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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