Profile of Learning Opportunities

Physiotherapy Department Hexham General Hospital Corbridge Road, Hexham, NE46 1QJ Tel 01434 655031 Fax 01434 655033 Profile of Learning Opportunities Hexham General Hospital Orthopaedics Welcome to the physiotherapy department at Hexham General Hospital, (HGH). HGH is a general hospital serving the community of Hexham and the Tyne Valley, a district that lies between Newcastle and Carlisle. The Physiotherapy Department is staffed by 28 physiotherapists who work on the wards, in the outpatient clinics, in outreach clinics and in the community. The Orthopaedic team has a complement of 3 staff and covers all elective inpatient and day case surgery and trauma returning to us for rehabilitation. Within these areas, we offer a variety of services, most of which are available to participate in or observe, (Additional Learning Outcomes). We strive to make the placement as enjoyable and productive as we can and we hope you enjoy your time with us. Please feel free to feedback on any aspect of your experience. Clare Casson Specialist Senior Physiotherapist Page 1 of 23 Clare Casson Last Updated 08 Oct 09

Table of Contents Profile of Learning Opportunities... 1 Hexham General Hospital Orthopaedics... 1 Table of Contents... 2 Introduction... 3 Orientation... 3 Pre-Placement Information... 4 Induction Checklist... 5 Placement Development Plan... 6 Year 1... 6 Week 1... 6 Week 2... 6 Week 3... 6 Week 4... 6 Year 2... 7 Week 1... 7 Week 2... 7 Week 3 + 4... 7 Year 3... 8 Week 1... 8 Week 2-4... 8 Week 4... 8 Week 4-6... 8 Learning Zones... 9 Learning Outcomes... 10 Interpersonal Skills... 10 Clinical Skills... 11 Specialist Skills...12 Organisational and Managerial Issues 13 Additional Learning Outcomes... 14 Additional References.15 Timetable - Week 1...16 Timetable - Week 2...17 Timetable - Week 3...18 Timetable - Week 4...19 Timetable - Week 5...20 Timetable - Week 6...21 Reflection / Notes 22-23 Page 2 of 23 Clare Casson Last Updated 08 Oct 09

Orientation Introduction Policies and Procedures On your first morning we will highlight the appropriate policies and procedures you need to be aware of throughout your placement. Your supervisor will show you the following during your induction: Fire points exits, alarms and extinguishers Resuscitation trolley and equipment Incident book (It is very important to report any accidents/incidents or near misses in relation to yourself or a patient when on placement) Further Safety Issues Do not proceed with any treatment following an initial assessment until you have discussed with your supervisor. If you are planning to change a treatment this should also be discussed with your supervisor first. Do not switch on any electrotherapy machines until a qualified member of staff has checked the settings or administer cryotherapy until a qualified member of staff has checked sensation is intact. Mobile phones must be switched off in clinical areas as they may interfere with medical equipment and pose a threat to the privacy and dignity of others. Orthopaedic Team Staffing Physio Manager Senior 1 Senior 2 Assistant (Mon - Thurs) Assistant (Fri - Sun) Lesley Black Clare Casson Luqman Afolabi Margaret Newton Jim Parr Preparation for Orthopaedic Placement: Students are expected to carry-out the following work prior to commencing placement 1. Background reading on common Orthopaedic conditions 2. Physiotherapy management of Orthopaedic conditions 3. Individual SWOT analysis Objectives:- 1.1 To assess the patient and reach a clinical diagnosis 1.2 To use this assessment to provide an effective treatment plan 1.3 To be able to show aims and objectives of treatment 1.4 To be able to evaluate the effectiveness of treatment at regular intervals 1.5 To be aware of possible complications of fractures and operative procedures 1.6 To be able to use various modalities for treatment and to justify why they are chosen Page 3 of 23 Clare Casson Last Updated 08 Oct 09

