Download The Newcastle upon Tyne Hospitals NHS Foundation Trust

The Newcastle upon Tyne Hospitals NHS Foundation Trust
Day Treatment Centre
Freeman Hospital
Information For Students
Welcome to the Day Treatment Centre. We hope your placement will be enjoyable as well as
educational.
This booklet has been designed as a brief guide to the ward. It lists some of the more common
operations/procedures patients undergo whilst on this ward. If you can, find out what these
involve before you start to gain maximum benefit from your placement. A Learning Zone and
Profile of Learning Opportunities are included.
As an adult learner you are expected to take responsibility for identifying your own learning
needs. You can do this by identifying outstanding competencies in your Profile, by looking at the
learning opportunities available to you during this allocation, and by talking to your mentor.
The ward staff will be more than willing to help, so take advantage of these opportunities, and
use this handout as a checklist to gain the most from this allocation.
If you wish to have a pre-placement visit, telephone 0191 2137004 and we will arrange it for
you.
YOUR MENTOR
On arrival to the ward you will be introduced to your mentor who will be responsible for you
during your allocation. Your mentor will show you around the ward and ensure your induction
checklist is completed. Many of our staff work part-time, so you may also have an associate
mentor. It may not always be possible to work with your mentor, but this will give you the
opportunity to experience different approaches to care.
If you have any problems during your placement you should discuss them with your mentor as
soon as possible. If you don’t want to discuss them with your mentor, you should speak to the
Sisters or Education Link Nurse. It’s normally easier to solve a problem straight away than at
the end of your allocation.
WARD DESCRIPTION
The Day Treatment Centre is situated on Level 3 of Freeman Hospital.
This is a mainly surgical ward catering for adult male and female patients having minor surgery
as day cases, as well as those having more extensive surgery who are admitted to this ward and
prepared for theatre, and are then transferred to the operating theatre and onwards to an
inpatient ward for their extended recovery. We also provide treatment and perform
investigations for non-surgical day case patients from a range of specialities.
Added to Practice Placements Website Oct 12
Surgery : The ward provides facilities for patients having surgical procedures performed under
general or local anaesthetic. Surgical specialities and some of their common operations are
listed below.
 General surgery - Varicose vein surgery, hernia repair
 ENT - Insertion of grommets, laryngoscopy, biopsy of lesions
 Orthopaedic - Hip/knee replacement, knee arthroscopy
 Vascular - Bypass grafts, endarterectomy
 Renal - Formation of brachial fistula, removal of Tenchoff catheter
 Urology - Embolisation
 Gynaecology Oncology - Brachytherapy
 HPB - Cholecystectomy
 Colorectal - Colostomy and ileostomy formation
Investigations : The following is a list of the common investigations performed on the ward,
which can involve the use of local anaesthetic or sedation.
 Cystoscopy
 Liver biopsy
 Angiogram/angioplasty
 Magnetic Resonance Imaging (MRI) scans
 Computed Tomography (CT) portograms
 Specialist blood tests
Treatments : we also care for patients with chronic conditions, providing treatments such as :
 Blood transfusions
 Drug infusions
 Venesection
 Paracentesis
 Pain management
The nurses on the ward provide holistic care for their patients, from completing the admission
procedure, providing pre- and post-operative care, administering drugs, and organising the
patient’s transfer or discharge from hospital.
ORGANISATION OF THE WARD
Kath Tyrrell is the ward sister who co-ordinates and takes charge of the ward.
Sarah Caise is a Band 6 sister who takes charge when Kath Tyrrell is away.
Mary Doona is the ward’s Educational Link Nurse.
The ward is divided into four bays each containing eight trolleys/chairs, 4 cubicles containing a
bed, and 4 cubicles containing 2 chairs each. You and your mentor will be allocated a bay or
cubicles and will care for the patients in that area. You will rotate around the different areas
during your allocation.
Added to Practice Placements Website Oct 12
SHIFT PATTERNS
The ward is open 0700 – 1900 Monday to Friday. You will work three 9 hour shifts and one 8
hour shift each week between the hours of 0700 and 1830. You will have every weekend off and
one day off during the week.
You are allowed a 20 minute morning break and a 40 minute lunch break. You may bring your
own food or buy it from the shop/restaurant and eat in the staff room or away from the ward.
