principles of Magnetic Resonance Imaging are important to understand. The standard unit of measurement of the magnetic field strength is a Tesla (T). One Tesla is equal to 10,000 Gauss (G). The earth’s magnetic field at the surface is equal to 0.5G to 2.0G and MRIs have field strength of 0.15T to 2.0T. Magnetic imaging acquisition takes longer and patient’s ability to remain in one position and motionless is imperative to obtain optimal imaging. This magnetic field disables or impedes the function of conventional monitoring equipment. Conventional monitoring equipment will not work in the magnet suite because of the strong magnetic field and conventional monitors and infusion pumps have parts made of ferrous materials. The magnet is always on. The ferrous materials can become dangerous projectiles that could kill a patient and damage the MRI unit and potential patient injury related to burns. Saturation of equipment monitors (magnets) can cause the motor to stop, slow down or accelerate causing the motor to burn-out. Conventional equipment has electronic circuitry may contain components that are affected by static magnetic fields such as transformers, switches, and relays. The magnetic field will stop a watch, erase magnetic strips on credit cards, cause burns for patients who have metallic paint on tattoos, and permanent eyeliner because of the ferrous content. Some patients cannot have this type of imaging because of pacemakers or other implanted devices. The Problem
Patients have special needs related to acuity, claustrophobia, inability to stay motionless during the imaging acquisition, positional pain, cognitive...