Pre-Placement Information Pre Placement Information Placement/speciality: Elective Orthopaedics and Trauma Rehabilitation Clinical Educator: Contact Address: E-mail: Directions: First Day: Uniform requirements: Lockers: On site parking: Canteen facilities: Common conditions to be treated: Clare Casson (To bleep dial 51, 1026, Ext no) Physiotherapy Department Hexham General Hospital Corbridge Road, Hexham, NE46 1QJ Tel 01434 655031 Fax 01434 655033 clare.casson@nhct.nhs.uk Nexus Journey Planner Map 24.com Enter NE46 1QJ in postcode Multimap Report to designated clinical educator Where Physiotherapy reception desk, HGH When 09:00 (normal hours 9:00-5:00, lunchtime 12:00-12:30 Friday 9:00-4:45, lunchtime 12:00-12:45) Tunic, navy blue trousers, black shoes, black/navy socks. A wedding ring and one pair of stud earrings may be worn. Watches should be removed for clinical duties and long hair should be tied back. May be available, please ring to confirm. Supply own padlock. On your first day place a notice in your car stating that you are a Physio student and can be contacted on ext 5031. (Public parking 80p/hour, staff parking available via swipe card to enter barrier). Canteen, Cafe and HVS shops on site, option of bringing own lunch if preferred. All common elective orthopaedic conditions from joint replacements and arthroscopies to foot and ACL reconstructions. Also a variety of trauma cases returning for ongoing rehabilitation. Suggested prereading: Essential Orthopaedics and Trauma Physiotherapy in Orthopaedics - Problem Solving Approach Orthopaedic Physiotherapy Orthopaedic Rehabilitation Dandy Karen Atkinson/Fiona Coutts/ Anne-Marie Hassenkamp Marion Tidswell S. Brent Brotzman Patient Contact Student can expect to have direct patient contact on day 1 of their placement. Page 4 of 23 Clare Casson Last Updated 08 Oct 09

Induction Checklist Induction Task Policies and Procedures Cardiac Arrest: procedure, equipment,tel no. x2222 Fire: escapes, alarms, extinguishers, tel no. x4444 Reporting Incidents: procedure and IR1 forms Health & Safety Rep / Steward Introduction to physio department staff Illness Procedure: phone reception 8am Housekeeping: toilets, changing/lockers, general up-keep of dept Working Hours: lunch, breaks Introduction to ward 3 and DTC staff Paperwork: documentation, statistics, equipment ordering Location of exercise sheets, assessment forms etc Computer Use Placement Development Plan Library Location / facilities Completed Name of Clinical Educator... Date Placement Started and Ended... Signed as Complete... Page 5 of 23 Clare Casson Last Updated 08 Oct 09

Year 1 Placement Development Plan Week 1 Orientation induction tick list. Discuss learning outcomes, SWOT analysis, areas of interest / weakness and preferred learning style. Discuss previous experience and identify gaps in knowledge. Timetable halfway assessment and tutor visit. Introduction to ward based staff including nursing staff, OT s and consultants. Shadowing your supervisor undertaking assessments and treatment plans. You will be informally assessed and guided on your basic knowledge of anatomy, physiology, and pathology of the patient s underlying Orthopaedic condition. By the end of the week you will be expected to participate in basic treatments and assessed on your communication skills. Week 2 You will start to perform basic assessments and treatments under supervision and document your findings/interventions, (with assistance if required). You will be actively participating in the moving and handling of patients. Half way assessment. Week 3 You will start to increase participation in assessments and treatments and suggest / discuss with your supervisor basic treatment plan progression. Week 4 Progressing your clinical reasoning skills. Final assessment. Throughout the placement there will be the opportunity for self directed learning and many learning opportunities as listed overleaf. This will include attending any appropriate in service training sessions. Page 6 of 23 Clare Casson Last Updated 08 Oct 09

