WARD 9 FREEMAN HOSPITAL PORTFOLIO OF LEARNING OPPORTUNITIES Introduction Ward 9 is a 28 bedded elderly care ward located on the 5th floor of the Freeman Hospital. We specialise in rehabilitation of older patients to maximise their potential. Our patients have a wide range of medical conditions and we provide a holistic approach to care and aim to meet their physical, social, and psychological needs. Our patients are transferred to us from acute medical wards from the Freeman and RVI hospital. The ward has one consultant: Dr Frearson who will have a team of doctors consisting of a registrar, senior house officer and junior house officer. He carries out two ward rounds on a Monday and Tuesday. You will have the opportunity to work within the multi-disciplinary team consisting of nurses, doctors, physios, O.Ts and Social Workers. During your first week of placement you will be orientated to the ward and shown where everything is. Before you start your placement you will be assigned a mentor and you will need to work 50% off your off duty with them. You will work 35 hours per week and depending on whether you work long or short days your shift patterns will consist of: Long day: 07:30 – 20:45 Early: 07:30 – 14:00 Late: 13:45 – 20:30 Night duty: 20:15 – 07:45 Short days: Early: 07:30 – 15:30 Late: 12:45 – 20:45 We hope you enjoy your time on ward 9 and find it educational!  Useful Information: There are toilets for staff use out on the landing of level 5 on the left hand side of the lifts through the double doors. The restaurant is located on Level 1 should you wish to use it. Most staff stay on the ward for their breaks and tend to bring in their own food. There is a fridge on the ward for staff use. There are changing facilities located on level 1 just past the lifts. Should you require a locker Hotel Services is located behind the lifts on level 1. Useful numbers: Cardiac Arrest: 2222 Fire: 333 Security: 333 Switchboard: 0 Ward: 2137009 Key elements: Interpersonal Skills: Leaning opportunities Use of telephone: Making/answering calls Transferring calls Bleep system Ring back Use of computer: Obtaining patient investigation results Patient information Internet Intranet E-Mail Communication Skills: Patients Relatives Doctors Nurses Members of the MDT Nurse handovers Booking transport in and out of trust Resource/relevant/personnel/ department Ward staff/Ward clerk Ward staff/Ward clerk Ward staff/members of the MDT KEY ELEMENTS Management of Care: Leaning opportunities Nursing Process: Assessments Resource/relevant/personnel/ department Registered Nurses/ physiotherapists/OT’s/social workers Planning of care Registered Nurse/Medical Staff/OT/Physio Implementing care Registered Nurse/Nurse/Medical Staff/Physio/OT Evaluating care Registered Nurse/Medical Staff/OT/Physio Care plans Registered Nurse/OT/Physio Care pathway Discharge planning Ward rounds MDT’s Documentation Registered Nurse/MDT/Discharge Liaison Registered Nurse Registered Nurse Registered Nurse Patient hygiene Registered Nurse/HCA Clinical observations Registered Nurse/HCA Policies and procedures Registered Nurse Philosophy of care Registered Nurse Referrals to other agencies Registered Nurse KEY ELEMENTS: Organisational skills Leaning opportunities Managing a team Organisational skills Delegation skills Prioritising skills Time management Leadership Off Duty Managing patient workload Quality Standards of care Implementing change Giving information to Staff Doctors Patients Relatives MDT Other departments Resources Stock control Materials management Non stock requisitions Stationary Establishment/skill mix Budget Resource/relevant personnel/ Department Ward Sister/Registered nurse Registered nurse/Specialist/Practice Development Nurse/Audit Dept Registered Nurse/Manager/Health Care Assistant Registered nurse/Pharmacy Ward clerk/Housekeeper Ward Sister