Download undergraduate orientation booklet

Undergraduate
Clinical Placement
Orientation Manual
January 2011
WELCOME
Welcome to Werribee Mercy Hospital. This orientation booklet has been designed to
provide you with some general information to assist you with your clinical placement.
Our aim at Werribee Mercy Hospital is to provide you with the support that enables you
to develop and achieve your assessment criteria. This placement will further provide the
opportunities that will help facilitate the development of becoming a competent and
confident registered nurse.
ABOUT WERRIBEE MERCY HOSPITAL
Werribee Mercy Hospital is a general community hospital comprising 200 beds and treats
approximately 20, 000 inpatients annually. It is a public hospital campus that was opened
in 1994 and is part of the Mercy Health & Aged Care Group. The hospital offers general
surgical, general medical, maternity, neonatal, ambulatory care, palliative care services,
day chemotherapy, renal dialysis, mother/baby unit, allied health services, hospital in the
home and a 24 hour emergency department. There is also a large psychiatric service
comprising acute care, community care and rehabilitation. The hospital is currently
undergoing rapid expansion and redevelopment in order to meet the increasing demand
for health services within the region. The hospital is busy, modern and provides a wide
variety of current clinical experiences.
Mission Statement
In keeping with this statement of philosophy, Mercy health care institutions shall:
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Provide general and acute health care services to those who come to us in need;
Design programs for the provision of acute health care services so as not to ignore
the dispossessed of our times;
Provide quality services with dignity and with the belief that the spirit of those
rendering such services is paramount to the fulfilment of patient needs;
Establish a continuing commitment to health education at all levels to meet the needs
of our times.
Core Values
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Compassion
Hospitality
Respect
Innovation
Stewardship
Teamwork
Ethical Guidelines in Clinical Practice
Students must respect staff, patients, families and all who are welcome to Werribee
Mercy Hospital regardless of their religious beliefs, nationalities and cultures.
The dignity of each person must be upheld at all times.
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FACILITIES AND AMENITIES
Café
Zouki offers a wide variety of hot and cold food, toasted sandwiches, salads,
cappuccinos, soft drinks and cakes.
Food may be eaten in the Café’s comfortable surroundings or in the outdoor eating area.
Each ward also has a small kitchen area.
Change Rooms
Change rooms and showers are available for staff. The change rooms are located
opposite the kitchen.
Car Parking
Car parking is available for staff members at a cost of $3 per day. ID badges must be
presented at the car park booth.
Public Transport
The Hoppers Crossing Railway Station is located within 5 minutes walking distance of
the hospital.
Pastoral Care
The Department of Pastoral Care aims to create a caring atmosphere through which the
service of Christian ministry is made available to all people within the hospital and in
particular provides support to enable patients, families and staff to call on their spiritual
and/or personal resources, in meeting the events and challenges of life.
Chapel
Staff are welcome, to use the Chapel near the Boutique, for prayer or as a place of
peace and rest.
Mobile Phones
Students are not permitted to carry their mobile phone on them whilst providing patient
care. Mobile phones can be checked during breaks.
Smoking
Werribee Mercy Hospital is a totally smoke free hospital.
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Identification Badges
ID badges are a means of identifying the particular person. Students are required to
wear their ID badge at chest height at all times whilst on duty.
Clinical Uniform
It is compulsory for students to wear the correct university uniform at all times whilst on
clinical placements. Students must adhere to the uniform code outlined by the university.
I f a student does not present in uniform they may be sent home from the clinical.
Neat and professional attire must be maintained throughout the clinical placement
including;
 The uniform must be clean.
 Long hair must be worn tied back.
 Nails are to be short and clean, without nail polish.
 Artificial / porcelain nails are not acceptable.
 Earrings: plain studs or sleepers should be worn.
 A plain wedding band may be worn.
 Necklaces and bracelets are not acceptable.
 For safety reasons, rings or studs worn in facial piercing may not be appropriate.
Customer Service
The Werribee Mercy Hospital values the provision of a quality service. In our working
environment there is a clear relationship between the quality of care to customers and a
collaborative and supportive working team.
Customer satisfaction is integral to the process of ongoing evaluation. Patients are
encouraged to complete a hospital questionnaire, in which their suggestions and
comments are a welcome contribution to our continuous quality improvement program.
All patients receive a brochure outlining their rights and responsibilities.
Infection Control
Infection control is an implicit component of the day to day activities of all health care
workers. All staff and students will ensure that they understand the hospital’s infection
control objectives and be able to articulate their role in reducing the risk of infection in the
hospital environment.
Standards Precautions apply to work practices which assume that all blood and body
fluids are potentially infectious, and should be used as a first line approach to infection
control. These precautions include good hygiene practices, particularly hand washing
before and after patient contact, the use protective barriers which may include gloves,
gowns, plastic aprons, masks, eye shields or goggles, appropriate handling and disposal
of sharps and other contaminated or infectious waste, and use of aseptic techniques.
Standard precautions are recommended for the treatment and care of all patients,
regardless of their perceived infectious status, and in the handling of blood, all other body
fluids, secretions, excretions, non intact skin; and mucous membranes.
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Health Care Workers (HCWs) maybe exposed to, and transmit, vaccine preventable
diseases Maintenance of immunity to such diseases helps prevent transmission of
infection to and from HCWs and patients. The likelihood of contact with patients and/or
blood or body substances determines vaccination recommendations.
The following vaccines are recommended for all nursing staff prior to the commencement
of placement programs or employment.
Hepatitis B
Course of three doses must be
completed.
Antibody levels checked after third dose.
Influenza
Annual vaccination is recommended for
all staff
Measles/Mumps/Rubella (MMR)
Booster dose recommended for all
persons age 18 – 30 years.
Tetanus/Diphtheria/Whooping cough
A single booster dose is recommended
for all health care workers.
Varicella (Chickenpox)
If no history of infection then blood test
check is recommended. If no immunity
demonstrated then vaccination is
required.
Manuals
Policy manuals are readily available in all units of the hospital, and are provided to guide
staff in obtaining uniform standards of practice.
It is important that students and staff become familiar with the content of these manuals.
The policies are divided into three books: General Hospital Policies (white cover),
Infection Control (yellow) and Emergency (orange)
Mercy Intranet is also available to access the most up to date policies and procedures.
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NOTES
Clinical Teacher: _________________________________________
Pager Number: ________________
Phone Number: _______________
Ward: __________________________________________________
Ward Phone Number: _____________________________________
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ORIENTATION
Objectives of Orientation
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To meet the clinical teacher and review expectations of the clinical placement and
assessment criteria.
Familiarize with the hospital and general practice and procedures.
Understand the legal and ethical responsibilities of the undergraduate nursing student
in relation to clients, their relatives and the Werribee Mercy Hospital.
Identify the expected outcomes / objectives for the clinical placement that is relevant
to the clinical experience to be undertaken.
STUDENTS RESPONSIBILITIES
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Students must present a current police check on the first day of clinical placement.
Students should ensure their vaccinations are up-to-date.
Students are expected to work a 7 day rotational roster including night duty; this is an
agreement between the hospital and the Universities.
Students who are going to be absent are required to notify the unit they are working
on and also the clinical teacher.
Any absences must be supported with a medical certificate.
The Nurses Board of Victoria (NBV) perceive clinical placement as essential to
prepare nurses to be safe and competent. Therefore it is a requirement of the NBV
that nursing students attend clinical placement and complete the required hours.
Try to be punctual. If you are going to be late please contact the unit you are working
on.
Identification badges and uniforms must be worn at all times during clinical
placement.
Students are expected to complete all of the assessments identified by the university.
Students must identify themselves to staff, patients and visitors.
Students are reminded that maintaining confidentiality is paramount.
Students are expected to respect and uphold the Werribee Mercy Hospital’s values
whilst on clinical placement.
Students are required to familiarize themselves with the Werribee Mercy Hospital
policy and procedures.
Students are expected to report any concerns or changes in patient state immediately
to nursing staff.
Students should be motivated, dedicated, show initiative and actively participate in
patient care appropriate to their level of learning experience.
Students are expected to care for a minimum of two acutely ill patients depending on
their level and experience. Students will discuss the patients Medical/ Nursing
management in detail and deliver this management appropriately to their level of
learning experience.
Personal belongings should be kept to a minimum. Werribee Mercy Hospital will not
take any responsibility for missing belongings.
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CLINICAL TEACHER RESPONSIBILITIES
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The clinical teacher / preceptor / buddy must be available for students to contact him /
her. The clinical teacher will have a phone.
The clinical teacher will confirm shift times and ward allocation at orientation, and
assist students in the completion of the various universities requirements.
The clinical teacher will provide support and supervision to each student to enhance
learning and to assess his / her competence. The clinical teacher / preceptor will
complete the clinical appraisal by reflecting on the evidence of the students’
performance.
The clinical teacher / preceptor have a responsibility in providing ongoing feedback to
each student regarding his / her progress and discuss recommendations for
improvement.
Any concerns regarding a students’ progress will be discussed with the universities
undergraduate coordinator and subject coordinator within a timely manner and not
left until the interim or final appraisal. Unsatisfactory progress of a student will require
the clinical teacher to place the student on a learning program. This usually requires
written objectives for the student to achieve with a maximum of three days from
implementation. Failure to achieve the stated objectives, the student will be placed on
a clinical challenge contract to be negotiated between the subject coordinator, clinical
teacher and student.
