Student Nurse Induction Pack The Paediatric Unit The Royal Gwent Hospital

Transcription

1 Student Nurse Induction Pack The Paediatric Unit The Royal Gwent Hospital September 2014

2 Written, edited and produced by Liz Burnett and Anna Taylor, Paediatric Nurses The Royal Gwent Hospital Newport South Wales Telephone: Contributors: The Nursing Staff and Students of the Paediatric Units The Royal Gwent Hospital, Newport Nevill Hall Hospital, Abergavenny Date for Review: September 2016 Paediatric Unit Student Induction Pack: EB/AT Sept

3 Table of Contents TABLE OF CONTENTS 2 WELCOME 3 INTRODUCTION TO THE ANEURIN BEVAN UNIVERSITY HEALTH BOARD 4 THE ROYAL GWENT HOSPITAL 5 NEVILL HALL HOSPITAL 5 ACUTE PAEDIATRICS WITHIN THE FAMILY AND THERAPIES DIVISION 6 STAFF OVERVIEW 6 SHIFT AND BREAK TIMES 7 SECURITY AND CONFIDENTIALITY GUIDANCE 7 MOBILE PHONES 9 THE CHILDREN S ASSESSMENT UNIT 10 D6 WEST - BLUEBELL WARD 11 D6 EAST SAPPHIRE WARD 11 D7 WEST EMERALD WARD 12 PAEDIATRIC HIGH DEPENDENCY 12 EXAMPLE OF TYPICAL DAYTIME WARD ROUTINE 13 ORIENTATION CHECKLIST 16 LEARNING AND DEVELOPMENT OPPORTUNITIES 19 REFERENCE LIST 20 EVALUATION OF THE STUDENT INDUCTION PACK 21 2 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

4 Welcome Welcome to the Aneurin Bevan University Health Board (ABUHB) Paediatric Nursing Service. We very much hope that you enjoy your time spent with us. You are encouraged, during your time with us, to fully integrate with our team. This package has been put together to make you feel welcome, orientated, and enable you to settle in quickly to the unit. The focus of your placement should be the development of your clinical and professional skills and knowledge. Your supernumerary status is assured and the team will help you to recognise your learning needs and identify learning opportunities. Care within our service is provided using the nursing process, and you should be able to participate in all aspects of this where possible, developing your clinical skills, whilst maintaining and enhancing the high standards of care we strive to deliver. Clinical Governance is about putting the user at the focus and developing excellent services that ensure what we do is right, timely and based on the best evidence. Clinical Governance in ABUHB is at the heart of effective services, and everyone working in the organisation has a responsibility to help develop and deliver quality services for patients and carers. Our Mission Statement to the public is: Working with you for a healthier community, whilst caring for you when you need us and aiming for excellence in all that we do. (ABUHB, 2014a) We hope that you enjoy your experience and your time with us is both rewarding and productive. If you have any concerns or queries, please don t hesitate to discuss them with your mentor or the staff in your clinical area. Best wishes for an enjoyable placement, Diane Mulholland Senior Nurse, Paediatrics Paediatric Unit Student Induction Pack: EB/AT Sept

5 Introduction to the Aneurin Bevan University Health Board Aneurin Bevan University Health Board covers the areas of Blaenau Gwent, Caerphilly, Monmouthshire, Newport, Torfaen and South Powys. The Health Board employs over 13,000 staff, two thirds of whom are involved in direct patient care. There are more than 1000 hospital and general practice doctors and 6,000 nurses, midwives, allied professionals and community workers (ABUHB, 2014b). The Health Board has two large district general hospitals providing the full range of acute surgical and medical services. These are: 1. Royal Gwent Hospital, Newport 2. Nevill Hall Hospital, Abergavenny There are also two local general hospitals: 1. Ysbyty Aneurin Bevan, Ebbw Vale 2. Ysbyty Ystrad Fawr, Ystrad Mynach These are supported by a network of community and mental health hospitals and day care premises. The Chairman, non-executive directors, the Chief Executive and other executive directors lead the Health Board. The Senior Management Team supports the Board. More information about the Health board, its strategic plan, and details of public board meetings are available on the intranet/internet. All policies and procedures for ABUHB are also accessible on the intranet. 4 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

6 The Royal Gwent Hospital This District General Hospital has more than 3,400 staff and approximately 774 beds and provides a comprehensive range of hospital services for inpatients, day cases and outpatients (ABUHB, 2014c). The address of the hospital is: Royal Gwent Hospital Cardiff Road Newport NP20 2UB Tel: Nevill Hall Hospital Nevill Hall district general hospital was opened in 1969 and provides inpatient, day case and outpatient services, and a range of investigations (ABUHB, 2014d). The children s ward is Ward 2/3, and comprises of 28 beds for children and young people aged 0-18, requiring both medical and surgical care. There are 4 children s assessment beds and also 1 high dependency bed within the ward. The address for the hospital is: Nevill Hall Hospital Brecon Road Abergavenny NP7 7EG Tel: There are floor plans on the Health Board website available for download. Paediatric Unit Student Induction Pack: EB/AT Sept

