8/13/2019 NE2.1 Ward Routines

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Version : 1.0

First issued: May 2010; Review date: December 2010Authorised by Nursing Human Resource CouncilAuthorised date: Verbal Acceptance Interim Document/25 August 2010

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WARDORGANISATIONANDWARDROUTINES

KEYPERSONNELONTHEWARDS

ClinicalNurseManager(CNM)/ClinicalNurseSpecialist(CNS)/ClinicalNurseManager(CNM)

TheCNM/CNSisresponsiblefor:maintainingandensuringthatahighstandardofcareisdelivered,adequate

staffinglevels,rostering,bedmanagementandensuresthatwardoperateswithinbudget.Theyaretheward

leaders that: manage the allocation of patients to inpatient wards/units within the hospital, improve

dischargepractices,promoteareaofexcellenceandpromotewardteamwork.

StaffDevelopmentNurse(SDN)

TheSDNisresponsibleforprovidingeducationtoallstaffmembersandisaresourceperson.

ClinicalNurse(CN)

TheCN

has

abroad

knowledge

base

specialising

in

that

particular

clinical

area

and

is

an

expert

clinician.

ShiftCoordinator

TheShiftcoordinatorcanbeaRNoraCNandhe/sheensuresthesmoothrunningofthewardforoneclinical

shift.

WardClerk

Thewardclerkhasavastknowledgeofwarddynamicsinadditiontotheextensiveclericalrole.

AssistantinNursing(AIN)

TheAINdelivershighstandardofpatientcarewhilstpracticingwiththescopeoftheAssistantinNursingas

directedby

the

Registered

Nurse.

PatientCareAssistant(PCA)

ThePCAsupportsnursingstaffindeliveringhighqualitycaretopatientsandsignificantothers.

Cleaningstaff

Thecleaningstaffsmaintainahighstandardofwardcleanliness.

NOTE:

ThenursingpersonnelatRPHare identified from theuniform (scrubs) theyarewearing.Thecolourof the

uniformisnavybluewithdifferentcolouredtrimmings whiteforRegisteredNurse(RN),redforClinicalNurse

(CN),green

for

Staff

Development

Nurse

(SDN)

and

blue

for

Area

Managers

(AM).

The

job

title

is

embroidered

onthepersonsrighthandsideandRPHlogoisonthelefthandsideofthescrubtop.TheRNandENgraduate

nurseswearasleevebadgeto indicatetheirpositions. Inadditiontotheuniform,theward leadersandthe

shiftcoordinatorsareidentifiedbythedifferentcolouredvesttheyarewearing.

Itisaadvisablethatyoufindoutnamesofthekeypersonnel(CNM/CNS/CNM&SDN/CN/SHIFT

COORDINATOR)whenyoufirstarrivedintheward/unitviayourpreceptor/buddynurseandintroduce

yourselfwithconfidence

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Version : 1.0

First issued: May 2010; Review date: December 2010Authorised by Nursing Human Resource CouncilAuthorised date: Verbal Acceptance Interim Document/25 August 2010

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SHIFTTIME

AMShift:Startat0700/0730

Finishat:1300/1430/1530hours

PMShift:Startat1200/1300/1400/1500

Finishat:2130/2230hour

NIGHTDUTY

Shift:

Start

at

2100/2115

Finishat:0730/0715hours

MEALBREAKTIMES

Youwillbeallocatedyourteabreakwithyourbuddy.Thetimesare:

Morningtea: 15minutesstartingat0900hours

Lunch: 30minutesstartingat1145hours

Afternoontea: 15minutesstartingat1430hours

Dinner: 30minutesstartingat1700hours

WARD

ROUTINES

Wardroutinesmayvaryslightlyfromwardtoward.Theexamplebelowwillgiveyousomeideaofhowa

medicalwardisrunduringamorningshift.ITISIMPORTANTTOREMEMBERYOURSCOPEOFPRACTICE

BEFOREIMPLEMENTINGANYNURSINGCAREFORYOURPATIENTSANDIDENTIFYSKILLSTHATYOUNEEDTO

ACHIEVEDURINGYOURCLINICALPLACEMENTINTHEFIRSTFEWDAYSOFYOURCLINICALPLACEMENT.

