Download children`s theatres new victoria wing royal victoria infirmary

CHILDREN’S THEATRES
NEW VICTORIA WING
ROYAL VICTORIA INFIRMARY
DEPARTMENT PROFILE
Welcome to Children’s Theatres. We are part of the Peri-Operative and Critical Care Directorate within
the Newcastle Upon Tyne Hospital Trust, and also have close links with Children’s Services and Plastic
Surgery.
The suite is made up of 6 theatres with 5 currently in use. Autumn 2010 will see Orthopaedic surgery
joining the suite. We are based within the New Victoria wing of the hospital, where all the Children’s
wards will eventually be situated
The department covers a broad spectrum of specialities, e.g. general surgery, plastics and
reconstructive surgery, and so on. We also cover Children’s surgical emergencies on a 24-hour basis.
The six Theatres are numbered 20-25. 20 is predominantly used for Plastic and General surgery, 21
and 22 are integrated laparoscopic Theatres, 23 and 24 have laminar flow facility, 25 is the Procedure
room, slightly smaller than the other Theatres but useful for Painful procedure lists ,Endoscopy and
Bronchoscopy. Theatre 24 will be the Orthopaedic Theatre, with 23 the designated Emergency
facility.
The suite has a dedicated reception area, where Children and their families are met by the
Anaesthetic nurse. Toys are available while they wait. There is a ten bed Recovery room, which is
staffed by a minimum of two nurses at any time.
Changing facilities are within the Suite, with showers available if required. Rest room facilities include
a vending machine ,fridges, freezers and microwaves.
The department is the regional centre for Children’s surgery, therefore within it there is great scope
for the development of your knowledge and skills. We welcome all levels of student nurse to the
department and hope that you find your placement enjoyable and worthwhile.
Before commencing your placement you will be allocated a mentor who will work with you throughout
your placement. However, during your placement you will also be allocated co-mentors who you will
work with so that you have a whole picture of the department. There are many skilled nurses working
within the department who can pass on their knowledge and expertise to you.
Shift Times/Off Duty
The department operates on a number of shift patterns. It is preferable that you work the same shifts
as your mentor ( at least 50% of the time), however there is flexibility if required. We tend to work
one long day a week (7.30am-8.30pm) and three altering shifts. These are 0900-1700 and 08001730.Shifts may vary to suit the needs of the Department on any given day.
Uniform
As every person in the theatre needs to conform to infection control regulations, you will also wear
the theatre greens with a pair of clogs and a hat, these are all supplied by the department. You will
change in the theatre suite, and there is no need to wear your student nurse uniform to placement.
Identification
At all times you are expected to wear your university identity badge, and the theatre environment is
no exception to this rule.
February 2010
PROFILE OF LEARNING OPPORTUNITIES FOR
PAEDIATRIC THEATRES
KEY ELEMENT:
INTERPERSONAL SKILLS
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Use of Telephone:
Answering calls
Making calls
Ring back, etc.
Bleep & Telephone systems
Use of the Computer:
Tray tracking system
Patient investigation results
Patient information
Internet & Trust intranet
E-mail
Talking to:
Patients
Relatives
Multi-disciplinary team members
Colleagues
Ancillary staff
Multi-disciplinary meetings & Medical ward
rounds
Facilitating investigations
Nursing handovers
Nursing staff/Medical staff/Health care
assistants/Orderlies
Nursing staff/Medical staff/Health care
assistants
Theatre & Ward sisters/Registered nurse/
