profile of learning opportunities - northumbria · pdf fileappendicitis testicular torsion...

Added to Northumbria University Practice Placements Website July 2011

This profile is a comprehensive document, detailing all learning

opportunities available within the paediatric assessment/day unit.

In most health care professions a suitably prepared registered

practitioner is expected to provide guidance and support to students

in practice placements.

It is intended that students and mentors select the appropriate

opportunities to meet the specific competencies for the placement.

Ward 6 Paediatric Assessment/Day Unit

P

Profile of Learning Opportunities

Guidance for Students and Mentors


CONTENTS

1. Guidance for students and mentors

2. Orientation of Ward 6

3. Interpersonal skills: key elements

4. Clinical skills: key elements

5. Day cases/emergency assessments: key elements

6. Management of care: key elements

7. Organisational and managerial issues: key elements

8. Link nurses/multidisciplinary team members

Ward 6 learning zone

Philosophy of care


GUIDANCE FOR STUDENTS AND MENTORS

This profile details the learning opportunities available within this

clinical area. From this learning profile the student is able to identify

which of the listed practice based learning opportunities and

activities they will gain the most from and discuss these with their

mentor during the preliminary interview.

ORIENTATION OF WARD 6 PAEDIATRIC EMERGENCY

ASSESSMENT/DAY UNIT

Ward 6 is the paediatric day unit which has two main functions: day

cases and emergency assessments which as students you will have

the opportunity to gain experience in both areas.

Ward 6 is located here at the Royal Victoria Infirmary on Level 3 of

the New Victoria Wing.

Telephone 0191 2826006 Emergency Assessment

Or 0191 2826135 Day unit

Or via switch on 2336161 extension 26006


Ward 6 is primarily nurse-led, but works alongside the

multidisciplinary team, encompassing a wide variety of specialities.

We care for children from 0-16yrs with a variety of illnesses and

complex needs.

The openings hours for the Day unit are 8-6pm Mon-Friday and 8am

to 2am for Emergency Assessment 7 days a week including bank

holidays.

We currently have two shift patterns-students are encouraged to

work whatever their mentor does and are allocated a mentor prior

to commencing the placement.

Day unit Emergency Assessment

8am-6:15pm (10hr shift) 8am-2am/ 8-6:15pm

8am-4pm or 10-6pm (7.5hr shift) 10-8pm/6pm-2am

Off duty is usually roistered four weeks in advance. If you require any

special requests please speak to your mentor or Sister.

Your first day will involve a thorough orientation of the ward

surroundings. You should learn the detailed emergency numbers:

FIRE: 333

SECURITY: 399

CARDIAC ARREST: Child 2222/Adult 2222.


Day Case

As a unit we carry out a large number of Day case

investigations/procedures on patients from the entire various

paediatric speciality teams within the trust. On the day unit we are

opened 8 to 6pm Monday to Friday closed weekend and bank

holidays.

We have planned day case workload by an appointment system pre-

booked in the diary.

A number of these investigations/procedures overlap between the

teams and as a result have slight variations in their protocols.

On Ward 6 we have files containing all the protocols for specific

investigations and procedures and at all times these should be

referred to.

Listed below are some of the tests we perform. Don’t worry during

your placement all these will be explained

Renal

Mag ІІІ Scan BP monitoring

DMSA Scan MCUG

Urine Microscopy Methylprednisolone administration

Blood tests Albumin infusions

Endocrine

Synacthen test LHRH test

Oral glucose tolerance test TRH test

Growth hormone provocation test (either glucagon or insulin)


Gastro

Lactose/Sucrose breath tests

White cell scan

Iron infusion

Infliximab infusion

Methotrexate injections

Meikles scan

Rheumatology

Methylprednisolone/Cyclophosphamide

Methotrexate

Immunoglobulins

Immunology

Vaccinations

Allergy testing (working alongside immunology specialist nurses)

Haemophilia

On Ward 6 we provide treatment when the haematology centre is

closed providing the care during the evening and weekends.

Oncology

On Ward 6 we provide treatment to the children when the oncology

day unit is closed.


Child Protection

Assessments and examinations

Respiratory

Regular reviews by the team and Cystic Fibrosis patients are seen on

the department

Surgery

Surgical day cases if surgical day unit full.

