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STUDENT OCCUPATIONAL THERAPIST INDUCTION PACKAGE Welcome to Nottingham From the poet Lord Byron, to the designer Paul Smith, Nottinghamshire has always taken centre stage for creativity. After all, Nottingham is one of the UK’s most stylish cities. Set within a county of outstanding natural beauty that includes Sherwood Forest, lively market towns and wonderful historic buildings. It’s also home to the world’s best-loved outlaw, Robin Hood. City life… If you like designer boutiques, stylish dining and a vibrant nightlife – we have it all. We’re a top UK shopping destination, with a compact city centre crammed with retailers. Experience the region’s premier restaurants and bars. Enjoy groundbreaking theatre and world famous sporting and cultural events. Steeped in history and legend, Nottingham has something for everyone. The great outdoors… Picturesque countryside, acres of woodland and parkland, extensive gardens, market towns, stately homes, ancient castles and mansions. Our sporting facilities are second-to-none and include the nationally recognised Nottingham Racecourse, The National Watersports Centre, Nottingham Tennis Centre and National Ice Centre, as well as football at Forest & County or cricket at historic Trent Bridge. Places to visit: www.nottinghamcity.gov.uk www.thisisnottingham.co.uk www.visitnottingham.com Reviewed by Jane Harrison-Paul 12th September 2011 3 Student Induction Checklist - Completed by end of day 1 of the student placement: Name: _________________________ Placement Dates: ____________________________ PPE: ______________________________ Placement Coordinator: ______________ Induction by Practice Placement Coordinator Administration Date Initials Next of kin sheet Confidentiality form Previous placement details (CV) ID Badge/ car parking application Diary pages, notebook & pens Student seminar list Date/time of manual handling training * Campus map ICT set up information Useful telephone numbers/access codes including use of bleep/private telephone calls Student job description Placement evaluation forms Tutorial evaluation forms Student support meetings Policies and procedures electronic resource link Orientation and housekeeping Tour of the OT department Bank/shops/general tour of hospital Lockers & changing facilities Introduction to reception staff Location of signing in register Location of fire exits and extinguishers * (including fire procedure in OT dept) Pigeonholes General processes Notification of sickness Joining the medical library Receiving gifts * Use of Abbreviations Stationery Reviewed by Jane Harrison-Paul 12th September 2011 4 Student Induction Checklist - Completed by end of day 1 of the student placement: Induction by Practice Placement Educator Orientation to the team Date Initials Introduction to team members Orientation to the wards/MDT office Staff toilet facilities / lockers General Processes Fire procedure & equipment (location & use) Fire exits Crash procedures Supervision & study time Breaks/lunch Hours of work Team meetings Support in PPE’s absence To be completed by end of week 1 of the student placement: Induction by Practice Placement Educator Date Initials Orientation to the team Members of MDT Discussion re MDT roles General Processes Aims of service Documentation of patient information Incident reporting Referral system Case conference/ward meetings Home visits/home visit book Procedure for taking patients off ward Booking transport Waste procedure Payment for tea/coffee Administration Post arrangements Team filing system Patient statistics Transfer of notes procedure Handover of patient information Reviewed by Jane Harrison-Paul 12th September 2011 5 To be completed by end of week 2 of the student placement: Induction by Practice Placement Educator Administration Date Initials Peripheral stores ICES Social services referrals Moving & Handling training completed Policies & procedures read and signed off * * Refer to Policies & Procedures electronic resource link (page 28, 29) Signed: _______________________ (Student) __________ (Date) _______________________ (PPE) __________ (Date) _______________________ (PDOT) __________ (Date) Please return completed induction checklist to Jane Harrison-Paul PDOT to countersign and file. Reviewed by Jane Harrison-Paul 12th September 2011 6 OT Service Guide for Reporting Sickness Student to contact PPE or PP Coordinator if unable to attend or going home sick from work ON FIRST DAY OF ABSENCE AT START OF SHIFT OR BY 8.30 AM (WHICHEVER IS EARLIER) TELEPHONE QMC Campus 0115 9249924 ext 63273/64225/63480/65770/63472 City Campus 0115 9691169 ext 54632/53257/53207/50015/50014 AND ASK TO SPEAK TO YOUR PPE or PP COORDINATOR INDICATE ANTICIPATED LENGTH OF SICKNESS STUDENT’S RESPONSIBILITY TO CONTACT THE UNIVERSITY TO INFORM THEM OF SICKNESS SICKNESS RECORD COMPLETED IN STUDENT’S REGISTER BY PPE OR PP COORDINATOR APPROPRIATE CASELOAD ACTION TAKEN STUDENT TO KEEP OT SERVICE UPDATED ON SICKNESS FOR EXAMPLE THE STUDENT WILL NEED TO CALL IN EVERY MORNING UNLESS SIGNED OFF FOR A DESIGNATED TIME PERIOD Reviewed by Jane Harrison-Paul 12th September 2011 7 Occupational Therapy Service Our aim is to help you be as independent and safe as possible for your return home from hospital. Occupational Therapy staff work in partnership with patients, carers and other professionals to provide a flexible and rapid assessment of an individuals’ needs in order to enable safe discharge. The emphasis of the Occupational Therapy Service is on maximising independence in essential activities of everyday living. SINGLE EMERGENCY NUMBER – 2222 The 2222 number has been adopted nationally so staff moving between Campuses will only need to remember one number to dial in all emergencies Staff will need to provide clear and accurate instructions to switchboard when calling for an emergency response, including what team you need and the location where they need to attend (See below). 