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NEUROLOGY / ELDERLYNEUROLOGY / ELDERLY
PHYSIOTHERAPY STUDENT PLACEMENTPHYSIOTHERAPY STUDENT PLACEMENT
BLYTH COMMUNITY HOSPITALBLYTH COMMUNITY HOSPITAL
Northumbria Healthcare NHS Trust
Physiotherapy Services
Blyth Community Hospital
Superintendent II Physiotherapist: Lynn Henderson
Tel: 01670 395632
Hospital Address:
Physiotherapy DepartmentMorpeth Cottage Hospital South RoadMorpethNorthumberlandNE61 2BT
Tel: 01670 395632Clinical Placement Information
Placement/Speciality: Care of the Elderly/ Neurology
Clinical Educators: Helen Price
Contact Address:Morpeth Cottage Hospital (MCH)South RoadMorpethNE61 2BT01670 395632
Blyth Community Hospital (BCH)Thoroton StreetBlythNE24 1DX01670 396431
Trust Website: www.northumbria-healthcare.nhs.uk
First day, who to report to: Lynn Henderson, Helen Price
Where: Physiotherapy Dept at the hospital site to be arranged prior to placement.
When: 08:45 a.m.
Access by rail: MCH – Yes. BCH – No Bus: MCH/BCH – Yes (see included timetables. www.uk.bus.co.uk). Road: see included maps www.multimap.com
On site parking: Both sites available free of charge.
Maps included: Yes
Normal Working Hours: 08:45 a.m. to 16:30 p.m.
Uniform Requirements: Regulation physiotherapy trousers and tunic, (polo shirt and trainers are acceptable)
Canteen facilities: Both sites have small dining rooms serving a selection of hot and cold meals (Tea and coffee free in the department!)
Common conditions to be treated: Neurological (in/out-patients) including; stroke, Parkinsons, M.S. Multi-pathology within elderly care (in/out-patients) including; ortho-geriatrics, falls, general medicine, palliative care.
Suggested Reading:National Service Framework for Older Person (Dept of Health Publication)Bamford Stroke Classification Scale (see included)Neurological Physiotherapy – A Problem Solving Approach. Susan Edwards.Recent journal articles dealing with elderly care/neurology
Student can expect to treat first patient on: day 2Average number of patients per day: 4-6
Student Induction Sheet
Name of Student:
Inducted by: Date:
CompletedHouse Keeping
LockersKeysCar ParkingRestaurantEquipmentOther
Personnel
Introduction to Clinical TeamIntroduction to Physiotherapy Technical Instructors and dutiesIntroduction to Wards/ DepartmentIntroduction to Multi-disciplinary team (MDT)
Policies/Procedures/Protocols
DocumentationAssessment formsOutcome MeasuresStandardsClinical ProtocolsPatient InformationEquipment Loan ServiceReference to Trust and Department Policy FilesOther
Documentation
Referral SystemStandards of DocumentationMDT notes/ Medical and Nursing DocumentationSOAP NotesStatistics
PhotocopierOther
Training and Resources
Discussion of previous learning/Knowledge/learning styleDiscussion of placement hopes/concernsDiscussion of Placement Learning OutcomesDiscussion of Specific Learning OpportunitiesDiscussion of Specific Learning OutcomesISTLearning ResourcesOther
Health and Safety
Fire alarms/ Evacuation ProcedureManual Handling PoliciesEquipment orientationOther
IN-PATIENT STAFFING AT MORPETH AND BLYTH HOSPITALS
Lynn HendersonSupt. II
Split between Morpeth and Blyth
Helen PriceClinical Specialist
Split between Morpeth and BlythKim Ferguson
Senior ILorna Kirk Snr 1Viv Scott Snr 1(part time)
1 x Rotational Senior II
Dawn McCurleyTechnical Instructor
Diane MeynellPhysio Assistant
Sandra ArmstrongSenior I
Carol WalkerTechnical Instructor
(Part-time)
Steven ClementsPhysio Assistant
(Part-time)
Learning Opportunities Specific to Morpeth Cottage and Blyth Community Hospitals
To develop an understanding of the role of community hospitals within the patients seamless care plan
To develop an understanding of the role of a community hospital as a care setting with in a large NHS Trust
To experience working over two sites, with the combined support from clinical educators
To become a member of a wider physiotherapy team, liasing with members of the acute team and continuing care team to enable a seamless care package for the individual patient
To become a member of a Multi-disciplinary team that encompasses many professions in the holistic care of individual patients
To gain experience of the Multi-disciplinary Stroke Care Pathway developed by Northumbria Healthcare Trust as part of its Beacon Trust Status
To be involved in innovative developments such as a MDT Falls Assessment Programme
To gain experience of Community Rehabilitation Teams and Intermediate Care Teams treating patients within a flagship Care Trust
To develop knowledge of Trust-wide physiotherapy assessment tools and outcome measures in areas such as Stroke, Falls and Parkinsons, devised from evidence-based practice
To develop assessment, treatment plan, goal-setting and discharge planning skills for patients in an in-patient, out-patient and Day Hospital Setting
The opportunity to develop an understanding of models of care from acute to community settings, Day Hospital, Domiciliary, Community Rehabilitation and Intermediate Care settings
There is the potential to work with Palliative Care patients and Psychi-geriatric Patients
Close working links with other members of the MDT will allow the opportunity for multi-professional learning opportunities.
