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Added to Northumbria University Practice Placements Website July 2011
This profile is a comprehensive document, detailing all learning
opportunities available within the paediatric assessment/day unit.
In most health care professions a suitably prepared registered
practitioner is expected to provide guidance and support to students
in practice placements.
It is intended that students and mentors select the appropriate
opportunities to meet the specific competencies for the placement.
Ward 6 Paediatric Assessment/Day Unit
P
Profile of Learning Opportunities
Guidance for Students and Mentors
Added to Northumbria University Practice Placements Website July 2011
CONTENTS
1. Guidance for students and mentors
2. Orientation of Ward 6
3. Interpersonal skills: key elements
4. Clinical skills: key elements
5. Day cases/emergency assessments: key elements
6. Management of care: key elements
7. Organisational and managerial issues: key elements
8. Link nurses/multidisciplinary team members
Ward 6 learning zone
Philosophy of care
Added to Northumbria University Practice Placements Website July 2011
GUIDANCE FOR STUDENTS AND MENTORS
This profile details the learning opportunities available within this
clinical area. From this learning profile the student is able to identify
which of the listed practice based learning opportunities and
activities they will gain the most from and discuss these with their
mentor during the preliminary interview.
ORIENTATION OF WARD 6 PAEDIATRIC EMERGENCY
ASSESSMENT/DAY UNIT
Ward 6 is the paediatric day unit which has two main functions: day
cases and emergency assessments which as students you will have
the opportunity to gain experience in both areas.
Ward 6 is located here at the Royal Victoria Infirmary on Level 3 of
the New Victoria Wing.
Telephone 0191 2826006 Emergency Assessment
Or 0191 2826135 Day unit
Or via switch on 2336161 extension 26006
Added to Northumbria University Practice Placements Website July 2011
Ward 6 is primarily nurse-led, but works alongside the
multidisciplinary team, encompassing a wide variety of specialities.
We care for children from 0-16yrs with a variety of illnesses and
complex needs.
The openings hours for the Day unit are 8-6pm Mon-Friday and 8am
to 2am for Emergency Assessment 7 days a week including bank
holidays.
We currently have two shift patterns-students are encouraged to
work whatever their mentor does and are allocated a mentor prior
to commencing the placement.
Day unit Emergency Assessment
8am-6:15pm (10hr shift) 8am-2am/ 8-6:15pm
8am-4pm or 10-6pm (7.5hr shift) 10-8pm/6pm-2am
Off duty is usually roistered four weeks in advance. If you require any
special requests please speak to your mentor or Sister.
Your first day will involve a thorough orientation of the ward
surroundings. You should learn the detailed emergency numbers:
FIRE: 333
SECURITY: 399
CARDIAC ARREST: Child 2222/Adult 2222.
Added to Northumbria University Practice Placements Website July 2011
Day Case
As a unit we carry out a large number of Day case
investigations/procedures on patients from the entire various
paediatric speciality teams within the trust. On the day unit we are
opened 8 to 6pm Monday to Friday closed weekend and bank
holidays.
We have planned day case workload by an appointment system pre-
booked in the diary.
A number of these investigations/procedures overlap between the
teams and as a result have slight variations in their protocols.
On Ward 6 we have files containing all the protocols for specific
investigations and procedures and at all times these should be
referred to.
Listed below are some of the tests we perform. Don’t worry during
your placement all these will be explained
Renal
Mag ІІІ Scan BP monitoring
DMSA Scan MCUG
Urine Microscopy Methylprednisolone administration
Blood tests Albumin infusions
Endocrine
Synacthen test LHRH test
Oral glucose tolerance test TRH test
Growth hormone provocation test (either glucagon or insulin)
Added to Northumbria University Practice Placements Website July 2011
Gastro
Lactose/Sucrose breath tests
White cell scan
Iron infusion
Infliximab infusion
Methotrexate injections
Meikles scan
Rheumatology
Methylprednisolone/Cyclophosphamide
Methotrexate
Immunoglobulins
Immunology
Vaccinations
Allergy testing (working alongside immunology specialist nurses)
Haemophilia
On Ward 6 we provide treatment when the haematology centre is
closed providing the care during the evening and weekends.
Oncology
On Ward 6 we provide treatment to the children when the oncology
day unit is closed.
Added to Northumbria University Practice Placements Website July 2011
Child Protection
Assessments and examinations
Respiratory
Regular reviews by the team and Cystic Fibrosis patients are seen on
the department
Surgery
Surgical day cases if surgical day unit full.
Other
MRI under GA
CT scans under GA
EEG under sedation
Added to Northumbria University Practice Placements Website July 2011
EMERGENCY ASSESSMENT
We accept Gp and A&E referrals for emergency assessment via the
Registrar on call. We also have open access patients who are directly
assessed on Ward 6. Under supervision from your mentor, you will
be able to assess and care for the patients requiring emergency
treatment, depending on your level of training. Due to the nature of
the unit, the pace and variety of workload is unpredictable and the
child can present with minor to critical conditions.