1. Teams ADULT CARDIAC ARREST, PAEDIATRIC ARREST, TRAUMA, OBSTETRIC EMERGENCY, FIRE, ALL OTHER EMERGENCIES 2. Location For your location, please give the name of your ward/clinic, floor and block. If you don’t work in a ward or clinic, phones that are situated on corridors have details of the specific location displayed alongside them. Be prepared. Display details of your location next to the phones in your work area, to avoid the possibility of delays or confusion during an emergency call. REMEMBER - DIAL 2222 Occupational Therapy Abbreviations Glossary of terms for effective communication Where any doubt or ambiguity may arise, please use full terminology These are the only accepted OT abbreviations which can be used within the OT documentation, nursing, medical and MDT paperwork. Glossary of terms for effective communication Where any doubt or ambiguity may arise, please use full terminology ADL BTE CC CCA CCO COTNAB Battery CPN DADL DLC FSTF HCOP ICES LHSH MAH MDT MEAMS OT PADL Rehab RMB RPAB RTS SSOT WAF WZF ZF 1 Activities of Daily Living Baltimore Therapeutic Equipment Work Simulator Case Conference Community Care Assistant Community Care Officer Chessington Occupational Therapy Neurological Assessment Community Psychiatric Nurse Domestic Activities of Daily Living Disability Living Centre Freestanding Toilet frame Health Care for Older People Integrated Community Equipment Stores Long Handled Shoe Horn Meals at Home Multi Disciplinary Team Middlesex Elderly Assessment of Mental State Occupational Therapy Personal Activities of Daily Living Rehabilitation Rivermead Memory Battery1 Rivermead Perceptual Assessment Battery Raised Toilet Seat Social Services Occupational Therapy Warden Aided Flat Wheeled Zimmer Frame Zimmer Frame Updated 05.06.07 C Thompson & S Howarth Reviewed by Jane Harrison-Paul 12th September 2011 10 General Medical Terminology This is not a definitive list and for audit purposes any abbreviations used within a medical dictionary is an accepted abbreviation. Glossary of terms for effective communication Where any doubt or ambiguity may arise, please use full terminology AAA ACS ADHD AF AFO AICU A/K AKA ALL AML AR AROM AS ATNR AV AXR Acute Aortic Aneurysm Acute Coronary Syndrome Attention Deficit Hyperactivity Disorder Atrial Fibrillation Ankle, Foot Orthoses Adult Intensive Care Unit Above Knee2 Above Knee Amputation Acute Lymphatic Leukaemia Acute Myeloid Leukaemia Aortic Regurgitation Active Range of Movement Aortic Stenosis Asymmetrical Tonic Neck Reflex Atrioventricular Abdominal X-Ray BaE Bd B/K BKA BP BPL BSO BSR Bx Barium Enema Twice a day Below Knee Below Knee Amputation Blood Pressure Brachial Plexus Lesion Bilateral Salpingo-Oopherectomy Blood sedimentation Rate Biopsy Ca CABG CAP CAPD CAT CCF CCU CDH CLBP CLL CML CNS Cancer Coronary Artery Bypass Grafting Community Acquired Pneumonia Continuous Ambulatory Peritoneal Dialysis Computerised Axial Tomography Congestive Cardiac Failure Coronary Care Unit Congenital Dislocation of the Hip Chronic Low Back Pain Chronic Lymphatic Leukaemia Chronic Myeloid Leukaemia Central Nervous System3 2 Updated 05.06.07 C Thompson & S Howarth Reviewed by Jane Harrison-Paul 12th September 2011 11 c/o COPD CRF CSF CSLP CRPS CT CTR CTS CVA CVS CXR Complaining of Chronic Obstructive Pulmonary Disease Chronic Renal Failure Cerebro Spinal Fluid Cervical Spine Locking Plate Chronic Regional Pain Syndrome Computed Tomography Carpal Tunnel Release Carpal Tunnel Syndrome Cerebrovascular Accident Cardiovascular System Chest X-Ray D&C DD DHS DIP DNA DOB DOI DRI DVT DXT Dilation and Curettage Developmental Delay Dynamic Hip Screw Distal Interphalangeal Did Not Attend Date of Birth Date of Injury Derby Royal Infirmary Deep Vein Thrombosis Radiotherapy EA ECG ECT ED EEG EMG ENT ERCP ESR EUA Emergency Admission Electrocardiogram Electro Convulsive Therapy Emergency Department Electroencephalogram Electromyelogram Ear, Nose and Throat Endoscopic Retrograde Cholangiopancreatography Erythrocyte Sedimentation Rate Examination Under Anaesthetic FBC FH FV FWB Full Blood Count Family History Femoral Vein Fully Weight Bearing GA GBS GCS GP GU General Anaesthetic Guillian-Barre Syndrome Glasgow Coma Scale General Practitioner Genito-Urinary Hb h/o Haemoglobin History of 3 Updated 05.06.07 C Thompson & S Howarth Reviewed by Jane Harrison-Paul 12th September 2011 12 HI HICM HOF HPC Head Injury Head Injury Care Manager Head of Femur History of Presenting Complaint ICU IDDM IDK IHD IP ISC ISQ ITU IVABS IVI Intensive care Unit Insulin Dependent Diabetes Mellitus Internal derangement of the Knee4 Ischaemic Heart Disease Interphalangeal Intermittent Self Catheterisation In Status Quo Intensive Therapy Unit Intravenous Antibiotics Intravenous Infusion JAJAR JIA Juvenile Arthritis Functional Assessment Report for Children Juvenile Idiopathic Arthritis LBP LFT LIF L/L LVF Lower Back Pain precede with A acute or C chronic Lung Function Test Left Iliac Fossa Lower Limb Left Ventricular Failure MCP Metacarpal Phalangeal MD Muscular Dystrophy MH Medical History MI Myocardial Infarction MID Multi Infarct Dementia MND Motor Neurone Disease MR Mitral Regurgitation MRI Magnetic Resonance Imaging MRSA +ve/-ve Methicillin Resistant Staphylococcus Aureus MS Multiple Sclerosis MUA Manipulation Under Anaesthetic N/A NAD NIDDM NH NOF NOH NOK NWB 4 5 Not Applicable No Abnormalities Detected5 Non Insulin Dependent Diabetes Mellitus Nursing Home Neck of Femur Neck of Humerus Next Of Kin Non Weight Bearing Updated 05.06.07 C Thompson & S Howarth Updated 05.06.07 C Thompson & S Howarth Reviewed by Jane Harrison-Paul 12th September 2011 13 OA O/E OP OPD ORIF Osteoarthritis In Examination Operation Out Patient Department Open Reduction Internal Fixation PA PC PD PE PICU PID PIP PMH PLIF POP PRA Pre OP PROM PRN PTA PU PV PVD PWB Pernicious Anaemia Presenting Conditions Parkinson’s Disease Pulmonary Embolism Paediatric Intensive Care Unit Prolapsed Intervertebral Disc Proximal Interphalangeal Past Medical History Posterior Lateral Interlocking Fusion Plaster of Paris Postural Reflux Activity Pre Operatively Passive Range of Movement As necessary Post Traumatic Amnesia Passed Urine Per Vagina Peripheral Vascular Disease Partial Weight Bearing QD 4 times a day RA RBC RH RIP ROM RS RSI RTA RVF Rheumatoid Arthritis Red Blood Corpuscle Residential Home Rest In Peace Range of Movement Respiratory System Repetitive Strain Injury Road Traffic Accident Right Ventricular failure SAH SALT SCC SDH SH SHO SLE SLR SOB SOBOE SOL SQC Sub-arachnoid Haemorrhage Speech and Language Therapy Spinal Cord Compression Subdural Haematoma Social History Senior House Officer Systemic Lupus Erythematosis Straight Leg Raise Short