welcome to main outpatients department - … · 2013-02-05 · 1 welcome to main outpatients...
TRANSCRIPT
INDEX
1 Welcome to Main Outpatients Department
2 The Multidisciplinary Team
3 Main Outpatients POLO
4 Map
5 The Patient’s Journey
6 Nursing Philosophy
7 Outpatients Department Objectives for Student Nurses
9 Student Induction
11 Health Promotion
12 Clinical Skills
13 Management of Care
14 Communication Skills
15 Organisational and Management Skills,
Resource and Risk Management
16 Learning Zones
17 Learning Zones (cont)
1
WELCOME TO MAIN OUTPATIENTS DEPARTMENT
We hope you enjoy your stay with us. On arrival, you will be greeted by a
member of staff and will be shown around the department. You will be allocated
a locker in the main changing room within the hospital (£10 deposit required).
You will be introduced to your mentor who will support you during your
placement. It may not always be possible to work with your mentor, but this will
give you the opportunity to experience other specialities
MEET THE TEAM
The Outpatient team consists of management, nursing and phlebotomy.
Head of Department Mrs K Jacques Dect 48174
Matron Gordon Elder Dect 48766
Sister Debbie Harris Dect 21871
OPD Services Manager Debbie Banks Dect 21870
Office Manager Christine Rutherford Ext 20594
2
THE MULTIDISCIPLINARY TEAM
OT/
Physiotherapist
Appliance Staff
Lab
Staff
Specialist
Nurses
Ambulance
Staff
Social
Worker
Radiographers
Radiologists
Dietician
Nurse
Practitioner
Nurse
Consultant
Sonographer
MULTIDISCIPLINARY
TEAM LINKED TO
MAIN OUTPATIENTS DEPARTMENT
Psychologist
3
MAIN OUTPATIENTS POLO
Where are we? (See map also)
Level 1 Royal Victoria Infirmary
New Victoria Wing
Queen Victoria Road
Newcastle upon Tyne
NE1 4LP
Telephone: Sister Debbie Harris
0191 2825620 (Office)
0191 2821871 (Dect)
Our department consists of reception areas, waiting areas, consultation and
examination rooms, treatment rooms and a phlebotomy room.
Your working week
Monday – Friday 8.30am to 5.00pm
You will have the opportunity to work in a variety of specialities:
Gynaecology Medical
Surgical Breast clinic
Gastroenterology Cardiology
Endocrinology Neurology/Neuro-surgical
Haematology Pain Management
4
5
THE PATIENT’S JOURNEY
Patients will be seen by appointment only. Referrals are via the GP or
another Consultant. Return patients are either ward discharged or
requested by the Doctor at previous visits.
Patient arrives and books in at the reception desk in area designated to their
clinic.
Patient is directed to the waiting area.
Patient’s height, weight, BMI, urine and smoking status are documented as
indicated. Notes taken to correct clinic.
Plasma screens showing clinic information are situated in each waiting area.
These are kept up-dated with named nurses and any outstanding waiting times.
Clinic nurse checks notes, looking for e.g. referral letters, results and
investigations. If missing, appropriate action is taken.
We endeavour to keep to appointment times with exception of poorly patients
and those travelling via hospital transport.
Patients are called into consultation room.
The consultation proceeds and if an examination/procedure is necessary the
nurse will chaperone/assist. Explanation of examination/procedure carried out
and verbal/written consent obtained.
Allow patient time for recovery and dressing.
Information leaflets given if applicable.
The patient’s understanding of clinic events is checked by a nurse.
The patient’s agreement and understanding of the treatment plan, as outlined
by the doctor, is checked.
As the patient leaves the clinic, the nurse directs them to other departments as
appropriate.
The patient is instructed to make a return appointment if required and the nurse
checks that they are fully aware of what they should do next.
If patient has travelled by hospital transport, ensure that arrangements are
made for transport home.
Any nursing comment is documented in the case notes.
6
NURSING PHILOSOPHY
Our aim as nurses in Main Outpatients is to promote optimum health and ensure
patients receive the best treatment and attention for their individual needs.
To help keep patients in the community either self-caring or with the help of other
agencies.
