Alina Nagornyuk – Independent Project

Alina Nagornyuk – Independent Project

Class of 2017

Introduction to Topic

My project was completed in the emergency department at Upper Chesapeake Medical Center. The emergency department at Upper Chesapeake is a highly-structured facility dedicated to the diagnosis and treatment of unforeseen illness or injury. The emergency department requires planning and oversight and every member must contribute. I chose to complete my independent project in the emergency department because it provided a wide range of experiences ranging from urgent care to life-threatening illnesses. Shadowing in the emergency department allowed me to engage with the patients, physicians, nurses, and technicians and provided a captivating and engrossing experience. Although the emergency department at Upper Chesapeake has a highly skilled team of physicians and nurses and the latest technology, there is always a way to improve a patient’s experience when they visit the emergency department.

Project Description

Originally, I was going to complete my shadowing experience in a chiropractic care office but I ended up gaining my shadowing experience in the emergency department at Upper Chesapeake Medical Center. Each day, I shadow a different nurse that worked in the emergency department and learned about how they performed their job. Shadowing in the emergency department also helped enrich my shadowing experience because of the variety of patients and conditions that are treated in the emergency department. Instead of focusing on just one field or condition, I was able to observe how a wide variety of illnesses and injuries were treated, ranging from paralysis to the flu. Since the emergency department is such a large unit made up of many components, there is also a lot of room for an innovation, and the department is constantly being innovated to be more efficient and patient friendly. The idea for my innovation came about over multiple days of shadowing in the emergency department. In a large number of cases, the most efficient way to diagnose a patient would be to send them to the radiology unit for a scan. These scans include x-ray scans, CT scans, and MRI scans. X-ray scans and CT scans use radiation that is harmful to the patient. I saw the opportunity to create an innovation that would make these scans more patient friendly and reduce the amount of radiation that a patient would receive during diagnosis.

Experience Description

Shadowing in the emergency department contributed to my understanding of the complex system that allows physicians and nurses to diagnose and treat patients. I could now map out my previous visits to the emergency department as a patient, and understand how the department worked. During my experience, I shadowed a different nurse each day. The nurses had a uniform way of working in the emergency department, but each nurse had their own style of interacting with the patients. Also, each nurse provided a different shadowing experience for me. Some nurses simply had me watch and follow them around while others allowed me to interact with the patients. The nurse I enjoyed shadowing the most was the nurse that allowed me to interact and engage with the patients and even help out with the treatment. I felt like a member of the team instead of just an observer.

Even the emergency department has different branches and can be divided based on age and triage. During my time in the emergency department, I shadowed nurses in the pediatric unit, the adult unit, and the urgent care unit. Each unit had a distinct way of functioning, but all units worked to diagnose and treat patients as efficiently as possible. My favorite unit to shadow in was the urgent care unit. The atmosphere in this unit was more relaxed and the team of nurses and physicians seemed closer. Patients treated in the urgent care unit of the emergency department were a level four or a five on the triage scale. This meant that their conditions were less urgent and this allowed the nurse I was shadowing to take time to explain everything in further detail to me. Also, the patients were friendlier and this allowed me to engage with the patients more. The urgent care unit treats patients much faster than the regular emergency department and this allowed me to see more patients being treated. The conditions in the urgent care unit also grasped my interest. There was a greater variety of conditions and some of the patient stories were surprising and different. I felt like an observer in the pediatrics unit. The atmosphere had the most tension in this unit and the nurses were very focused on treating the children. The adult unit was a combination of the experience I had in the pediatric unit and the urgent care unit. I got to engage with the patient more than I did in the pediatrics unit but there were still more urgent cases that the nurses had to focus on.

I got the most out of my shadowing experience. I was able to follow a nurse around and see all the steps they took to diagnose and treat a patient. I learned more about the triage system and how it worked at Upper Chesapeake. I watched the nurses I shadowed use the nurse’s program to figure out the next step they had to take with a particular patient. I was able to see how multiple nurse interacted with their patients and how they made patients feel comfortable because they were well informed. I watched nurses use the medication dispensing machine and scan the medication into the program before giving the patient a particular medication and treatment. I was able to see the interaction between the different team members and this allowed me to understand the team member hierarchy. My favorite experience was helping a nurse draw blood from a patient and putting tape over the gauze for the patient. Overall, I learned about how the emergency department functions and why it functions the way it does.