of Breath Short of Breath On Exertion Space Occupying Lesion Static Quadriceps Contraction Reviewed by Jane Harrison-Paul 12th September 2011 14 SR STO Sinus Rhythm Stitches Taken out TAH TAHBSO T/C TCI THR TIA TID TKR TLC TLSO TTO’s TURBT TURP TURT TVMS TVPS TWB TWOC Total Abdominal Hysterectomy Total Abdominal Hysterectomy Bilateral Salpingo Oopherectomy Telephone call To Come In6 Total Hip Replacement Transient Ischaemic Attack 3 Times a day Total Knee Replacement Tender Loving Care Thoracic Lumbar Sacral Orthosis Tablets to Take Out Transurethral Resection of Bladder Tumour Transurethral Resection of Prostrate Transurethral Resection of Tumour Test of Motor Skills Test of Perceptual Skills Touch Weight Bearing Trial Without Catheter U&E’s U/L URT USS UTA UTI Urea and Electrolytes Upper Limb Upper Respiratory Tract Ultra Sound Scan Unable to Attend Urinary tract Infection VBI VF VT Vertebro-Basilar Insufficiency Ventricular Fibrillation Ventricular Tachycardia WB WBC WR Weight Bearing White Blood Corpuscle7 Ward Round Δ # 1/7 1/52 1/12 1° 2º Diagnosis Fracture One day One week One month Primary Secondary 6 7 Updated 05.06.07 C Thompson & S Howarth 05.06.07 C Thompson & S Howarth Reviewed by Jane Harrison-Paul 12th September 2011 15 Equipment Integrated Community Equipment Service (ICES): In line with the National Service Framework programme Nottingham and Nottinghamshire South now operate ICES. The Nottingham contract is held by the British Red Cross (BRC). Each therapist has a unique PIN, which determines their place of work, level/grade, and specifies what equipment they can request. However an authorising PIN is often needed from a Team Leader/Head OT for emergency deliveries and equipment that is above the requisition level. Your training will be arranged by the Team Leader. You should receive your PIN shortly afterwards. Social Services: On occasions we need to refer to Social Services OT’s. A Social Services OT will assess the long term need of patients for items such as bath aids, kitchen equipment, grab rails, ramps, stair lifts and major adaptations such as bathroom conversions/extensions. These referral forms need to be faxed to the appropriate Social Services office. Disability Living Centre: You can advise patients and carers to visit the Disability Living Centre if they wish to privately purchase equipment or aids. Here, they can get advice on suitable equipment and also be seen by an OT. They have on site items that patients can try out, and they also have an outreach scheme, whereby a DLC representative can bring items to the patient at home. There are different rules for City and County patients. Wheelchairs: Nottingham Mobility Centre is located on the City Campus. It supplies and maintains all wheelchairs for the county. Wheelchairs are issued on either a short term (up to six months) or long term basis. The OT service can issue wheelchairs to be used at ward level and/or if there is an identified wait between the patients’ discharge home and provision of their own long term wheelchair. Student Job Description Job Title: Student Occupational Therapist Clinical Area: QMC Campus Musculoskeletal in & out patients, Paediatrics, Medicine & surgery, Neurosciences/Spinals, Healthcare of older people, Integrated discharge team City Campus Musculoskeletal in & outpatients, Cancer services Medicine, Linden Lodge, Stroke, Mobility Centre, Burns and Plastics Responsible to: Practice placement educator, Practice placement coordinator Job Summary: Placements are offered to: Derby, Sheffield and Northampton University students as required. Elective placements may be offered to other educational establishments as requested. The length of each placement varies according to the university and the stage of training. The placements are organized in accordance with the educational establishments’ Practice Placement Education Agreement. Each placement offers the opportunity to consolidate the learning that has been acquired in an academic situation into a practical environment. Trust values: The role/duties of the post are outlined above. In undertaking this role, the student will be expected to behave at all times in a way that is consistent with, and actively supports the Trust’s shared values (see next slide for details) Main duties and responsibilities: To experience a comprehensive range of occupational therapy practices including the assessment of occupational performance, goal orientated remedial activities, rehabilitation programmes and discharge planning. This must occur under direct supervision that is appropriate to the stage of training. To participate in appropriate community visits with the Practice Placement Educator. These may include home, work, school, nursery, nursing home, etc. These visits will be undertaken in line with department procedures. To be aware, and participate if appropriate, in the process of liaison with community colleagues and agencies. To be aware of the occupational therapy department policies and procedures. To be aware of the occupational therapy department’s philosophies, aims of service and professional minimum standards. Under the direction of the Practice Placement Educator, to communicate and cooperate with the multi disciplinary team. Reviewed by Jane Harrison-Paul 12th September 2011 17 To ensure the completion of all allocated duties within the timescale outlined. These may include patient documentation, statistical recording, etc. To be aware of and comply with health and safety regulations of the Trust, therefore ensuring the safety of staff and patients at all times. To attend all available seminars to ensure as broad a spectrum of experience is provided within each placement. Evaluation forms must be completed following each seminar and returned to the Practice Placement Coordinator. To communicate closely with, and act on the direction of the Practice Placement Educator. To liaise with the Practice Placement Coordinator in terms of any issues raised within the clinical practice setting. To participate in the report structure outlined by the appropriate educational establishment. Job revision: This job description only outlines the basis of the occupational therapy student role. Clarification should always occur with his/her Practice Placement Educator and Practice Placement Coordinator. A set of