Radiology (NT RadIN)

All nursing staff within the Department of Radiology are employed under the Interventional Radiology Nursing cost center.  Aside from Interventional Radiology, nursing staff is utilized in various modalities throughout Radiology to include Ultra Sound, MRI, Nuclear Medicine/PET, General Diagnostic, Computed Tomography and CTA, Radiology Care Unit (RCU), and the Orthopedic Center.  Interventional Radiology functions 24/7 with the inclusion of an on-call status to include after hours, weekends, and holidays. The RCU staff maintain 24/7 call for anesthesia cases performed in the MRI areas. The unit consists of seven Angio suites and two patient holding areas.  Six of the suites are located in the North Tower and two in the Cancer Center Tower.  The IR suites within the North Tower serve Vascular and Neuro-Surgical Interventional services.  Vascular utilizes four of the Angio suites (11-16), which contain single-plane fluoroscopy equipment. Neuro uses the two remaining suites (OR 15 & 16 HVN), which contain bi-plane fluoroscopy equipment. The Cancer Center Tower contains one single-plane visceral suites technically located within the Surgical Services area. The Radiology Care Unit (RCU) for the North Tower has 16 beds. The space is utilized by several Radiological modalities as a pre-, intra-, and post-op area.  The RCU area is currently used accommodate Phase 1 & Phase 2 post-general anesthesia patients.

Description of Patient Populations

Patients within Radiology consist of Outpatients and Inpatients.  Outpatients are checked in via a standardized process and are referred as consults from various services to include Shands/UF Health Clinics and other outside facilities.  Inpatients may consist of patients from any nursing floor and include all acuity levels.  Ages of patients served include infants up to adults of all ages.

Nursing Care

Nursing care is focused on: assessment, diagnosis, planning, moderate sedation, evaluation, education, care and treatment of patients; pre-, intra-, and post-Invasive Radiologic / Interventional procedures and other ancillary area procedures.  As mentioned, Interventional Radiology is the only modality within the Radiology Department that employs nursing staff; therefore, our services are provided to various modalities to include; Ultra Sound, MRI, Nuclear Medicine/PET, General Diagnostic, CT/computerized tomography, CTA, and the Orthopedic Center.  Interventional Radiology nurses, hired into an Interventional position, are required to have at least one year of acute care experience; ICU, ED, Cardiac Cath Lab, and/or other IR experience. Nurses hired into the Radiology Care Unit are preferred to have at least one year working in an acute care setting as an RN. Any nurses without acute care experience will be provided acute care education at the discretion of the nurse manager. All Nurses must maintain certifications in BLS and ACLS due to the high acuity scenarios typically encountered. All RNs without pediatric care experience will be assigned to attend pediatric courses include PEARS in nursing education. Charge nurses in the RCU are require to maintain PALS certification.

Health Care Team

The Medical Director of Interventional Radiology is appointed by the Chairman of Radiology.  Vascular and Neuro Interventional Radiology services consist of Attending Physicians, Fellows, Residents, Interns, Physician Assistants, and Medical Students. Available support services for Interventional Radiology patients include, but are not limited to: Hospitalists, Nurse Practitioners, Pharmacy, Respiratory Therapy, Nutritional Services, Biomedical Engineering, and Patient and Family services.

The nursing management consists of a Nursing Manager, and departmental nursing educator.  Training experiences, scenarios, and continuing education opportunities are provided to maintain competency related to unit/role specific job description plans.  The nursing staff is required to successfully complete Annual Validation on Emergent Event Competencies.

Staffing Plan

The nursing staff within Interventional Radiology is comprised of full-, part-time, and PRN positions consisting of one (1) Nursing Manager, two (2) FT FTE Charge Nurses, mix of thirty-four (37) Registered Nurses, and one (1) Licensed Practical Nurse. The one LPN is staffed fulltime at the Orthopedic Clinic.

Nursing care delivery is based on a procedural care delivery model catering to the pre-, intra-, and post-op needs of patients and family members.  Nursing coverage in the Interventional suites is provided 24/7 with an on-call team available after hours, weekends, and holidays.  The ratio of nurses to patients is 1:1 within the procedural room. The RCU staffing is based on ASPAN care delivery model and staffing is optimally 1:3, but can be as high as 1:4 for lower acuity care requirements. The ancillary radiology areas are also staffed based on the procedural care delivery model and staffing is 1:1 in MRI, CT, Ultrasound, CTA, and Nuclear Medicine.