Health care assistant/Medical staff/Multidisciplinary team/Specialist nurses/Research
sisters/Orderlies
Domestics/Porters
Medical staff/Registered nurse/
Physiotherapist/Infection control team/
Pharmacist
Registered nurse/Medical staff
Registered nurse
Managerial structure within the Trust
Registered nure/Theatre & Ward sisters/
Clinical nurse manager/Speciality manager/
Modern matron
Team working
Observation of roles with the team – all team
members
Patient transfer within the Trust
Patient transfer outside the Trust
Patient/Relative/Bed co-ordinator/Ward staff
Bed co-ordinator/Ward staff/Ambulance crew
KEY ELEMENT:
CLINICAL SKILLS
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Patient hygiene:
Skin care
Pressure care
Registered nurse/Health care assistant
Recording of physiological
observations:
Blood pressure, Central venous pressure,
Temperature, Pulse, Respirations, Oxygen
saturations, Weight, Blood glucose, Fluid
balance
Maintaining accurate documentation
Registered nurse/Anaesthetic & Recovery
staff/Ward nurses/Medical staff
Administering medication:
Oral
Intramuscular
Intravenously
Rectal
Subcutaneously
Intravenous infusions
Care of cannulas & Central lines
Venepuncture & Cannulation
NG/NJ
Phlebotomy
Administratin of blood & blood products
Registered nurse/Anaesthetic & Recovery
staff/Ward nurses/Medical staff/Infection
control team/Transfusion nurse/ Nutritional
nurse/Dietician/Trust policies/Intranet/
Literature/Internet
Aseptic Technique/Universal
Precautions
Theatre nurses/Anaesthetic & Recovery staff/
Health care assistants
Nutritional intake
Ward nurse/Nutritional nurse/Dietician
Risk assessment:
Falls
Health & Safety
COSHH
Moving & Handling – use of patslide
Infection Control:
Handling blood-borne infection in the perioperative environment
Hand hygiene policy
Theatre wear policy
Infection control policy – trust intranet
Registered nurse/Theatre, Anaesthetic, &
Recovery staff/Infection control team & Link
nurse/Moving & Handling link nurse/Health
care assistants/Orderlies
Theatre nurse/Medical staff/Infection control
team/Trusts policies – Intranet
Theatre nurse/Medical staff/Health care
assistants/Theatre sisters/Trusts policies Intranet
KEY ELEMENT:
CLINICAL SKILLS CONTINUED
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Catheter Insertion & Care:
Procedure for inserting catheter
Urinalysis
CSU MSU collecting
Registered nurse/Medical staff
Registered nurse
Registered nurse/Health care assistant
Faecal occult blood testing
Registered nurse/Medical staff
Arterial pressure monitoring:
Patient safety
Checking/setting up equipment
Insertion & removal
Arterial blood removal
Scrubbing up Procedure:
Handwashing
Gowning up
Gloving up
Disinfection Policy:
Registered nurse/Medical staff/Haematologist
Theatre sisters/Registered nurse/Medical
staff/Intranet/Trust policies/Literature/
Internet – NATN website
Cleaning endoscopes
Setting up medivator
Theatre sisters/Theatre nurses/Health care
assistants
Risk assessment
Theatre sisters/Theatre nurses/Medical staff/
Risk assessment officers
Health & Safety
Theatre sisters/Theatre nurses/Medical staff/
Health care assistants/ Health & Safety
officers
Preparation for investigations:
Consent
Information
Invasive radiology
Non-Invasive radiology
[1]
Registered nurse/Medical staff/Trust
policies/ Intranet/Literature
Radiologist/Radiology nurse/Trust policies/
Intranet/Literature
KEY ELEMENT:
MANAGEMENT OF CARE
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Use of Nursing Model
Philosophy of Care
Documentation used
Registered nurse/Theatre sister
Registered nurse/Theatre sister
Registered nurse/Theatre sister/Health care
assistant
Nursing Process:
Assessment –
Who assesses?
How is assessment carried out/open or
closed questions?
What is assessed?
Where does assessment take place?