The two main categories of patients attending the department are:
New referrals
Patients attending for review
Objectives
Continually assess all patients needs throughout their time in the
department
To be nursed in a safe and suitable environment
To respect patients privacy and dignity
To explain procedures and if necessary clarify information given to patients
and relatives by medical staff
Safeguard confidential information
Be supportive to patients and their relatives
To keep clinics running as near to appointment time as possible and keep
patients informed of any delays
Arrange suitable transport if necessary
WE AIM TO PROJECT A FRIENDLY, CARING AND EFFICIENT
ATMOSPHERE AND TO MAINTAIN A HIGH STANDARD OF NURSING
CARE TO ALL PATIENTS ATTENDING THE DEPARTMENT
7
OUTPATIENT DEPARTMENT OBJECTIVES FOR STUDENT NURSES
Orientation to Departments
Become familiar with the Department
Be aware of clinic timetables and where different clinics are held
Be aware of Emergency equipment and its location within the department
e.g. crash trolley, defibrillator, fire equipment and fire exits
Understand where other departments are in relation to Outpatients, e.g.
Pharmacy, X-Ray, Cardiology, Medical Physics, other wards and
departments
Understand times of specimen collection and who to ring for urgent
specimen collection
The Departments/Clinics
Be aware of the Quality Care Commissions standards and targets
appropriate to Outpatients
Be aware of the Department’s Philosophy of Care
Understand the importance of maintaining the privacy and dignity of
patients
Understand about the Pathway of Care through the department and how it
works. The importance of documentation if the patients visit deviates from
the norm
Learn about the members of staff working within the clinics, their role and
how they can be contacted
Be aware of investigations and treatments carried out on the department
Understand the procedure for specimen collection, labelling and the forms
used
Understand procedure to access pathology/radiology investigation results
Understand about clinic preparation
To have observed patients in all outpatient specialities
Where possible, to have spent time with Nurse Specialists and understand
their role
Be aware of patient transportation by ambulance
8
Professional Conduct
Understand the importance of confidentiality
Understand the importance of good communication/interpersonal skills
Understand the importance of patient advocacy and autonomy
Understand the importance of gaining patient’s consent, both verbally and
written
To understand about the responsibility to establish the duty of care to be
given to patients
9
STUDENT INDUCTION
To be completed within First week of Placement
Orientation to Placement Signature of
Mentor
Date
Introduction to Departmental Colleagues and key people
Start finish times etc
Access to changing, toilet, restaurant and library facilities
Break times, dress code etc
Explanation of Telephone facilities
and lines of communication
What to do if sick
Check wearing ID Badge and accessed IT from Trust Induction
Discuss the importance of confidentiality and IT security
Explanation of patient call and emergency buzzer system
Share emergency contact details for student
( this needs to be destroyed at end of placement)
Policies and Procedures
Signature of
Mentor
Date
Be made aware of how to access all policies and procedures
Local, Professional and Organisational.
Be aware of how to report accidents / incidents
Care of personal property and Patient property
Be aware of how to contact security and report security
incidents
Fire Signature of
Mentor
Date
Ensure have completed annual online update.
Date completed:
Identify location and how to use
extinguishers and alarms on placement
Describe action to be taken on hearing fire alarm.
Meeting point / evacuation process etc
Emergency / Cardiac Arrest Procedure
Signature of
Mentor
Date
Identify the location of resuscitation equipment
Describe method of summoning relevant arrest team
10
Health and Safety Signature of
Mentor
Date
Disposal of waste – Student can identify correct procedure
for disposal of:
Clinical waste
Non Clinical waste
Infectious waste
Body Fluids
Sharps
Confidential waste
Moving and Handling Signature of
Mentor
Date
Student should be made aware of equipment used and its
decontamination:
Electronic Couches
Patient hoist and slings
Commode
Wheelchair scales
Food Hygiene Signature of
Mentor
Date
Student should be able to demonstrate knowledge in the safe
handling and storage of food and refrigerator care.