values we can all share Values: thoughtful patient care Values: continuous improvement Caring and helpful Accountable and reliable • Polite, respect individuals, thoughtful, welcoming • Reliable and happy to be measured • Helpful, kind, supportive, don’t wait to be asked • Appreciative of the contributions of others • Listening, informing, communicating • Effective and supportive team-working Safe and vigilant Best use of our time & resources • Clean hands and hospital so patients are safe • Simplify processes, to find more time to care • Professional, ensure patients feel safe • Eliminate waste, investing for patients • Honest, will speak up if needed, to stay safe • Making best use of every pound we spend Clinically excellent Innovation for patients • Best outcomes through evidence-led clinical care • Empowered to act on patient feedback • Compassionate, gentle, see whole person • Improvement led by research and evidence • Value patients’ time to minimise waiting • Teaching the next generation Reviewed by Jane Harrison-Paul 12th September 2011 18 Current Practice Development OT Jane Harrison-Paul (MonWed) is NUH’s OT practice placement coordinator. This role scope is: To provide a link between all educational establishments and the occupational therapy service To liaise with the student, the individual university, practice placement educators, and the department designated admin staff regarding each clinical placement offered To coordinate an appropriate intake of occupational therapy students to each clinical area To attend practice placement educator days held by individual universities and disseminate the information to the practice placement educators To induct all students to the occupational therapy department and hospital in accordance with the induction policy To be available to all practice placement educators and students where indicated To participate in student reports and to attend each case presentation as appropriate To coordinate and facilitate a quarterly meeting for practice placement educators at NUH To coordinate a teaching programme for all practice placement educators to promote the educational needs related to student supervisors To analyse and act upon student placement and tutorial evaluation forms To record and monitor practice placement educators’ activity and liaise with the occupational therapy manager To participate in curriculum development Reviewed by Jane Harrison-Paul 12th September 2011 19 Student Meetings – Wednesdays 3pm to 4pm A student meeting is available to all students who have a clinical placement in occupational therapy at Queens Medical Centre or City Hospital, Nottingham. The group is self-directed with the support of the Practice Placement Coordinator, as appropriate. The group attendance is compulsory to enable all students to gain full benefit from the group. If you are unable to attend a meeting please inform the Practice Placement Co-ordinator. 1. To provide a self-directed, informal and supportive forum to enable discussion and peer support. 2. To discuss clinical caseload and critically evaluate occupational therapy intervention. 3. To discuss critical incidents encountered in clinical practice. 4. To feedback on courses, seminars, in-service training and visits. 5. To discuss case studies and gain advice and support from other students. 6. To practise presentation skills in preparation for placement case study presentations. 7. To identify own training needs and discuss with the Practice Placement Co-ordinator as appropriate. 8. To gain support and advice from the group regarding assignments where appropriate. Suggested topics for discussion Presentation skills Interview skills Job applications Audit Literature search Evidence based practice Sharing clinical knowledge in speciality areas The various roles of the multidisciplinary team Useful books, articles relevant to the clinical area Research dissertation Social appointments and general peer support Some of the above suggestions may need to be incorporated into the student seminars Reviewed by Jane Harrison-Paul 12th September 2011 20 Student Guidelines for Case Study Presentations Patient profile including age, sex, religion, ethnic origin, social situation, occupation, hobbies and leisure Diagnosis, presenting medical symptoms, relevant past medical history, reason for admission to hospital, reason for referral to OT Describe the assessment process and justify the unique contribution of occupational therapy Analyse the occupational therapy treatment intervention Summarise the contribution of the multidisciplinary team to the overall discharge process Evaluate the occupational therapy intervention and the patient’s attitude to treatment Link theory to practice (e.g. for 2nd/3rd years models/approaches/frames of reference and/or understanding of medical conditions and impact on occupational performance – for 1st years just the latter): Personal Reflection Please note: All students will complete a case presentation of up to 20 minutes duration. Students who complete placements of 8 weeks or longer may take up the opportunity of completing a case presentation at halfway as well as at the final report. Please discuss this with your supervisor. The aim of the presentation is to gain experience in presentation skills and to effectively evaluate your contribution to patient care. Reviewed by Jane Harrison-Paul 12th September 2011 21 Student Case Study Presentation Evaluation Form Student’s name and year: ___________________________ Date: _______ Placement area: ____________________________________________ Please highlight the number on the scale which most closely represents how well the student demonstrated their knowledge and skills in the following areas, by circling a score between 1 – 4 (1 = poor / 4 = excellent). Poor 1 Satisfactory 2 Good 3 Excellent 4 Good 3 Excellent 4 1) Aims and objectives of the presentation: Poor 1 Satisfactory 2 2) Patient’s profile (e.g. age, sex, religion, ethnic origin, social situation, occupation, hobbies and leisure): Poor 1 Satisfactory 2 Good 3 Excellent 4 3) Medical history and reason for admission to hospital (including presenting medical symptoms, diagnosis, relevant past medical history): Poor 1 Satisfactory 2 Good 3 Excellent 4 4) Reason for referral to OT (demonstrating understanding of OT role in relation