Registered nurse
Sources of information Patient/Relatives/Notes/District nurse/
Transferring nurse
nurse/Pharmacist/Specialist nurse
Ward/Theatre communication concerning
assessment issues
Ward/Theatre personel
Planning –
Care Plans
Risk assessment tools
Care pathways
Multi-disciplinary planning
Discharge planning
Registered nurse
Link nurse
Registered nurse/Specialist nurse/Medical
staff
Multi-disciplinary team
Registered nurse/Medical staff/Patient/
Relatives
Referrals to other agencies –
Specialist nurses (child protection, laser nurse
specialist, etc)
Implementation/Evaluation –
Multi-disciplinary team
Documentation
Standards
Protocols
Policies
Communication with patients &
relatives
Registered nurse/Medical staff
Registered nurse/Medical staff/Health care
assistant/Orderlies/Physiotherapist/Infection
control team/Dietician/Radiologists
Registered nurse/Medical staff
Registered nurse
Registered nurse/Theatre sister/Trust
Intranet/Medical staff
Registered nurse/Medical staff/Trust Intranet
– Royal Marsden handbook
KEY ELEMENT:
MANAGEMENT OF CARE CONTINUED
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Time Management
Registered nurse
Planning priorities
Registered nurse/Medical staff
Dealing with difficult situations
Registered nurse/Theatre sister
Deceased patients
Patient property/valuables
Refusal of operation
Religious needs –
Arranging priest, communication, etc
Registered nurse/Theatre sister/Bereavement
officer/Chaplain/Priest
Registered nurse/Health care assistant
Registered nurse/Medical staff/Ward
manager/Theatre sister/Specialisty manager
Registered nurse/Medical staff/Hospital
chaplian/Priest/Interperator
KEY ELEMENT:
ORGANISATIONAL AND MANAGERIAL ISSUES
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL
DEPARTMENT
Managing a Team:
Organisational skills
Delegation skills
Prioritising skills
Time Management
Leadership
Off-Duty
Managing patient work load
Quality
Standards of care
Registered nurse/Theatre sister
Registered nurse/Theatre sister
Registered nurse/Theatre sister/Medical staff
All Theatre staff
Senior nurses/Theatre sister
Senior nurses/Theatre sister
Registered nurse
Registered nurse/Theatre sister/Audit tool
Registered nurse/Theatre sister
Implementing change
Registered nurse/Theatre sister/Medical staff
Giving information to –
Staff
Theatre sister/Speciality manager/Modern
matron/Registered nurse
Medical staff
Theatre sister/Speciality manager/Registered
nurse/Multi-disciplinary team/Theatre staff/
Ward staff
Patients & Relatives
Registered nurse/Theatre sister/Medical staff/
Anaesthetics & Recovery staff/Health care
assistant
Multi-disciplinary team members
Registered nurse/Medical staff/Theatre sister
Other departments
Radiologist/Histopathology/etc
Resources:
Stock control
Drugs
Materials management
Non-stock
Stationary
Establishment/Skill-mix
Budget control
Managing risk:
Policies & Procedures – Safeguards for
Invasive procedures
Senior nurses/Theatre sisters
Registered nurse/Pharmacist
Senior nurses/Theatre sisters
Registered nurse/Health care assistant
Registered nurse/Theatre sisters
Senior nurses/Theatre sisters
Theatre sisters/Speciality manager/Senior
nurses
Theatre sisters/Senior nurses/Medical
staff/Trust Intranet
KEY ELEMENT:
ORGANISATIONAL & MANAGERIAL ISSUES CONTINUED
RESOURCE/
LAERNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
Managing risk continued:
Equipment safety checks – Bi-polar &
diathermy machines, etc
Health & Safety officer/Electronics/Registered
nurse/Health care assistant
Quality control
Theatre sister/Registered nurse
Infection control
Theatre sister/Registered nurse/Infection
control team & link nurse/Health care
assistant
Moving & Handling
Moving & Handling link nurse/Health & Safety
advisor/Registered nurse
Emergency situations:
Cardiac arrest
Cardiac arrest team/Registered nurse/Medical
staff/Anaesthetist & anaesthetic nurse
Fast bleep system
Registered nurse/Switchboard
Violen incidents
Registered nurse/Medical staff/Theatre sister/
Security officer
Fire
Theatre sister/Registered nurse/Fire officer
Patient falls