Innovation Description

For my innovation, I decided to create a device that would absorb radiation during scans, specifically CT scans. Everybody wants to get the maximum benefit from X-ray and CT scans without having to worry about radiation, especially in the emergency department where every second counts. There is only a slight increase in the chance of developing cancer later in life due to radiation caused by scans but that lifetime risk of cancer increases as a person undergoes more X-ray exams and the accumulated radiation dose gets higher (Reducing Radiation from Medical X-rays, 2009). It is not uncommon for multiple scan to be done on patients visiting the emergency department, especially when the problem is internal. Therefore, my innovation is a device composed of fans and lead that absorbs radiation (alpha, beta, and/or gamma rays) in the surrounding air and around the person.

X-rays are an important technology in today’s medicine. They not only identify injuries from accidents, but they can also be used to screen for, diagnose, and treat various medical conditions. They are a form of electromagnetic radiation that can penetrate clothing, body tissue, and internal organs. Some of the radiation is absorbed in body tissues. Radiation doses per person from medical X-rays has increased almost 500 percent since 1982. Also, nearly half of all medical X-ray exposure today comes from CT equipment, and radiation doses from CT scans are higher than other X-ray studies. The FDA works to reduce radiation doses to the public while preserving image quality for an accurate exam. The average person in the United States receives a dose of about 3 mSv per year from naturally occurring radiation. This can be used to compare the effects of radiation of X-rays. The radiation exposure from one CT scan equals the amount of radiation a person is exposed to from their natural surroundings in 3 years (10 mSv). This means the patient is being exposed to the equivalent amount received by atomic bomb survivors in the low-dose range. The radiation exposure from one radiography equals the amount of radiation a person is exposed to from their natural surroundings in 16 months (4mSv). These numbers may not seem significant but many Americans get X-rays multiple times a year and in some cases, like the emergency department, people may need multiple scans in a short period of time. Eventually the radiation exposure adds up. The risk of any one person developing a fatal cancer from a typical CT procedure is about 1 in 2,000. Individuals who had multiple CT scans before the age of 15 were found to have an increased risk of developing leukemia, brain tumors, and other cancers in the decades following their first scan (Reducing Radiation from Medical X-rays, 2009).

There is no technology available to reduce the level of radiation exposure from CT and other imaging procedures that use ionizing radiation. However, several organizations and government agencies have developed guidelines and recommendations regarding the appropriate use of these procedures. In 2010, the U.S. Food and Drug Administration launched the Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging. This initiative focuses on the safe use of medical imaging devices, informed decision making about when to use specific imaging procedures, and increasing patients’ awareness of their radiation exposure. Also, the NIH Clinical Center requires that radiation dose exposure from CT and other imaging procedures be included in the electronic medical records of patients treated at the center. The American College of Radiology developed the ACR Appropriateness Criteria evidence based guidelines to help providers make appropriate imaging and treatment decisions for a number of clinical conditions (Computed Tomography (CT) Scans and Cancer, 2013).

Another thing that is available is a shield that is used to cover up areas of the body that the doctor does not need an image of. This shield is made out of lead and it absorbs radiation. Although this is a useful innovation, it only protects certain parts of the body from radiation and radiation particles remain in the air. Also, this cover is heavy and this can be a complication for some patients (Lead Garments (Aprons, Gloves, etc.), n.d.).

My innovation will not only block radiation particles from entering certain parts of the body, but it will also absorb radiation particles from the air so that they do not remain there after a scan. I will use both lead and fans to create this innovation. Lead is a good choice because it’s a very dense substance, and dense substances can get in the way of the radiation and soak it up. The more density a substance has, the more atoms it has and this means it will potentially interact with rays and stop them. Another benefit of using lead for my innovation is that it will turn the energy from the x-ray or the gamma ray into other forms of energy inside the material. Lead neutralizes the effect of the radiation by causing the electron to depart from the nucleus it was originally orbiting. The fan attached to the lead is what will cause the radiation particles to be pulled away from the body tissue and the surrounding air. Together the lead and the fans will create a technology that absorbs rays and creates a safer experience for patients. This innovation will allow people to leave the hospital with less radiation in their bodies.

I spent four hours researching various ways to cope with radiation exposure and what is available today in the medical field to block radiation exposure. I also researched how much of a problem radiation exposure is in the medical care system and why it is a problem. Next, I spent two hours creating my innovation on SketchUp. I used a downloaded image of a CT scan and added the lead bars and fans to create my final product, the radiabsorber. Next, I spent four hours creating a website to inform people why they should get a scan that utilizes the radiabsorber and how my innovation makes these scans safer.