The clinical coordinator will review each student’s completion of their personal
learning objectives weekly, and discuss these with the student.
The clinical teacher will set aside a specific time each day to meet with the students
for debriefing and discussion.
ROSTERS
Rosters will be developed on the first day of placement during orientation.
A clinical area will be allocated to each student according to availability and previous
clinical experience. Each student will have the opportunity to make some shift requests,
however there is no guarantee that the hospital will be able to accommodate these.
Ward Shift Times:
Emergency Department
Early (D) Late (E) Night (N) -
Early (D)
Late (E)
Middle (M)
0700 - 1530
1300 - 2130
2100 - 0730
0700 -1530
1300 -2130
1000 -1830
DPU
Early (D) - 0700 - 1530
Middle (0930) 0930 -1800
Late (E) 1130 - 2000
Theatre
0800 - 1630 (D)
1130 - 2000
During this time you are entitled to a 10 minute tea break and a 30 minute meal break.
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CLINICAL DEBRIEFING / GROUP SUPERVISION
CONTRACT
1.
The supervisor and supervisee are both responsible for their own clinical
practice.
2.
Debriefing/supervision should take place in a confidential environment.
3.
Confidentiality is maintained between the supervisor and supervisees unless
there is a breach in codes of practice or MHAC policy. Prior to any breach of
this confidentiality the issue will firstly be discussed with the supervisee.
4.
The supervisor will have the option of keeping a record of clinical
supervision/debriefing sessions and agrees to keep this information stored in
a confidential place. This information will not be used for any other purpose
apart from supervision/ debriefing.
5.
The model of supervision/debriefing being used is one of support and
development. Ideally the topics for discussion will have been planned in
advance by both the supervisor and supervisees.
6.
The time is to be used to discuss clinical issues not personal or outside
issues.
7.
The supervisor will ensure that the session will remain professional. It is not
a venue for gossip and/or destructive criticism about other staff members or
units.
8.
If a session is fostering a culture of negativity or promoting discontent and
blame among the wider group it is the responsibility of the supervisor to bring
the group back on track with problem solving strategies or positive solutions.
9.
This contract whilst needing to be adhered to is always negotiable.
Date:
Name of Supervisor:
Signature of Supervisor:
Name of Supervisee:
Signature of Supervisee:
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STUDENT PRIVACY AND CONFIDENTIALITY AGREEMENT
As a student on clinical placement at Werribee Mercy Hospital I agree that I will abide
by the privacy policy, privacy legislation and privacy procedures which apply to the
Werribee Mercy Hospital. In particular, I agree that:
a) I will read both the Mercy Health & Aged Care and the Entity’s Privacy Policy
and Procedures (however named) within seven (7) days of commencing
employment.
b) I shall not, during my period of placement with Werribee Mercy Hospital,
disclose or use any patient files, medical reports or confidential knowledge
obtained through my placement with Werribee Mercy Hospital other than to
perform my duties as authorised and detailed in my University guidelines for
clinical placement or specifically requested by my supervisor to perform.
c) Any breach of Werribee Mercy Hospital’s privacy policy or privacy legislation,
caused by me, whether intentional or not, may result in disciplinary action,
including immediate termination.
d) I may be held personally liable for any compensation payable resulting from a
breach of privacy which has been caused by me, whether intentional or not.
e) The obligations contained in clauses (a) to (c) inclusive will continue even after
the completion of my clinical placement with Werribee Mercy Hospital.
f) Upon termination of my clinical placement with Werribee Mercy Hospital I will
immediately deliver to Werribee Mercy Hospital all patient files, medical
reports or other documents which are in my possession or under my control
which in any way relate to the business of Werribee Mercy Hospital or its
patients past or present.
Name: ……………………………………... Signed: ……………………… Date: …/…/…
Witness Name: …………………………… Signed: ……………………… Date: …/…/
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Code of Conduct
Policy Statement:
This Code of Conduct outlines what is expected by all people employed directly or indirectly by
entities comprising the Mercy Health group. It is designed to help you understand your
responsibilities and obligations, and provide guidance if you are faced with an ethical dilemma or
conflict of interest in your work.
Policy
It is expected that all employees will demonstrate the following behaviours at work:
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To respect and work with the Mission and Vision of Mercy Health
To aspire to demonstrate the Values of Mercy Health and the associated behaviours, namely:
Compassion
Behaviour:
Demonstrate kindness and generosity of spirit
Provides support in times of need
Displays a passion to serve others
Hospitality
All people are greeted and made comfortable
Seek to provide assistance where needed
Provide a consistent level of customer service, internally and externally
Respect
Behaviour:
Recognises that each person is individual and unique
Strives to be open and honest in all things, at all times
Delivers good and bad news in ways that ensure people retain their sense of dignity and
self respect
Innovation
Behaviour:
Embraces change as an opportunity for renewal and improvement
Seeks opportunities to try new ideas and, as Mercy people, be acknowledged for their
contribution
Focuses on present and future actions
Stewardship
Behaviour
Holds in trust and builds on the tradition and spirit of Mercy
Develops Mercy people to be accountable for the highest standard of performance
Seeks opportunities to lead and made decisions, within agreed financial frameworks
Teamwork
Behaviour:
Working together to serve others and provide the best possible care
Communicates openly and honestly, to work as team members for the collective good
Respects the need and feelings of others and actively seeks their perspective
It is expected that all employees of Mercy Health will demonstrate the following behaviours at
work:
Policy Compliance
Comply with all Mercy Health policies, procedures and relevant statutory regulations.
Uniform
Adhere to the specified uniform policy, or if not applicable, to present for work neatly and
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professionally attired in a manner appropriate to the setting and context of the workplace.
Position Description
Comply with the organisational Position Description (PD) for their role and actively take
part in regular appraisal process.
Smoking
Adhere to non-smoking policies with Mercy Health facilities
Alcohol and Drugs
Present for work at all times free from the effects of alcohol and or other drugs that affect
the ability to work safely (see Risk Management Alcohol and Drug Policy).
Environmental Setting
Respect the workplace and its environmental setting
Outside Employment
Not engage in outside employment or conduct a business, trade or profession without
written authority from their General Manager, Chief Executive Officer or Chairperson as
appropriate. Consideration of requests to engage in outside employment would need to
be established to determine whether the outside employment would give rise to an actual
or perceived conflict of interest.
External Committees / Boards
Not participate as a member of any external Committee or Board that may cause a
conflict of interest with their role at Mercy Health. A written request specifying the time
and obligations of the desired membership should be provided to their General Manager,
Chief Executive Officer or Chairperson as appropriate.
Acceptance of Gifts and Benefits
Not accept gifts or benefits for services performed in connection with their perceived
duties and responsibilities, which might directly, indirectly or be perceived to comprise
them in their official capacity.
Conflict of Interest
Not engage in activities or behaviour that causes actual or potential conflict with personal
interests and employment responsibilities. Where a personal interest exists employees
must openly disclose that interest to their General Manager, Chief Executive Officer or
Chairman of the Board as appropriate.
Intellectual Property
It is a condition of employment that all employees assign to Mercy Health all intellectual
property rights in the works created by them during employment with Mercy Health. The
right to retain intellectual property rights of work may only be approved by their General
Manager, Chief Executive Officer or Chairperson as appropriate or if it can be
demonstrated that Mercy Health’s time, name, information or resources were not utilised
in producing the work.
Moral Rights
It is a condition of employment that all employees confirm they will not exert their moral
rights during their employment with Mercy Health. For example, if an employee creates
artistic works, written material, computer programs etc for a facility and the facility wants
to move or change the original works, it needs to be agreed that the Mercy Health facility
will have rights to move or change those works.
Excessive Hours
To ensure sufficient sleep and rest is obtained in order to perform work duties in a safe
and responsible manner.
Unacceptable behaviour / serious misconduct includes, but is not restricted to:
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Breach of patient/resident or staff privacy
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Breach of patient/resident or staff privacy
Breaching Mercy Health policies/procedures
Failure to report a work related accident/serious near miss
Continual lateness for duty/unauthorized absence
Careless action/neglect of professional conduct or duty
Failure to report a criminal conviction or impending action, which in the opinion of Mercy -Health, directly relates to a risk in performing your duties
Failure to disclose a prior or current conviction when requested to do so
Sleeping during working hours where there is a requirement to be working
Falsification of qualifications leading to employment
Public misrepresentation – causing damage to the reputation or image of Mercy Health or
its employees
Actions which deliberately or recklessly injure other employees, patients, clients or visitors
or that place their health, safety or welfare at serious risk
Improper use of workplace equipment, supplies and other physical resources
Breaches of this policy will be regarded as a discipline issue. Cases of unacceptable and/or
serious misconduct may result in summary dismissal of employment.
Employee Declaration
I agree that I have read and understand the Mercy Health Code of Conduct Policy.
Signature: ____________________________
Date: ___________________
Witness: _____________________________
Date: ___________________
Definitions
Term
Mercy Health Group
Definition
All facilities and entities across Mercy Health
References
All Mercy Health Policies
AS8002: Organisational Code of Conduct 1983
Facility Staff Handbooks
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HOSPITAL UNITS
C2 – Surgical Unit
C2 is a 16 bed unit that primarily cares for patients who have undergone elective and
emergency surgical procedures. These types of surgical procedures include; general
surgery (eg Laparoscopic Cholecystectomies, appendicectomies), gynaecology,
paediatrics and adult ENT, some orthopaedic and plastic surgery procedures, and
urology. The ward area also includes a four-bed Monitored Beds Area which facilitates
some higher level monitoring of Postoperative Patients, as well as acutely unwell medical
patients.
C3 – Acute Medical Unit
C3 is a 28 bed unit. This unit is dedicated predominately to care for patient with medical
conditions. These include COAD, Pneumonia, Infectious Illness, cellulitis, renal failure,
CVA, AMI, Diabetes, DKA, APO, IHD and Heart Failure. This clinical area will enable
students to develop, consolidate and extend their skills within the area of medical
nursing.
