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Ward 16
Student
Orientation
Package
Ward 16
Elective Orthopaedic & Minor Trauma Admissions
Ninewells Hospital, Dundee
Ward 16 is the admitting ward for patients who have undergoing elective
orthopaedic and minor semi-elective trauma admissions. We also on
occasion directly admit minor trauma to the ward.
We care for patients of mixed gender and wide age ranges, in a 16
bedded acute nursing setting.
During your clinical placement here you will have the opportunity to learn
many new skills and consolidate previous learning experiences, linking
learning to practice. Designated experienced staff nurses will act as your
mentors throughout this learning period.
Your education is of paramount importance – please request to attend
focus
visits
listed
in
the
programme
and
any
other
tutorial/lecture/training sessions that are scheduled for the
Orthopaedic unit.
The staff here hope you enjoy this clinical placement and that you gain
advantage of the knowledge, experiences and skills that are available for
you.
Marie Thomas
Senior Charge Nurse
ORIENTATION
1. Introduction to members of staff and Mentor / Associate Mentor.
2.Tour of the practice setting.
3.Receipt of teaching package, handout on Orthopaedic
Terminology and abbreviations.
4.Introduction to ward routine.
5.Discuss the role of the multi-disciplinary team.
6.Location of Policies, protocols and textbooks.
7.NMC Documents held in the clinical area: NMC Code of Conduct
Code of Conduct for Students
Scope of Professional Practice
Confidentiality
Standard for the safe Administration of Drugs
Standard for Records and Record Keeping
Exercising Accountability
Advertising
Signature of Student
Signature of Mentor
Signature of Associate
Mentor
Date
AIMS
1.
Our aim is to integrate the theory you have obtained in the
School of Nursing and Midwifery by providing instruction within
an Orthopaedic environment.
2.
You will have your educational experience planned with your
Mentor / Associate Mentor, within the first week.
3.
You will meet with your Mentor / Associate Mentor for a planned
mid placement evaluation.
4.
You should identify what your educational needs are and we will
endeavour to provide the learning opportunity for you.
Mentor/ASSOCIATE Mentor
During your placement on the ward you will be allocated a Mentor and
Associate.
You and your Mentor /Associate Mentor should discuss the objectives
you require to achieve whilst allocated to the ward.
The roles of your Mentor /Associate Mentor are to act as an educator,
assessor, counsellor and confidante to you.
Their responsibilities in partnership with you are,
1.
To assist you in achieving identified learning outcomes.
2.
To provide on going feedback to you on your progress.
3.
To assess your performance.
4.
To facilitate you in acquiring knowledge and skills in order to
Deliver optimal patient care.
5.
To demonstrate integration of theory and practice.
6.
To maximise learning opportunities which will assist you to
Develop competencies.
7.
To provide individual support and guidance to you.
8.
To create a supportive learning climate by maintaining
Effective interpersonal relationships.
ORTHOPAEDIC VOCABULARY
[Look these up in any good Orthopaedic book or medical dictionary]
ABDUCTION
IMMOBILISATION
SCLEROSIS
ADDUCTION
IMPLANTS
SCOLIOSIS
AMPUTATION
INERT
SEQUESTRUM
ARTHRODESIS
INTERTROCHANTERIC
SPASTICITY
ARTHROPLASTY
INTRAMEDULLARY
SPONDYLOSIS
ACHONDROPLASIA
INTRATHECAL
SPONDYLITIS
ANKYLOSIS
ISCHAEMIA
STABILITY
APPROXIMATE
IDIOPATHIC
STRESS
ARTHRITIS
INVERSION
SUBLUXATION
ARTHROTOMY
ATAXIA
SUPINATION
KYPHOSIS
SPASTICPARALYSIS0TALIPES
APPARENT SHORTENING
ARTHROGRAM
BURSA
TRAUMA
MYELITIS
TRUE SHORTENING
MEDIAN LINE
TOMOGRAM
METAPHYSIS
COXA
MOBILISATION
CAVUS
MEDIAL ROTATION
UNILATERAL
CHONDROMALACIA
MONO-ARTICULAR
VALGUS
CREPITUS
MUSCLE IMBALANCE
VARUS
CUBITUS
CIRCUMDUCTION
NECROSIS
CALLUS
NEUROMA
DYSPLASIA
OSSEUS TISSUE
DYSTROPHY
OSTEOCHONDRITIS
DIPLEGIA
OSTEOMYELITIS
DISCOGRAPH
OSTEOPOROSIS
OSTEOTOMY
EQUINUS
OSTEOPHYTE
EROSION
OPTIMUM POSITION
EXOSTOSIS
EVERSION
PES
PNEUMATIC BONES
PRONATION
PROSTHESIS
POLY - ARTICULAR
FIBROUS UNION
PSEUDO – ARTHROTHIS
FRACTURE
OR
GAIT
PSEUDARTHROSIS
SURGICAL PROCEDURES AND FIXATION OF JOINTS
Abduction
To pull a way from the median line of the body.