Student Learning Plan at Morpeth and Blyth
Expected levels of Learning Outcomes
Year 1 Year 2 Year 3 Develop skills of
communication, handling and basic assessment
Gain experience in the physiotherapeutic management of elderly/neurological patients
Carry out subjective/objective assessments of selected patients
Opportunity to implement simple treatment procedures
Develop skills of assessment, analysis and treatment of patients
Frame and analyse patient problems Apply evidence in making informed
decisions related to the selection of appropriate interventions
Develop skills of assessment, analysis, and treatment
Frame and analyse patient problems Apply evidence in making informed
clinical decisions Able to compare models of
physiotherapy within different healthcare settings
Extend experience of physiotherapy in management of patients with complex problems
Develop transferable skills and clinical reasoning
Negotiate realistic and achievable goals
Formulate effective plans and strategies
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The following is a guide to the placement structure, but is flexible to the student’s course stage, learning needs, length of placement and learning opportunities. The numbers and complexity of patients may be expected to increase with the student’s progression through the course. The level of support required by the student through the placement will progress at a rate consistent with their learning needs, level of course and through continued informal and formal evaluation of the students development.
Week 1 Induction Period (see included) Discussion with student about learning outcomes, areas of interest/concern and learning styles Observation of assessment/ treatment with clinical educator (in/out-patients) Feedback on clinical assessment form, including additional learning outcomes for the placement and dates to remember:
half-way appraisal, end-of-placement appraisal, patient study assessment (year3) and date for visiting tutor Ongoing informal/formal opportunities to talk with clinical educator Independent subjective assessments (in-patients) Introduction to MDT and observation at daily ward report, MDT meeting and any Care Planning Meetings Introduction to discharge planning and continuing care options Familiarisation with documentation, Care Pathway and Physiotherapy written records Attend IST if appropriate Supervised/independent objective assessment (in-patients) Ongoing discussion of assessment findings Independent Study Time Opportunities to observe Technical Instructors and assist in basic treatments
Week 2 Ongoing informal/formal opportunities to talk with clinical educator Observation of assessment/ treatment with clinical educator (in/out-patients) Independent subjective and objective assessments (in-patients) Supervised subjective and objective assessments (out-patients) Supervised analysis of assessment and formulation of problem lists Discussion and development of treatment plans Development of a small in-patient caseload (appropriate to level of study) Attendance at ward reports and MDT meeting with reporting on own patients (with support) Development of discharge planning and continuing care options Opportunity of shared learning with other student professions
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Completion of MDT records and Physiotherapy written records (with support) Attend IST if appropriate Independent Study Time End of week discussion/tutorial – possibly inter-disciplinary
Week 3 Ongoing informal/formal opportunities to talk with clinical educator Half-way appraisal Patient study assessment (if applicable) Visiting Tutor Observation of assessment/ treatment with clinical educator (in/out-patients) Independent subjective and objective assessments (in-patients) – gradually increasing caseload Independent subjective and objective assessments (out-patients) – with support Development of treatment plans/goal setting Progressions of treatments – with support Active participation in MDT meetings/ Discharge planning Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
round with Nurse sister, spend time with Nurse Assistants Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group Completion of MDT records and Physiotherapy written records Attend IST if appropriate Independent Study Time End of week discussion/tutorial – possibly inter-disciplinary
Week 4 Ongoing informal/formal opportunities to talk with clinical educator Observation of assessment/ treatment with clinical educator (in/out-patients) Independent subjective and objective assessments (in-patients) – gradually increasing caseload Independent subjective and objective assessments (out-patients) Development of treatment plans/goal setting – in and out-patients Progressions of treatments – in and out patients (with support) Active participation in MDT meetings/ Discharge planning Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
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round with Nurse sister, spend time with Nurse Assistants Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group Completion of MDT records and Physiotherapy written records Attend IST if appropriate Independent Study Time Presentation of student-chosen article (appropriate to caseload) End of week discussion/tutorial – possibly inter-disciplinary