C3 is set up with a security unit for wandering confused patients, which is affectionately
known as the granny tracker system. The unit works by activating an alarm on the four
exits to C3. The patient at risk must wear the activation device as an anklet. If the patient
wearing the devices passes through an exit once they have been activated, an alarm
sounds at the desk area and a display panel indicates which exit has been passed. The
alarm can be turned off once the patient has been found by turning the key twice to the
left until it is line with the black marker.
D3 – Medical Unit & Gabrielle Jennings Centre – Palliative Care Unit
D3 and the Gabrielle Jennings Centre is an integrated unit with 10 palliative care beds
and 18 medical beds. Palliative care patients are admitted for pain management, terminal
care and respite. The care provided to a palliative patient is a team effort. Registered
Nurses work closely alongside Medical staff, Social Workers, Physiotherapists,
Occupational therapists, Speech Pathologist, Pastoral Carers, Pharmacists and
volunteers to provide optimal holistic care to the patients.
Ambulatory Care Unit – Day Procedure, Renal Dialysis, Hospital in the
Home (HITH), Midwifery in the Home (MITH)
The Ambulatory Care Department cares for patients who are having a procedure where
they will be admitted and discharged on the same day or require a nursing service at
home.
It consists of the following units: Day Procedure: cares for patients having medical and surgical procedures or
chemotherapy
 Renal dialysis: Provides haemodialysis for patients with end stage renal failure.
 Hospital in the Home: provides nursing care for acute patients in the home
 Midwifery in the Home: provides postnatal care in the home for women after
childbirth.
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Also managed by this department is the:
 Preadmission service: All patients having surgery have their health details checked
by a nurse prior to the procedure.
 Home Oxygen: Co-ordination of oxygen for patients who require it at home.
D2 – Childbirth Centre
The Childbirth Unit is a busy integrated unit that provides antenatal, labour, birth and
postnatal care. Other services include Pregnancy Booking Clinic, Pregnancy Day Stay,
Childbirth Education, Breastfeeding Day Stay, Midwifery in the Home and Team
Midwifery Program. Obstetric care is provided by consultant obstetricians and one GP
Obstetrician. The current birth rate is approximately 2,000 births per year.
The Special Care Nursery provides Level 2 care, and accepts babies from 32 weeks
gestation. The unit can provide care for up to 12 Neonates.
Emergency
The Emergency Department was recently upgraded, with the new department being
opened in June 2005. The new Emergency Department is currently seeing 37,000
patients per year, with that number expected to rise to 50,000 over the next two to three
years. The Emergency Department has a total of 21 cubicles.
Currently we are working with 10 cubicles which include 2 resuscitation bays. We also
have a procedure room where minor procedures such as suturing and plastering are
attended to, a dedicated eye room and a negative pressure isolation room. The new
Emergency Department provides separate waiting areas for adult and paediatric patients,
a triage room so patients who need privacy can be assessed quickly on arrival and a
lounge room for distressed family members.
There are dedicated facilities to care for the increasing number of patients presenting
with mental health issues. The Crisis Assessment and Treatment Team (CATT) are
based permanently in the ED.
Operating Suites
The Operating Suite at Werribee Mercy Hospital consists of;
 General Theatres
 1 Endoscopy Room
 A seven (7) bay recovery
 CSSD
General and gynaecological surgery are the predominant types of surgery performed in
this very busy and efficient unit. Other specialties include;
 ENT
 Urology
 Plastics
 Paediatric general
 Oral Maxillary
 Basic Vascular
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The Endoscopy Unit (located in the Day Procedure Unit) carries out Flexible
cystoscopies, bronchoscopies, ECT, colon and gastroscopies
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Diabetes Education
The Diabetes Education Unit has been operating for the past 6 years. There is a
Diabetes Educator available 4 days a week. She sees both inpatients and outpatients.
Hospital Admission Risk Program (HARP)
1. HARP aims to prevent avoidable hospital presentations and admissions.
2. HARP targets people with chronic disease, aged and/or complex needs that
frequently use hospitals or are at imminent risk of hospitalisation and could
benefit from coordinated care.
3. Health services may have people who present frequently for many different
reasons. HARP specialises in managing people with diabetes, chronic respiratory
disease, chronic heart failure, complex psychosocial and complex aged needs.
4. HARP provides specialist medical care and multidisciplinary services through an
integrated response of hospital and community services, delivered in hospital,
community and home-based settings.
5. HARP works in collaboration with other acute, community, aged care and
specialist services, but does not duplicate them.
6. For clients who are acutely, psychiatrically unwell and meet the mental health
eligibility criteria, referral to an area mental health service is the most appropriate
response.
What does HARP provide?
Our HARP Care Coordination Team is multidisciplinary and includes Allied Health and
Registered Nursing staff. We also utilise the services of medical specialists where
appropriate. The services we provide are:
Short Term Care Coordination:
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Outreach service: hospital, home and community visits.
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Comprehensive assessment.
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Development of a self-management care plan.
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Education about chronic conditions and how best to manage them.
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Linking in with the local health network (GP, specialists, home services, support
groups, allied health and counselling).
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Advocating for the client’s individual needs and goals.
Rehabilitation (Pulmonary and Heart Failure):
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Twice weekly individualised exercise sessions for 8 weeks (Pulmonary) and 10
weeks (Heart Failure).
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Education discussions with multidisciplinary team targeting disease education
and self-management.
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Who is eligible for HARP?
Patient/Client exhibits complex care, aged or psychosocial needs, and/or unstable
or complicated chronic respiratory disease, chronic heart failure, diabetes or other
chronic disease
AND
Has had at least one (1) unnecessary or avoidable hospital presentation or
admission in the past twelve (12) months
AND
Meets the screening criteria for each HARP care stream as follows:
Chronic Obstructive Pulmonary Disease:
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Diagnosis of moderate to severe COPD as per Lung Function Test.
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No age limit.
Pulmonary Rehabilitation:
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Diagnosis of COPD as per Lung Function Test or other chronic lung conditions
(Pulmonary Fibrosis or Bronchiectasis).
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Excludes unstable cardiac conditions, unstable pulmonary hypertension and
clients with severe physical, neurological or psychological conditions which
prevent participation in exercise.
Chronic Heart Failure:
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Diagnosis of Chronic Heart Failure (CHF) as per Echocardiography.
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No age limit.
Heart Failure Rehabilitation:
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Diagnosis of Chronic Heart Failure (CHF) as per Echocardiography.
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Excludes medically unstable clients and clients with severe physical, neurological
or psychological conditions which prevent participation in exercise.
Diabetes:
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Diagnosis of Type 1 (T1DM) or Type 2 (T2DM) Diabetes as per Fasting Blood
Glucose (FBG) pathology.
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High risk diabetic patient/client (i.e. psychosocial issues, poorly controlled
diabetes).
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Excludes gestational diabetic and juvenile clients.
Older People with Complex Needs:
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55+ years of age.
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Two or more chronic diseases.
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Complex psychosocial issues contributing to hospitalisations (e.g. self-care,
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limited support network, demanding care responsibilities).
MEDICATION MANAGEMENT
Students must be supervised at all times when preparing and administrating medications.
This hospital has a double checking protocol which includes all intravenous,
intramuscular, subcutaneous medications. Please familiarize yourself with the section on
medications in the nursing procedures manual and the hospital protocol on double
checking of medications (H005).
Safe Medication Administration Principles
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Right Record
Right Drug
Right Dose
Right Patient
Right Route
Right Time
AND
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Check the expiry date of the medication
Check the patient does not have any allergies
Question the order if it is unclear or illegible.
Check the labelling of the drug or ampoule.
A patient has the right to refuse their medications if this occurs, report to doctor
and nurse in charge.
Converting Metric Units
1kg = 1000g
1g = 1000mg
1mg = 1000mcg
1L = 1000ml
Administration of drugs
There is one formula to calculate the amount of medication required for an injection or
oral tablet.
Drug to be given
(Mass/ volume)
Strength required
=
x
Volume
Stock strength
1
Drugs to be given: is the mass or volume of stock to be given to the patient.
Strength Required is the amount of drug required for the patient.
Stock Strength is the amount of drug in the stock per an amount of drug (volume of the
ampoule).
Volume: is the volume of the stock solution if applicable.
17
Intravenous Infusion Rates
Formulae:
Volume
=
Rate x Time
Time
=
Volume
--------Rate
Rate
=
Volume
--------Time
Volume is measured in units of volume (mL, L, etc).
Time is measured in units of time (mins, hours, etc).
Rate is measured in units of volume per time (mL/hour, L/day, etc).
Intravenous Drug Doses
Standard giving set: 20drops per minute = 1ml
Microdrip set: 60 microdrops = 1ml
drip rate
=
rate (mL/hr)
_________
1
x
drop factor (drops/mL)
__________________
60 minutes
To calculate mcg/kg/min
This formula is often used to calculate inotrope and vasoactive drug dosages.
mcg/kg/min = Amount required X 1000 (convert to mcg) X mls/hr (rate set)
Volume
60 (convert to min)
weight
mls/hr =
Volume
X 60 (convert to min)
Amount Required 1000 (convert to mcg) X mcg/min (dose required) X weight
A student must never administer any type of medication unsupervised
18
COMMONLY USED MEDICATIONS
SURGICAL
Pethidine
Tramadol
Metoclopramide
Prochlorperazine
Panadeine Forte
Kytril
Dexamethasone
Midazolam
Metronidazole
Cephazolin
Ceftriaxone
Ampicillin
Getamicin
Amoxycillin
Endone
Dolasetron
Panadeine Forte
Diflofenac
Oxycodone
MEDICAL
Clexane
Heparin
Warfarin
Salbutamol
Atrovent
Sodium Valproate
Ranitidine
Roxithromycin
Atorvastatin
Lanoxin (Digoxin)
Frusemide (Lasix)
Endone
Ibersartin
Potassium
Enalapril Maleate
Actrapid
Levemir
Magnesium
Ramipril
Clexane
Azithromycin
Protophane
Metformin
PALLATIVE
Fentanyl
Ketamine
Haloperidol
ANAESTHETICS
Propofol
Sodium Thiopentone
Atracurium
Atropine sulfate
Vecuronium
Suxamethonium
Rocuronium bromide
Adrenaline
DOCUMENTATION GUIDELINES














