North East Surgery Centre Level 3 Pre-assessment Unit Portfolio of Learning Opportunities Review date January 2012
Pre-Admission Assessment Learning Zone Interpreter Dietician Occupational Therapy Physio G.Ps Anaesthetists Infection Control Pre-Admission Clinical Nurse Specialists Assessment Clinic Modern Matron Pharmacy Surgeons Wards, other depts X-Ray Audit ECG + Echo Pathology Lung function Theatre
Contents 1) Pre-admission Assessment Learning Zone 2) Guidance for Learners and Mentors 3) Surgical Directorate Structure 4) Pre-admission Assessment Clinic 5) Generic Pre-assessment Process 6) Portfolio of learning opportunities Management of care 7) Portfolio of learning opportunities Interpersonal skills 8) Portfolio of learning opportunities Health development opportunities 9) Portfolio of learning opportunities Clinical skills 10) Portfolio of learning opportunities Pathophysiological process 11) Portfolio of learning opportunities Organisational and Managerial 12) Who s Who
Guidance for Learners and Mentors This document (polo) has been produced to detail the learning opportunities on the Pre-assessment Unit, of the North East Surgery Centre. It is intended that students and mentors work together to select appropriate opportunities to meet their specific competencies for their placement. We will try to ensure that the students are able to access all opportunities that are relevant to their particular needs, whilst they are on their placement in the preassessment unit.
Surgical Directorate Structure Divisional Manager Assistant Divisional Managers Modern Matrons Specialist Nurses Ward Manager Junior Sister/Charge Nurse Ward Teams
Pre-Admission Assessment Clinic The pre-assessment clinic is a generic clinic, bringing together the specialties of: Orthopaedics Gynaecology General Surgery Day Surgery Gynae-oncology ENT We also undertake several anaesthetic clinics during the week. Three outpatient clincs and a shockwave clinic. The unit is based within the North East Surgery Centre, and is a purpose built unit. The Pre-Assessment Manager is: Gareth Armstrong Senior are: Jean McDonald Edwina Leedale Janet Rose Margaret Hogan Jane Parkin Vicki Sharp Gerry Grigg Anne Whitaker are: Reception Staff: HCSW: Caroline Barker Terry Chester Carole Cook Katina Winship Sue McNaughton Wendy Pickering Jean McDonald is Educational lead and will co-ordinate your placement within preassessment. The purpose of the educational lead is to guide you through your placement, enabling you to achieve competencies and to provide a learning environment. To ensure that your placement is successful you will have regular meetings with your mentor and educational lead to discuss your progress and identify any problems that may arise. If you do have any concerns or worries throughout your placement, please speak to your mentor as soon as possible to enable us to deal with the problem at the earliest
opportunity. Alternatively you can speak to me Sr. Jean McDonald, or Gareth Armstrong, Pre-assessment Manager. The shifts that we work are: 08:00 to 16:30 Monday to Thursday and 08:00 to 13:30 on Fridays. But we are very flexible. These shifts are not set in stone and we will accommodate all requests if possible. The pre-assessment clinic cares for people of all ages (not children) with a variety of problems, providing support, health education, information about their forthcoming surgery, treating each patient as an individual using a holistic approach. The unit has a good rapport with all members of the multidisciplinary team, which is essential when referring patients to the different departments.
Generic Pre-Assessment Process * The patient is referred to Consultant via GP * The patient attends the outpatient department for appointment with the Consultant * The Consultant makes the decision regarding listing the patient for surgery * The notes are transported to the pre-assessment unit where they are tracked in and then allocated to the relevant Nurse Practitioner. * The patient is sent out a letter with a date for them to come for their preassessment, and a provisional date of surgery is given to them. * The nurse practitioner undertakes the pre-assessment and instigates any necessary tests, such as bloods, ECG (the nurses in pre-assessment follow the NICE guidelines for these tests). * It is the responsibility of the Nurse Practitioner carrying out the assessment to check blood results and take appropriate action if required. * Patients who are having joint replacement surgery will attend a joint care clinic where they will have a talk by the physio and ward nurse, and then see the Consultant to have their consent taken. * All patients except day patients and some surgical patients will attend an Anaesthetic Clinic where they will have Heart and Lung examination carried out by and then will be seen by the Anaesthetist, who will discuss the anaesthetic with them and give them their fasting instructions. All Orthopaedic and Gynaecological patients are brought into hospital on the day of their surgery. Most surgical patients are now admitted day of surgery. The ultimate aim is that ALL patients will be same day admissions.