Year 2 Week 1 Orientation induction tick list. Discuss learning outcomes, SWOT analysis, areas of interest / weakness and preferred learning style. Discuss previous experience and identify gaps in knowledge Timetable halfway assessment and tutor visit. Introduction to ward based staff including nursing staff, OT s and consultants. Shadowing your supervisor undertaking assessments and treatment plans. You will undertake a subjective / objective assessment together then be assessed undertaking a full assessment independently. During the assessment you will be assessed on you communication skills. You will be formally assessed and guided on your basic knowledge of anatomy, physiology, and pathology of the patient s underlying Orthopaedic condition through questioning by your supervisor and reflection. You will be formulating patient problem lists and start to think about goal orientated treatment plans. You will be assessed on your documentation of the assessment and treatment plans. Week 2 as week 1 plus: You will progress the treatment plans of your own patient s. You will be increasing your own caseload. Half way assessment. Week 3 + 4 You will be evaluating the effectiveness of your treatments and altering your treatment plans accordingly. You will progress your patient assessment, handling skills and clinical reasoning skills. You will acknowledge appropriate referral and liaison with other members of the multidisciplinary team. You will be expected to manage your time efficiently and effectively. Final assessment. Throughout the placement there will be the opportunity for self directed learning and many learning opportunities as listed overleaf. This will include attending any appropriate in service training sessions. You will be relating evidence based practice to the clinical workplace. You will have allocated time set aside with your clinical educator to review and reflect on your caseload and treatment progression one to one. Page 7 of 23 Clare Casson Last Updated 08 Oct 09

Year 3 Week 1 Orientation induction tick list Discuss learning outcomes, SWOT analysis, areas of interest / weakness and preferred learning style. Discuss previous experience and identify gaps in knowledge Timetable halfway assessment, tutor visit and case presentation Introduction to ward based staff including nursing staff, OT s and consultants. On day 1 you will be observed undertaking a subjective / objective assessment and be assessed on your communication and patient handling skills. By the end of the week you will be undertaking this independently. You will be increasing your own caseload daily. Your caseload will be varied regarding Orthopaedic conditions, patient ages, and where possible various cultures and social backgrounds You will be formulating patient problem lists and goal orientated treatment plans with short and long term goals. You will be formally assessed on your reasoning skills regarding all of the above points. You will be asked to analyse and reflect upon your documentation of the assessment and treatment plans. You will be asked to demonstrate various treatment techniques with your own and your clinical educator s patients. You will be expected to manage your time efficiently and effectively. You will have the opportunity to shadow your supervisor undertaking treatment techniques. Week 2-4 as week 1 plus: You will progress the treatment plans of your own patient s and some of your clinical educator s. You will be increasing your own caseload. You will be evaluating the effectiveness of your treatments and altering your treatment plans accordingly. You will progress your patient assessment, handling skills and clinical reasoning skills. You will acknowledge appropriate referral and liaison with other members of the multidisciplinary team. Half way assessment. Week 4-6 as weeks 2 4 plus: You will be given the opportunity to take an education group of your choice that you have previously observed under supervision You will be asked to give a small presentation to the Orthopaedic staff on an aspect of your self directed learning Final assessment. Throughout the placement there will be the opportunity for self directed learning and many learning opportunities as listed overleaf. This will include attending any appropriate in service training sessions. You will be relating evidence based practice to the clinical workplace. You will have allocated time set aside with your clinical educator to review and reflect on your caseload and treatment progression one to one. Page 8 of 23 Clare Casson Last Updated 08 Oct 09

Learning Zones Middle: Clare Casson - Elective Orthopaedics, Day case surgery, Trauma rehabilitation Zone 1: (physiotherapy) Pre and post-op physiotherapy Home visit assessments Multi-disciplinary ward meetings Multi-disciplinary ward hand-over Zone 2: (health) Ward staff Orthopaedic consultants Anaesthetists Pre Assessment nurse specialist Clinical nurse specialist Orthopaedics Occupational therapist Pharmacy team Phlebotomists X-ray Plaster technicians Pain team Orthotics Care of the Elderly Physiotherapists Orthogeriatric consultants Community rehabilitation assistants Palliative care team Zone 3: (Primary care) Out patient physiotherapy departments Community rehabilitation hospitals Community rehabilitation teams Domiciliary physiotherapy Hartford final rehabilitation unit Joint equipment loan store (JELS) Wheelchair service Care managers Zone 4: (Advisory) Care facilitators Manual handling advisory service Tissue viability nurse Zone 5: (others) Family /Carers Product advisers for specialist equipment Dietician Podiatrist Page 9 of 23 Clare Casson Last Updated 08 Oct 09