Other

MRI under GA

CT scans under GA

EEG under sedation


EMERGENCY ASSESSMENT

We accept Gp and A&E referrals for emergency assessment via the

Registrar on call. We also have open access patients who are directly

assessed on Ward 6. Under supervision from your mentor, you will

be able to assess and care for the patients requiring emergency

treatment, depending on your level of training. Due to the nature of

the unit, the pace and variety of workload is unpredictable and the

child can present with minor to critical conditions.

Listed are a few of the conditions we see regularly:-

Bronchiolitis Head injuries (minor only)

Asthma Meningitis

Croup Child protection assessments

Upper/lower respiratory infections Intoxication/poisoning

Pneumonia Cellulitis

Febrile convulsions Viral infections

Limps/painful joints Diarrhoea and vomiting

Surgical problems:-

Appendicitis

Testicular torsion

Intussusceptions

Irreducible hernias

Trauma requiring surgery

Ingestion of foreign object


WARD 6

List of Profile of Learning Opportunities with direct supervision of

mentor and support of nursing team.

MANAGEMENT SKILLS

Organisational

Delegation

Prioritising tasks

Time management

Leadership qualities

Quality assurance

Implementing change

Standards of care

Staff development

Managing patient workload

Managing a team

DEVELOPMENT OPPORTUNITIES

Clinical supervision

Reflective practice

Critical incidents

PROFESSIONAL OPPORTUNITIES

Self awareness

Professional attitudes

Confidentiality

Code of conduct


CLINICAL PRACTICE

Ward Philosophy

Admission and Discharge Procedure

Process of Assessment, Planning, Implementing And Evaluating Care

Caseload Management

Enhancing of Assessment Skills (Communication, Observational Skills)

Health Promotion

Multidisciplinary Working

Dispensing Medication

Administration of Im/Sc Injections

Venepuncture/Cannulation of Patients

Administration of Radioactive Isotope

Catheterisation of Patients

Ordering of Medication

Referrals to Other Agencies

Challenging Behaviours/Conflict Resolution

Ward Handover

Community Resources


AWARENESS OF:-

Trust/Ward Policies

Health and Safety at Work

Fire Procedure

Moving and Handling

Ward Environment

Saving Lives

Infection Control

THIS LIST IS NOT EXHAUSTIVE


3. INTERPERSONAL SKILLS: KEY ELEMENTS

LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL/DEPARTMENT

COMMUNICATION Use of the telephone

Answering calls

Transferring calls

Making calls

Contacting other wards/departments

Use of bleep system Use of the computer

Understanding of confidentiality issues

Access to patient information

Access patient results

Use of Trust intranet

District nurse letters

Talking to

Patients

Relatives/carers

Doctors

Visitors

Specialist Nurses/Matrons

Members of multi-disciplinary team

All nursing staff

Other ward staff

Other hospitals

All staff All staff (As appropriate) Matron Ward Sister Doctors/Multi-disciplinary Team Specialist Team Registered Nurse Health Care Assistant Domestic/Ancillary Staff


ORGANISATION/PLANNING

Facilitating investigations

Booking follow-up appointments

Managerial structure in Trust

Patient transfer within Trust

Patient transfer outside Trust

(As Appropriate) Sisters/Doctors Registered Nurse/OT/Physio Specialist Nurses Ward Clerks Patient/Relatives Registered Nurse Patient Services Co-ordinator Ambulance Service


4. CLINICAL SKILLS: KEY ELEMENTS

LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL/DEVELOPMENT

PHYSIOLOGICAL OBSERVATIONS

Blood pressure

Temperature, pulse/apex & respirations

Pain assessment tool

Oxygen saturations

Blood glucose

Maintaining accurate charts ADMINISTRATION OF MEDICATION

Oral

Intra-muscular

Sub-cutaneous

Intravenous infusion/antibiotics

Cannulation/Venepuncture

Inhalation

Rectal

Use of cytotoxic medication

Intraosseous

Via central line/portacath PREPARATION FOR INVESTIGATIONS

Consent (informed)

Information (verbal and written) CLINICAL INVESTIGATIONS

Venepuncture

Cannulation

Urinalysis-dipstick and micro

X-ray

Nursing staff Nursing staff/pharmacist Nursing staff Medical staff Nursing staff Medical staff/specialist nurse Nursing staff Nursing staff Nursing staff/uti team Nursing/radiology