+ Project Topic

Introduction to Topic

My project was completed in the emergency department at Upper Chesapeake Medical Center. The emergency department at Upper Chesapeake is a highly-structured facility dedicated to the diagnosis and treatment of unforeseen illness or injury. The emergency department requires planning and oversight and every member must contribute. I chose to complete my independent project in the emergency department because it provided a wide range of experiences ranging from urgent care to life-threatening illnesses. Shadowing in the emergency department allowed me to engage with the patients, physicians, nurses, and technicians and provided a captivating and engrossing experience. Although the emergency department at Upper Chesapeake has a highly skilled team of physicians and nurses and the latest technology, there is always a way to improve a patient’s experience when they visit the emergency department.

+ Project Overview

Project Description

Originally, I was going to complete my shadowing experience in a chiropractic care office but I ended up gaining my shadowing experience in the emergency department at Upper Chesapeake Medical Center. Each day, I shadow a different nurse that worked in the emergency department and learned about how they performed their job. Shadowing in the emergency department also helped enrich my shadowing experience because of the variety of patients and conditions that are treated in the emergency department. Instead of focusing on just one field or condition, I was able to observe how a wide variety of illnesses and injuries were treated, ranging from paralysis to the flu. Since the emergency department is such a large unit made up of many components, there is also a lot of room for an innovation, and the department is constantly being innovated to be more efficient and patient friendly. The idea for my innovation came about over multiple days of shadowing in the emergency department. In a large number of cases, the most efficient way to diagnose a patient would be to send them to the radiology unit for a scan. These scans include x-ray scans, CT scans, and MRI scans. X-ray scans and CT scans use radiation that is harmful to the patient. I saw the opportunity to create an innovation that would make these scans more patient friendly and reduce the amount of radiation that a patient would receive during diagnosis.

+ Experience

Experience Description

Shadowing in the emergency department contributed to my understanding of the complex system that allows physicians and nurses to diagnose and treat patients. I could now map out my previous visits to the emergency department as a patient, and understand how the department worked. During my experience, I shadowed a different nurse each day. The nurses had a uniform way of working in the emergency department, but each nurse had their own style of interacting with the patients. Also, each nurse provided a different shadowing experience for me. Some nurses simply had me watch and follow them around while others allowed me to interact with the patients. The nurse I enjoyed shadowing the most was the nurse that allowed me to interact and engage with the patients and even help out with the treatment. I felt like a member of the team instead of just an observer.

Even the emergency department has different branches and can be divided based on age and triage. During my time in the emergency department, I shadowed nurses in the pediatric unit, the adult unit, and the urgent care unit. Each unit had a distinct way of functioning, but all units worked to diagnose and treat patients as efficiently as possible. My favorite unit to shadow in was the urgent care unit. The atmosphere in this unit was more relaxed and the team of nurses and physicians seemed closer. Patients treated in the urgent care unit of the emergency department were a level four or a five on the triage scale. This meant that their conditions were less urgent and this allowed the nurse I was shadowing to take time to explain everything in further detail to me. Also, the patients were friendlier and this allowed me to engage with the patients more. The urgent care unit treats patients much faster than the regular emergency department and this allowed me to see more patients being treated. The conditions in the urgent care unit also grasped my interest. There was a greater variety of conditions and some of the patient stories were surprising and different. I felt like an observer in the pediatrics unit. The atmosphere had the most tension in this unit and the nurses were very focused on treating the children. The adult unit was a combination of the experience I had in the pediatric unit and the urgent care unit. I got to engage with the patient more than I did in the pediatrics unit but there were still more urgent cases that the nurses had to focus on.

I got the most out of my shadowing experience. I was able to follow a nurse around and see all the steps they took to diagnose and treat a patient. I learned more about the triage system and how it worked at Upper Chesapeake. I watched the nurses I shadowed use the nurse’s program to figure out the next step they had to take with a particular patient. I was able to see how multiple nurse interacted with their patients and how they made patients feel comfortable because they were well informed. I watched nurses use the medication dispensing machine and scan the medication into the program before giving the patient a particular medication and treatment. I was able to see the interaction between the different team members and this allowed me to understand the team member hierarchy. My favorite experience was helping a nurse draw blood from a patient and putting tape over the gauze for the patient. Overall, I learned about how the emergency department functions and why it functions the way it does.