Listed are a few of the conditions we see regularly:-
Bronchiolitis Head injuries (minor only)
Asthma Meningitis
Croup Child protection assessments
Upper/lower respiratory infections Intoxication/poisoning
Pneumonia Cellulitis
Febrile convulsions Viral infections
Limps/painful joints Diarrhoea and vomiting
Surgical problems:-
Appendicitis
Testicular torsion
Intussusceptions
Irreducible hernias
Trauma requiring surgery
Ingestion of foreign object
Added to Northumbria University Practice Placements Website July 2011
WARD 6
List of Profile of Learning Opportunities with direct supervision of
mentor and support of nursing team.
MANAGEMENT SKILLS
Organisational
Delegation
Prioritising tasks
Time management
Leadership qualities
Quality assurance
Implementing change
Standards of care
Staff development
Managing patient workload
Managing a team
DEVELOPMENT OPPORTUNITIES
Clinical supervision
Reflective practice
Critical incidents
PROFESSIONAL OPPORTUNITIES
Self awareness
Professional attitudes
Confidentiality
Code of conduct
Added to Northumbria University Practice Placements Website July 2011
CLINICAL PRACTICE
Ward Philosophy
Admission and Discharge Procedure
Process of Assessment, Planning, Implementing And Evaluating Care
Caseload Management
Enhancing of Assessment Skills (Communication, Observational Skills)
Health Promotion
Multidisciplinary Working
Dispensing Medication
Administration of Im/Sc Injections
Venepuncture/Cannulation of Patients
Administration of Radioactive Isotope
Catheterisation of Patients
Ordering of Medication
Referrals to Other Agencies
Challenging Behaviours/Conflict Resolution
Ward Handover
Community Resources
Added to Northumbria University Practice Placements Website July 2011
AWARENESS OF:-
Trust/Ward Policies
Health and Safety at Work
Fire Procedure
Moving and Handling
Ward Environment
Saving Lives
Infection Control
THIS LIST IS NOT EXHAUSTIVE
Added to Northumbria University Practice Placements Website July 2011
3. INTERPERSONAL SKILLS: KEY ELEMENTS
LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL/DEPARTMENT
COMMUNICATION Use of the telephone
Answering calls
Transferring calls
Making calls
Contacting other wards/departments
Use of bleep system Use of the computer
Understanding of confidentiality issues
Access to patient information
Access patient results
Use of Trust intranet
District nurse letters
Talking to
Patients
Relatives/carers
Doctors
Visitors
Specialist Nurses/Matrons
Members of multi-disciplinary team
All nursing staff
Other ward staff
Other hospitals
All staff All staff (As appropriate) Matron Ward Sister Doctors/Multi-disciplinary Team Specialist Team Registered Nurse Health Care Assistant Domestic/Ancillary Staff
Added to Northumbria University Practice Placements Website July 2011
ORGANISATION/PLANNING
Facilitating investigations
Booking follow-up appointments
Managerial structure in Trust
Patient transfer within Trust
Patient transfer outside Trust
(As Appropriate) Sisters/Doctors Registered Nurse/OT/Physio Specialist Nurses Ward Clerks Patient/Relatives Registered Nurse Patient Services Co-ordinator Ambulance Service
Added to Northumbria University Practice Placements Website July 2011
4. CLINICAL SKILLS: KEY ELEMENTS
LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL/DEVELOPMENT
PHYSIOLOGICAL OBSERVATIONS
Blood pressure
Temperature, pulse/apex & respirations
Pain assessment tool
Oxygen saturations
Blood glucose
Maintaining accurate charts ADMINISTRATION OF MEDICATION
Oral
Intra-muscular
Sub-cutaneous
Intravenous infusion/antibiotics
Cannulation/Venepuncture
Inhalation
Rectal
Use of cytotoxic medication
Intraosseous
Via central line/portacath PREPARATION FOR INVESTIGATIONS
Consent (informed)
Information (verbal and written) CLINICAL INVESTIGATIONS
Venepuncture
Cannulation
Urinalysis-dipstick and micro
X-ray
Nursing staff Nursing staff/pharmacist Nursing staff Medical staff Nursing staff Medical staff/specialist nurse Nursing staff Nursing staff Nursing staff/uti team Nursing/radiology
Added to Northumbria University Practice Placements Website July 2011
CT scan
MRI scan
DMSA scan-use of isotope
MCUG scan-catheterisation PREPARATION FOR INVESTIGATIONS
Play therapy/distraction PATIENT HYGIENE
Mouth care
Skin care
Pressure sore prevention
Baby cares INFECTION CONTROL
Hand washing technique
Barrier nursing
Disposal of waste
Disposal of sharps
Disposal of linen NUTRITION
Food hygiene
Special diets
Feeding babies
Ng feeding
Gastrostomy feeding
Documentation/Stamp tool PAIN
Physiology
Assessment tools