Registered nurse/Health & Safety officer
Staff Development:
Clinical supervision
Registered nurse/Theatre sister
Reflective practise
Registered nurse/Theatre sister
Preceptorship/mentorship
Registered nurse/Theatre sister
KEY ELEMENT:
PATHOPHYSIOLOGICAL PROCESSES
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
INFECTION:
Inflammatory process:
Source
Cross infection
Treatment
IMMUNOLOGICAL FACTORS:
Antigens
Suppression of immune system
Drugs
Rejections
SCIDS
Medical staff/Registered nurse/Literature/
Internet/Trust Intranet/Infection control
team/Pharmacist
Medical staff/Registered nurse/Pharmacist/
Literature/Internet/Transplant team/
Immunologists
DISTURBANCES IN ELECTRLYTE
BALANCE:
Normal electrolyte balance
Analysing blood results
Dehydration
Acidosis
Medical staff/Registered nurse/Laboratory
staff
ONCOLOGY:
Aetiology
Pathology
Treatments, Chemotherapy, Intratechal
medications, Bone marrow aspirates &
harvests, Bone marrow transplants, Insertion
of CVC Lines & Portacaths
CARDIOVASCULAR SYSTEM:
Anatomy & physiology
Investigations
Treatment regimes
Cardiac arrest
Defibrillation
Cardiac arrhythmia’s
ECG’s
Medical staff/Registered nurse/Palliative care
team (Ward 16 multi-disciplinary team)/
Radiologists/Haematologists/Pharmacist
Medical staff/Registered nurse/Anaesthetic
staff/Cardiac arrest team/Cardiology team/
Pharmacist
KEY ELEMENT:
PATHOPHYSIOLOGICAL PROCESSES CONTINUED
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
RESPIRATORY SYSTEM:
Anatomy & physiology
Investigations
Infections
Oxygen therapy
Continuous Positive Airway Pressure (CPAP)
Treatments
Drugs, Nebuliser therapy
Analysis of blood gas monitoring
Collection of B.A.L specimens
Tracheostomy – permanent & temporary
Tracheoscopy, Laryngoscopy, & Brochoscopy
Laser treatment
Medical staff/Anaesthetist/Anaesthetic nurse/
Registered nurse/Medical physics officer/
Physiotherapist/Respiratory consultant/
Pharmacist
LIVER & BILIARY SYSTEM:
Anatomy & physiology
Hepatitis B
Paracetamol overdose
Liver tumours & biosies of these tumours
Symptoms of liver disease – jaundice,
ascites, encephlopathy
Medical staff/Registered nurse/Hepat-biliary
nurse specialist/Literature/Palliative care
team
Nutrition
Treatments
Dietician/Registered nurse/Medical staff
Medical staff/Registered nurse/Pharmacist
BLOOD DISORDERS:
Blood formation & destruction process
Red blood cells
White blood cells
Platelets
Clotting factors
Lymphoma
Oesophageal Variceal haemorrhage &
banding
Endoscopy procedures
Blood transfusion
DVT
Medical staff/Registered
nurse/Haematologist/Heamatology
nurse/Literature/Gastroenterologists/
Endoscopy unit/Transfusion nurse/ Trust
intranet – policies & procedures
KEY ELEMENT:
PATHOPHYSIOLOGICAL PROCESSES CONTINUED
RESOURCE/
LEARNING OPPORTUNITIES RELEVANT PERSONEL/
DEPARTMENT
ENDOCRINE & METABOLIC
DISEASE:
Diabetes mellitus
Long term use of steroids & administration of
high dose steroids
NERVOUS SYSTEM:
Encephlopathy
Infections
Drugs
Medical staff/Registered nurse/Diabetic nurse
specialist/Diabetologist/Pharmacist/Literature
Trust Intranet – policies
Medical staff/Registered
nurse/Microbiologist/Pharmacist/Literature/
Trust Intranet – policies
SKELETAL SYSTEM:
Craniofacial Procedures – Cleft palates
Treatments
Drugs
Plating/Wiring/Fixations
Removal of accessory digits
Medical staff/Registered nurse/Cleft palate
team/Radiology/Pharmacist/Ward staff/
Anaesthetist
BURNS:
Classification of Burns
Causes of burns
Treatment & Dressings
Drugs & Therapies
Skin grafts
Fluid resucitation
Medical staff/Registered nurse/Ward staff/
Pharmacist
Specialist
Nurse
Matro
n
Orderlies
Consultants and
Medical Staff
Ward 1
Ward 6
BMT 23
Social
Services
PICU
NGH
24 + 26
Radiographers
Oncology
Gastroenterology
UNN
ENT
Airways
Ward 8
Orthopaedics
FINANCE
Community
CHILDREN’S
THEATRES RVI
Burns and
Plastics
Out
Patients
Intensive
Care
Neo
Natology
General
Surgery
Ward 9
Ward11
STERILE
SERVICES
Cardio
FRH
Technical Services
ie. Medical Physics,
Electronics, Anaesthetic
Technician
Ward
14&16
Ward
35
SENIOR THEATRE NURSE
Ward 9
DIRECTORATE
MANAGER