Managing Risk Policies and procedures Equipment safety checks Quality Control/Environmental checks Infection Control Moving and Handling Emergency Situations Cardiac Arrest Fire Violent Incidents Patient Falls Staff Development Clinical Supervision Reflective Practice Ward Sister/Registered Nurse/Practice Development nurse Registered Nurse/Health Care Assistant/Health and Safety Officer/Electronics Registered Nurse/HCA/Health and Safety Officer/Infection Control Nurse Registered Nurse/Infection Control Nurse Registered Nurse/Moving and Handling coordinator Registered Nurse/Cardiac Arrest team Fire Officer/Registered Nurse Registered Nurse/Security Officer Registered Nurse/Risk Management Dept Registered Nurse/Practice Development Nurse KEY ELEMENTS Clinical skills: Learning Opportunities Patient Hygiene: Skin care Mouth care Pressure area care Recording of physiological observations: Pulse/temp/respirations Blood pressure Blood glucose Neurological observations Urinalysis Faecal occult blood Weight Maintaining accurate charts Administration of medicines: Assist in medicine rounds Intramuscular/subcutaneous/intravenous injections Oxygen therapy Nebulisation Suction Medical devices Aseptic technique: Dressings/clip/suture removal Catheterisation Administration of suppositories/enemas Risk Management: Moving and Handling equipment Falls Pressure areas Resource/relevant personnel/department Registered Nurse/HCA Registered Nurse Registered Nurse/HCA Registered Nurse Registered Nurse/Diabetes Nurse Registered nurse/HCA Registered Nurse/HCA Registered Nurse Registered Nurse Registered Nurse/Doctor Registered Nurse Registered Nurse Registered Nurse Registered Nurse Registered Nurse/Electronics Registered Nurse/Tissue viability Nurse/Infection control nurse Registered Nurse/Moving and Handling facilitator Registered Nurse/falls assessment Registered Nurse/tissue viability Nurse Registered Nurse/Dietician Nutrition Prep for investigations Registered Nurse/Doctor/Radiology/Med ical Physics dept/ Endoscopy dept/Theatre KEY ELEMENTS Health Development Learning Opportunities Health lifestyle strategies in relation to: Smoking cessation Cancer Obesity Diabetes Drug and alcohol abuse Promotion of exercise Osteoporosis Falls prevention Resource/relevant personnel/dept Smoking cessation advisor/Pharmacist Registered Nurse/Macmillan Nurse Registered nurse/dietician Registered Nurse/Diabetes Nurse specialist Registered Nurse/Specialist Nurses Registered nurse/Doctor/specialist nurse Registered Nurse/Falls prevention team/Doctor/Physio/O.T Health promotion/education literature Health promotion unit/Specialist nurses Models of health promotion Health promotion unit/Discussion with Mentor Counselling Macmillan nurses/Clinical Psychology/Bereavement/Grief Counsellors KEY ELEMENTS Pathophysiological Process: Learning Opportunities Infection Wound healing Inflammatory process Source Nature/Spread Treatment Drugs Joints/Bones/Connective Tissue Normal/abnormal anatomy and physiology Osteoporosis Arthritis Infection X Rays Drugs Cardiovascular System Normal/abnormal anatomy and physiology Myocardial Infarction/Angina/Congesti ve cardiac failure Hypertension ECG’s Drugs Respiratory System Normal/abnormal anatomy and physiology Asthma/Chronic obstructive pulmonary disease Chest Infection Chest X Rays Treatment Drugs Fluid and Electrolyte Balance Resource/Relevant personnel/department Registered Nurse/Specialist Nurse/Doctors/Pharmacy/Laboratory/ Observation/ Literature Registered Nurse/Specialist Nurse/Doctor/Literature/Physio Registered Nurse/Specialist Nurse/Doctors/Pharmacy/Cardiographers Registered Nurse/Specialist Nurse / Doctors/Pharmacy/Pulmonary technician Normal/abnormal electrolyte balance Reading and understanding blood results Dehydration Acidosis Drugs Renal and Genitourinary System Normal/abnormal anatomy and physiology