profile of learning opportunities (polo) - 211.3 - polo day surgery... · updated may 2017 jg/gv...

Updated May 2017 JG/GV

Profile of Learning Opportunities (PoLO) for nursing and midwifery students in practice

Practice Placement: Day Surgery

http://www.lsbu.ac.uk/


Introduction to the Ward / Unit

Welcome to: The Day Surgery Unit (DSU) at King’s College Hospital, also known as the Arthur Levin

Building, which is divided into four areas: pre-assessment, wards, theatres, and anaesthetics and

recovery.

There is a separate admission lounge for East and West Wing

West Wing comprises of a 15 bedded bay and a 4 bedded bay with side room. East Wing has 7 beds,

and William Bowman ward has its own admission lounge and waiting area for eye patients.

We manage seven day surgery theatres and five recovery bays, providing patient care post

procedure/operation within the following specialities:

General surgery

Paediatric General

Ophthalmic surgery

Gynaecology

Maxillofacial

Dental

Orthopaedics

Renal

Vascular

Urology

Endoscopy

Laparoscopy

Location

We are located: Ground Floor, Arthur Levin Building, Bessemer Road, Denmark Hill, London SE5 9RS

Ward / Unit telephone: 020 3299 3483 (reception)

Welcome to the team

Ward / Unit Manager is: TBC – awaiting new Matron

Modern Matron is: TBC - extension 31782

Student co-ordinator is: PDN Guian Burbano extension 31783 [email protected] (no bleep)

Practice Development Nurse is: Guian Burbano extension 31783 [email protected] (no bleep)

The unit team consists of:

Registered Nurses

Health Care Assistants

mailto:[email protected]

mailto:[email protected]


Operating Department Practitioners

Theatre support workers

Consultant Anaesthetists and team

Consultant Surgeons and teams for specialisms listed above

Day Surgery Unit Philosophy of Care

“We believe that patient care is at the centre of all we do in Day Surgery.” “Our goal is to enable patients to return to an independent life at home as quickly and as safely as possible.”

“To achieve this we aim to:

Maintain dignity, privacy and comfort to each patient.

Provide the highest standard of professional care and technical skills based on current research from competent knowledgeable, friendly staff.

Promote teamwork to ensure patient safety, cost effectiveness and an efficient service.

Maintain a clean, comfortable and welcoming environment.

Listen to feedback from patients and their family making changes where necessary.

Ensure that patients, relatives or carers receive the appropriate and relevant information and advice to aid recovery.”


Shift pattern students may follow

5 day week 6 day week Weekends (not Sunday)

Shift: (Ward and Pre-assessment) Early - 07.15 -18.00hrs

Early half - 07.15 – 14.00hrs

Shift: (Theatres and Anaesthetics) Early - 08.00 - 18.00/18.00hrs

Early half - 08.00 – 14.00hrs

Shift: (Recovery 1) Early 08.00 -18.00hrs

(Recovery 2) Early 08.30 – 18.00hrs

(Recovery 3) Early 09.00 – 19.00hrs

Staffing establishment

Varies according to the operating sessions planned

Meal breaks

You are permitted a 30 minute break on a full shift

To contact colleagues:

Bleeping:

Dial 736 followed by the bleep number and the extension you wish to be called back on. Wait for the

long tone and replace the receiver

Air calling and Paging:

Dial 737* - the operator will ask for your ‘call sign’ (i.e. page number e.g. KH 6789) and your

message. This is then sent to the person you are trying to contact

Useful numbers

Cardiac arrest 2222

Fire 2222

Security 2444


Hub and Spokes for Day Surgery

Day surgery

'hub'

care of patients short term surgical

needs A to E assessment

post anaesthesia

care

MDTeam working

infection control

pain management

pre-op care

post op care intraoperative care

pre-assessment clinic

developing communication

skills

patient admission and

discharge

principles of asepsis

observing surgery

following the patient journey

for adult and paediatrics


Core Learning Opportunities (Under Supervision):

Participate in the assessment of individuals pre/post operatively (ward area),

intraoperatively (in theatres & anaesthetics) and post-operatively (in recovery)