Acetabulum
Cup like socket which head of femur sits in.
Active Flexion
Bending a joint by oneself, e.g. knee.
Apparent Shortening
Abnormal position of limb (adduction) makes limb appear short.
Arthritis
Inflammation of joint.
Arthrogram
X-ray of joint space using radio-opaque dye.
Arthrodesis
Fusion of a joint by surgery.
Arthroplast
Formation of a new joint by surgery. Artificial.
Arthroscopy
Examination of joints via fibre optic scope.
Avulsion
Forcible separation of two joints.
Back Slab
Half bandage half plaster of Paris.
Bennett’s Fracture
Fracture of proximal end of thumb, metacarpal.
Camp Splint
Removable splint used to give leg support to prevent bending of the knee.
Charnley Wedge
Triangular shaped piece of foam used for total hip replacement to
keep legs abducted. Placed between the knees to prevent dislocation.
Colles’ Fracture
Fracture to lower radius.
Callus
Formation of new bone.
Dislocation
Dislocation of Articular surface of a joint. Movement of part of joint out of
usual position. E.g. Head of Femur from Acetabulum.
Exostosis
Benign bone outgrowth.
External Rotaton
Limb is turned outwards. (Can be a sign of dislocation).
Fasciotomy
To relieve tension or pressure of the fascia.
Treatment for Compartment Syndrome.
Gait
Manner of posture and walking.
Haemarthrosis
Bleeding into a joint.
Internal Rotation
Limb is turned inwards. (Can be a sign of dislocation).
Log Roll
Position used whilst in bed. Patient is rolled on to un-operated side, 2-3
nurses required to roll patient in a straight line, mainly used when patient
has had a total hip replacement to prevent dislocation with legs in abduction.
Or when spinal injury suspected or confirmed.
Neuroma
Benign tumour involving a nerve.
Osteochondritis
Inflammation of bone and cartilage.
Osteoporosis
Form of brittle bones.
Osteomalacia
Soft bones.
Osteotomy
Division of bones by surgery.
Passive Flexion
Someone/something bending a joint e.g. knee
Pendular Exercises
To move limb in a pendular motion, like a pendulum in a clock
Poly Sling
Foam sling commonly used for people following shoulder
injuries.
Potts Fracture
Fracture of lower ends tibia and fibula.
Prosthesis
Artificial part used as replacement i.e. hip joints.
Pseudo - Arthrosis
False joint e.g. girdlestone.
Straight Leg Raise
To be able to lift leg off a bed without assistance.
Subluxation
Displacement within a joint of the Articular surfaces but not
dislocation.
True Shortening
Bone short
COMMONLY USED ABBREVIATIONS
DHS
Dynamic Hip Screw
EOSD
Early Orthopaedic
Supported Discharge
CPT
Collarless, Polished and Tapered
SLR
Straight Leg Raise
ABP
Angle Blade Plate
ACL
Anterior Cruciate Ligament
CSM
Circulation, Sensation and Movement
BAS
Broad arm sling
CPM
Continuous Passive Movement
RA
Rheumatoid Arthritis
FWB
Full Weight Bearing
OA
Osteo Arthritis
PWB
Partial Weight Bearing
#
Fracture
TWB
Touch Weight Bearing
L or R
Left or right
IM Nail
Intra – Medullary Nail
K – Wire
Kirschner Wire
TBW
Tension Band Wiring
THR Total Hip Replacement
TKR
Total Knee Replacement
DCS
Dynamic Cannulated Screws
Tendon Achilles
NOF
Neck of Femur
ORIF
Open Reduction Internal Fixation
POP
Plaster of Paris
M.U.A.
Manipulation Under Anaesthetic
E.U.A.
Examination Under
Anaesthetic
R.O.S
Removal of Stitches
OTHER TERMS USED IN WARD REPORTING
PMH
Past Medical History
CVA
Cerebral Vascular Accident
Stage 1/Stage 2 Diabetes
COAPD
T.A.
Chronic Obstructive Airways Disease
IDENTIFIED LEARNING OPPORTUNITIES
The following list is of possible learning opportunities for you during
your placement.
The list is not prescriptive and you do not have to participate in all the
activities identified, the list is not all encompassing.
There may be other opportunities for learning available that are not identified
in this list.
1.
Admission procedure of the patient.
Discuss and familiarise with Nursing Documentation
2.
Discharge of patients.
3.