Investigations Urinalysis Infection Drugs Liver and Biliary System Normal/abnormal anatomy and physiology Jaundice Gall Bladder Drugs Circulatory System Normal/abnormal anatomy and physiology Blood disorders Anaemia Blood transfusions Pulmonary embolus/DVT Drugs Gastrointestinal System Normal/abnormal anatomy and physiology Gastro-Intestinal bleeds Gastric Ulcers Irritable bowel disease Colitis Constipation/Diarrhoea Investigations Treatments Drugs Endocrine and Metabolic Disease Diabetes Mellitius Thyroid Disease Steroid therapy Drugs Registered Nurse/Doctor/Laboratory Technician/Pharmacy/Literature Registered Nurse/Specialist Nurse/Doctors/ Pharmacy/ Laboratory/Literature Registered Nurse/Specialist Nurse/Doctors Registered Nurse/Doctors/Laboratory/Ultrasound/ Medical Physics/Pharmacy/Warfarin Clinic Registered Nurse/Specialist Nurse/Endoscopy Unit/Doctors/Pharmacy GLOSSARY OF TERMS ABBREVIATION ABX ADL’s AF BD BM’s BP C.Diff C&S Ca CKD COPD CPR CSU CXR D/C DVT HAV IDDM IHD IM IV IVT K Mane MDT MI MMSE MSU Na NBM NG NOK NOF Nocte NSAID’s OD OT PMH POC PRN QDS S/C TDS SOB MEANING Antibiotics Activities of Daily Living Atrial Fibrillation Twice Daily Blood Glucose Monitoring Blood Pressure Clostridium Difficile Culture and Sensitivity Calcium Chronic Kidney Disease Chronic Obstructive Pulmonary Disease Cardio-Pulmonary Resuscitation Catheter Specimen of Urine Chest X-Ray Discharge Deep Vein Thrombosis Home Assessment Visit Insulin Dependent Diabetes Mellitus Ischaemic Heart Disease Intramuscular Intravenous Intravenous Therapy Potassium In the Morning Multidisciplinary Team Myocardial Infarction Mini Mental State Examination Mid Stream Urine Sodium Nil By Mouth Nasogastric Next of Kin Neck of Femur At Night Non Steroidal anti-inflammatory drugsOnce daily Occupational Therapist Past Medical History Package of Care As Required Four Times per Day Subcutaneous Three Times per day Shortness of Breath TIA TTO’s TWOC TVN U&E USS UTI WCC WZF Transient Ischaemic Attack Discharge medication Trial Without Catheter Tissue Viability Nurse Urea and Electrolytes Ultrasound Scan Urinary Tract Infection White Cell Count Wheeled Zimmer Frame Common groups of drugs: Proton pump inhibitor Lanzoprazole Omeprazole Laxatives Ispaghula Sodium Docusate Senna Movicol Lactulose Diuretics Bendroflumethiazide Bumetanide Furosemide Spironolactone Drugs for arrhythmias/hypertension Amiodarone Propranolol Bisoprolol Metoprolol Hypertension Lisinopril Perindopril Ramipril Angina GTN Isosorbide mononitrate Amlodipine Diltiazem Nifedipine Analgesia Paracetamol Codeine phosphate Tramadol Nefopam Morphine Sulphate Anti-Emetics Domperidone Cyclizine Metoclopramide Drugs for Dementia Donepezil Galantamine Rivistigmine Memantine Antibiotics Co Amoxiclav Amoxicillin Flucloxacillin Cephalexin Ciprofloxacin Nitrofurantoin Trimethoprim Anti Depressants Mirtazepine Fluoxetine Citalopram Amytriptyline Drugs for Diabetes Metformin Gliclazide Tolbutamide Insulin Hypnotics Nitrazepam Temazepam Zopiclone Chlormethiazole Drugs which act on the Bladder Tamsulosin Oxybutynin Tolterodine Solfenacin Doxazosin Drugs for Parkinsons Disease Co-Careldopa Co-Beneldopa Diabetes Nurse Specialist Dietician Chiropodist Physiotherapist Speech and Language Therapist (SALT) Social Worker Care agencies GP’s Ward 9 Chaplaincy Occupational Therapist Radiography District Nurses Family/Friends Medical Staff Continence specialist nurse Tissue viability nurse Pharmacist WARD 9 LINK NURSES Education………….. …..S/N Susan Hall Infection Control….........S/N Liz Taylor Diabetes………………S/N Kath Clayton/ S/N Phillip Swinbank Continence………………S/N Sudesh Handa Moving and Handling…..Sr Gill Cockburn, Sr Jane Perkins, S/N Kath Clayton Nutrition………………..S/N Dee Ndlovu Tissue Viability…………S/N Susan Hall Risk Assessment………..Sr Jane Perkins Medical Devices……….Sr Jane Perkins COSHH…………………Sr Gill Cockburn