to clinical setting): Poor 1 Satisfactory 2 Good 3 Excellent 4 5) OT assessment process and justification of the unique contribution of occupational therapy: Poor 1 Satisfactory 2 Good 3 Excellent 4 6) Analyses the occupational therapy treatment intervention: Poor 1 Satisfactory 2 Good 3 Reviewed by Jane Harrison-Paul 12th September 2011 Excellent 4 22 7) Summarises the contribution of the multidisciplinary team to the overall discharge process: Poor 1 Satisfactory 2 Good 3 Excellent 4 8) Evaluates the occupational therapy intervention and the patient’s attitude to treatment: Poor 1 Satisfactory 2 Good 3 Excellent 4 9) Ability to link theory to practice (e.g. for 2nd/3rd years - models/approaches/frames of reference and/or understanding of medical conditions and impact on occupational performance – for 1st years just the latter): Poor 1 Satisfactory 2 Good 3 Excellent 4 10) Personal Reflection (level of depth depending on whether 1st/2nd or 3rd year): Poor 1 Satisfactory 2 Good 3 Excellent 4 11) Presentation Skills (e.g. clear communication, eye contact, confidence, visual aids, handouts etc): Poor 1 Satisfactory 2 Good 3 Excellent 4 Additional Comments (including areas of strength / areas for development): ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Reviewed by Jane Harrison-Paul 12th September 2011 23 Guidelines for the Completion of All Student Reports Please look at this with your supervisor and discuss with them any of the points as needed. Following the commencement of a clinical practice, the arrangement of the date and time of both the halfway and final report is negotiated with the student, Practice Placement Educator and Practice Placement Coordinator (as appropriate). It is the responsibility of the Practice Placement Educator to inform the student to book an appropriate venue and to access audio/visual equipment, i.e. laptop/projector, flip chart, pens, etc. Prior to the arranged date of the case presentation and the report, it is most helpful if some general discussion has taken place between the Practice Placement Educator and the Practice Placement Coordinator regarding the student’s progress. Following a student presentation, the completion of the report will be discussed between the Practice Placement Educator and negotiated with the student (from some colleges). The Practice Placement Coordinator can be involved if requested. The completed report should be photocopied and distributed as follows; 1. The original report is sent to the university/college by the student 2. A copy is given to the student for their reference 3. A copy is sent to the Practice Placement Coordinator to be kept in your student file Please also give your practice placement coordinator copies of your case presentation and supervision records for your student file. Reviewed by Jane Harrison-Paul 12th September 2011 24 Student Seminar Evaluation Form Please fill in this form electronically on the shared drive (o drive) at occupational therapy/staff/student and PPE information/seminar evaluation. This information is essential for us to continually update and develop the seminar programme for future students Seminar title: _____________________________________ Date: ___________ Student year: _____________ University: _______________________________ 1. Did you find the topic of the seminar interesting? YES / NO Comments: _______________________________________________________ 2. Did you find the seminar relevant to your stage of training? YES / NO Comments: _______________________________________________________ Presentation Please underline or highlight the number on the scale which most closely represents how you felt regarding the particular item. Very dissatisfied / Poor / Satisfactory / Good / Very Good / Excellent 1 2 3 4 5 6 Content: 1 2 3 4 5 6 Comments: _______________________________________________________ Visual Aids: 1 2 3 4 5 6 Comments: _______________________________________________________ Handouts: 1 2 3 4 5 6 Comments: _______________________________________________________ Duration: 1 2 3 4 5 6 Comments: _______________________________________________________ 3. Please suggest any other topics you would like to be included in the seminar list. 4. Any other comments or suggestions: Reviewed by Jane Harrison-Paul 12th September 2011 25 Hoisting General information and handy hints. Basic manual handling principles Risk assess – patient, environment, self Recognise own limitations – both physical and skill. Dynamic Movement Sequence – feet hip width apart and slightly staggered, knees soft, maintain normal curves in spine, relax the shoulders, do not grip, lead with your head. Risk assessing The environment Space – is there enough room for the correct number of people, all the equipment e.g. hoist, commode/wheelchair, bed. Is the floor clear of obstacles and tripping hazards. Does the environment maintain the patients dignity whilst being hoisted, e.g. pulling curtains around or shutting the door of cubicle. The patient Confused patients – may not understand what is happening and are therefore not able to cooperate. They may “fight” against the sling and become unsafe during the transfer. Pain – If patients are in a lot of pain they may find the position they are in within the sling uncomfortable or the edges of the sling may cause pain particularly if they have delicate skin or actual pressure sores. Anxiety – being hoisted means that a person has no control over their movement during the time that they are in the sling. Patients who need hoisting are usually quite vulnerable both physically and psychologically and this can create a high level of anxiety. Reassurance is essential both prior to the transfer and throughout the intervention to ensure that the person is as calm as possible. Own Limitations Are you suffering from any illness/injury that could make you or the patient unsafe if you continue with the transfer? If yes then you need to speak to your supervisor or senior member of the team to discuss options. Are you familiar with the equipment you are using?.If not discuss with a member of the team who has used the equipment before or contact your manual handling link person either on the ward or in the OT department. Are you confident in your knowledge of hoisting to perform the activity? If not you need to ensure you have support during the activity from someone who is confident and identify this as a learning need within your supervision. Do you know the patient well enough to risk assess them? If not speak to other members of the MDT to gather the correct information, and discuss with your supervisor/senior. Reviewed by Jane Harrison-Paul 12th September 2011 26 Student Evaluation of Visits Visit: Date: 1. What were your prior expectations of this visit? 