Produce dual-energy x-ray absorptiometry (dxa) scans for diagnostic purposes

URN: SFHCI.M
Business Sectors (Suites): Clinical Imaging
Developed by: Skills for Health
Approved on: 01 Feb 2019

Overview

SFHCI.M SFHCI.M This standard is concerned with the use of dual-energy X-ray absorptiometry (DXA) to produce scans that will be used for bone mass and body composition measurements and image analysis for the diagnosis of osteoporosis and sarcopenia. Production of DXA scans should be undertaken within the scope of your own role and practice. Key people are those involved in the individual's care and others involved in provision of services. Users of this standard will need to


Performance criteria

You must be able to:

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  1. apply standard precautions for infection control and other appropriate

    health and safety measures

  2. ensure all necessary preparations have been made by the individual

    and staff before starting the procedure

  3. check and prepare the equipment required for the examination

  4. ensure the environment is conducive to maintaining the privacy and

    dignity of the individual

  5. check the identification details before commencing the procedure in

    accordance with national standards

  6. introduce yourself and other members of staff present during the

    examination

  7. communicate with the individual / key people to facilitate their

    understanding of and co-operation with the examination

  8. establish the individuals capacity to understand the procedure with

    the help of key people if necessary

  9. obtain valid consent for the procedure in accordance with national

    and local guidelines

  10. respect the individuals privacy, dignity, beliefs and decisions

  11. clearly explain the procedure and possible outcomes, including risk,

    benefits and limitations

  12. check individuals of child-bearing potential for pregnancy or

    possible pregnancy, if appropriate to the examination, and take action

    in accordance with local protocols

  13. confirm the status of key people before the examination and, where

    their presence is required, adhering to local guidelines

  14. position the individual and adjust their clothing where required

    according to the protocols for the examination which allows an optimal

    outcome to be achieved while:

    14.1 recognising the individuals need to retain their dignity and selfrespect

    14.2 ensuring their comfort as far as possible

    14.3 preventing the appearance of artefacts

  15. seek confirmation that the individual is ready before the exposure is

    made

  16. maintain communication with the individual /key people to facilitate

    their understanding and co-operation throughout the examination

  17. observe the individuals condition and well-being at all times and

    take appropriate action

  18. consider the technical aspects of the scanner set up in relation to

    the anatomical areas to be scanned

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  19. ensure the correct technical parameters have been chosen and

    assess the correct area ready for analysis

  20. on post processing of the scan, ensure all quality standards are

    correct, including anatomical sites and demographics

  21. following the preliminary clinical examination, inform the appropriate

    person if an abnormality is observed on the image which is likely to

    require further investigation or treatment

  22. explain the process for obtaining results

  23. record, collate and prepare appropriate documentation, images and

    scan analysis for transfer or storage according to local protocols

  24. verify that the images and scan data have arrived/been stored

    according to local protocols

  25. recognise where help or advice is required and obtain this from

    appropriate sources

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Knowledge and Understanding

You need to know and understand:

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  1. legal, organisational and policy requirements relevant to your role,

    the role of others in your organisation and the activities being

    carried out

  2. the relevant national and local standards, guidelines, policies and

    procedures that are available and how and when they should be

    accessed

  3. the importance of respecting individuals culture, privacy, dignity,

    wishes, beliefs and decisions

  4. the limitations of your own knowledge and experience and the

    importance of operating within your scope of practice

  5. the roles and responsibilities of other team members

  6. the importance of obtaining valid consent in line with national and

    local guidelines

  7. clinical appropriateness of the examination request and the action

    to take when the request is not appropriate

  8. the gross anatomy of the area being scanned

  9. physiological and pathological processes relevant to the area

    being scanned

  10. anatomical landmarks on the body that are relevant to DXA

    imaging

  11. the relevant joints in the body of the area being scanned and their

    movements

  12. the common relevant pathologies and normal variants of the area

    being scanned

  13. medical terminology relevant to the examination including

    abbreviations

  14. positioning terminology including abbreviations

  15. manifestations of individuals physical and emotional status

  16. production, interactions and properties of DXA images

  17. the process involved in the formation of DXA images

  18. the harmful effects of radiation to the human body and use of

    radiation protection equipment

  19. ways in which images can be captured, processed and

    permanently stored

  20. equipment capabilities and the differences in manufacturers

    specifications which will affect follow up scans and comparability

  21. the limitations and routine daily quality assurance processes

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    required by the operator

  22. how to adapt communication styles, ask questions, and listen

    carefully in ways which are appropriate for the needs of the

    individual

  23. the importance of providing individuals and key people with

    opportunities to ask questions and increase their understanding

  24. the information that should be given to individuals before, during

    and on completion of the examination

  25. considerations for the individuals size, body habitus and scan

    modes for image optimisation, which will affect analysis of the

    bone mineral density values

  26. variables affecting the bone mineral density measurement and

    how to select appropriate scan modes for the examination and the

    individual as appropriate

  27. accurate positioning of the individual relevant to the area of

    interest

  28. the technical quality requirements of the image for precise and

    reliable bone mineral density measurements

  29. the recognition of artefacts, their impact and appropriate actions

    to mitigate or limit the effects

  30. factors which influence the decision to rescan or take

    supplementary images in a different scan mode or with adjusted

    positioning to aid diagnosis

  31. the requirements for accurate scan analysis

  32. the use of reference data and the impact of the reference

    database selected on the scan results

  33. the principal of least significant change in relation to follow up

    scan interval and subsequent statistically significant change in

    bone mineral density

  34. the importance of timely equipment fault recognition and local

    procedures for reporting these

  35. procedures relating to recording, collating and preparing

    appropriate documentation, images and scan analysis for transfer

    or storage according to local protocols

  36. how to keep full, accurate and clear records in line with

    organisational procedures

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Scope/range


Scope Performance


Scope Knowledge


Values


Behaviours


Skills


Glossary


Links To Other NOS


External Links

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This standard links with the following dimension within the NHS

Knowledge and Skills Framework (October 2004):

Dimension: HWB6 Assessment and Treatment Planning

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Version Number

1

Indicative Review Date

01 Feb 2024

Validity

Current

Status

Original

Originating Organisation

Skills for health

Original URN

sfhci.m

Relevant Occupations

Health Professionals

SOC Code

2259

Keywords

Radiography; Dexa; Diagnostic; Clinical; Images; Bone; Density; Osteoporosis; Osteopenia; Sarcopenia