Ward area: you may participate in (with context related examples):

Applying relevant knowledge / measuring & interpreting clinical observations e.g.

blood pressure, respirations and pulse

Developing skills in the use of related equipment under supervision e.g. dynamap

Communication e.g. highlighting potential hazard for surgery e.g. fasting pre-op

Pre-op checklist

Obtaining specific specimens as required e.g. urine / pregnancy testing

Documentation e.g. consent/capacity

Risk Assessment e.g. VTE prophylaxis

Discharge planning e.g. suitability of escort home/home care required

Theatres and Anaesthetics: you may participate in (with context related examples):



Airway assessment

Risk Assessment e.g. environmental safety/ patient protection

Wound assessment e.g. choice of dressing

Assisting with specimens obtained

Documentation e.g. WHO checklist/record keeping

Communication e.g. providing support for patient under local anaesthetic

Recovery: you may participate in (with context related examples):

A to E assessment e.g. airway, pain assessment, wounds



Recognising the deteriorating patient

Communication e.g. information transfer between theatres and recovery staff


The learning opportunities above are mapped against the Professional Values and

Essential Skills in your PLPAD and presented in the box below. This will assist you to

identify and plan for what you could achieve.

Programme and Part 1, 2 or 3 as per PLPAD

Professional Values statements in PLPAD

Essential Skills PLPAD Outcome Number

BSc Part 2 (adult) and PGDip Part 2 (adult)

1, 2, 4-6, 8-10, 12, 13

1, 3, 4, 5, 6, 7, 9, 10, 11, 13, 18, 22, 24, 37, 38, 39, 40,


1, 2, 4 – 7, 9-14

1, 2, 7, 13, 14, 16, 20, 24, 27, 43, 49, 52, 78, 84, 88

BSc Part 2 (child) and PGDip Part 2 (child)

1, 2, 5 - 6, 8 -10, 12, 13

1, 5, 6, 7, 9, 10, 11, 12, 16, 17, 18, 27, 33


Core learning Opportunities (Under Supervision):

Participate in the planning of individualised patient centred care

Ward area e.g. discharge planning

Theatres and Anaesthetics e.g. airway management/patient safety, privacy and

dignity

Recovery e.g. preparation of the recovery space

You may participate in (with context related examples)

Prioritisation of patient need e.g. o Patient position in theatre/recovery o Pain management in theatre/recovery o Staff to patient ratio

Decision making e.g. MDT working

Patient inclusion e.g. informed consent/capacity pre-op

Patient centred care e.g. determine patient’s priorities/preferences

Documentation e.g. electronic systems

Multi-disciplinary working e.g. team brief and daily huddle

Communication e.g. sensitive issues/family/parents/carers

Discharge planning o Safety o Unexpected change o Care transfer








1, 2, 5, 6, 8, 9, 10 1, 3 - 6, 12, 16, 17, 18, 22


1, 2, 6, 7, 9, 10, 11, 13, 14

1, 2, 3, 7, 8, 11, 13, 16, 20, 24, 28, 31, 52


1, 2, 5, 6, 8, 9, 12, 13 1, 3, 4, 5, 6, 12, 16, 17, 18, 22


Core learning Opportunities: (Under Supervision): in Ward area,

Theatres/Anaesthetics and Recovery

Participate in implementing patient centred care and nursing interventions, promoting

identity and inclusion, and maintaining privacy and dignity:

Ward area: you may participate in (with context related examples)

Meeting hygiene needs e.g. ensuring patient cleanliness following bowel prep

Meeting elimination needs e.g. bowel prep pre-procedure

Meeting mobility needs e.g. accompanying patient to anaesthetic room

Meeting psychological needs e.g. patient anxiety/parent anxiety

Meeting nutritional needs e.g. post op refreshments

Maintaining fluid balance e.g. IV infusion

Care specific to identified risk e.g. pre-op checklist

Pain management e.g. monitoring effect

Care evaluation, re-assessment and review

Communication e.g. explanation of procedure pre-op

MDT liaison/communication e.g. patient referral

Theatres/Anaesthetics: you may participate in or observe (with context related examples)