2. What have you learned in relation to your expectations? 3. What new knowledge have you gained? (or reinforced prior knowledge) 4. How will you use this in your practice? Comments / suggestions to feedback? Reviewed by Jane Harrison-Paul 12th September 2011 27 Student Placement Evaluation Form Name: _________________________________________Date: ________________ Placement: ________________________ University: _________________________ Please circle the number on the scale which most closely represents how you felt regarding the particular item. Very dissatisfied / Poor / Satisfactory / Good / Very Good / Excellent 1 2 3 4 5 6 1. The information I received from the hospital pre-placement was sufficient and beneficial 1 2 3 4 5 6 Comments: ____________________________________________________________ 2. On arrival at the placement was your welcome/ Induction satisfactory? 1 2 3 4 5 6 Comments: ____________________________________________________________ 3. Did your programme take into account your knowledge and previous experience? 1 2 3 4 5 6 Comments: ____________________________________________________________ 4. Did your programme meet your needs? 1 2 3 4 5 6 Comments: ____________________________________________________________ 4. Was supervision and support by staff appropriate and beneficial to your learning needs? 1 2 3 4 5 6 Comments: ____________________________________________________________ 5. Was the role of the placement coordinator clear and useful? 1 2 3 4 5 6 Comments: ____________________________________________________________ 6. Has the placement improved your theoretical knowledge? 1 2 3 4 5 6 Your professional skills? 1 2 3 4 5 6 Your clinical skills? 1 2 3 4 5 6 Reviewed by Jane Harrison-Paul 12th September 2011 28 7. Was the responsibility given appropriate to your stage of training? 1 2 3 4 5 6 Comments: ____________________________________________________________ 8. Did you feel part of the team? 1 2 3 4 5 6 Did you feel you had sufficient contact with other OT’s? 1 2 3 4 5 6 Did you feel you had sufficient contact with other disciplines? 1 2 3 4 5 6 Comments: ____________________________________________________________ 9. Did you receive sufficient feedback on your performance? 1 2 3 4 5 6 Comments: ____________________________________________________________ 10. Did you give your clinical supervisor feedback? 1 2 3 4 5 6 Comments: ____________________________________________________________ 11. Was the student seminar programme a good use of time? Were the seminars appropriate to your learning needs? 1 2 3 4 5 6 1 2 3 4 5 6 Which seminars would you recommend for future students? ____________________________________________________________ ____________________________________________________________ 12. Was the weekly student support meeting useful? 1 2 3 4 5 6 Comments: ____________________________________________________________ 13. Would you consider a Junior (Band 5) post here? 1 2 3 4 5 6 Comments: ____________________________________________________________ 14. Any further suggestions / comments with regard to your placement? Comments: ____________________________________________________________ __________________________________ __________________________ Reviewed by Jane Harrison-Paul 12th September 2011 29 Induction for OT Students Policies & Procedures Mandatory Reading- Please ensure that you have read the information on the links below so that you can sign off the induction sheet at the end of week two. http://nuhnet/wearehereforyou/All%20staff%20documents/Behavioural%20sta ndards%20for%20everyone%20at%20NUH.pdf (We are here for you, behavioural standards). http://nuhnet/sbar/Pages/default.aspx (SBAR - Improving communication). http://nuhnet/medical_director/patient_safety/Documents/0865v11010_Patient _safety_information_for_staff.pdf (Patient safety document). http://www.nuh.nhs.uk/foi/services/patient_information/leaflets/nuh_leaflets/08 34v11110_Your_safety_reducing_risk_of_falling.pdf (Falls prevention leaflet). http://nuhnet/nuh_documents/Documents/Forms/Staff%20View.aspx (Management of slips trips and falls policy). http://nuhnet/ig/Pages/theigcode.aspx (Information governance- keeping patient information private) http://nuhnet/diagnostics_clinical_support/infection_prevention_control/Docum ents/Patient%20Leaflets/NUH%20Leaflets/ic-medilink-web-version.pdf (Infection control see also below) http://nuhnet/nuh_documents/Documents/Fire%20Policy.doc (Fire Safety Policy) http://nuhnet/nuh_documents/Documents/Manual%20Handling%20policy.doc (Manual Handling Policy) http://nuhnet/medical_director/integrated_governance/safeguarding/safeguard ing_vulnerable_adults/Safeguarding%20Folder/02Safeguarding%20vulnerabl e%20adults%20NUH%20policy.doc (Safeguarding vulnerable adults) http://nuhnet/nuh_documents/Documents/Safeguarding%20Children.doc (Safeguarding children and young adults) Reviewed by Jane Harrison-Paul 12th September 2011 30 http://nuhnet/nuh_documents/Documents/Resuscitation%20Policy.doc (Resuscitation Policy) http://nuhnet/nuh_documents/Documents/Health%20Record%20Keeping%20 Policy.doc (Health Care record keeping policy) O:\Staff\OT Awareness Session\Work Experience docs (Go to Confidentiality code of conduct and Uniform policy) Optional Reading- Discuss with your supervisor and read as appropriate. O:\Staff\Procedures and guidelines\NUH OT procedures (Go to this link on the shared drive to see OT policies, procedures and guidelines for Home assessment visits, wheelchair loan, gifts of money, lone working and minimum standards for referral, splinting guidelines and major incidence plan.) http://nuhnet/nuh_documents/Documents/Mobile%20Phone%20Use%20withi n%20the%20Hospitals%20Policy.pdf (Mobile phone policy) http://nuhnet/medical_director/patient_safety/Ulcers/PU%20Guidelines.pdf (Pressure Ulcer Prevention.) http://nuhnet/medical_director/integrated_governance/safeguarding/safeguard