Interpersonal Skills Learning Outcomes Learning Opportunity Effective communication, talking / interaction with patients / clients / carers / relatives / teaching staff in a variety of settings. Resource / Personnel Clinical Educator / Orthopaedic physio staff / MDT members Awareness of own communication skills both verbal and non-verbal. Clinical Educator / Orthopaedic physio staff / MDT members Demonstrate sensitivity for patients / carers / relatives in relation to distressing information. Clinical Educator / Orthopaedic physio staff / MDT members Use of telephone / answering calls / taking messages / bleep systems. Use of computer, email and internet. Clinical Educator / Orthopaedic physio staff / MDT members Demonstrate effective communication and professionalism with other relevant professionals involved in patients care. Orthopaedic Consultant / Anaesthetist / MDT members / CSP Rules of Professional Conduct Holistic care of different groups of people (e.g. young, elderly, learning difficulties, language difficulties). Clinical Educator / Orthopaedic physio staff / MDT members Promotion of patients compliance with treatment / health promotion strategies / medications. Writing up patient records / discharge summaries / weekend handovers. Clinical Educator / Orthopaedic physio staff / MDT members Clinical Educator / standard pathways and report formats Page 10 of 23 Clare Casson Last Updated 08 Oct 09

Clinical Skills Learning Opportunity Elective Orthopaedics Day case surgery Trauma rehabilitation Pre operative education group for joint replacement patients Joint Replacement Group Dedicated teaching time Care of the Elderly Non-patient contact time Resource / Personnel Clinical Educator/OPD Staff/MDT Orthopaedic physio staff OPD Staff Clinical Educator Karen Robinson There will be time to reflect when not attending to patients (reference material is available in dept) Library facilities, internet / intranet Documentation Record keeping standards CSP documentation standards Writing should be legible in black ink Every entry should be dated, timed and signed and then countersigned by clinical educator Every side of paper requires patients name / DOB and numbered Page 11 of 23 Clare Casson Last Updated 08 Oct 09

Specialist Knowledge Learning Opportunity Physiotherapy- role within the MDT and approaches to assessment and rehabilitation in elective and trauma Orthopaedics Occupational Therapy - role within the MDT Orthopaedic Consultants - Assessment and management of Orthopaedic conditions. Theatre and clinic visits, ward rounds. Consultant Orthogeriatricians - Ward rounds for review of elderly elective and trauma patients. Wheelchair Therapist - Assessment and prescription of specialist wheelchairs Orthotist -assessment and provision of orthotics Orthopaedic nurse specialist Pre op and follow up clinics for joint replacement patients. Pre-admission nurse specialist Pre op assessment and clerking of elective Orthopaedic patients Plaster technicians Application of plaster of paris and fibre glass casts and splints. Pain Team Assessment and management of acute and chronic pain Palliative care team- assessment and management of patients needs Resource / Personnel Clinical Educator and other members of the orthopaedic physiotherapy team as appropriate. Rachael Heywood Smith, Senior occupational therapist and Karen Gargett OT TI Mr Carluke, Mr Reed, Mr Partington, Mr Gibbons, Mr Candal Couto, Mr Muller, Mr Murty, Mr Prasad, Mr Kramer, Mr Prasad, Mr Assad, Mr Caullay. Dr Edmonds Tina Bewick Orthotics dept staff Heather Brooks Liz Thompson and Helen Fletcher Robin Lee Leigh Kelly, Acute Pain Specialist Nurse, (at WGH) Consultant Anaesthetists Jane Laffan, MacMillan physio Page 12 of 23 Clare Casson Last Updated 08 Oct 09