Care specific to identified risk e.g. patient airway ‘laryngospasm’

Infection prevention and control e.g. observing ANTT

Care evaluation, re-assessment and review

Documentation and record keeping

Infection prevention and control e.g. observing scrub technique, gowning procedure

and instrument preparation

Pain management e.g. administration of prescribed medication to manage/prevent

pain

Communication e.g. patient under local anaesthetic

Measuring & interpreting clinical observations e.g. blood pressure, respirations and

pulse, visual skills

Maintaining patient’s dignity


Recovery: you may participate in or observe (with context related examples)

Meeting psychological needs e.g. orientating patient during recovery/supporting

parents

Pain management e.g. administration of prescribed medication/monitoring

effect/observing infusion pumps

Care specific to identified risk e.g. patient airway ‘laryngospasm’

Measuring & interpreting clinical observations e.g. blood pressure, respirations and

pulse, visual skills

Communication e.g. escalating concern/deteriorating patient

Documentation of care implemented

Infection control e.g. safe disposal body fluids

Wound care e.g. monitoring dressing intact








1, 2, 4- 13 1, 5, 6, 7, 9, 12, 16- 18, 22, 27, 33, 36, 38, 41, 49- 51


1, 2, 4, 5- 14 1, 2, 3, 6, 7, 8, 13, 14, 16, 17, 19, 20, 21, 24, 27, 29, 43, 46, 47, 49, 52, 60, 76, 77, 78, 84, 87, 88, 89


1, 2, 5, 6, 8, 9, 12, 13 1, 3, 4, 5, 6, 7, 9, 12, 13, 16, 17, 18, 27, 33, 41, 49 -51


Specific Learning Opportunities (Under Supervision)

Under supervision, participating in the administration of prescribed medication using a

variety of routes.

You may participate in /observe (with context related examples)

Oral medication (on ward)

Injections subcutaneous & intra-muscular (in recovery and on ward)

Eye drops and correct procedure (ward)

Medication dose calculations e.g. paediatric dose

Observation only of IV drug administration (recovery and anaesthetics)

Observe anaesthetic administration by Anaesthetist

Observing setting up infusion pump/syringe driver

Access British National Formulary (BNF) resource








1, 2, 4- 13 49 -51


1, 2, 4, 5- 14 78, 84, 88


1, 2, 5 -10, 12, 13 49, 50, 51, 54,


Core Learning Opportunities (Under Supervision)

Participate in the assessment of patient risk.

In Pre-assessment: you may participate in/observe (with context related examples)

VTE prophylaxis

Identify allergies

Observe an anaesthetic assessment/suitability for day surgery criteria

Observe a CNS assessment

Tissue viability e.g. Waterlow score

Deteriorating patient e.g. NEWS score

Falls e.g. hemi-paresis

Nutrition / Hydration e.g. pre-op fasting information/concordance

Mobility e.g. sensory impairment

Continence e.g. mobility

Manual Handling

Infection control e.g. MRSA screening

Disability

Safe guarding

Health & Safety of potential complications e.g. cardiac history/co-morbidities

Medicine management e.g. existing anti-coagulant therapy

Communication e.g. liaise with GP

In Theatres/Anaesthetics: you may participate in /observe/identify (with context related

examples)

Tissue viability e.g. pressure prevention/equipment

Nutrition / Hydration e.g. dysphagia

Manual Handling e.g. equipment/positioning patient

Infection control e.g. observe insertion of IV cannula

Disability e.g. consent/capacity

Safe guarding e.g. patient under general anaesthetic

Health & Safety e.g. WHO checklist/environmental hazards

Medicine management e.g. observe the process for labelling syringes


In Recovery: you may participate in /observe/identify (with context related examples)

Tissue viability e.g. skin integrity

Deteriorating patient e.g. NEWS score

Falls e.g. patient recovering from general anaesthetic/trolley rails

Manual Handling

Infection control

Disability e.g. sensory/visual/auditory

Safe guarding

Health & Safety e.g. environmental hazards

Medicine management








1, 2, 4 - 6, 8, 9, 10, 12, 13

5, 6, 7, 8, 9, 10, 22


1, 2, 4 - 7, 9 - 11, 13, 14

5, 23, 27, 26, 29, 46, 53, 57


1, 2, 5 -10, 12, 13 5, 6, 7, 8, 9, 10, 22


Core Learning Opportunities (Under Supervision)