ing_vulnerable_adults/SVATraining/Safeguarding%20AdultsLDMCA%20Corp orate1110.ppt (Safeguarding vulnerable adults and The Mental Capacity Act) Reviewed by Jane Harrison-Paul 12th September 2011 31 Infection Control We are governed by The Health Act 2006 published by The Department and Health which provides us with A Code of Practice for The Prevention and Control of Health Associated Infections. Here are some basic facts about Clostridium difficile (known as C diff). What is Clostridium difficile? Clostridium difficile (C diff) is a bacteria that lives in the gut of around 1 in 30 healthy adults and children. When it multiplies C diff produces spores that are present in the faeces, can survive for a long time in the environment, and are resistant to ‘normal’ disinfectants. The normal bowel contains millions of different types of bacteria, which help break down and digest our food. There are lots of these ‘good’ bacteria, but also some bacteria, such as C diff, which can cause ill health. The ‘good’ bacteria usually help keep C diff in check. How do you catch C diff? A few people carry C diff but remain in good health. People can become infected with C diff if they touch items or surfaces (such as beds and equipment) that have been contaminated with C diff spores and then touch their mouths. Reviewed by Jane Harrison-Paul 12th September 2011 32 If the ‘good’ gut bacteria are not able to keep C diff in check, or if the body’s resistance to infection is lowered, C diff can multiply and produce spores and toxin. The toxin can cause inflammation of the bowel. This most often happens when people take antibiotics to treat other infections (the antibiotics kill off the ‘good’ gut bacteria), or if patients’ immunity is lowered by chronic or serious ill health, surgery, or drugs. What are the symptoms of C diff? Bowel symptoms range from mild tummy upset to moderate loose stools to severe painful bloody diarrhoea. Other symptoms include fever, loss of appetite, nausea and abdominal pain. How is C diff diagnosed? C diff is diagnosed by testing for C diff toxin in a stool sample or by examination of the bowel lining with a special camera (sigmoidoscopy). Are some patients more likely to be made ill by C diff? Elderly patients, patients who have received antibiotics, and those whose resistance is lowered by chronic or serious ill health, surgery, or drugs are more likely to be made ill by C diff. Can C diff be treated? Mild illness usually responds well to stopping antibiotics and preventing dehydration by taking plenty of fluids. In more severe illness anti-C diff antibiotics are added. Most patients will improve within a few days, and the diarrhoea symptoms typically resolve within two weeks. Anti-diarrhoea medication may make C diff diarrhoea worse, and is not recommended. Is it possible to get C diff more than once? C diff infection usually responds well to treatment, but approximately 20% of patients will experience recurrence of diarrhoea symptoms up to several weeks after treatment has finished. A further course of anti-C diff antibiotics will be effective in almost all patients, and other specialist treatments are available. If diarrhoea returns after treatment for C diff infection it is important to restart treatment promptly. If a patient has been discharged home they should visit their GP as soon as possible, taking a stool sample with them. (Sample containers can be obtained from your GP if you have not already got one). Reviewed by Jane Harrison-Paul 12th September 2011 33 How can C diff pass from one person to another? C diff is spread on hands person-to-person, or environmental surface-to-person. It is always important to wash your hands after using the toilet and before handling food or eating and drinking. In hospitals staff, patients, relatives, and other visitors must all be thorough in their hand-washing with soap and water every time they deliver treatment or visit. Alcohol gel alone is not effective against C diff - soap and water must be used. Is C diff just a problem in hospitals? People who have had antibiotics or have lowered immunity can develop C diff illness without any contact with hospital. These community-acquired cases account for approximately 25% of the total. What is the hospital doing to tackle C diff? The prevention of hospital infections is the top clinical priority for the Trust. At NUH we do everything we can to prevent C Diff. We are: Ensuring staff routinely wash their hands with soap and water before and after touching every patient Training all staff in the correct way to wash hands and to clean equipment to prevent cross-infection Monitoring and improving cleanliness in all wards and departments Minimising the risk of cross-infection by quickly isolating patients with suspected or proven C diff in a single room or in a separate bay Using a new (2007) isolation ward on the Queen’s Medical Centre campus Using hydrogen peroxide, which kills C diff spores, to support other deep cleaning on the wards Making sure antibiotics are used correctly and prescribed only when absolutely necessary and for the shortest possible time. What can patients and visitors do to help prevent C diff? Wash hands carefully and every time with soap and water Remind staff to wash their hands when they may have forgotten Reviewed by Jane Harrison-Paul 12th September 2011 34 What is MRSA? MRSA stands for Methicillin Resistant Staphylococcus Aureaus. The MRSA germ belongs to the Staphylococcus Aureus (SA) family. SA is a common germ. It lives harmlessly on the skin and in the nose of around a third of healthy people. MRSA is a particular type of SA that has developed resistance to most antibiotics. What causes MRSA? SA and MRSA cause problems only when they get into breaks in the skin (wounds, cuts, sores) or into the bloodstream, or into normally sterile body cavities (e.g. the bladder) Infections are more likely and more serious in patients whose resistance is lowered by a long term ill health, frailty, injury, surgery or drugs. Risk of MRSA is higher in patients with catheters or intravenous drip and in patients on Intensive/critical care. In rare cases MRSA can be fatal. How can MRSA pass from one person to another? People may carry MRSA without knowing and some patients may have it before they are admitted to hospital. I can be caught and passed