Always date and time all entries.
Writing should be legible.
Always print your name clearly after your signature.
Always print clearly the designation of the author.
Be objective and clearly reflect the event of the shift.
Additional entries can be added if an event occurs.
Entires should not be written prospectively ( or out of date / time order)
Liquid paper should never be used.
Errors should be initialled and a line put through them.
Do not leave any spaces between previous entries and the one you are writing.
Always ensure bradma labels are applied to the page you are writing on or that the
patient’s details are written including name, DOB, UR number.
Students must always get a registered nurse to co-sign their entries.
Ensure if referring to anyone in the notes, e.g. Doctor that you use their surname and
don’t just document RMO.
Changes in patient care should be clearly documented with investigations and plan of
treatment outlined.
19
HANDOVER GUIDELINES
Handover is a process of communicating the current information and condition of the
patient’s on the ward. Handover is commenced at the start of the shift and last
approximately 30 minutes.
There are different styles of handover throughout the hospital these include, taped
handover, verbal handover and individual handover.
Guidelines for Handover




Be concise.
Handover any abnormal results.
Handover the patients
Patients: Name
Written on handover sheet.

Age:

Reason for Admission
/ Diagnosis:
Written on handover sheet.

Past History:


Operation / treatment so far:

Observations:




Input:

Output:

Mobility:


Hygiene:
Wound Care:

Pain:

Emotional:

Social:

Plan:
Written on handover sheet.






















