Portfolio of Learning Opportunities: TISSUE VIABILTY PLACEMENT Information for Students Welcome to the placement. We hope that your placement will not only be educational, but enjoyable. During your placement you will work with one of the three members from the team We work Monday-Friday and you will be expected to start working at 8am until 16.00. We are aware that you work 35h, so on one of the days, you will be able to leave earlier. Newcastle-upon-Tyne NHS Hospitals Trust is a large acute Trust, which has 1800 beds over two main sites, Freeman Hospital and Royal Victoria Infirmary, as well as few Care of the Elderly wards at Walkergate Hospital. The has one Nurse Consultant (Tissue Viability), one Tissue Viability Nurse as well as one Health Care Assistant. The Team provides a Trust wide service, where the aim is to see patients within 24-48 hours of referral, concentrating on the management of both acute and chronic, non-healing wounds, as these are the most problematic. It is also concerned with the delivery of services for specific types of tissue injury such as diabetic ulceration and traumatic wounds as well as managing therapy beds and mattresses for the prevention and management of pressure ulcers. However, the main role for Nurse Consultant (tissue viability) is to teach generalist nurses how to expand their own role and therefore improve patient care, without taking over the care themselves. The consists of: Fania Pagnamenta Nurse Consultant (Tissue Viability) fania.pagnamenta@nuth.nhs.uk Heather Barker Tissue Viability Nurse heather.barker@nuth.nhs.uk Val Rimmer Heath Care Assistant (Tissue Viability) val.rimmer@nuth.nhs.uk Address: Room 44c, Education Centre, Freeman Hospital. 0191 2231405 Aims of the reflect the Aims of the Trust To promote equality in health care and in collaboration with other organisations, be responsive to the needs and wishes of patients and their relatives.
To support staff across all clinical areas to deliver a high quality of service to patients. To maintain and enhance our reputation as a centre of excellence in the fields of teaching, training and research. To secure the appropriate resources within which we will seek to operate effectively and efficiently to ensure value for money, without loss of quality. To address the organisation and communications challenges posed within a large, technically complex and diverse organisation. To develop the existing strong patterns of teamwork and shared purpose and use these as a foundation for further co-operation in the changing patters of health care delivery. To ensure that the benefits of developments, advances and innovations in heath care continue to be made available to patients and shared with other service providers. It is essential that the nurse referring the patient is able to give a brief patient history. It is very useful for the nurse who is looking after the patient Diabetic Foot ulcers should be referred to Podiatry for assessment via the Tissue Viability intranet site. HEALTH CARE ASSISTANTS AND TISSUE VIABILTY ISSUES A) Pressure ulcers Trust guidelines stipulate that within 6 hours of admission, a registered nurse will undertake the initial pressure risk assessment and thorough skin inspection. The decision to use a pressure relieving aid is based on an overall assessment of the individual and not solely on the basis of the score from the risk assessment tool (Braden). Assessment should be ongoing and the type of pressure relief support changed to suit any alteration in risk. Health Care Assistants should monitor pressure areas during their contact with patients, it is imperative that they report any changes to a registered member of the multidisciplinary team. B) Tissue Viability tasks that can be performed by HCA Health Care Assistants after suitable training, can undertake simple wound dressings under the direction of a registered nurse such as: Removal or application of dressings to closed post operative wounds Superficial wounds Removal of dressings for qualified nurses to redress Wash limb/limbs after removal of bandages in leg ulcers. - After training, cut patients toe nails.
All Wards at FH, RVI and WGH Burns Outreach Nurse Dermatology Out-pt Sr Dietician/Peg Nurse Equipment libraries Industry Infection Control Team Matrons Medical Photographers Medical staff (all disciplines) TISSUE VIABILITY TEAM Microbiology Pain Team Plastic Outreach Nurse Stoma Supplies Theatres Tissue Viability Link Nurses Vascular Nurse in the Community
INTERPERSONAL SKILLS: Key Elements LEARNING OPPORTUNITIES Use of the telephone Answering calls Making calls Ring back etc RESOURCE/ RELEVANT PERSONEL/ DEPARTMENT Use of the computer to get Patient investigation results Patient information Internet E mail access Talking to Patients Relatives Doctors Other nurses including specialist nurses Multi disciplinary team referrals, Plastic outreach, Burns outreach, Dermatology Out-patient Registered/auxiliary nurse. Ward sister/ charge nurse, Doctors, multi disciplinary team Ancillary staff MDT meetings Doctors ward rounds Consultants ward round Facilitating investigations Nurses handovers Managerial structure in Trust Team working Patient transfer in Trust Patient transfer outside the Trust
CLINICAL SKILLS: Key Elements LEARNING OPPORTUNITIES RESOURCE/ RELEVANT PERSONEL/ DEPARTMENT Patient hygiene Nail care Skin care Pressure care prevention (Braden scoring) Nutritional intake Risk assessment - Braden BMI Moving and handling Infection control with the support of: Registered/Health Care Assistant and all wards staff Preparation for treatment Consent (informed) Information (verbal and written) Application of dressings Aseptic technique Isolation of patient Infection control Patient safety/risk assessment Medical Devices Moving and Handling Use of aids/hoists Checking equipment Medical Devices - VAC Developed Feb 2011 Review Feb 2014