Nursing staff/radiology Nursing staff/radiology Nursing staff/medical physics Nursing staff/radiology Nursing staff/play therapist/nursery nurse Nursing staff/support worker Nursing staff/infection control team/link nurse Nursing staff/domestic Nursing staff Nursing staff/dietition Nursing staff Nursing staff/stoma nurse Nursing staff/medical team/pain control team
Added to Northumbria University Practice Placements Website July 2011
CHILD PROTECTION
Types
Recognising signs
Management protocol
Documentation
Investigations AIRWAY
Assessment of airway
Causes of poor airway
Treatment/medication
Artificial airway
Suctioning BREATHING
Assessment of breathing
Effort of respirations
Noise of respirations
Rate of respirations
Auscultation of chest
Causes of difficulties
Treatment
Asthma
Administration of oxygen/use of equipment
Administration of neb/inhaler
Cystic fibrosis CIRCULATION
Assessment of circulation
Colour
Perfusion
Causes of shock
Treatment of hypovolemia
Assessing dehydration
Nursing staff/child protection team/child protection specialist nurse Nursing staff Medical staff/named consultant Nursing/medical staff Anaesthetist/resus team Nursing staff/PICU Nursing staff Nursing staff/medical staff Medical staff/nurse practitioners/nursing staff Respiratory specialist nurse Nursing staff CF nurses Nursing/medical staff/intranet
Added to Northumbria University Practice Placements Website July 2011
DISABILITY/NEUROLOGICAL STATUS
Assessment of disability
Assessment of neurological status
Alertness/behaviour/conscious level
Use of Glasgow Coma scale
Use of PEWS early warning score
Head injury
Raised intracranial pressure
Seizures-febrile convulsions/status
Epilepticus
Treatment causes BASIC LIFE SUPPORT/CPR
LEARNING OPPORTUNITIES
Renal and Genito-urinary system
Nursing/medical staff/Resus Team Nursing staff/Resus officer
Added to Northumbria University Practice Placements Website July 2011
Anatomy and physiology Infections-causes, diagnosis, treatment, investigations. Chronic renal failure/dialysis Renal conditions and treatment Blood pressure readings Transplant Endocrine and metabolic system Identification of endocrine glands, effect on the body and hormone production Disorders and treatment Investigations Diabetes DKA-assessment and treatment Growth Gastro-intestinal system Anatomy and physiology Common diseases and treatment Constipation Investigations Diarrhoea and vomiting Re-hydration and monitoring fluid balance Jaundice Rheumatology Juvenile Idiopathic Arthritis-symptoms and treatment
RESOURCE/RELEVANT PERSONNEL DEPARTMENT
Nursing and medical staff/renal team/ specialist nurse/haemodialysis unit/UTI nurse consultant/intranet/books Nursing and medical staff/books/intranet/endocrine specialist nurse/intranet/books Diabetic specialist nurse/nursing and medical staff/intranet Nursing and medical staff/intranet Gastro specialist nurse
Added to Northumbria University Practice Placements Website July 2011
Methotrexate injections Steroid treatment Infection Symptoms Source Nature, spread Treatment Identification of types of rashes Sepsis-symptoms and treatment Suppression of immune system Auto-immune disorders Drugs Immunisation Allergy testing-allergic reaction assessment and treatment Neurological Anatomy and physiology Head injuries- minor/major VP shunt Neurological observations-Glasgow Coma Scale Identification of signs and symptoms Treatment and medication Investigations, EEG, CT and MRI(under GA or sedation Haematology Anatomy and physiology Common diseases and conditions
Nursing and medical staff/Rheumatology specialist nurse Nursing and medical staff/Immunology specialist nurse Nursing/medical staff/Neurology team Epilepsy specialist nurse/intranet/books
Added to Northumbria University Practice Placements Website July 2011
Obtaining blood samples appropriately Administration of blood products Monitoring accurately during blood transfusions recording all signs and symptoms. Treatment and medication Investigations
Nursing/medical staff/haematology team Blood transfusion nurses/haemophilia specialist nurse
5. DAY CASES/EMERGENCY ASSESMENTS: KEY ELEMENTS
LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONNEL DEPARTMENT
Renal Genito-urinary system
Nursing and medical staff/renal
Added to Northumbria University Practice Placements Website July 2011