Any relevant past history:
- Medical past history.
- Smoker, alcohol, drug use.
- Allergies
- Psychiatric history.
Discussed.
Including relevant medications / relevant blood results.
Any vital signs outside of the normal limits and treatment
given as a result.
IV therapy: Rate and if relevant fluid.
Date of the last IV site change.
Diet: any restrictions.
FBC
Need for Dietician involvement?
IDC & measurement frequency,
Trail of void.
Bowel activity.
Drain tubes/ vaginal packs
Level of mobility, any changes in mobility.
Need for Physiotherapy involvement?
Level of assistance.
Description of the wound; type, location and size. Dressing and
frequency, any changes to the wound.
Skin integrity/pressure area care.
Type, location, intensity, duration.
What analgesia has been administered and it’s effectiveness.
PCA or Epidural:
Psychological/emotional status eg. Patient’s reaction to surgery,
illness or treatment.
Need for Pastoral Care involvement?
Any issues which need to be discussed.
Need for social work/ interpreter involvement?
Planned procedures or treatment. Discharge planning: when,
what is required, what needs to be organised, etc.
20
FLUID BALANCE CHARTS
Maintaining an accurate fluid balance chart is an important aspect of nursing care that
assists with fluid management therapy. Where indicated any patient who requires close
observation or monitoring of fluids should be commenced on a fluid balance chart. It is
advisable that you familiarise yourself with the different charts that are used in the clinical
area you will be working in. It is also desirable that you will subtotal the fluid balance
chart throughout the shift ensuring you maintain your patient’s fluid status.
Fluid Measurements
Cup Tea / Coffee
180mls
Bowl of soup
210mls
Carlton of Milk
140mls
Tumbler of Fluid
200mls
Container of Juice
110mls
Jelly
120mls
Ice-cream (Dixie)
150mls
Icy-pole
80mls
21
EARLY
TIME
GUIDE
0700
Handover, allocations
Intro to patient
Mane tablets, IV AB’s
s/c injections, Insulin
0730
0800
Name:
Room:
Dr:
0830
Work out time plans
Look at patient’s charts,
care plans
Patient hygiene, beds
0900
0930
Patient hygiene, beds
Morning tea
1000
Wound dressings
Update & sign care plans,
FBC charges, PAC
1030
1100
1130
1200
1230
1300
1330
Name:
Room:
Dr:
Name:
Room:
Dr:
Medications, injections
QID obs
Check updated info on
patient
BSL’s / Insulin
Lunch
Prepare patient for lunch
Update FBC, PAC
Handover
Patient rest period
Write nursing notes
1400
1430
TDS obs and medications
1500
Check charts
Update care plans
Home time
1530
Name:
Room:
Dr:
REPORT:
BSL’s <4mmol or >8mmol
Urine <30ml/hr, pH,
leukocytes
Blood or protein
Temp <35.5 or >37.5
Pulse <60 or >110
Resps <14 or >24
Systolic BP <100mmhg
Sa02 <95/%
PATIENT 1:
PATIENT 2:
NURSING NOTES:
Visualise patient from head to
toe
Mobility, e.g. RIB, NWB
Wounds, e.g. dressings, PAC
Fluid balance, e.g. IDC, IVT,
FBC, FWT
Pain Control
Medications, injections, AB’s
Observations
PATIENT 3:
PATIENT 4:
22
LATE
TIME
GUIDE
Name:
Room:
Dr:
1300
1330
Handover, allocations
Intro to patient
TDS obs and medications
1400
Work out time plans
1430
Look at patient’s charts,
care plans
1500
1530
Afternoon tea
1600
QID Obs
1630
QID & BD Medications
1700
Check updated info on
patient
Name:
Room:
Dr:
Name:
Room:
Dr:
Name:
Room:
Dr:
1730
BSL’s / Insulin
Prepare patient for dinner
1800
Dinner break
1830
Update FBC, PAC
1900
1930
Write nursing notes
2000
TDS, QID obs and
medications
2030
Patient hygiene,
dressings
BSL’s, Insulin
2100
Check charts
Update care plans
2130
Home time
REPORT:
BSL’s <4mmol or >8mmol
Urine <30ml/hr, pH,
leukocytes
Blood or protein
Temp <35.5 or >37.5
Pulse <60 or >110
Resps <14 or >24
Systolic BP <100mmhg
Sa02 <95/%
NURSING NOTES:
Visualise patient from head to
toe
Mobility, e.g. RIB, NWB
Wounds, e.g. dressings, PAC
Fluid balance, e.g. IDC, IVT,
FBC, FWT
Pain Control
Medications, injections, AB’s
Observations
PATIENT 1:
PATIENT 2:
PATIENT 3:
PATIENT 4:
23
ROOM
0700
0800
0900
1000
1100
1200
1300
1400
1500
HANDOVER
TIME
PATIENT 1
PATIENT 2
PATIENT 3
PATIENT 4
PATIENT 5
1400
1500
1600
1700
1800
1900
2000
2100
2200
25
26
EMERGENCY RESPONSE CODES
EMERGENCY: DIAL 3333
RED
- FIRE
ORANGE
- EVACUATION
BLUE
- MEDICAL EMERGENCY
PURPLE
- THREATS – BOMB, ARSON, EXTORTION
YELLOW
- INTERNAL DISASTER
BROWN
- EXTERNAL EMERGENCY
BLACK
- HOLD UP, ASSAULT
GREY
- PSYCHIATRIC EMERGENCY
27
BASIC LIFE SUPPORT SUMMARY 2010
[Reference – Australian Resuscitation Council (ARC)]
D
R
A
B
C
D
Check for danger to self/patient/bystanders.
Response. If unresponsive, call for local help and call 3333 and state Code Blue and the
location.
Airway:
- visually inspect the airway
- clear the airway prn; suction is recommended
- open the airway – head tilt & chin lift or jaw thrust
Breathing. If not breathing normally or not at all, deliver 2 effective breaths (allowing
about one second per inspiration) with a laerdal circuit connected to Oxygen flowmeter set
at maximum delivery.
Check for * signs of life; if no signs of life, commence chest compressions (lower half of
sternum, one third the depth of the chest cavity). Aim 100 compressions per minute.
Compression to ventilation ratio 30:2. Pause compressions for ventilation.
Defibrillation – apply defibrillation pads (‘Multifunction Adult Defib Electrodes’) as soon as
available (when there are no signs of life & the individual is over 8 years of age) and
follow the audible prompts.
The defibrillator should be turned on in AED mode.
* Signs of Life
Conscious
Responsive
Breathing
Moving
No signs of life
Unconscious
Unresponsive
Not breathing normally
Not moving
Management of foreign body airway obstruction (choking):
‘…The victim with an effective cough should be given reassurance and encouragement to keep
coughing to expel the foreign material’ (ARC).
In the case of conscious victim with severe airway obstruction (ineffective cough), ‘…perform up to
five sharp back blows with the heel of one hand in the middle of the back between the shoulder
blades’ (ARC). ‘…If back blows are unsuccessful the rescuer should perform five chest thrusts.
Check to see if each chest thrust has relieved the airway obstruction. To perform chest thrusts
identify the same compression point as for CPR…these are similar to chest compressions but
sharper and delivered at a slower rate’ (ARC).
Resuscitation in late pregnancy:
‘…In the obviously pregnant woman the pregnant uterus causes pressure on the major abdominal
vessels when she lies flat, reducing venous return to the heart. The pregnant woman should be
positioned on her back with her shoulders flat and sufficient padding under the right buttock to
give an obvious tilt to the left’ (ARC).
Extra points relating to defibrillation:
- apply pads firmly to bare, dry & hairless skin
- avoid placing pads over ECG electrodes, any medication patches, implanted devices eg.
pacemakers/CVC insertion sites