Off duty is written in advance, and you will be given shifts with your mentor as much as possible
to ensure you have continuity of supervision and to comply with the requirement that you work
at least 50% of your time with your mentor. You may make requests in the request diary.
LEARNING OPPORTUNITIES
There are many learning opportunities available on the ward, so try to experience as many as
possible, including :
 Aseptic technique
 Catheterisation
 Stoma care
 Pain management
 Infection control
 Transfer of patients to and from departments and wards
 Drug administration
 Nursing handovers
 Nursing documentation
 Patient education
 Admission and discharge of patients
 Care of patients having a blood transfusion
 Managing your workload
 Liasing with community care providers
 Liasing with the Ambulance Service
We can access specialist nurses who can provide expert advice in their areas, including :
 Colorectal nurse specialist
 Nutritional nurse specialist
 Tissue Viability nurse specialist
 Orthopaedic nurse specialist
 Hepatobilary nurse specialist
We can also arrange for students to see members of the multi-disciplinary team at work, such as
physiotherapists. If appropriate, students may also be able to visit other departments such as Xray, operating theatres, and ECG to enable you to achieve your clinical competencies and work
in a multi-disciplinary team environment.
Students are allowed to use the ward computer to access selected information. There is also a
library in the hospital.
Added to Practice Placements Website Oct 12
CONCLUSION
We hope you enjoy this allocation and find it helpful in developing your skills as a student nurse.
It would be useful to tell us of things we do well, and also how we could improve the experience
for future students.
PHILOSOPHY OF CARE FOR THE DAY TREATMENT CENTRE
AIM – To provide nursing care to the highest standard, taking into consideration the patient’s
physical and psychological needs, within the time permitted for a day case or DOSA admission.
To provide a friendly but efficient atmosphere where patients and their relatives feel at ease with
the staff.
The ward philosophy is to ensure that each individual has the right to confidentiality, privacy,
and dignity at all times.
We believe that you have a right to a named nurse who will be responsible for your care during
your stay on this ward.
We aim to provide the correct treatment, help, and advice for your individual needs.
We believe in providing a safe and relaxed environment in order to help reduce your fears and
anxieties.
Our philosophy of care aims to keep you informed of your treatment, as well as the relevant
health professionals involved with your care.
We aim to deal promptly with any complaint or comment you may have on any aspect of your
short stay with us in the Day Treatment Centre
WE GREET A STRANGER BUT DISCHARGE A FRIEND – ALL IN ONE DAY
Added to Practice Placements Website Oct 12
STUDENT INDUCTION CHECKLIST
STUDENT NAME :
START DATE :
MENTOR :
ASSOCIATE MENTOR :
This checklist is a guide to assessors to aid the integration of student nurses into the working
environment. It is good practice to have the document completed within the first week of the
placement.
ORIENTATION TO PLACEMENT
Shown around the workplace
Introduced to staff members
Access to changing, toilet, restaurant and library facilities
Explanation of shift times, including break times
Shown the off duty and how to request days off
Explanation of telephone facilities and lines of
communication
What to do if sick
Check ID badge has been issued and being worn
Check student has valid IT passwords and arrange if
necessary
Discuss uniform policy
Discuss the importance of confidentiality and IT security
Explanation of patient call and emergency buzzer system
Obtain emergency contact and GF details for student
(these need to be destroyed at end of placement)
POLICIES AND PROCEDURES
Be made aware of how to access all policies and
procedures ie 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
EMERGENCY / CARDIAC ARREST PROCEDURE
Identify the location of resuscitation equipment
Describe method of summoning relevant arrest team
Added to Practice Placements Website Oct 12
SIGNATURE
OF MENTOR
DATE
FIRE
Identify location and how to use extinguishers and alarms
Describe action to be taken on hearing fire alarm meeting point / evacuation process etc
Inform student of time of regular fire alarm testing
Date of last fire update :
HEALTH AND SAFETY
Disposal of waste – Student can identify the correct
procedure for disposal of : linen
clinical waste
non-clinical waste
infectious waste
body fluids
sharps
confidential waste
Manual Handling –Student should be made aware of
equipment used and its decontamination
electric beds
patient trolleys
Liko hoist and sling
slide sheets
wheelchairs
Patslide
Infection Control – 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 the bed pan disposal unit
Food Hygiene – Student should be able to demonstrate
knowledge in the safe handling and storage of food and
refrigerator care.