KEY ELEMENT MANAGEMENT OF CARE LEARNING OPPORTUNITIES Use of Nursing Model Philosophy of care Documentation used Minor/Major nursing process RESOURCE/RELEVANT PERSONEL/DEPARTMENT. Registered nurse practitioners Nursing Process Assessment: Who assesses How is assessment carried out What is assessed Communication Skills Patient, notes, relatives Planning Care Pathways Risk Assessment Tools * DVT * Waterlow * Activities of daily living * Falls * Nutrition Multi-disciplinary plan Referrals to other agencies Physio OT S/W Specialist Nurses Relevant departments Physio Nurse Practitoners Specialist MDT team Implementation/Evaluation MDT Documentation Protocols Policies Communication patients/relatives Time Management Planning priorities Dealing with Difficult situations Religious needs
KEY ELEMENT INTERPERSONAL SKILLS LEARNING OPPORTUNITIES Use of telephone Answering calls Making calls Bleep system Fax machine Computer system Patient results, Ice system Patient information (PAS) Echo + PFT,s Internet E-mail access X-Rays Talking to Patients Relatives Consultants Anaesthetists Specialist Nurses X-ray department ECG department Echo department GP,s Consultant secretaries Cort team Medical records Ancillary staff MDT meetings Facilitating investigations Managerial structure Team working and working autonomously RESOURCE/RELEVANT PERSONEL/DEPARTMENT Clerk//HCSW Clerk//HCSW Nurse practitioners/hcsw/clerk Domestics Managers/Senior staff Nurse practitioners Observation of roles Nurse practitioners
KEY ELEMENT HEALTH DEVELOPMENT OPPORTUNITIES LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONEL/DEPARTMENT Healthy lifestyle strategies in relation to: Smoking cessation Bowel disorders Obesity/Malnutrition Diabetes Healthy Eating Alcohol Abuse Promotion of Exercise Cancer Support BP Monitoring Anaesthetic Risks Pulmonary Problems Smoke cessation nurse Specialist nurses/dietician Diabetic Nurse/Dietician Alcohol Nurse Specialist Specialist Nurses Anaesthetic Practitioners/Anaesthetist HealthEducation and health promotion leaflets Models of health promotion/education Specialist Nurses/Leaflets Nurse Clinics Communication between Pre-assessment and Specialist Nurses Counseling Specialist Nurses/Counseling Services Communication between Hospital and Community
KEY ELEMENTS CLINICAL SKILLS LEARNING OPPORTUNITIES Extensive clinical history taking/problem solving approach Concise History Physiological Observations BP + pulse ECG Weight Height BMI Blood Glucose Urinalysis Spirometery Medication review Phlebotomy Blood tests required Risk Assessment Scores O2 Sats Nutrition Infection Control MRSA Screening RESOURCE/RELEVANT PERSONEL/DEPARTMENT Nurse practitioners Nurse practitioners/ecg technicians /HCSW /HCSW Preparation for Theatre Consent Anaesthetic Information Patient leaflets Pods Theatre procedures Consultant Anaesthetic Practitioners/Anaesthetist Registered Nurses Theatre Staff
KEY ELEMENT PATHOPHYSIOLOGICAL PROCESS LEARNING OPPORTUNITIES Cardiovascular System Anatomy & Physiology/History Heart Failure CCF, LVF MI Angina Palpitations Murmur Cardiac Arrythmias ECG Echo Stents Internal Defibrilator Pacemaker RESOURCE/RELEVANT PERSONEL/DEPARTMENT Books/Nurse practitioners /ECG Depatment/Specialist Nurses Respiratory System Anatomy & Physiology/History Asthma Bronchitis COPD Pneumonia TB Emphysema Infections Medications Nebulisers SOB Smoke Liver & Biliary System Anatomy & Physiology/History Jaundice Tumours Alcoholic Liver Disease Treatments/Investigations/Surgery Kidney & Genitourinary System Anatomy & Physiology/History Infections Drugs Urinalysis Books/Nurse practitioners/specialist Nurses Books//Specialist Nurses Books//Specialist Nurses Microbiology
KEY ELEMENTS PATHOPHYSIOLOGICAL PROCESS CONT LEARNING OPPORTUNITIES Endocrine & Metabolic Disease Anatomy & Physiology/History Diabetes Thyroid Problems Investigations Treatments Ear, Nose & Throat Anatomy & Physiology/History Infections Drugs Investigations Treatments Blood Disorders Haemorrhage Anaemia DVT/PE Blood Transfusion Investigations Treatments Gastrointestinal Disorders Anatomy & Physiology/History Malignant disorders Colorectal Disorders Gastro Disorders Investigations Treatments Gynaecological Anatomy & Physiology/History Investigations Treatment RESOURCE/RELEVANT PERSONEL/DEPARTMENT Books/ Books/ Books//Haemotology Books//Endoscopy Books//Gynae Clinics
KEY ELEMENT ORGANISATIONAL AND MANAGERIAL ISSUES LEARNING OPPORTUNITIES Managing a Team Organisational Skills Delegation Skills Prioritising Skills Time Management Leadership Managing Patient Workload Quality Change implementation Standards Giving Information To: Staff Doctors Patients Relatives MDT ECG Echo Pulmonary Function Wards GP,s Secretaries Resources Stock Control Materials Management Non-Stock Stationary Drugs Establishment Staff Rota Budget Control Managing Risk Policies/Procedures Equipment Safety Checks Weekly/Daily Environment Checks Infection Control RESOURCE/RELEVANT PERSONEL/DEPARTMENT Pre-assessment Manager/Nurse Practitioners /HCSW Pre-assessment Manager/Nurse Practitioners /HCSW
KEY ELEMENT ORGANISATIONAL & MANAGERIAL ISSUES CONT LEARNING OPPORTUNITIES Emergency Situations Cardiac Arrest Violence & aggression Fire Patient/Staff Incidents Staff Development Preceptorship Reflective Practice Study Days Mandatory Study Days RESOURCE/RELEVANT PERSONEL/DEPARTMENT Mentor/Educational Lead Own Development Needs To discuss with Mentor
Who,s Who Colour of Tunic/ Dress Bright purple, white piping Persons Title Modern Matron Navy blue, white piping Ward Manager Burgundy, white piping / Specialist Nurses Navy Blue Sister/Charge Nurse Light Blue Staff Nurse Lilac HCSW Blue pattern blouse Receptionist/Admin Green pinstripe Domestics