- avoid having the victim in contact with metal fixtures eg. bed rails
- position pads below the right collarbone & the other, below the left breast over the ribs in
line with the armpit
- when in AED mode, follow audible prompts
if ‘shock’ is advised, loudly state ‘all clear’ & visually check that everyone is clear of the patient &
bed.
28
CHECKLIST
This needs to be completed on the first day of clinical placement
CAN YOU PROMPTLY LOCATE:
()
Resuscitation Trolley
Break Fire Alarms
Air Viva - paediatric and adult
Paediatric emergency equipment
Wall oxygen and suction
Portable oxygen and suction
Fire Extinguishers
Fire Hose Reels
Red Phones
Designated Evacuation Area
Emergency Buzzer
Duress Alarms
Bomb Threat Forms
Emergency Procedures Manual
Practices & Procedures Manual
Communication Book
Incident Forms
Utility Room - clean / other
Storage Room
Drug Room
Call bell system
29
CHECKLIST Continued
ARE YOU ABLE TO:
()
Use telephone system
Contact VMO’s and RMO’s
CAN YOU PROMPTLY LOCATE:
Thermometers
Intravenous / Blood Taking Trolley
Pathology tubes, forms, plastic bags
Asthma equipment: drugs, nebulisers, peak flow meters
Blood Glucose Monitor
Suture equipment: suture material, instruments, local anaesthetic
Syringes, needles
Intravenous, intra-muscular and oral medication
Suppositories, antibiotics, vaccines
Plaster trolley
Sterile stock: gowns, drapes, dressing trays
Patslide
Name bands / Allergy bands
30
ABBREVIATIONS
A
A&B
A&E
A/N
A/V
A/W
AAA
Ab / Abort
Abdo
ABG
AB's
AC
ADLs
ADT
AE
A/F
AF
AFI
AFP
AIDS
AK
AKA
ALD
AMI
Amp
Anaes
ANC
Ant.
AO
A-P
APH
APO
Appt
APTT
ARDS
ARF
ARM
ART
ASAP
ASD
AUM
AUR
AV
AXR
B
B/F
Apnoea and bradycardia
Accident and Emergency
Antenatal
Anteverted
Associated with
Abdominal aortic aneursym
Abortion
Abdomen
Arterial blood gases
Antibiotics
Antecibum – before meals
Activities of daily living
Adult diphtheria and tetanus
Air entry
Artificial feeding
Atrial fibrillation
Amniotic fluid index
Alphafetoprotein
Acquired immune deficiency syndrome
Above knee
Above knee amputation
Alcoholic liver disease
Acute myocardial infarction
Ampoule
anaesthetics
Antenatal Classes
anterior
Admitting officer
Anterior - posterior
Antepartum haemorrhage
Acute pulmonary oedema
Appointment
Activated partial thromboplastin time
Adult respiratory distress syndrome
Acute renal failure
Artificial rupture of membranes
Arterial, artery
As soon as possible
Atrial septal defect
Associate unit manager
Acute urine retention
atroventricular
Abdominal x-ray
Breastfed
31
BA
Ba Enema / Meal
BBA
BBB
BCC
BCG
BD
BFDS
BGL
BHCG
BIBA
Bili
BKA
BMI
BPS
BNO
BO
BOS
BP
BPD
BPM
BSE
BSL
BSO
B/W
Bx
C
c/o
Ca
CA125
CABG
CAD
CAG
Cas
CATT
CCF
CCP
CCT
CCU
CE’s
CEA
CHB
CHD
Chol
Chole
CI
CIN
Circ
CIS
CLD
Bowel action
Barium enema / barium meal
Born before arrival
Bundle branch block
Basal cell carcinoma
Vaccination against tuberculosis
Twice daily
Breast Feeding Day Stay
Blood glucose levels
Beta Human Chorionic Gonadotrophin
Brought in by ambulance
Bilirubin
Below knee amputation
Body Mass Index
Biophysical profile score
Bowels not open
Bowels open
Base of skull
Blood pressure
Biparietal diameter
Beats per minute
Breast self examination
Blood sugar level
Bilateral salpingo-oopherectomy
Birth weight
Biopsy
Complaining of
Carcinoma
Tumour marker for ovarian carcinoma
Coronary artery bypass graft
Coronary artery disease
Coronary artery graft
Casualty
Crisis assessment triage team
Congestive cardiac failure
Central chest pain
Controlled cord traction
Community care unit
Cardiac enzymes
Carcino embryonic antigen
Complete heart block
Congenital heart disease
cholesterol
Cholecystectomy
Coitus interruptus
Cervical intraepithelial neoplasm
Circumcision
Carcinoma in situ
Chronic lung disease
32
cm
CMV
CNS
CO
CO2
COAD
CP
CPAP
CPD
CPR
Creat
Creps
CRF
CRP
CS or C/S
CSF
CSU
CT
CTG
CTR
CTS
CVA
CVC
CVL
CVP
CVS
CWMS
Cx
CXR
D
D&C
D&E
D&V
D/C
D/W
DBE
DD
DIC
DM
DNA
DNW
DOA
DOB
DOM
DPM
Dr.
DRG
DT
centimeter
Cytomegalo virus
Central nervous system
Clinical Nurse Specialist
Carbon monoxide
Cardiac output
Carbon dioxide
Chronic obstructive airways disease
Chest pain
Continuous positive airways pressure
Cephalo pelvic disproportion
Cardiopulmonary resuscitation
Creatinine
Crepitations
Chronic renal failure
C reactive protein
Caesarean section
Cerebrospinal fluid
Catheter specimen of urine
Computed tomography (scan)
Cardio tocograph
Carpal tunnel release
Carpal tunnel syndrome
Cerebrovascular accident
Central venous catheter
Central venous line
Central venous pressure
Cardiovascular system
Colour, warmth, movement, sensation
Cervix
Chest x-ray
Dilatation and curettage
Dilatation and evacuation
Diarrhoea and vomiting
Discharge
Discussed with
Deep breathing exercises
Differential diagnosis
Disseminated intravascular coagulopathy
Diabetes mellitus
Did not attend
Did not wait
Dead on arrival
Date of birth
Domiciliary midwifery service
Drops per minute
Doctor
Diagnostic related groups
Drain Tube
33
DTA
DTs
DU
DUB
DVT
Dx
E
E.coli
E/O
EAR
EBM
ECG
ECHO
ECT
ECTR
ECV
EDC
EDD
Eg.
EMD
ENT
ERCP
ESR
ESRF
ETOH
ETT
EUA
Exac
F
F/S
F/U
FB
FBC
FBE
FC
FDIU
Fe
FFP
FG
FGM
FH
FHH
FHR
FHx
FI
Fib
FMF
FOOSH
FSE
Deep transverse arrest
Delirium tremens
Duodenal ulcer
Dysfunctional uterine bleeding
Deep vein thrombosis
Diagnosis
Escherichia coli
Excision of
Expired air resuscitation
Expressed breast milk
Electrocardiograph
Echocardiogram
Electro convulsive therapy
Excision carpal tunnel release
External cephalic version
Estimated date of confinement
Estimated due date
Example
Electromechanical dissociation
Ear, nose and throat
Endoscopic retrograde cannulation of pancreatic duct
Endoscopic retrograde cholangiopancreatography
Erythrocyte sedimentation rate
End stage renal failure
Alcohol (ethanol)
Endotracheal tube
Examination under anaesthetic
exacerbation
Frozen section
Follow up
Foreign body
Fluid balance chart
Full blood examination
Filschie clips
Fetal death in utero
Iron
Fresh frozen plasma
French gauge
Female genital mutilation
Fetal heart
Fetal heart heard
Fetal heart rate
Family history
For investigation
Fibula
Fetal movements felt
Fall on outstretched hand
Fetal scalp electrode
34
FSH
FTA
FTSG
FWB
FWT
Fx
G
G
GA
GAMP
GBS
GCS
GCT
GDM
GIT
GNC
GOR(D)
GP
GTT
GU
Gutt
Gynae
H
H&M
H/O
H/T
Hb
HCG
HDU
HELLP
Hep A,B,C,D
HITH
HIV
HIE
HMD
HNPF
HNPU
HOPC
HOT
HOV
HPF
HPV
HR
Hrly
HSG
Ht
HVS
Hx
Hypo
Follicle stimulating hormone
Failed to attend
Full thickness skin graft
Full weight bearing
Full ward test
Fornix
Gravid
General anaesthetic
General anaesthetic, manipulation and plaster
Group B streptococcus
Glasgow coma score
Glucose challenge test
Gestational Diabetes Mellitus
Gastro intestinal tract
General nursing care
Gastro-oesophageal reflux (disease)
General Practitioner
Glucose tolerance test
Gastric ulcer
Eye drop
Gynaecology
Hematemesis and malaena
History of
Hypertensive
Hypertension
Haemoglobin
Human chorionic gonadotrophin
High dependency unit