AnexampleofwardroutinesperformedbyaRNinamedicalwardinamorningshift

AM

SHIFT

DUTIES

0700 Collecthandoversheet CheckAllocationBoard Takehandover Establishifanyofyourpatientshaveappointments,specimenstobecollected,

showers,dischargedrugsorspecificprocedures.

0715 Lastminuteverbalupdatesfromnightstaff.Checkmedchartshavebeensignedoff.Clarifyanyissueswithnightstaffbeforetheyleave.

CheckIV/SCinfusions,checkInsulintobegiven&givesuppositories.CompletetimemanagementplanwhenreviewingNursingCarePlan(NCP).

Performdailyobs(observation)andLying&StandingBPs(BloodPressure). SitpatientsoutforbreakfastToiletifrequired.Negotiateteabreakwithteam

member.

Iftimepermitsshoweronepatientpriortobreakfast0730 RNcommencesdrugrounds.Ensuredrugdrawersarereplenishedandnon

imprestdrugsordered.

RNensuresthatmedicationChartsarecorrectandgiveRMOforrewriting,orderdrugsasrequired.

RNdoSC/IV/IMmedicationsascharted.. AssistpatientswithfeedingPRN.

0800 Observedietaryintake,Completedietsheets,Fluidbalancechart(FBC)PRN. Continuetoileting&showering Observemobility&functionalstatus,ADLsability,skinintegrity,emotionalwell

being.

AllpatientsaretowearDayclothesunlessmedicallycontraindicated.

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Version : 1.0

First issued: May 2010; Review date: December 2010Authorised by Nursing Human Resource CouncilAuthorised date: Verbal Acceptance Interim Document/25 August 2010

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0900 Firstmorningteafor15minfollowedbysecondtea. SharedcareModel(SCM)Teammemberscovereachotherspatients

AnexampleofwardroutinesperformedbyaRNinamedicalwardinamorningshift(continue)

AMSHIFT DUTIES

1000 Doobservations,TPR,BPlyingandstanding,oxygensaturationasrequiredorif

moreoftenthandaily.

DoSharedCareModelrounds. Checkifshiftcoordinatorwantstoviewwounddressing. Patientsmayrestontheirbedsifc/opain. Dobladderscans

1100 Complete/reviewNursingcareplans DoContinencecharts/bowelcharts DoBarthelScoresandBradenscoreswhendueasperNURSINGPRACTICE

STANDARDS (NPS)

Handovertocoordinatorpatientsstatus1130 Monitorbloodsugar&giveInsulin. Sitpatientsoutforlunch Feedingandtoileting

1145 Medicationsround. HandovertoSCMteammemberandgotofirstlunch.

1200 Assistpatientswithfeedingasrequired;completeintakecharts. Putpatientsbacktobedafterlunchforrestperiod Attendtoiletingneedsanddopostvoidbladderscans Answeranycallbellswardwide.

1300 Handovertoafternoonstafftakingoveryourpatientload;together,checkpatients

and

charts.

CheckIVinfusions CompleteIntegratednotes,chartsetc Attendinserviceeducation(13.3015.00hrs.Variable)

1400 Sitpatientsoutforafternoontea Dovitalsigns&woundcareifrequiredmoreoftenthandaily. Medicationrounds,checkdrugchartsandreplenishdrugdrawers. PrepareequipmentfornextdoseofIVABs.

1430 Afternoonteaforafternoonstaff CompleteIntegratednotes,chartsetc Answeranycallbellswardwide.1530 RNENSURESdrugkeysarerelocatedintodrugcupboardorhandedtoPMstaffand

registerissigned.

LastminuteverbalupdatestoPMstaff.Checkmedchartshavebeensignedoff.ClarifyanyissueswithPMstaffbeforeyouleave.

CheckwithAMorPMshiftCoordinatorbeforegoinghomeREMINDERWITHMEDICATIONSADMINISTRATION:

Asundergraduatenursingstudents,theabovewardroutineshowsthetimewhenmedicationsare

administeredtopatients.Beforeadministeringanymedicationspleaserememberyourscopeofpractice

andalladministrationofmedicationsmustbesupervisedbyaRegisteredNurse