Infection Control
Signature of
Mentor
Date
Students should be aware of how to access infection control
policies
Hand Hygiene technique Gel, Soap and water
5 Moments of Care
Saving Lives documentation
Bed Cleaning Procedure
Commode Cleaning Procedure
How to use bed pan disposal unit
Placement specific Signature of
Mentor
Date
11
KEY ELEMENTS: HEALTH PROMOTION
LEARNING OPPORTUNITIES RESOURCES
Health Education and Promotion
Mentor, nursing/medical staff
Models of Health
Health promotion leaflets
Sexual Health
Mentor, nursing/medical staff
Gynaecology specialist nurses
Stop Smoking Brief Advice
Mentor, nursing/medical staff
Stop smoking advisors
Diet and Nutrition
Obesity
Mentor, nursing/medical staff
Dieticians
Exercise
Cardiac specialist nurse
Alcohol
Alcohol Liaison Team
12
KEY ELEMENTS: CLINICAL SKILLS
LEARNING OPPORTUNITIES RESOURCES
Blood Pressure
Pulse
Temperature
Respirations
Oxygen Saturation Levels
MEWS
Height
Weight
BMI
Urinalysis
Peak Flow
Falls Risk Assessment Tool
Glucose Monitoring
MUST – Nutritional Score
Aseptic Technique/ANNT
Moving and Handling
Mentor, nursing/medical staff
and/or other appropriate staff as
indicated below
Diabetic link nurse
Dietician
Tissue viability nurse
Moving and Handling Team
13
KEY ELEMENTS: MANAGEMENT OF CARE
LEARNING OPPORTUNITIES RESOURCES
THE NURSING PROCESS:
Continual ASSESSMENT of
patient’s needs:
Observation, collection of
information, relevance of
information, use of Trust
documentation
PLANNING CARE:
Patient’s journey, organisation of
care (follow-up appointments,
appointments for investigations,
hospital transport, co-ordinating
follow-up appointments with
investigations, patient transfers to
ward)
EVALUATE CARE
M D T
Religious and Cultural needs
Patient, relatives, carers
Nursing/medical staff
Medical notes
Outpatient department staff
Internal mail
Ambulance service
Clerical staff/other departments
Ward staff
Patient services manager
14
KEY ELEMENTS: COMMUNICATION SKILLS
LEARNING OPPORTUNITIES RESOURCES
VERBAL COMMUNICATION:
Telephone- making internal and
external calls
Use of DECT phone system
Communicating with patients, their
relatives and to all members of the
MDT
Big Word telephone and Face to
Face interpreters
Loop System
NON VERBAL
COMMUNICATION
White board
Patient Notes
Modulex
COMPUTER SKILLS
Understanding Confidentiality
Access to patient information
Access to patient results
Access to Trust Policies
Access to training
NHS phone direct
Switchboard
MDT
Porters
Ambulance staff
PALS
Boards in waiting area
Medical Notes
All Outpatient Staff
I.T. helpline
Intranet
15
KEY ELEMENTS: ORGANISATIONAL AND MANAGEMENT SKILLS
Role of Department Sister
Off Duty- Skill Mix
Delegation
Prioritising work load
Time management
Standards of Care
Quality issues
Implementing Change
Staff development/ Appraisal
RESOURCE MANAGEMENT
Stock Control
Budget Control
Pharmacy
RISK MANAGEMENT
Policies and Procedures
Equipment safety checks
Moving and handling
Infection Control
Health and safety
Sister
Mentor
Other nursing Staff on department
Sister
Mentor
Other nursing staff on department
Intranet
Electronics
Link Nurses
16
Whilst the majority of your placement will be within the department, there may be the
opportunity to visit other areas linked to specialities as follows:-
CARDIOLOGY
ENDOCRINE
ECG PIU visit
ECHO Specialist Nurse
Exercise Test
Perfusion Scan
Rapid Access Clinic
BREAST
GYNAECOLOGY
Assessment/Screening Women’s Health Services
Breast Care Nurse TOP Clinic
Nurse Practitioner Cystometry Clinic
Cytology Colposcopy
MDM PMB/Pelvic Mass Clinic
Radiotherapy (NCCC) Specialist Nurse
Plastics/Reconstructive Surgery Nurse Consultant
Hysteroscopy Services
Centre for Life
NEUROLOGY
UPPER GI
EEG Endoscopy
EMG Specialist Nurse
Muscle Biopsy Manometry
Lumbar Puncture Peg Nurse/ Dietician
Specialist Nurses- MS Pre-Assessment
Parkinson’s MDM
MND Barium Swallow
Epilepsy
Mitochondrial
Neuro oncology
Head Injury
17
COLORECTAL
PAIN MANAGEMENT
Endoscopy/Biddlestone Road Specialist Nurse
Specialist Nurse
Biofeedback
Pre -Assessment
MDM
Barium Enema
HAEMATOLOGY
Specialist Nurse