Haemolysis elevated liver enzymes low platelets
Hepatitis A,B,C,D
Hospital in the home
Human immuno deficiency virus
Hypoxic ischaemic encephalopathy
Hyaline membrane disease
Has not passed flatus
Has not passed urine
History of presenting condition
Hands off Technique - Breast Feeding Education programme
Head on view
Has passed flatus
Human papilloma virus
Heart rate
hourly
Hysterosalpingogram
height
High vaginal swab
History
hypoglycaemia
35
I
I/O
I/P
ICC
ICH
ICP
ICS
ICU
IDC
IDDM
IF
IHD
II
IM
IMB
IMI
Imp
Ing.
INR
IOL
IOP
IPPV
IT
ITP
IU
IUD
IUGR
IV
IVB
IVF
IVH
IVP
IVT
Ix
J
J
JVP
K
K+
KCl
KUB
L
L
L/Min
LA
Lac
LAD
Insertion of
Inpatient
Intercostal catheter
Intracranial haemorrhage
Intercranial pressure
Intercostal space
Intensive care unit
Indwelling catheter
Insulin Dependent Diabetes Mellitus
Iliac fossa
Ischaemic heart disease
Image intensifier
Intramuscular
Intermenstrual bleeding
Intramuscular injection
Impression
Inguinal
International normalised ratio
Induction of labour
Intraocular pressure
Intermittent positive pressure
Intrathecal
Idiopathic thrombocytopaenia purpura
International unit
Intrauterine device
Intrauterine growth restriction
Intravenous
Intravenous bung
In vitro fertilisation
Intraventricular haemorrhage
Intravenous pyelogram
Intravenous therapy
Investigation
joules
Jugular venous pressure
Potassium
Potassium chloride
Kidneys, ureter, bladder
Left
Litres per minute
Local anaesthetic
Left arm
Left atrium
Laceration
Left anterior descending (coronary artery)
36
LAMP
Local anaesthetic, manipulation and plaster
Lap
Lat
LAVH
LBBB
LBO
LBW
LC
LCM
LEEP
LFC
LFT's
LH
LHF
LIF
LLETZ
LLL
LLQ
LML
LMO
LMP
LNMP
laparoscopy
lateral
Laparoscopically assisted vaginal hysterectomy
Left bundle branch block
Large bowel obstruction
Low birth weight
Lactation consultant
Left costal margin
Loop electro surgical excision procedure
Laparoscopic filschie clips
Liver function tests
Luteinising hormone
Left heart failure
Left iliac fossa
Large loop excision transformation zone
Left lower lobe
Left lower quadrant
Left middle lobe
Local medical officer
Last menstrual period
Last normal menstrual period
Left occipito anterior (? Midwifery term – is it used?)
Loss of appetite
Loss of consciousness
Left occipito posterior (? Midwifery term)
Left occipito transverse (? Midwifery term)
Loss of weight
Lumbar puncture
Left salping-ooppherectomy
Left upper lobe
Left upper quadrant
Lower uterine segment caesarean section
Left ventricle
Left ventricular failure
Leave without Pay
LOA
LOC
LOP
LOT
LOW
LP
LSO
LUL
LUQ
LUSCS
LV
LVF
LWOP
M
MA
M, C & S
M/W
Mane
MAP
MBA
MCA
mcg
MCHN
M-C-P joint
mg
Mg
Metered aerosol
Micro, culture and sensitivity
Midwife
morning
Mean arterial pressure
Motorbike accident
Motor car accident
microgram
Maternal & Child Health Nurse
Metacarpophalangeal joint
Milligram
Magnesium
37
MG
MI
MICA
MITH
ml
mm
mmHg
mmol
MO
MOW
MR
MRI
MROP
MRSA
MS
MSU
MUA
Multi
MV
MVA
MVR
MV regurg
Mx
N
N/A
N/CT
N/O
N/S
N2O
Na
NaCl
NAD
NASS
NBM
NST
NCP
Neb
NEC
Neg, -ve
NESB
Neuro
NFO
NG
NGT
NICU
NIDDM
NIPPV
NKDA
NMRI
Multigravida
Myocardial infarction
Mobile intensive care ambulance
Midwifery in the Home
millilitres
Millimetres
Millimetres of mercury
Millimols
Medical officer
Meals on wheels
Membranes ruptured
Magnetic resonance imaging
Manual removal of placenta
Multiple resistant staphylococcus aureus
Multiple sclerosis
Mid stream specimen of urine
Manipulation under anaesthetic
Multiparous
Mitral valve
Motor vehicle accident
Mitral valve replacement
Mitral valve regurgitation
Management
Not applicable
Nasal cautery
Nil orally
Nipple shield
Nitrous oxide
Sodium
Sodium chloride
Nil abnormalities detected
Neonatal abstinence scoring system
Nil by mouth
Newborn screening test
Nursing care plan
Nebuliser
Necrotising enterocolitis
Negative
Non english speaking background
Neurological
No further orders
Nasogastric
Nasogastric tube
Neonatal intensive care unit
Non Insulin Dependent Diabetes Mellitus
Nasal intermittent positive pressure
Non-invasive positive pressure ventilation
No known drug allergies
Nuclear magnetic resonance imaging
38
NND
No.
Nocte
NOF
NOK
NP
NPA
NPO
NSAID
NST
NVD
NVB
NVF
O
O
O&G
O/A
O/E
O/N
O/T
O2
O2 Sat
OA
Obs
Occ
OCP
OD
OHS
OP
Op
OR
ORIF
OT
Oz
P
P
p.c.
P/C
P/T
PA
PAC
PACFU
Paed
Palp
PANDA
PAP
Pb
PC
Neonatal death
Number
Night
Neck of femur
Next of kin
Nasal prong
Naso-pharyngeal aspirate
Nil per os (nil orally)
Non-steroidal anti-inflammatory drug
Non stress test
Normal vaginal delivery
Normal Vaginal Birth
Normal vaginal flora
Orally
Obstetrics and Gynaecology
On admission
On arrival
On examination
Overnight
Operating theatre
Oxygen
Oxygen saturation
Osteoarthritis
Observations
Eye ointment
Oral contraceptive pill
Overdose
Occupational health and safety
Occipito-posterior
Out patient
Operation
Operating room
Open reduction, internal fixation
Occupational therapist
Ounce
Parity
Post cibum – after meals
Presenting complaint
Phototherapy
Postero - anterior
Pressure area care
Premature atrial contraction
Post acute care funding unit
Paediatrics
Palpation
Post and Antenatal Depression Association
Pulmonary artery pressure
Lead
Packed cells
39
PCA
PCEA
PCOS
PD
PDA
PDS
PDPH
PE
PE(T)
PEA
PEEP
PEFR
PFO
PG
Primip
PHx
PID
PIH
PKU
PM
PMB
PMS
PND
PNx
PO
POC
POD
POP
POP
Pos, +ve
Post
PPH
PPHN
PR
PRBC
Preg
Pre-med
Pre-op
PRN
PROM
Prox
PT
Pt
PTTK
PTL
PTSD
Patient controlled analgesia
Patient controlled epidural analgesia
Polycystic ovarian syndrome
Peritoneal dialysis
Patent ductus arteriosis
Pregnancy Day Service
Post dural puncture headache
Pre-eclampsia
Pulmonary embolus
Pre-eclamptic toxaemia
Pulseless electrical activity
Positive end expiratory pressure
Peak expiratory flow rate
Patent foramen ovale
Primigravida
Past history
Pelvic inflammatory disease
Pregnancy induced hypertension
Phenylketonuria
Post mortem
Post meridien
Post menopausal bleeding
Premenstrual syndrome
Postnatal depression
Pneumothorax
Per orally
Products of conception
Pouch of douglas
Plaster of Paris
Persistent occipito posterior
Positive
Posterior
Post partum haemorrhage
Primary Pulmonary Hypertension
Persistent pulmonary hypertension of the newborn
Per rectum
Packed red blood cells
Pregnancy
Pre medication
Pre operatively
As required
Premature rupture of membranes
Proximal
Prothrombin time
Patient
Partial thromboplastin time with kaolin
Pre-term labour
Post traumatic stress disorder
40
PU
PUIT/
PUIB
PUO
PV
PVC
PVD
Q
QA
QID / qid
Quad
R
R
R/O
R/V
R/V
RA
RAF
RBBB
RBC
RBG
RCM
RDNS
RDS
Reg
Rehab
RFT
Rh
RIB
RIF
RLL
RLQ
RM
RML
RMO
RN
ROA
ROM
ROP
ROP
ROS
RPAO
RPOC
Rpt
RR
Passed urine
Per urethra
Passed urine in toilet
Passed urine in Bed
Pyrexia of unknown origin
Per vaginum
Premature ventricular contraction
Peripheral vascular disease
Quality assurance
Four times daily / 6 hourly
Quadriplegia
Right
Removal of
Review
Review
Rheumatoid arthritis
Right atrium
Right arm
Rapid atrial fibrillation
Right bundle branch block