Participate in preparing for patient discharge /care transfer /handover for example:

For patient to be discharged home

Care transfer within the day surgery unit

You may participate in/observe (with context related examples)

shift change handover

effective handover between areas at different stages of the patient’s care journey

documentation process

discharge process e.g. assessing patient against criteria for recovery : ward

MDT & other agencies working e.g. interpretation service

referrals e.g. home help team

family support / involvement

transfer to inpatient care following deteriorating patient and escalation








1, 2, 5-13

1, 3, 4, 5, 13, 16, 17


1, 2, 5-14

1, 2, 8, 10,11, 24, 31, 46, 64,90


1, 2, 5 -10, 12, 13 1, 4, 5, 13, 16, 17, 18


Core Learning Opportunities (Under Supervision) unit based

Participate in working within a multi-disciplinary team

You may participate in/observe (with context related examples)

Working alongside colleagues during patient interventions in all areas of DSU

Participating in daily team brief

Participating in a ‘huddle’

Observing how and who co-ordinates a theatre operating list

Recognising barriers to communication e.g. facemasks/protective equipment

Communication e.g. documentation








1, 2, 4, 5, 6, 12, 13 1, 5, 18


1, 2, 4, 5, 6, 7, 9, 11, 13, 14

1, 2, 3, 16, 17, 20, 24


1, 2, 5, 6, 8, 9, 12, 13 1, 18


Specific Learning Opportunities (Under Supervision) ward area only

Participate in the management of a group of patients depending on the complexity of

patient need and student competence

Part 2 students the opportunity to develop/enhance skills

Part 3 students the opportunity to enhance skills and contribute to Part 3 Practice

Assessment Episode of Care

You may participate in /observe/identify (with context related examples):

Participating in patient care: assessing, planning, implementing and evaluating

Analysing a situation

Prioritisation of patient need

Problem solving e.g. patient lives alone

Decision making e.g. escalation process

Communication e.g. care transfer to anaesthetic team

Team working e.g. observing rest time

Leadership e.g. raising concerns

Delegation

Supervising others (where appropriate)

Observing/shadowing the nurse co-ordinator

The learning opportunities above are mapped against the Professional Values, Essential

Skills and Practice Assessments in your PLPAD and presented in the box below. This will

assist you to identify and plan for what you could achieve.



Essential Skills PLPAD Outcome


N/A N/A but may be given the opportunity where appropriate


1, 2, 6, 7, 9, 10, 12, 13, 14 1, 2, 3, 7, 8, 13, 16, 17, 19, 20, 24, 28, 29, 34 - 41, 45, 46, 52 and Part 3 Practice Assessment Episode of Care


N/A N/A but may be given the opportunity where appropriate


Specific Learning Opportunities (Under Supervision): recovery based

Assessment and management of the patient with hypovolemic shock

You may participate in /observe/enhance skills relating to (with context related examples):

A-E assessment

Recognising the deteriorating patient e.g. NEWS

Escalating concern

Application of observational assessment skills e.g. observing for pallor

Measuring vital signs e.g. blood pressure/respirations

Participating in administration of prescribed medication e.g. observe intravenous

fluids infusion

Monitoring patient response to treatment

Communicating with the Multi- Disciplinary Team e.g. SBAR

Maintaining patient safety

Psychological patient support



identify and plan for what you could achieve





1,2,5-13 5, 10, 12, 18, 41, 49, 51


1,2,6-7,9-11,13

1, 2, 11, 13, 16, 17, 19, 24, 27, 29, 36, 39, 59, 75, 76, 78, 84, 88


1, 2, 5, 6, 8, 9, 12, 13 10, 11, 12, 18, 41, 49, 50


Specific Learning Opportunities (Under Supervision): recovery and ward area

Participate in the assessment and management of pain, for example patients undergoing:

Gynaecological surgery e.g. hysteroscopy

Orthopaedic surgery e.g. for halux valgus

Urological/general e.g. circumcision

You may participate in /observe (with context related examples):

Assessment of pain by medical /nursing team

Recognising specific analgesia for types of pain

Pain assessment tool

Participate under supervision in administering prescribed analgesia

Monitoring effectiveness of intervention for pain

Pain team if appropriate








1, 2, 6-13 5, 11, 12, 18, 49, 50, 51, 54


1, 2, 6-14 1, 2, 13, 14, 24, 27, 29, 78, 84, 88


1, 2, 5, 6, 8, 9, 12, 13 5, 10 -12, 18


Reflective learning log

This reflective learning log may be used (optional) by you to record learning activity undertaken

during a spoke visit / learning opportunity. It provides you with additional evidence on which to

focus discussion with your mentor as part of formative feedback. Additionally it serves as a reminder

for your personal reflection.

Spoke learning opportunity: ___________________________________

Date / time: ___________________________________

Learning opportunities identified:

Comments / feed forward from practitioner in area:

Practitioner’s signature: _________________________________

Student Reflection Comments:

Student name / signature: ________________________________


Student Placement Evaluation

Please provide the practice team with feedback on your learning experience by answering the

questions below, and make any comments you wish to be considered. Please give this to your

mentor/ward manager/PDN/CPF or PDM/MPF before you leave. Thank you.

Domain 1 - Establishing effective working relationships (NMC 2008)

Did you receive an orientation to the practice placement?

Domain 2 – Facilitation of learning (NMC 2008)

How did you identify and select appropriate learning opportunities?

Domain 3 – Assessment and accountability (NMC 2008)

How were you provided with feedback on your development and progress?

Domain 4 – Evaluation of learning (NMC 2008)

Were you allocated a mentor and how much time did you spend with them?

Domain 5 – Create an environment for learning (NMC 2008)

How did your mentor and the practice team facilitate your learning?


Domain 6 – Context of practice (NMC 2008)

What did you learn about the specific nature of care provided in the placement?

Domain 7 – Evidence-based practice (NMC 2008)

How were you supported in applying an evidence base to your practice learning?

Domain 8 – Leadership (NMC 2008)

How well were your learning needs met?

How could we enhance your learning experience?

Please make any further comments in the box below.

Thank you for taking the time to complete this evaluation

Reference: Nursing and Midwifery Council (2008). Standards to support learning and assessment in practice. Online

available from www.nmc-uk.org

http://www.nmc-uk.org/


Suggested reading:

Lapham, R. and Agar, H. (2009) Drug Calculations For Nurses (3rd Edition). Hodder and

Arnold: London

Wicker, P. and O’Neil, J. (2006) Caring for the Perioperative Patient. Blackwell Publishing:

London

Useful sites:

DYP Day Surgery: https://www.rcn.org.uk/__data/assets/pdf_file/0009/78507/004_464.pdf

The American Association of Perioperative Registered Nurses

http://www.aorn/org/clinicalfaqs/

The Association of Anaesthetists of Great Britain and Ireland

http://www.aagbi.org/publications/publications-guidelines/A/F

The Association for Perioperative Practice www.afpp.org.uk

The British Anaesthetic and Recovery Nurses Association www.barna.co.uk

The British Association of Day Surgery (BADS) http://daysurgeryuk.net

The National Institute for Health and Care Excellence (NICE)

http://www.nice.org.uk/guidance/

The Royal College of Nursing http://www.rcn.org.uk/development/publications

https://www.rcn.org.uk/__data/assets/pdf_file/0009/78507/004_464.pdf

http://www.aorn/org/clinicalfaqs/

http://www.aagbi.org/publications/publications-guidelines/A/F

http://www.afpp.org.uk/

http://www.barna.co.uk/

http://daysurgeryuk.net/

http://www.nice.org.uk/guidance/

http://www.rcn.org.uk/development/publications

profile of learning opportunities (polo) - 211.3 - polo day surgery... · updated may 2017 jg/gv...

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