PLACEMENT SPECIFIC
Routine for opening and closing the ward each day
Use of the toaster
How to use the dishwasher
Setting up patient trays
Ordering and collecting meals from the kitchen
Requesting and collecting patient prescriptions from
Pharmacy
Added to Practice Placements Website Oct 12
SIGNATURE
OF MENTOR
DATE
KEY ELEMENT : INTERPERSONAL SKILLS
LEARNING OPPORTUNITIES
Use of the telephone
 answering calls
 making calls
 ring back etc
RESOURCE / RELEVANT
PERSONNEL / DEPARTMENT
ward clerk /RN /HCA
Use of the computer to get
 patient investigation results
 patient information
 Internet access
 E-mail access
ward clerk / RN / HCA / IT staff
Talking to
 patients
 relatives/carers
 doctors
 other nurses including specialist
nurses
RN / HCA / ward clerk / doctor / multidisclinary team
Multi disciplinary team referrals
RN / physio / dietician / specialist nurses
Ancillary staff
Domestics / porters
Booking transport
RN / HCA / ward clerk / ambulance
control
Facilitating investigations
Doctors/ RN / ward clerk
Nurses handovers
RN / HCA / ambulance staff / doctors /
multi-disclinary team members
Managerial structure in Trust
Service/assistant managers/ sisters
Team working
Observation of roles
Patient transfer
Patient / relative / RN / /bed manager /
ambulance crew / staff at destination
Added to Practice Placements Website Oct 12
KEY ELEMENT : CLINICAL SKILLS
LEARNING OPPORTUNITIES
RESOURCE/ RELEVANT
PERSONNEL/ DEPARTMENT
Patient hygiene
 Mouth care
 Hair/nail care
 Skin care
RN / HCA
Pressure care prevention
RN / HCA/ Tissue Viability Nurse
Recording of physiological observations
 TPR and BP
 MEWS
 weight
 blood glucose
 fluid balance
 BM
RN / HCA / Diabetic Nurse
Maintaining accurate charts
RN / HCA
Giving medications
 Oral
 Intramuscular
 Subcutaneous
 Rectal
 Intravenous
 IV infusions
RN / Pharmacist / doctor
Cannulation / care of venflons
RN / HCA / doctor
Phlebotomy
RN / HCA / doctor
Medical devices
RN / HCA / loan library staff
Administration of blood and blood
products
RN / HCA / doctor
Aseptic techniques i.e. dressings
RN / doctor / Tissue Viability Nurse /
Infection Control Nurse
Nutritional intake
RN / HCA / Dietician / Nutrition Nurse
Added to Practice Placements Website Oct 12
Risk assessment
 FALLS
 MUST
 DVT
RN / HCA / Pre-assessment Nurse /
Relative
Moving and handling
 Use of aids
 Patient assessment
RN / HCA / Moving and Handling
facilitator / Moving and Handling team
Infection control
 Isolation of patients
 Use of PPE
 Cleaning of isolation room
RN / HCA / Infection Control Nurse /
domestics
Catheter insertion and care
RN / doctor / HCA / Continence Advisor
Test urine
RN / HCA / laboratory
Patient safety
Everyone / Practice Development Nurse
Checking equipment
RN / HCA / medical electronics / estates
Preparation for investigations
RN / HCA / doctor / anaesthetist / nurse
specialists
Consent
doctor
Information
RN / HCA / specialist nurse
Invasive / non-invasive radiology
RN / HCA / doctor / radiologist
Added to Practice Placements Website Oct 12
KEY ELEMENT : HEALTH DEVELOPMENT OPPORTUNITIES
LEARNING OPPORTUNITIES
Healthy life style strategies in relation to
 Smoking cessation
 Alcoholic Liver Disease

Bowel disorders






Diabetes
Drug and alcohol abuse
Cancer
Obesity
Eating for a healthy heart
Promotion of exercise
RESOURCE : RELEVANT
PERSONNEL / DEPARTMENT
Smoking cessation adviser / pharmacist
Drug and alcohol team / dietician /
gastroenterology consultant nurse
Colorectal nurse / pharmacist / dietician /
Nutrition nurse
Dietician / Diabetic nurse
Drug and alcohol team
Macmillan nurse / pain team
Dietician / Nutrition nurse / physio
CHD / Heart failure nurse / dietician
Physio
Health education and health promotion
literature
Health Promotion Unit
Models of health promotion / education
Patient wise data base
Internet
Specialist nurse clinics
Discussion with mentor
Counselling