Red blood cells
Random blood glucose
Right costal margin
Royal District Nursing Service
Respiratory distress syndrome
Registrar
Rehabilitation
Renal function test
Rhesus
Rest in bed
Right iliac fossa
Right lower lobe
Right lower quadrant
Registered Midwife
Right middle lobe
Resident Medical Officer
Registered Nurse
Right occipito anterior
Rupture of membranes
Range of movement
Right occipito posterior
Retinopathy of prematurity
Right occipito posterior
Removal of sutures/staples
Routine post anaesthetic observation
Retained products of conception
Repeat
Respiratory rate
41
RSO
RSV
Rt
RTW
RUL
RUQ
RV
RVF
RVH
Rx
S
S&S
S/B
S/I
S/L
SA node
SAH
SANDS
SaO2
Right salpingo - oophorectomy
Respiratory syncytial virus
Right
Return to ward
Right upper lobe
Right upper quadrant
Right ventricle
Right ventricular failure
Right ventricular hypertrophy
Treatment
SBE
Sub-acute bacterial endocarditis
SBO
SBR
SC
SubCut
SCC
SCN
SD
SDH
Se
SFD
SG
SGA
Sib
SIDS
SIMV
Sl
SLE
SO
SOB
SOBOE
SOF
SOH
SOL
SOOB
SPC
SPPS
SR
SROM
SSD cream
Small bowel obstruction
Serum bilirubin
Signs and symptoms
Seen by
Sexual intercourse
Sublingual
Sinoatrial node
Subarachnoid haemorrhage
Stillborn and neonatal death society
Saturation of oxygen
Subcutaneous
Squamous cell carcinoma
Special care nursery
Syringe driver
Sub dural haemorrhage
Serum
Small for dates
Specific gravity
Small for gestational age
Sibling
Sudden infant death syndrome
Synchronised intermittent mandatory ventilation
Slight
Systemic lupus erythematosis
Salphingo-oopherectomy
Short of breath
Short of breath on exertion
Shaft of femur
Shaft of humrus
Space occupying lesion
Sat out of bed
Suprapubic catheter
Stable protein plasma solution
Sinus rhythm
Spontaneous rupture of membranes
Silver sulphadiazine cream
42
SSF
SSG
ST
Stat
STD
STI
STOP
Supp
SVC
SVD
SVB
SVT
T
T
T/L
T’s & A’s
T1DM
T2DM
Tab
TAC
TAH
TB
TBG
TDS
Tet Tox
TFI
TFT
THR
TIA
Tib
TKJR
TKR
TKVO
TLC
TMJ
TML
To
TOF
TOL
TOP
Top.
TOS
TOV
TPN
TPR
TTN
TURBT
TURP
TVT
Sacrospinous fixation
Split skin graft
Sinus tachycardia
Immediately
Sexually transmitted disease
Sexually transmitted infection
Suction termination of pregnancy
Suppository
Superior vena cava
Spontaneous vaginal delivery
Spontaneous Vaginal Birth
Supraventricular tachycardia
Term
Tubal ligation
Tonsils ad adenoids
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Tablet
Transport accident commission
Total abdominal hysterectomy
Tuberculosis
Total blood glucose
Three times daily
Tetanus toxoid
Total fluid intake
Thyroid function test
Total hip replacement
Transient ischaemic attack
Tibia
Total knee joint replacement
Total knee reconstruction
To keep vein open
Tender loving care
Temporomandibular joint
Trachea midline
Temperature
Trial of forceps
Tetrology of fallot
Trial of labour
Termination of pregnancy
Topical
Trial of scar
Trial of void
Total parenteral nutrition
Temperature, pulse, respiration
Transient tachypnoea of newborn
Transurethral resection of bladder tumour
Trans urethral resection of prostate
Transvaginal tape
43
Therapy
Treatment
Tx
U
U&E
U/A
U/S
UAC
UGIT
UHCG
UO
UR
URTI
Ut
UTI
UTV
UVC
V
Vag
VBAC
VCS
VE
VF
VT
VV
W
WB
WBC
WCC
WNL
WPW
WRIGTN
Wt
X
x-match
XR
Y
Yr
Urea & electrolytes
Urinalysis
Ultrasound
Umbilical artery catheter
Upper gastrointestinal tract
Urine human chorionic gonadotrophins
Urine output
Unit record
Upper respiratory tract infection
Uterus
Urinary tract infection
Unable to void
Umbilical vein catheter
Vaginal
Vaginal birth after caesarean
Victorian Cytology Service
Vaginal examination
Ventricular fibrillation
Ventricular tachycardia
Varicose veins
Weight bearing
White blood cells
White cell count
Within normal limits
Wolfe-Parkinson White
Wedge resection ingrown toenail
Weight
Cross match
x-ray
year
Symbols
<
1/24
1/52
#
Less than
1 hour
1 week
Fracture
>
1/7
1/12
￪
Greater than
1 day
1 Month
Increased
￬
Ψ
Decreased
Psychiatric History / Illness
Δ
Change
44
Medical Emergency Team – MET
Aim
-
To provide an early and rapid response to seriously ill patients with life threatening
conditions.
To offer support to nursing and medical staff in the management of critically ill
patients.
Process
1. Nursing and Medical staff can call a MET if the patient meets one or more of the
criteria below:
Airway
Difficulty Speaking
Threatened Airway
Breathing
Circulation
BP < 90mmHg Systolic
RR > 30/min
RR < 6/min
SaO2 < 90% on O2
despite treatment
PR > 130
PR < 45
Neurology Altered Conscious State
Fitting
Respiratory Distress
Other
Concerned
2. Call the Emergency Department on Ext. 8651 and liaise with the Senior Medical
Officer, clearly stating that it is a MET call.
3. You will be required to outline the reasons for the MET call, relevant events prior to
the MET call, vital signs and any care initiated.
4. The Bed Co-ordinator or After Hours Co-ordinator (AHC) should be notified on Ext.
8529 that a MET call has been made.
5. Vital signs should be monitored and documented. The Emergency Trolley and patient
notes should be readily available. A nurse must remain with the patient.
6. After a MET call has been made to the Emergency Department, a telephone or ward
assessment shall be made by the Senior Medical Officer. A decision will be made to
either manage the patient on the ward or to transfer the patient to the ED for
stabilisation.
7. The Consultant of the patient and/or other relevant medical staff eg Anaesthetist
should be notified of the situation in an appropriate time frame.
45
EVALUATION
The following evaluation is designed to elicit feedback concerning your clinical
placement. Your response will be useful in assisting in the future development of the
undergraduate program.
Please circle the response that best describes your feelings concerning the following
statements and provide comments where applicable.
Strongly
Disagree
1
Disagree
Unsure
Agree
4
Strongly
Agree
5
2
3
1
2
3
4
5
Hospital orientation was
informative and appropriate
to your learning needs.
If not, please comment:
How would you describe your clinical
teacher?
A.
Professional
1
2
3
4
5
B.
Approachable and conducive
to professional development
1
2
3
4
5
C.
Supportive
1
2
3
4
5
D.
Helped me to meet my learning
objectives.
1
2
3
4
5
Please comment if you disagree with the above:
The clinical teacher gave regular
feedback concerning my progress.
1
2
3
4
5
The debriefing sessions were
appropriate to my needs.
1
2
3
4
5
If not, please comment:
What aspects of this clinical placement did you like the most?
What aspects of this clinical placement did you like the least?
Was your preceptor / buddy nurse supportive, informative and encouraging with clinical
interventions / nursing?
During your clinical placement was there a preceptor / buddy nurse who has had a
positive impact on your learning?
YES
NO
If yes, please name:
Additional comments:
Thank you for your participation and we hope your clinical placement has been a
positive and rewarding experience.