CT scan

MRI scan

DMSA scan-use of isotope

MCUG scan-catheterisation PREPARATION FOR INVESTIGATIONS

Play therapy/distraction PATIENT HYGIENE

Mouth care

Skin care

Pressure sore prevention

Baby cares INFECTION CONTROL

Hand washing technique

Barrier nursing

Disposal of waste

Disposal of sharps

Disposal of linen NUTRITION

Food hygiene

Special diets

Feeding babies

Ng feeding

Gastrostomy feeding

Documentation/Stamp tool PAIN

Physiology

Assessment tools

Nursing staff/radiology Nursing staff/radiology Nursing staff/medical physics Nursing staff/radiology Nursing staff/play therapist/nursery nurse Nursing staff/support worker Nursing staff/infection control team/link nurse Nursing staff/domestic Nursing staff Nursing staff/dietition Nursing staff Nursing staff/stoma nurse Nursing staff/medical team/pain control team


CHILD PROTECTION

Types

Recognising signs

Management protocol

Documentation

Investigations AIRWAY

Assessment of airway

Causes of poor airway

Treatment/medication

Artificial airway

Suctioning BREATHING

Assessment of breathing

Effort of respirations

Noise of respirations

Rate of respirations

Auscultation of chest

Causes of difficulties

Treatment

Asthma

Administration of oxygen/use of equipment

Administration of neb/inhaler

Cystic fibrosis CIRCULATION

Assessment of circulation

Colour

Perfusion

Causes of shock

Treatment of hypovolemia

Assessing dehydration

Nursing staff/child protection team/child protection specialist nurse Nursing staff Medical staff/named consultant Nursing/medical staff Anaesthetist/resus team Nursing staff/PICU Nursing staff Nursing staff/medical staff Medical staff/nurse practitioners/nursing staff Respiratory specialist nurse Nursing staff CF nurses Nursing/medical staff/intranet


DISABILITY/NEUROLOGICAL STATUS

Assessment of disability

Assessment of neurological status

Alertness/behaviour/conscious level

Use of Glasgow Coma scale

Use of PEWS early warning score

Head injury

Raised intracranial pressure

Seizures-febrile convulsions/status

Epilepticus

Treatment causes BASIC LIFE SUPPORT/CPR

LEARNING OPPORTUNITIES

Renal and Genito-urinary system

Nursing/medical staff/Resus Team Nursing staff/Resus officer


Anatomy and physiology Infections-causes, diagnosis, treatment, investigations. Chronic renal failure/dialysis Renal conditions and treatment Blood pressure readings Transplant Endocrine and metabolic system Identification of endocrine glands, effect on the body and hormone production Disorders and treatment Investigations Diabetes DKA-assessment and treatment Growth Gastro-intestinal system Anatomy and physiology Common diseases and treatment Constipation Investigations Diarrhoea and vomiting Re-hydration and monitoring fluid balance Jaundice Rheumatology Juvenile Idiopathic Arthritis-symptoms and treatment

RESOURCE/RELEVANT PERSONNEL DEPARTMENT

Nursing and medical staff/renal team/ specialist nurse/haemodialysis unit/UTI nurse consultant/intranet/books Nursing and medical staff/books/intranet/endocrine specialist nurse/intranet/books Diabetic specialist nurse/nursing and medical staff/intranet Nursing and medical staff/intranet Gastro specialist nurse


Methotrexate injections Steroid treatment Infection Symptoms Source Nature, spread Treatment Identification of types of rashes Sepsis-symptoms and treatment Suppression of immune system Auto-immune disorders Drugs Immunisation Allergy testing-allergic reaction assessment and treatment Neurological Anatomy and physiology Head injuries- minor/major VP shunt Neurological observations-Glasgow Coma Scale Identification of signs and symptoms Treatment and medication Investigations, EEG, CT and MRI(under GA or sedation Haematology Anatomy and physiology Common diseases and conditions

Nursing and medical staff/Rheumatology specialist nurse Nursing and medical staff/Immunology specialist nurse Nursing/medical staff/Neurology team Epilepsy specialist nurse/intranet/books


Obtaining blood samples appropriately Administration of blood products Monitoring accurately during blood transfusions recording all signs and symptoms. Treatment and medication Investigations

Nursing/medical staff/haematology team Blood transfusion nurses/haemophilia specialist nurse