Attend and participate in ward patient report sessions.
4.
Observe the role of the Physiotherapist in the care of the Orthopaedic
patient.
5.
Observe the role of the Occupational Therapist in the care of the
Orthopaedic patient (? Attend a home visit).
6.
Preparation of patient for theatre.
7.
Post-operative care of patient following surgery: *
Orthopaedic Surgery
Total Knee and Hip Replacements, Primary and 2nd Stage
*
Intermediate Surgery
Anterior Cruciate Ligament Reconstruction
Removal of Metal Work
O.R.I.F Ankle/Wrist #
*
Minor Orthopaedic Surgery
Release of Dupytrens
Arthroscopy of knee
Carpal Tunnel Decompression
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OBSERVE AND PARTICIPATE IN PATIENT CARE WHERE
APPROPRIATE
1.
Maintain a safe environment for the patient.
2.
Assist where appropriate with patient hygiene: * Bathing - Shower / bed bath / assisted wash
* Oral hygiene-care of dentures
* Eye care
* Hair care, nails etc.
3.
Monitoring temperature, pulse respiration and blood pressure:* With manual and electronic monitoring equipment
4.
Maintaining patients comfort:* Bed making
* Pain Control
* Positioning pillows etc.
5.
Assisting where appropriate with elimination needs: * Toileting
* Catheterisation
* Administration of prescribed aperients
6.
Control of Infection: * Cross Infection
* Wound care
* Aseptic technique
* Specimen collection
7.
Monitoring fluid intake and output: * Administering and recording oral fluids
* Care of patient undergoing an intravenous infusion /transfusion
* Care of patient with urinary catheter
* Care of patient with wound drain
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8.
Monitoring patient’s nutritional status: - MUST, Protected Meal times
9.
Mobilising patients
* Non-weight bearing
* Weight bearing
* Bedfast patients
* Using aids i.e. Zimmer frame, crutches etc.
10. Ensuring adequate rest and sleep.
11. Care of patient undergoing oxygen therapy: * Via venti-mask
* Nasal prong
12. Supervised administration of medications
* Oral medicines
* Inhaled medicines
* Subcutaneous injections
* Intra-muscular injections
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EMERGENCY PROCEDURES
For Fire or Cardiac Arrest
Phone EMERGENCY NUMBER 2222, state ward number and if Cardiac Arrest
or Fire.
E.g. “Cardiac Arrest Ward 17” or “Fire (area) Ward 17”.
Page System
i.e.
to
1. Dial 88 and wait for response.
2. Dial required page number, wait for response.
3. Dial your extension number followed by # sign, wait for
response
4. Replace receiver and wait for reply.
To call page holder 3010 from phone extension 33816,
Dial 88, then 3010, then 33816#, hang up and wait for 3010 to call back
33816.
It is vital you are aware of the location of the following
Date Student sig. Preceptor sig.
Sign
Cardiac Arrest Trolley
Portable Oxygen/Suction
Emergency Box
Emergency Buzzers
Defibrillator
Fire Points
Fire Extinguishers
Nurse Call System
All of the above must be shown to the student on the first day in the ward
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EVALUATION QUESTIONNAIRE
We are interested in obtaining your views on Ward 16 as a learning
environment.
Please complete the following questionnaire before you leave the placement by
placing a (X) in the column that most accurately reflects your views.
Columns vary from 5 = Strongly Agree to 1 = Strongly Disagree
STATEMENTS

5
You received an introduction/orientation
Package on arrival to the ward, was this of
benefit?
2. You were allocated an Associate
Preceptor During this placement.
3. Your Preceptor and you discussed and
identified learning objectives and
opportunities at initial meeting.
4. You were given the opportunity
identify
your own specific personal learning
objectives.
5. You worked with your Preceptor/
Associate more than two shifts per
week during placement.
6. You had a planned midway placement
Evaluation with your Preceptor.
6. You achieved your set objectives by
the end of this placement.
8. You found this ward placement an
environment conducive to learning.
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4
3
2
1
Ward 16
Ninewells Hospital
We recognise our patient’s needs to be cared for in an approachable, professional and courteous manner.
We believe that privacy for our patients is of paramount importance and give great consideration to all communications regarding values,
beliefs and customs.
We appreciate the need to maintain a safe environment for our patients, staff and visiting members of the public.
We realise research is important for the promotion and transference of safe clinical nursing practice with which we aim to continue.
We endeavour to remain adaptable to change and to enjoy new challenges
We understand and appreciate that education and development of our clinical practice is essential in remaining progressive.
We endeavour to maintain a harmonious relationship with our professionals within the multi-disciplinary team.
Our aim is to continually improve the quality of care delivered and provide a service of excellence for the patients of Tayside
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