Week 5 Final Assessment Student assessment of placement Patient study (if applicable) Tutor visit Ongoing informal/formal opportunities to talk with clinical educator Observation of assessment/ treatment with clinical educator (in/out-patients) Independent subjective and objective assessments (in-patients) Independent subjective and objective assessments (out-patients) Development of treatment plans/goal setting – in and out-patients Progressions of treatments – in and out patients Active participation in MDT meetings/ Discharge planning Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
round with Nurse sister, spend time with Nurse Assistants Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group Completion of MDT records and Physiotherapy written records Attend IST if appropriate Independent Study Time
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Portfolio of Learning Opportunities(POLO’S)
Placement: Neurology / Care of the Elderly
Base: Blyth Community HospitalNorthumberland
Clinical Educators: Iain Laing / Helen Price
POLO Learning Zones – See Diagram
Middle: (clinical educator speciality)
Iain Laing – Neurological rehabilitation General elderly medicine Orthogeriatric Rehabilitation Vestibular Rehabilitation
Helen Price – Clinical Specialist Elderly Care Neurological rehabilitation General elderly medicine Orthogeriatric Rehabilitation
Zone I: (extended physiotherapy team)
Parkinson’s Disease SpecialistStroke SpecialistPalliative Care SpecialistCommunity Rehabilitation Teams (CRT) – Stroke serviceCommunity Rehabilitation Teams (CRT) – Falls serviceDomiciliary ServicesTechnical Instructors (TI’S)Admin. Support
Zone II: (health multidisciplinary team)
SALT (speech and language therapy)OT (occupational therapy)DieticianNursing/ NPs (nurse practitioners)Zone II (cont.): (health multidisciplinary team)
HCAs (health care assistants)Medical staff – Ward and Day Hospital
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Day Hospital Nursing StaffCommunity Rehabilitation TeamsPharmacistsWheelchair therapist (specialist seating and wheelchair assessments)Orthotist
MDT meetingsWard roundsClinicsPlanning MeetingsHome visits (HAVs)
Zone III: (social services)
Care manager/social workers Elderly Persons Team Younger Persons Team Mental Health Team
Planning meetingsHome VisitsCase Conferences
Zone IV: (others)
FamilyCarers Voluntary ServicesChaplaincy
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Middle Neuro-elderly Ortho-geriatric General Medical In-patients Out-patients Day Patients
I
II
III
IV
Palliative care Specialist
PD Specialist
Falls Specialist Stroke Specialist
Comm. Rehab. Team
DomiciliaryTechnical Instructors
Admin. Support
Medical Clinics
Medical Ward Rounds
MDT Meetings
OrthoticsNurse Practitioner Parkinsons Disease
Specialist Wheelchair Assessment
Occupational Therapist
Community Rehab. Team
SALT
Dietician
Pharmacist
Ward Nursing Staff
Day Hospital Staff
Young Persons Care Manager
Elderly Persons C.M.
Mental Health C.M.
Planning Meetings
Home Visits
Voluntary Services
Family/Carers
Chaplaincy
HAVs
Planning Meetings
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KEY ELEMENT
Specialist Knowledge
LEARNING OPPORTUNITIES RESOUCE/RELEVANT PERSONNEL/DEPARTMENT
Physiotherapy - role within the MDT and approaches to assessment and rehabilitation in neurology and elderly client groups.
Speech and Language Therapy - role within the MDT and perspective on problems in patients with swallowing and/or communication difficulties.
Occupational Therapy - role within the MDT and perspective on problems in patients following stroke
Occupational Therapy - role within the MDT and perspective on patients with complex problems
Occupational Therapy - role within the MDT and perspective on rehabilitation patients
Occupational Therapy - role within the MDT and perspective on problems in patients following stroke in the community.
Dietician - role within MDT and perspective on problems in patients with nutritional needs.
Nursing Team - role within the MDT and perspective on problems in patients with stroke and complex nursing needs.
Nursing Team - role within the MDT and perspective on problems in patients with Mental Health and complex nursing needsNursing Team - role within the MDT and perspective on problems in patients with Palliative care and complex nursing
Clinical Educators and other members of the neuro/elderly physiotherapy team as appropriate.
Fiona HinshelwoodSenior Speech and Language TherapistMelissa PotterSpeech and Language Therapist
Senior Occupational TherapistPosition Currently Advertised
Michelle Turnbull/ Julie TaylorSenior Occupational Therapists
Katherine KnoxOccupational Therapist Assistant
Mike RidleyOccupational Therapist Community Rehabilitation Team
Can vary
Diane RutherfordWard Manager Stroke UnitJoyce Foggert/ Diane HeadleyWard Sisters Stroke UnitNursing Team Members Ward One
Suzanne BurbridgeWard Manager Ward TwoNursing Team Members Ward Two
Kath ParryWard Manager Ward ThreeNursing Team Members Ward Three
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needs
Nursing Team - role within the MDT and perspective on problems in patients with continuing needs, 24 hour blood pressure and cardiac monitoring
HCAs – role within the MDT and involvement with patients with caring needs.