5. DAY CASES/EMERGENCY ASSESMENTS: KEY ELEMENTS

LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL DEPARTMENT

Renal Genito-urinary system

Nursing and medical staff/renal


Anatomy and physiology Infections-causes, diagnosis, treatment, investigations. Acute/chronic renal failure/dialysis Renal conditions and treatment Blood pressure readings Transplant Endocrine and metabolic system Identification of endocrine glands and effect on the body and hormone production Disorders and treatment Investigations Diabetes DKA assessment and treatment Growth Gastro-intestinal system Anatomy and physiology Common diseases and treatment Constipation Investigations Diarrhoea and vomiting Re-hydration and monitoring fluid balance Jaundice Rheumatology Juvenile Idiopathic Arthritis-symptoms and treatment Methrotrexate injections Steroid treatment

team Specialist nurse/haemodialysis unit/Uti nurse consultant Consultant/intranet/books

Nursing and medical staff books/intranet/endocrine specialist nurse Diabetic specialist nurse/nursing and medical staff/intranet Nursing and medical staff/intranet Gastro specialist nurse Nursing and medical staff/Rheumatology specialist nurse


Infection Symptoms Source Nature, spread Treatment Identification of types of rashes Sepsis-symptoms and treatment Suppression of immune system Auto-immune disorders Drugs Immunisation Allergy testing-allergic reaction assessment and treatment Neurological Anatomy and physiology Head injuries minor/major VP shunt Epilepsy Neurological observations- Glasgow coma scale Identification of signs and symptoms Treatment and medication Investigations, EEG, CT and MRI under GA/Sedation Haematology Anatomy and physiology Common diseases and conditions Obtaining blood samples

Nursing and medical staff/Immunology specialist nurse Nursing/medical staff/Neurology team Epilepsy specialist nurse/books/intranet Nursing/medical staff/Haematology team Blood transfusion nurses/link nurse/Haemophilia specialist


appropriately Administration of blood products Monitoring accurately during blood administration recording all signs and symptoms relating to adverse reaction Treatment and medication Investigations

nurse

6. MANAGEMENT OF CARE: KEY ELEMENTS

LEARNING OPPORTUNITIES RESOURCES/RELEVANT PERSONNEL/DEPARTMENT


NURSING CARE Assessment:

Long/short stay/A&E

Use of Trust documentation

Relevance of information

Collection of information

Observation

Practice Planning Care

Use of care plans

Assessment tools

Use of protocols/Trust policies

Care pathways

Discharge planning/involvement

with other agencies

Liaison with community teams/health visitor/Cani team

Implementation/Evaluation

Documentation skills

Time management

Planning priorities

Communication

Informing the child and families

Continuous monitoring of the child’s condition

7. Organisational skills

LEARNING OPPORTUNITIES

Nursing staff Nursing staff Intranet/ward policies/files Nursing staff

RESOURCE/RELEVANT PERSONNEL/DEPARTMENT


Role of Ward Manager/Sister

Delegation

Off duty

Standards of care

Quality issues

Leadership skills

Assuring quality care/clinical governance

Bed management MANAGEMENT OF WARD/RESOURCES

Stock control

Ordering drugs

Sisters responsibilities

Moving and handling

Risk management

Health and safety

Staff Development

Senior Sister Senior Staff Registered staff Modern matron Senior Sister Senior staff/Sister/Support worker Senior Sister

8. STAFF MEMBERS ON WARD 6


Ward Manager Allyson Turnbull

Sister Sister Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Play specialist Nursery nurse Health care assistant Ward clerk Ward clerk Ward clerk Ward clerk Domestic Domestic

Sharon Mcguffog Dawn Gerrard Catherine Haynes Carol Scott Claire Snow Hannah Dunn Jill Ferguson Rebecca Atthey Victoria Porter Rebecca Kimber Fiona Blair Nicola Raine Hayley Barker Helen Marshall Karen Morton Angela Potts Lyndy Fawcus Craig Douglass Viv Chambers Alison Foreman Linda Smith Pauline Thompson Linda Fletcher Michelle Irene

LINK NURSES WITHIN WARD 6.


Allyson Turnbull Dawn Gerrard Catherine Haynes Carol Scott Claire Snow Hannah Dunn Jill Ferguson Rebecca Atthey

Venepuncture/Cannulation Blood Transfusion/Pain Education Risk Assessment Tracheostomy Care/Asthma Moving and Handling Infection Control Infection Control

We hope that you enjoy your time spent on Ward 6 however if you

have any problems please feel free to speak to:

Allyson Turnbull, Ward Manager

Sharon Mcguffog, Sister

Dawn Gerrard, Sister

This Polo was updated in March 2011 by Dawn Gerrard...

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