Chapter 13: Diagnostic tests
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Clinical governance
An organization that provides any diagnostic services must have clear, identifiable policies and procedures. There must be open, bidirectional communication between the department, organizational board and national bodies such as the Medicines and Health products Regulatory Agency (MHRA) to ensure appropriate care is delivered. Internal monitoring processes must be in place to identify potential clinical or organizational risks, and there must be a clear reporting mechanism.
Competencies
In accordance with the Nursing and Midwifery Council's (NMC's) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates (NMC [165]), nurses must always practice using the best available evidence. This includes giving patients evidence‐based information and advice, and maintaining their own skills and knowledge for safe and effective practice.
Consent
It is essential that healthcare professionals and healthcare support staff gain consent before beginning any treatment or care, or undertaking any diagnostic tests or procedures. Consent is continuous throughout any patient episode and the practitioner must ensure that the patient is kept informed at every stage (NMC [165], RCN [202]). For diagnostic tests and procedures, this may include:
- informing the patient of the reason for the diagnostic test or procedure
- telling the patient what the diagnostic test or procedure will involve
- ascertaining the patient's level of understanding (especially if they need to be directly involved in the preparation, sampling technique or positioning)
- telling the patient how long the results may take to be processed
- telling the patient how the results will be made available
- giving the patient information about the implications this may have for their care
- giving the patient information regarding any post‐procedural considerations.
Risk management
New research and evidence continue to be produced. It is essential that any risk or change in practice is communicated to clinicians. Alerts from the MHRA – for example, concerning issues related to medical devices used in the diagnostic testing process and changes in practice – should be acted upon. Several agencies, such as the Health Protection Agency, also publish new guidance and best practice using the latest available evidence.
Accurate record keeping and documentation
Good record keeping is an integral part of nursing practice and it is essential to the provision of safe and effective care (NMC [165]). Accurate, specific and timely documentation of any diagnostic tests should be recorded in the patient's electronic or paper notes, care plan, or designated record charts or forms. This assists in the communication and dissemination of information between members of the inter‐professional healthcare team.