on almost anywhere not just in hospital. The MRSA bacteria is spread on hands and skin from person-to-person. Staff, patients relatives and other visitors can help prevent spread of MRSA by thorough regular hand washing with soap and water and by the use of the alcohol gel found on our hospital wards and at the entrances to wards and clinical areas. Can visitors catch MRSA? If visitors hand wash or gel before entering and when leaving wards they will largely protect themselves from becoming colonised with MRSA. Even if they acquire MRSA it will usually cause them no harm, they will probably be unaware, will be temporary, wont need investigated or treated. Visitors who have reduced resistance to infection themselves because of ill health should discuss these risks with the clinical team looking after their relative/friend. Reviewed by Jane Harrison-Paul 12th September 2011 35 Can MRSA Be Treated? MRSA can usually be treated by one of the small number of antibiotics which kill it. Other medications such as antiseptic wash and nasal ointments, are used to remove MRSA from the skin and nose of patients who are susceptible to serious MRSA infection. Patients may be moved to a single room or separate bay to help prevent cross infection. How do you know if you’ve got MRSA? Patients may be unaware they have MRSA because it may not have caused any problems. To identify such ‘colonised’ people many groups of patients are screened before entering hospital or during their stay by taking skin and nose swabs. Where MRSA is found, patients may be treated in separate areas and offered antiseptic skin and hair washes and ointments to eradicate the MRSA and therefore prevent potential problems. What is the hospital doing to tackle MRSA? The prevention of hospital infections is the top clinical priority for the Trust. At NUH we do everything we can to prevent MRSA infections. We are: Ensuring staff routinely wash their hands with soap and water or alcohol gel before and after touching every patient. Training all staff in the correct way to wash hands and to clean equipment to prevent cross infection. Monitoring and Improving cleanliness in all wards and departments. Minimising the risk of cross infection by quickly isolating patients with MRSA in a single room or separate bay. Asking some patients to routinely was and shower in hospital using an antibacterial shower gel to reduce the number of germs on the skin and/or to use antibiotic nasal cream. Screening patients (skin and nose swab) before admission or operation in some specialities and treating with antiseptic wash if MRSA is found. Encouraging visitors to wash their hands with soap and water and to use alcohol gel (found at all bedsides and entrances to wards) every time they enter or leave a ward. Reviewed by Jane Harrison-Paul 12th September 2011 36 Please remember to remove any wrist watches, stoned rings and any clothing below the elbow before contact with patients Reviewed by Jane Harrison-Paul 12th September 2011 37 Hand Hygiene Hand washing is the simplest and most effective way of controlling the spread of germs. We all have a part to play in reducing and preventing infections in our hospitals - infection control is everyone's responsibility and is the Trust's number one clinical priority. Please play your part. Staff should use alcohol gel: On entering a ward On entering a bay or patient’s room Before and after skin contact with a patient On leaving an isolation room After removal of gloves Before clean and aseptic procedures Staff should use soap and water: When hands are visibly dirty If hands become contaminated After visiting the toilet Before an aseptic procedure Before handling food Before breaks When looking after patients with Clostridium difficile Staff must: Remove all stoned rings and bracelets when attending to patients Remove wrist watches when in clinical areas Cover all abrasions with a waterproof plaster Wet hands before applying soap to minimise the drying effect Dry hands thoroughly with paper towels Use alcohol gel for rapid decontamination between patients Use nail brushes for a surgical scrub or if nails are heavily soiled Use the hand cream supplied in the wall mounted dispensers ONLY Contact Occupational Health for advice regarding skin problems Reviewed by Jane Harrison-Paul 12th September 2011 38 Six stage hand washing technique 1. Palm to palm 2. Backs of hands 3. Between the fingers 4. Fingertips 5. Thumbs and wrists 6. Nails in the palm of the hand Reviewed by Jane Harrison-Paul 12th September 2011 39 Infection Control Questions Q. What is the single most effective method of reducing spread of infection? A. Hand Washing Q. What should you remove before any patient contact? A. Rings, Watches and any clothing below the elbows Q. Name 3 occasions you should use? a) hand gel b) soap or water A. a) entering a ward before and after skin contact with patient after removal of gloves entering bay or patients room leaving an isolation room before and after clean and aseptic procedures when hands visibly dirty if hands become contaminated if visiting the toilet before an aseptic procedure before handling food before breaks when looking after patients with Clostridium Difficile b) Q. Can MRSA be treated? A. Yes with certain antibiotics Q. How is MRSA spread? A. Skin to Skin Q. How is Clostridium Difficile spread A. By touching surface contaminated by the spores Reviewed by Jane Harrison-Paul 12th September 2011 40 Last Day Student Audit Checklist Name: Placement Dates: to: PPE: Placement Coordinator: PPEs please ensure that the following are dated and initialled before signing off the student’s placement on their final report form. Please hand this form to the PDOT for audit purposes. Date Initials Induction checklist completed and filed in student file Register completed and filed in student file Risk assessment completed and filed Library books returned ID badge returned to access control Copies of case study presentation and evaluations filed in student file Copies of negotiated halfway and final report filed in student file Copies of learning contract, objectives and supervision records filed in student file. Student placement evaluation form completed and sent to PDOT Any other records that have been kept during the placement Reviewed by Jane Harrison-Paul 12th September 2011 41