Anatomy and physiology Infections-causes, diagnosis, treatment, investigations. Acute/chronic renal failure/dialysis Renal conditions and treatment Blood pressure readings Transplant Endocrine and metabolic system Identification of endocrine glands and effect on the body and hormone production Disorders and treatment Investigations Diabetes DKA assessment and treatment Growth Gastro-intestinal system Anatomy and physiology Common diseases and treatment Constipation Investigations Diarrhoea and vomiting Re-hydration and monitoring fluid balance Jaundice Rheumatology Juvenile Idiopathic Arthritis-symptoms and treatment Methrotrexate injections Steroid treatment
team Specialist nurse/haemodialysis unit/Uti nurse consultant Consultant/intranet/books
Nursing and medical staff books/intranet/endocrine specialist nurse Diabetic specialist nurse/nursing and medical staff/intranet Nursing and medical staff/intranet Gastro specialist nurse Nursing and medical staff/Rheumatology specialist nurse
Added to Northumbria University Practice Placements Website July 2011
Infection Symptoms Source Nature, spread Treatment Identification of types of rashes Sepsis-symptoms and treatment Suppression of immune system Auto-immune disorders Drugs Immunisation Allergy testing-allergic reaction assessment and treatment Neurological Anatomy and physiology Head injuries minor/major VP shunt Epilepsy Neurological observations- Glasgow coma scale Identification of signs and symptoms Treatment and medication Investigations, EEG, CT and MRI under GA/Sedation Haematology Anatomy and physiology Common diseases and conditions Obtaining blood samples
Nursing and medical staff/Immunology specialist nurse Nursing/medical staff/Neurology team Epilepsy specialist nurse/books/intranet Nursing/medical staff/Haematology team Blood transfusion nurses/link nurse/Haemophilia specialist
Added to Northumbria University Practice Placements Website July 2011
appropriately Administration of blood products Monitoring accurately during blood administration recording all signs and symptoms relating to adverse reaction Treatment and medication Investigations
nurse
6. MANAGEMENT OF CARE: KEY ELEMENTS
LEARNING OPPORTUNITIES RESOURCES/RELEVANT PERSONNEL/DEPARTMENT
Added to Northumbria University Practice Placements Website July 2011
NURSING CARE Assessment:
Long/short stay/A&E
Use of Trust documentation
Relevance of information
Collection of information
Observation
Practice Planning Care
Use of care plans
Assessment tools
Use of protocols/Trust policies
Care pathways
Discharge planning/involvement
with other agencies
Liaison with community teams/health visitor/Cani team
Implementation/Evaluation
Documentation skills
Time management
Planning priorities
Communication
Informing the child and families
Continuous monitoring of the child’s condition
7. Organisational skills
LEARNING OPPORTUNITIES
Nursing staff Nursing staff Intranet/ward policies/files Nursing staff
RESOURCE/RELEVANT PERSONNEL/DEPARTMENT
Added to Northumbria University Practice Placements Website July 2011
Role of Ward Manager/Sister
Delegation
Off duty
Standards of care
Quality issues
Leadership skills
Assuring quality care/clinical governance
Bed management MANAGEMENT OF WARD/RESOURCES
Stock control
Ordering drugs
Sisters responsibilities
Moving and handling
Risk management
Health and safety
Staff Development
Senior Sister Senior Staff Registered staff Modern matron Senior Sister Senior staff/Sister/Support worker Senior Sister
8. STAFF MEMBERS ON WARD 6
Added to Northumbria University Practice Placements Website July 2011
Ward Manager Allyson Turnbull
Sister Sister Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Play specialist Nursery nurse Health care assistant Ward clerk Ward clerk Ward clerk Ward clerk Domestic Domestic
Sharon Mcguffog Dawn Gerrard Catherine Haynes Carol Scott Claire Snow Hannah Dunn Jill Ferguson Rebecca Atthey Victoria Porter Rebecca Kimber Fiona Blair Nicola Raine Hayley Barker Helen Marshall Karen Morton Angela Potts Lyndy Fawcus Craig Douglass Viv Chambers Alison Foreman Linda Smith Pauline Thompson Linda Fletcher Michelle Irene
LINK NURSES WITHIN WARD 6.
Added to Northumbria University Practice Placements Website July 2011
Allyson Turnbull Dawn Gerrard Catherine Haynes Carol Scott Claire Snow Hannah Dunn Jill Ferguson Rebecca Atthey
Venepuncture/Cannulation Blood Transfusion/Pain Education Risk Assessment Tracheostomy Care/Asthma Moving and Handling Infection Control Infection Control
We hope that you enjoy your time spent on Ward 6 however if you
have any problems please feel free to speak to:
Allyson Turnbull, Ward Manager
Sharon Mcguffog, Sister
Dawn Gerrard, Sister
This Polo was updated in March 2011 by Dawn Gerrard...
Added to Northumbria University Practice Placements Website July 2011
Added to Northumbria University Practice Placements Website July 2011