Chapter 20: Diagnostic investigations
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Legal and professional issues
An organization providing diagnostic services must have clear identifiable policies and procedures in regards to diagnostic tests. Bidirectional communication must be open between the department, organizational board and national bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure appropriate care is delivered. Internal monitoring processes must be in place to identify potential clinical or organizational risks.
Competencies
In accordance with the Nursing and Midwifery Council (NMC)'s The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives (NMC [116]), the collection of specimens should be undertaken by professionals who are competent and feel confident that they have the knowledge, skill and understanding to do so, following a period of appropriate training and assessment.
Consent
It is essential that healthcare practitioners gain consent before beginning any treatment or care; this includes the collection of samples or conducting a diagnostic test. Consent is continuous throughout any patient episode and the practitioner must ensure that the patient is kept informed at every stage (RCN [130], [133]). For specimen collection this includes:
- informing the patient of the reason for specimen collection
- what the procedure will involve
- ascertaining their level of understanding
- how long the results may take to be processed
- how the results will be made available
- information about the implications this may have for their care or treatment plan.
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 and changes in practice should be acted upon. Several agencies such as the Health Protection Agency (HPA) also contribute new guidance and best practice using the 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 [114]). Accurate, specific and timely documentation of specimen collection or diagnostic tests should be recorded in the patient electronic or paper notes, care plan or designated record charts/forms. This assists in the communication and dissemination of information between members of the inter‐professional healthcare team.
