Download ward 11 ninewells hospital

WARD 11 NINEWELLS HOSPITAL
STUDENT NURSE LEARNING PROGRAMME
AND OBJECTIVES
STUDENT NURSE
YEAR & BRANCH:-
MENTOR:-
ASSOCIATE MENTOR:-
LINK TEACHER:- Carolyn Johnstone
WELCOME TO WARD 11
Ward 11 is a busy, general surgical ward specialising in Upper
gastro-intestinal, Bariatric and Hepatobiliary surgery.
Meet our Team Consultant Surgeons
1.
2.
3.
4.
5.
6.
7.
Mr
Mr
Mr
Mr
Mr
Mr
Mr
Sami Shimi
Iain Tait
Pradeep Patil
Francesco Polignano
Afshin Alijani
Christoph Kulli
Stuart Oglesby
Senior Charge Nurse
Rosalyn McKinnes
Charge Nurse
Christine Stewart
&
Morag Motherwell.
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WARD 11 PHILOSOPHY FOR STUDENTS
We aim to provide an optimum learning environment that
creates and develops opportunities for students to identify and
undertake experiences to meet their learning needs.
We provide a welcoming and supportive atmosphere to allow
students to reach their maximum potential. All students will
receive a comprehensive orientation and shall be mentored by
staff members who have the appropriate qualifications and
experience to facilitate student learning.
We believe that by facilitating effective learning we can
promote personal, professional and academic development.
Students will be able to develop their knowledge and skills,
which will lead to the development of abilities such as inquiry,
analysis, critical thinking and problem solving. By providing
students with the best possible learning environment we are
investing in the future of nurses and promoting fitness for
award, practice purpose and development.
You will be allocated to a trained nurse who will act as your
mentor throughout your placement. You will also be allocated
an Associate mentor to give you guidance in the absence of
your mentor. In the event of both of your mentors being absent
you will allocated to a trained nurse.
There will be plenty of opportunity for you to meet the other
members of our multi-professional team who all play an
important part in patient care. Please familiarize yourself with
them for effective communication.
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Ward 11 is a very busy clinical area and offers numerous
learning opportunities. We hope that you will be able to take
part in many different nursing procedures and that you will be
able to enhance your knowledge by doing this.
REMEMBER this is your placement and it is your responsibility
to ensure that your personal, university and ward objectives
are met. Please ensure that a date for your half way assessment
is decided upon during your first meeting with your mentor.
Please ask any member of staff for help and advice.
We hope that your time on ward 11 allows you to achieve your
objectives and is an enjoyable placement
Access to key policy documents can be made via the
intranet/internet or SCN office.
Mentor Guidance folder can be accessed at the nursing station.
HALF WAY ASSESSMENT DATE:-
FINAL ASSESSMENT DATE:-
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COMMON TYPES OF
ADMISSION
The type of patient admissions you are likely to see are:Emergency admissions from Ward 7 ASRU ABDOMINAL PAIN
JAUNDICE
PANCREATITIS
CHOLECYSTITIS
BOWEL OBSTRUCTION
ACHALASIA
Elective admissions CANCERS OF THE GASTROINTESTINAL TRACT (e.g. Stomach, bowel,
oesophagus, liver)
OESOPHAGECTOMY/ GASTRECTOMY
INVESTIGATIONS
BARIATRIC SURGERY (Sleeve Gastrectomy/Gastric Bypass)
CHOLECYSTECTOMY
HIPEC (Hyperthermic Intraperitoneal Chemotherapy)
LIVER RESECTION
HERNIA REPAIR
HEMICOLECTOMY
LAPAROSCOPIC FUNDOPLICATION
HEPATECTOMY
REVERSAL OF ILEOSTOMY
DISTAL PANCREATECTOMY
TRANSVERSE COLECTOMY
FEEDING JEJUNOSTOMY
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ABBREVIATIONS AND TERMS
The following is a list of abbreviations and terms in common
use on the ward.
Abbreviation/Term
Meaning
“LAP”
“CHOLE”
“FUNDO”
“A.P. “
“CRYO”
“CA”
Laparoscopic or Key Hole
Relating to the Gall Bladder
e.g. Cholecystectomy
Fundoplication – tightening of
the top of the stomach
Abdominal Perineal Resection
of Bowel
Cryotherapy- Freezing Cells
Cancer
The following are Prefixes and Suffixes that you must know.
Prefixes /Suffixes
-otomy
-ostomy
-ectomy
-itis
Resection
CholeHepaticHaemoOesophagoGastroColAscites
Meaning
Surgical incision e.g.
Colotomy
Surgical opening e.g.
Colostomy
Surgical Removale.g.
Colectomy
Inflammation e.g.Colitis
Partial Removal
Relating to the Gall Bladder
e.g. Cholecystectomy
Relating to the Liver
Relating to Blood
Relating to the Oesophagus
Relating to the Stomach
Relating to the Colon
Fluid in the Abdomen
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COMMON INVESTIGATIONS
Investigations
ERCP- Endoscopic Retrograde
Cholangio Pancreatography
Barium Meal
CT Scan-Computerised
Tomography
MRI- Magnetic Resonance
Imaging
OGDOesophagogastricduodenoscop
y
Gastrograffin Swallow
Chest and abdominal X-Ray
Sigmoidoscopy
Ultrasound
Oesophageal Function Test
Meaning
Examination or Cannulation
of the Biliary Ducts
Examination of the stomach
and duodenum
Images of body slices
generated by computer
The nucleus of certain
elements wobble under the
influence of magnetic fields.
MRI uses this property to
generate images.
Visualisation of the of the
oesophagus, stomach and
duodenum
Examination of oesophagus
Plain x-ray pictures of the
chest and abdomen.
Visualisation of the Sigmoid
Colon
High frequency sound waves
are used to image the body
(3.5-10 MHz)
Examination to determine the
motility of the oesophagus.
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EMERGENCY PROCEDURES
EMERGENCY PHONE NUMBER IS 2222
THIS SECTION MUST BE COMPLETED ON THE FIRST DAY
FIRE
1. Show where fire extinguishers are located
2. Show where Break Glass points are located
3. Show where oxygen shut off valve is situated
4. Discuss and explain evacuation procedures
5. Discuss how to a tackle fire
6. Show ward exit points
7. Give copy of Ward Fire Evacuation protocol
CARDIAC ARREST
1. Show where emergency buzzers are located and what they
sound like
2. Show where to find cardiac arrest trolley and how to use it
3. Show where to find emergency box
4. Show where portable oxygen and suction are kept
5. Ensure CPR is explained
I CONFIRM I HAVE BEEN SHOWN ALL OF THE ABOVE AND HAVE A
GOOD UNDERSTANDING OF THE PROCEDURES
STUDENT NURSE SIGNATURE:-
I CONFIRM I HAVE SHOWN MY STUDENT NURSE ALL OF THE
ABOVE
STAFF NURSE SIGNATURE:-
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WARD OBJECTIVES
OBJECTIVE
DATE
COMPLETED
STN SN
SIG SIG
HEALTH AND SAFETY
 Waste disposal Linen disposal
 Use of Personal Protective
Equipment (PPE)
 Cleaning up of spills (e.g.
Blood)
 Dealing with hazards
 Manual Handling
 Universal symbols
 Bed cleaning and bed making
 MRSA/VRE/CPE – (screening
regime) & environmental
placement.
 Disposal of sharps & correct
sharp bin assembly
WOUND CARE
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