Specialist nurses
Palliative care
Clinical Psychologist
Interface between hospital and
community care
HAZ
Health promotion unit
Specialist nurses
Added to Practice Placements Website Oct 12
KEY ELEMENT : MANAGEMENT OF CARE
LEARNING OPPORTUNITY
RESOURCE : RELEVANT
PERSONNEL / DEPARTMENT
Use of nursing model
RN / practice development nurse / specialist nurse
Philosophy of care
RN
Documentation used
RN / HCA / practice development nurse / ward
clerk
Nursing process
Assessment
 Who assesses
 What is assessed
 Where does it take place
 How is assessment carried out (open or
closed questions)
Pre-assessment nurse / RN / HCA
Sources of information – patient / relative / carer /
doctor / pharmacist / notes / GP / district nurse /
specialist nurse / ambulance personnel
Planning
 Care plans
 Risk assessment tools
 Care pathways
 Multi disciplinary plan / working
 Discharge planning
 Referrals to other agencies
 OT
 Physio
 Social worker
 District / Practice nurse
 Discharge liaison
 Specialist nurses
 ARAS team
 Macmillan nurse
 Hospice
 Relevant departments
RN / practice development nurse / MDT /
Link nurse / Specialist nurse / Discharge liaison
nurse / doctor / Macmillan nurse / ambulance
control
Implementation / Evaluation
 MDT
 Documentation
 Standards
 Protocols
 Policies
 Time management
 Communication with patient / relative
 Planning priorities
 Dealing with difficult situations
 Deceased patients
 Patient property / valuables
 Self discharge
 Religious needs of patient
RN / HCA / doctor / nursing manager / practice
development nurse / modern matron / patient
welfare officer / hospital chaplain / Royal
Marsden handbook / Intranet / ward policies
Added to Practice Placements Website Oct 12
KEY ELEMENT : ORGANISATIONAL AND MANAGERIAL ISSUES
LEARNING OPPORTUNITIES
RESOURSE : RELEVANT
PERSONNEL / DEPARTMENT
Managing a team
 Organisational skills
 Delegation skills
 Prioritising skills
 Time management
 Leadership
 Off duty
 Managing patient work load
 Quality
 Standards of care
 Implementing change
 Documentation
RN / nurse manager / doctor / all ward
staff / audit tools / specialist nurses /
practice development nurse
Giving information to
 Staff
 Doctors
 Patients
 Relatives
 Multi-disciplinary team members
 Other departments
Sister / nurse manager / RN / HCA /
doctor
Resources
 Stock control
 Drugs
 CSSD
 Materials management
 Non-stock items
 Stationary
 Establishment / skill mix
 Budget control
RN / Sister / pharmacist / reps /HCA /
stores department / ward clerk /
Added to Practice Placements Website Oct 12
Managing risk
 Policies and procedures
 Equipment safety checks
 Quality control
 Weekly environment checks
 Infection control
 Moving and handling
Sister / RN / HCA / Practice
Development nurse / Health & Safety
officer / medical electronics / Control of
infection sister / Moving and handling coordinator / domestic supervisor
Emergency situations
 Cardiac arrest
 Fast bleep system
 Violent incidents
 Fire
 Bed alerts
 Patient falls
RN / HCA / Cardiac arrest team / Fire
officer / security officer / switchboard /
bed co-ordinator / health and safety
officer
Staff developments
 Clinical supervision
 Reflective practice
RN / practice development nurse
Added to Practice Placements Website Oct 12
DTC LEARNING ZONE
Family/Carers
Support Groups
PALS
Ambulance Service
Wards
IT Dept
Interpreter services
Social Services
Specialist Nurses
Laboratory
Porters
District Hospitals
Out Patients Dept
Modern Matron
Xray Dept
Diabetic Team
Library
Operating Theatres
Infection Control
DAY
TREATMENT
CENTRE
Occupational therapist
SALT
Pharmacy
Social Worker
NCCC
Medical staff
Chaplaincy
G.Ps
Dietician
Pre-assessment Clinic
Physiotherapist
Pain Team
Northumbria University
Patient Services
Research Nurses
Domestic Staff
Equipment Library
Added to Practice Placements Website Oct 12
District Nurse
Hospice care