+ Innovation

Innovation Description

For my innovation, I decided to create a device that would absorb radiation during scans, specifically CT scans. Everybody wants to get the maximum benefit from X-ray and CT scans without having to worry about radiation, especially in the emergency department where every second counts. There is only a slight increase in the chance of developing cancer later in life due to radiation caused by scans but that lifetime risk of cancer increases as a person undergoes more X-ray exams and the accumulated radiation dose gets higher (Reducing Radiation from Medical X-rays, 2009). It is not uncommon for multiple scan to be done on patients visiting the emergency department, especially when the problem is internal. Therefore, my innovation is a device composed of fans and lead that absorbs radiation (alpha, beta, and/or gamma rays) in the surrounding air and around the person.

X-rays are an important technology in today’s medicine. They not only identify injuries from accidents, but they can also be used to screen for, diagnose, and treat various medical conditions. They are a form of electromagnetic radiation that can penetrate clothing, body tissue, and internal organs. Some of the radiation is absorbed in body tissues. Radiation doses per person from medical X-rays has increased almost 500 percent since 1982. Also, nearly half of all medical X-ray exposure today comes from CT equipment, and radiation doses from CT scans are higher than other X-ray studies. The FDA works to reduce radiation doses to the public while preserving image quality for an accurate exam. The average person in the United States receives a dose of about 3 mSv per year from naturally occurring radiation. This can be used to compare the effects of radiation of X-rays. The radiation exposure from one CT scan equals the amount of radiation a person is exposed to from their natural surroundings in 3 years (10 mSv). This means the patient is being exposed to the equivalent amount received by atomic bomb survivors in the low-dose range. The radiation exposure from one radiography equals the amount of radiation a person is exposed to from their natural surroundings in 16 months (4mSv). These numbers may not seem significant but many Americans get X-rays multiple times a year and in some cases, like the emergency department, people may need multiple scans in a short period of time. Eventually the radiation exposure adds up. The risk of any one person developing a fatal cancer from a typical CT procedure is about 1 in 2,000. Individuals who had multiple CT scans before the age of 15 were found to have an increased risk of developing leukemia, brain tumors, and other cancers in the decades following their first scan (Reducing Radiation from Medical X-rays, 2009).

There is no technology available to reduce the level of radiation exposure from CT and other imaging procedures that use ionizing radiation. However, several organizations and government agencies have developed guidelines and recommendations regarding the appropriate use of these procedures. In 2010, the U.S. Food and Drug Administration launched the Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging. This initiative focuses on the safe use of medical imaging devices, informed decision making about when to use specific imaging procedures, and increasing patients’ awareness of their radiation exposure. Also, the NIH Clinical Center requires that radiation dose exposure from CT and other imaging procedures be included in the electronic medical records of patients treated at the center. The American College of Radiology developed the ACR Appropriateness Criteria evidence based guidelines to help providers make appropriate imaging and treatment decisions for a number of clinical conditions (Computed Tomography (CT) Scans and Cancer, 2013).

Another thing that is available is a shield that is used to cover up areas of the body that the doctor does not need an image of. This shield is made out of lead and it absorbs radiation. Although this is a useful innovation, it only protects certain parts of the body from radiation and radiation particles remain in the air. Also, this cover is heavy and this can be a complication for some patients (Lead Garments (Aprons, Gloves, etc.), n.d.).

My innovation will not only block radiation particles from entering certain parts of the body, but it will also absorb radiation particles from the air so that they do not remain there after a scan. I will use both lead and fans to create this innovation. Lead is a good choice because it’s a very dense substance, and dense substances can get in the way of the radiation and soak it up. The more density a substance has, the more atoms it has and this means it will potentially interact with rays and stop them. Another benefit of using lead for my innovation is that it will turn the energy from the x-ray or the gamma ray into other forms of energy inside the material. Lead neutralizes the effect of the radiation by causing the electron to depart from the nucleus it was originally orbiting. The fan attached to the lead is what will cause the radiation particles to be pulled away from the body tissue and the surrounding air. Together the lead and the fans will create a technology that absorbs rays and creates a safer experience for patients. This innovation will allow people to leave the hospital with less radiation in their bodies.

I spent four hours researching various ways to cope with radiation exposure and what is available today in the medical field to block radiation exposure. I also researched how much of a problem radiation exposure is in the medical care system and why it is a problem. Next, I spent two hours creating my innovation on SketchUp. I used a downloaded image of a CT scan and added the lead bars and fans to create my final product, the radiabsorber. Next, I spent four hours creating a website to inform people why they should get a scan that utilizes the radiabsorber and how my innovation makes these scans safer.

By | 2017-05-12T03:28:11+00:00 May 12th, 2017|Biomed Capstone Project 2017|0 Comments

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