Consultant Physician in Stroke – role within the MDT and medical perspective on the management of stroke and multipathology in the elderly.
Consultant Physician in Parkinson’s Disease – role within the MDT and medical perspective on the management of PD and multipathology in the elderly.
Consultant Physician in Falls – role within the MDT and medical perspective on the management of Fallers and multipathology in the elderly.
Consultant G.P. – role within the MDT and medical perspective on the management of multipathology in the elderly.
Consultant Physician in Old Age Psychiatry – role within the MDT and medical perspective on the management of Mental Health and multipathology in the elderly.
Parkinson’s Disease Nurse Specialist – role within the MDT and nursing perspective on the management of PD
Wheelchair Therapist - assessment and prescription of specialist seating.
Orthotist - assessment and provision of orthotics.Pharmacist – role in the monitoring of patient medications and advice on polypharmacy
Social Worker – role within the MDT and involvement with patients complex needs.
Shirley FairleyWard Manager Thomas Knight Day HospitalNursing Team Members
HCAs All Wards and Day Hospital
Dr. Chris PriceDr. Richard Curless
Dr. Brian Wood
Dr. Nigel Stout
Dr. Georgina Smith
Dr. Celia Marshall
Annette BowmanNurse Specialist
Alistair McCord Head of Wheelchair Services
Jan GloverSenior Orthotist
Various members of pharmacy team visit the wards
Narinda KaurLiason Social Worker Ward 1
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Care Managers for individual Patients
KEY ELEMENT
Clinical Skills
LEARNING OPPORTUNITIES RESOUCE/RELEVANT PERSONNEL/DEPARTMENT
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Stroke Rehabilitation (in-patient)
General Elderly Medicine
Neurology and Elderly (out-patient)
Orthogeriatrics
Parkinson’s Disease Rehabilitation
Vestibular Rehabilitation
Palliative Care
Community Rehabilitation Team for Stroke
Community Rehabilitation Team for Falls
Physiotherapy Domiciliary Services
Helen Price (Clinical Specialist Elderly Care)Carol Walker (TI)
Helen Price (Clinical Specialist Elderly Care)Carol Walker (TI)Sandra Branley (TI)
Lynn Henderson (Supt II)Helen Price (Clinical Specialist Elderly Care)
Helen Price (Clinical Specialist Elderly Care)Sandra Branley (TI)
Helen Price (Clinical Specialist Elderly Care)
Iain Laing (Senior I)
Jane Laffan (Senior I)
Lorna Kirkham (Senior I)
Joan Kirkpatrick (Senior II)
Lorna Kirkham (Senior I)Nanda Bailey (Senior I)
KEY ELEMENT
Organisational and Managerial Issues
LEARNING OPPORTUNITIES RESOUCE/RELEVANT PERSONNEL/DEPARTMENT
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Managing a caseload
Organisational skillsDelegation skillsPrioritisation skillsTime managementStandards of care
Giving information to
Ward staffPatientRelatives/carersDoctorsMDT members
Resources
Ordering of special equipmentRe-ordering of standard walking aidsOrdering of standard wheelchairsOrdering of specialist wheelchairsRe-ordering of stock
Managing risk
Policies and proceduresEquipment safety checksDaily environmental checksInfection control
Moving and Handling
Emergency situations
Cardiac arrestFireRoom alerts
Staff DevelopmentsReflective Practice/CPD
Clinical EducatorsClinical EducatorsClinical EducatorsClinical EducatorsClinical Educators/Standards file
Clinical EducatorsClinical EducatorsClinical EducatorsClinical EducatorsClinical Educators
Clinical Educators/ TIsClinical Educators/Physio assistant/TI'sClinical Educators/Physio assistant/ TI'sClinical EducatorTI
Policies and Procedures fileClinical Educators/equipment repsClinical EducatorsInfection control policy/ nurse/ Infection Control LiasonClinical Educators/ Moving and handling file
Clinical Educators will discuss in induction refer to relevant procedure documents
Clinical educator will provide guidance
KEY ELEMENT
Interpersonal Skills
LEARNING OPPORTUNITIES RESOUCE/RELEVANTPERSONNEL/DEPARTMENT
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Use of telephone
Answering callsMaking callsTaking messages
Talking to
PatientsCarers/relativesDoctorsOther members of MDTStaff on other sites re patient transfers
Writing reports
Moving and handling risk protocolsDischarge lettersDischarge summariesReferral letters to other services
Administration
Booking ambulancesBooking out-patient appointments
Clinical Educators/TI’s/Clerical staffClinical EducatorsClinical Educators/TI’s/Clerical staff
Clinical Educators/MDT members
Clinical Educators/standard report formats
Clerical staff/TI’s/Clinical Educator
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