Caring for closed wounds
Caring for open wounds
Care of drains
Vac Therapy
PRE-OP CARE
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

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


TPR and BP (SEWS)
Pre-op check list
Informed consent
MUST score
Fasting for theatre
Anti-embolic stockings
Administration of medicines
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 Compliance with pregnancy
assessment & testing
POST-OP CARE
 TPR& BP
 SEWS Score
 Wound checks e.g for
haemorrahage
 Positioning of patient
 Restricted fluid and diet
intake
 Oxygen therapy and hypoxia
 Pain control
 Blood Transfusion
 Monitoring of respiratory rate
on all Bariatric patients
 The use of the Bariatric
protocol
NUTRITION
 Weight and height (all
patients weighed weekly)
 MUST Score
 TPN & PPN
 Enteral feeding
 PEG tube
 Food charts
 Dietician’s role
 Protected mealtime
policy/peach trays
PERSONAL HYGIENE
 Skin care
 Oral hygiene
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 Shower/ bath etc
ELIMINATION





Care of urinary catheter
Bowel Preparations
Altered bowel habits
Stoma care
Stool Charts
BAY NURSING
 Advantages and
disadvantages
COMMUNICATION
 Patient confidentiality
 Report to multi-professional
team
 Communication with patient
and relatives
 Listening skills
 Accurate history taking
/admission process
ASSESSMENT & DOCUMENTATION
 Assessment – accurate
assessment of patients needs,
appropriate selection of
treatment plans, up dating
plans and discontinuing
 Discharge planning –
commence on day of admission
and review daily
 Accurate completion of
associated charts
 All care plans should be kept
accurate appropriate and
timely
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 Maintenance of CQI/SPSI
bundles for quality
measurement & improvement.
PRESSURE AREA CARE
 Waterlow score
 Assessment tools
 Action:- use of special
mattresses, dressings
 Pressure Ulcer Prevention,
PPURA within 6 hours of
admission to the clinical area.
 PPURA post operatively.
SLEEP & REST
 Patients rest period
 Night sedation
 Noise levels to be at their
minimum
NMC GUILDELINES &
PROFESSIONAL CONDUCT
 How do they affect our
practice?
 Why do we need them?
 Code of Conduct.
 Maintain standards of
Professional image and
courteous behavior
SPIRITUAL & CULTURAL BELIEFS
 What do we need to know?
 What benefit can our help give
to patients and relatives?
 Maggies Centre: - What can it
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do for patients and relatives?
 Wellbeing Centre for staff.
PRIVACY & DIGNITY
 Importance for patients and
relatives
 How can we achieve this?
SAFETY
 Awareness of safety briefs
 Patient centred handover
between early & late shifts
 Review TPAR & current
medication for assessment prior
to surgery
 Red flag system to identify the
deteriorating patient.
 Administration of FRAGMIN pre
operatively.
 Consider commencement of
Warfarin when safe to do so.
Senior students only
WARD MANAGEMENT
 Drug rounds
 Missed doses
 Admission and discharge
procedures
 Organisation of other agencies
e.g OT, Physio, Social work,
District nurse
 Organisation of workload /
delegation
 Ward rounds
 Participation in nursing
handovers
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 Attending Monday Consultant
meeting
YOUR OWN OBJECTIVES
DATE
ACHIEVED
STN
SIG
SN
SIG
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REVIEWED OCTOBER 2014
BY
SCN ROSALYN MCKINNES
&
SN KELLIE CAVANAGH
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