Organisational/Management Issues Learning Opportunity Managing a caseload Organisational skills Delegation skills Prioritisation skills Time management Standards of care Giving information to: Orthopaedic staff Patients Relatives/carers Doctors MDT members Resources Ordering of special equipment Re-ordering of standard walking aids Re-ordering of standard wheelchairs. Resource / Personnel Clinical Educator Clinical Educator Clinical Educator Clinical Educator Clinical Educator/Standards file Clinical Educator Clinical Educator Clinical Educator Clinical Educator Clinical Educator Clinical Educator Clinical Educator/Physio assistant Clinical Educator/Physio assistant Managing risk Policies and procedures Equipment safety checks Daily environmental checks Infection control Moving and Handling Emergency situations Cardiac arrest Fire Patient alarms Incident reporting Staff Developments Reflective Practice Policies and Procedures files in physio managers office / intranet Clinical Educator/equipment reps Clinical educator Infection control policy/ nurse Clinical Educator/ Moving and handling file Clinical Educator will discuss in induction / refer to relevant procedure documents Clinical educator will provide guidance Page 13 of 23 Clare Casson Last Updated 08 Oct 09

Additional Learning Outcomes Additional Learning Outcomes Interest Completed Orthopaedic Theatre A morning or afternoon session in Orthopaedic theatre to observe the Orthopaedic surgeons perform either elective upper or lower limb surgery. Orthopaedic Clinic A morning or afternoon session in Orthopaedic clinic to observe the Orthopaedic surgeons assess patients with a wide range of conditions both pre and post operatively. Trauma Clinic A morning or afternoon session in trauma clinic to observe the Orthopaedic surgeons review patients following trauma surgery or conservative treatment of a wide range of fractures and soft tissue injuries. Joint Replacement Class Patients who undergo knee joint replacement have the opportunity to attend this class to improve their level of function and exercise tolerance. Pre op Education group for Joint Replacements Patients who undergo knee or hip joint replacement have the opportunity to attend this clinic to learn about their surgery / rehab / discharge and so are less anxious and better prepared on discharge. Pre Assessment Clinic Patients who undergo knee or hip joint replacement attend this clinic for a full medical assessment and screening prior to admission. Here they also complete various consent and audit forms. Occupational Therapy Following pre assessment joint replacement patients are assessed by the OT s to establish which pieces of equipment they may require post operatively. Post operatively the patients are assessed in the OT department to ensure they can complete everyday functional tasks, some may require a home visit before discharge. Orthopaedic Nurse Specialist Clinic An afternoon session in clinic to observe the Orthopaedic nurse specialist review patients following joint replacement surgery. Orthopedic Nurse Practitioner An opportunity to shadow the nurse practitioner to observe them in their daily management of Orthopaedic patients. Name of Clinical Supervisor / Rotation Coach... Date Placement Started and Ended... Signed as Complete... Page 14 of 23 Clare Casson Last Updated 08 Oct 09

Additional References University of Northumbria (http://northumbria.ac.uk/) Chartered Society of Physiotherapy (http://www.csp.org.uk/) Northumbria Healthcare NHS Foundation Trust (http://www.northumbria-healthcare.nhs.uk/) Wheeless Textbook of Orthopaedics (http://www.wheelessonline.com/) Orthoteers (http://www.orthoteers.co.uk/) www.evidence.nhs.uk www.library.nhs.uk www.edheads.org www.boa.ac.uk www.nice.org.uk www.jbjs.org.uk Page 15 of 23 Clare Casson Last Updated 08 Oct 09

Timetable Week 1 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 16 of 23 Clare Casson Last Updated - 19-Oct-2009

Timetable Week 2 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 17 of 23 Clare Casson Last Updated - 19-Oct-2009

Timetable Week 3 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 18 of 23 Clare Casson Last Updated - 19-Oct-2009

Timetable Week 4 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 19 of 23 Clare Casson Last Updated - 19-Oct-2009

Timetable Week 5 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 20 of 23 Clare Casson Last Updated - 19-Oct-2009

Timetable Week 6 Monday Tuesday Wednesday Thursday Friday AM PM Reflection Reflection Reflection Reflection Reflection Page 21 of 23 Clare Casson Last Updated - 19-Oct-2009

Reflection / Notes Page 22 of 23 Clare Casson Last Updated - 19-Oct-2009

Reflection / Notes Page 23 of 23 Clare Casson Last Updated - 19-Oct-2009