The Procedural Charge Nurse is responsible for patient flow, liaison with physicians and health care team, as well as coordinating all work flow for procedures and rooms.  The RCU Charge Nurse oversees the daily staffing, patient flow within the unit, patient care, family issues, and physician interactions.

Patient care and procedural room assignments are made daily by the charge nurses and approved/modified by the Nursing Manager if needed.

Requests for Scheduled Time off (STO) are reviewed on a case by case basis, and staffing needs of the unit are taken into account. Requests are granted only if minimum staffing numbers are maintained with coverage. Staff attendance at meetings, educational offerings, and other activities are coordinated so that patient care coverage is uninterrupted.

Staffing Pattern

There shall be a minimum of 23 Nurses available during a 24-hour shift within the Radiology Departments. This staffing will accommodate the following room assignments Monday – Friday:

Radiology Nursing (all inclusive)

Interventional 14-16 RNs:

  • Charge: 1 Nurse
  • HVN 15: 1 Nurse
  • HVN 16: 1 Nurse
  • Room 11: 1 Nurse
  • Room 12: 1 Nurse
  • Room 13: 1 Nurse
  • Room 14: 1 Nurse
  • Room 15: 1 Nurse
  • Room 16: 1 Nurse
  • South 1: 1 Nurse
  • CT procedures: 2 Nurse(s)
  • Float NT: 1 Nurse
  • Evenings: 1 Nurse
  • Nights: 1 Nurse

RCU 12 RNs:

  • RCU: 8 Charge + 7 in staffing
  • Ortho Center: 1 Nurse (LPN/RN)
  • US/Nuc Med/MRI/CTA:  1
  • Evening shift: 2 (1930)

Nurses not given a room or patient bay assignment upon start of shift will be a designated a ‘float nurse’ and provide breaks, procedural case/patient care assistance, ancillary radiology assistance, RCU patient care, and/or any other job duty as assigned by either Charge Nurse.

Radiology Care Unit (RCU): Ten (10) nurses is the minimum staffing level.  This includes 6 scheduled to patient bay’s, 1 RN to float, 1 nurse at the Ortho Center, 1 RN to cover MRI, 1-2 nurses in HVN RCU, 2 RN evening shifts and 1 (one) Charge nurse who makes the staffing assignments.

Procedural Area Nursing:  Minimum staffing is eleven (11) nurses.  This includes one (1) Charge Nurse and one (1) nurse for each procedural room (North and South) and 2 RN’s to cover CT. Charge RN makes all staffing assignments. Evening and Night RN’s have assigned job duties.

Ortho Area:  One nurse (LPN/RN) needed Monday – Friday.  LPN is a FT FTE and a RCU RN will cover as needed for supplemental staffing (call-in’s, scheduled time off, etc).

Weekends / Holidays: One RN in-house 7a – 7p and 7p – 7a in procedures. Simultaneously one RN is on-call 7a-7p and 7p-7a and will be called in to cover all cases occurring during this time period. RCU nursing take 24 hour call for MRI anesthesia cases.

Radiology Care Unit

The Radiology Care Unit of Interventional Radiology acts as a pre-, intra-, and post-op area.  There are 16 usable bed spaces available, with the addition of Rooms “A” and “B”.  Rooms “A” and “B” shall be prioritized for utilization for Radiation Impregnated patients, Pre-Evals, Pediatrics, and Isolations, as needed.  The Charge Nurse will assign the bays and rooms as needed for optimum patient flow and preparation. RCU nurse equally share weekly on-call duties for the MRI area with the exception of a PRN 0.1 FTE.

The Charge Nurse is responsible for the overall flow of the RCU.  Among their responsibilities is the need to make assignments of patients and bed spaces.  The Charge Nurse should stay at the Nurses station as much as possible, and oversee the area.  They shall also be responsible for the accuracy of the scheduling board.

The nurses assigned to a bed space areas shall be solely responsible for their patients and shall follow instructions provided by the charge nurse, mid-level provider, and/or physician.  As time allows, each nurse shall assist other nurses with patient care within the department.

The nurses assigned to the remaining areas shall be responsible for their assigned patients (inpatients and outpatients) as delegated by the Charge Nurse.  They will float to the assigned areas as needed for patient procedures.

Reviewed and Revised: 2/1/2021

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Jennifer Zimmerman, RN, explaining to a parent and her daughter how to use a bedside asthma action plan.