7 Acute Paediatrics within the Family and Therapies Division The Family and Therapies Division within Aneurin Bevan University Health Board delivers a diverse range of acute and community services to children, young people and their families in the whole of Gwent. For example, the services range from school health nursing and health visiting, right across to neonatal intensive care (ABUHB, 2014e). The Acute Paediatric Service within this division is predominantly delivered on two sites - Royal Gwent and Nevill Hall Hospital, but is undergoing exciting plans to be centralised in a specialised Critical Care Centre, part of the clinical futures programme in Wales (ABUHB, 2014e). Further information on our developing strategies across the Health Board can be found on the intranet. Staff Overview A pay banding system covers almost all NHS staff. On the paediatric unit, bands 2, 3 and 4 staff are unregistered health care workers and nursery nurses and are dressed in dark and light green uniforms respectively. They play a large role in caring for children across the unit, including play and distraction, clinical and supportive tasks, or managing their own patients. Band 5 nurses are qualified staff nurses and are dressed in light blue uniforms. They make up a majority of the nursing workforce, with a variety of skills and experiences. Each has individual responsibilities and many are link nurses for different illnesses or aspects of nursing care. Band 6 and Band 7 staff are deputy sisters and senior ward sisters/managers, and wear navy uniforms. Each deputy sister has individual responsibilities and assists the ward sister with the running of the ward. Each ward sister is responsible for managing their nursing and healthcare team, as well as education, finances and day-to-day ward issues. Specialist nurses are of varying pay bands and wear bright blue uniforms. We have an investigations nurse based in CAU, who organises and performs outpatient procedures and investigations. 6 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

8 All the unit team are experienced and strive for excellence. Take the opportunity to talk with them about their career pathways, what has led them to work within the Health Board and engage them to share their expertise with you. Shift and break times All the paediatric wards operate a 24-hour service 7 days a week and work the same shift hours, with the exception of the Children s Assessment Unit, (CAU), twilight shift as described below: Long Day: Early: Late: Night: Twilight: CAU Twilight: All staff are entitled to a 30-minute lunch break on a long day or night shift, plus a concessionary 15-minute break. On a 6 hour shift there is no break entitlement, and during a CAU twilight a 20-minute break is accounted for. Set break times are not always allocated on every ward, depending on the needs of the ward and patient flow. However, we work as a team on each ward and are often willing for any staff or students to put the kettle on! We appreciate that it can be difficult getting used to long shifts on the ward, so please communicate your break time needs with your mentor as well as considering the workload of yourself and others. Paediatric Unit Student Induction Pack: EB/AT Sept

9 Security and confidentiality guidance All of the paediatric wards within the Royal Gwent Hospital are locked by a card operated security system. This means that while you are working in the ward you will need to ring the intercom to enter the ward in the same way that parents do, as we are unable to issue student nurses with card passes. While you are in the ward you will be asked to operate the security system to let parents, children and visitors in and out of the ward. When doing this please ensure you know who they are, who they are visiting and who they are leaving with in order to maintain the safety of the children on the ward. The children s assessment unit does not have this security system, so please be extra vigilant about who attends the unit. There is a safety gate to prevent young children from leaving the unit unattended. If you are letting in any other healthcare professionals or hospital workers to any unit or ward, please verify who they are before they read a child s notes or examine them. It is good practice to remain with them whilst they are examining the patient, or to find and inform the allocated nurse as soon as possible. As a student nurse you can look at the medical and nursing records of the children you are helping to care for. Parents can usually look at the nursing care plans as well, but please ask a qualified nurse before showing these to them. Do not show parents or any visitors medical notes. To maintain the confidentiality of the children and families you meet in the ward, please: Do not discuss a child and families circumstances outside of the ward environment e.g. at coffee/travelling home Do not discuss a child s care with another parent Ensure that if you are discussing a child s care, such as on the ward round that confidentiality is maintained Do not leave nursing or medical notes where people may be able to gain inappropriate access to them & ensure computer programmes (such as blood test results) are minimised or closed when not in use Always ensure that any visitors for the children on the ward are their main carers or have permission to visit from their main carers i.e. parents/guardian DO NOT post any information about patients or the ward onto social media sites such as Facebook or Twitter 8 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

10 Mobile Phones The use of Personal mobile phones in clinical areas, or when escorting patients between departments, is prohibited for Health Board staff. Mobile Phones must not be carried in uniform pockets. Text messaging and personal calls must only be undertaken during designated break times, and there is to be no access to social media sites such as Facebook or Twitter during working hours (either by computer or mobile phone). The uploading of any confidential information or photos to any social media site will be immediately reported to the university and senior staff within the health board. You must NEVER take any photos on the ward area. Please remember that you are to act within the NMC Guidance on professional conduct for nursing and midwifery students (2011) at all times. Paediatric Unit Student Induction Pack: EB/AT Sept

11 The Children s Assessment Unit Sister: Sharon Driscoll Telephone Number: or The Children s Assessment Unit (CAU) at The Royal Gwent Hospital is a busy unit, which accepts referrals of acutely unwell children and young people from the General Practitioner, Accident and Emergency, midwives and paediatric nurse specialists. Some children and young people with complex or chronic conditions have direct access to the unit for assessment if they are unwell. The unit cares for children and young people aged 0-16 years, or sometimes up to 18 years if they remain under the care of paediatric consultants as outpatients (for example, children with diabetes or cystic fibrosis). Our Unit Vision is: PRIDE: Through pride in our work we remain patient focused Passionately care about our patients, families, our work and our team Respect others by listening, valuing opinions and contributions Individualised care to meet each child s and family s needs Deliver and implement consistent evidence based care for both child and their family Endeavour to learn and share our knowledge with students, colleagues, patients and their families All children/ young people who attend CAU are triaged. The system we use is the Manchester Triage System. The aim is to quickly prioritise patients objectively according to set discriminators. Nursing staff in the unit will explain this system and give you opportunity to use it while on placement with us. As we are based in close proximity to the Children s Accident and Emergency and Resuscitation department, we regularly become involved in emergency procedures, caring for critically unwell children and young people. During your placement with us, you will have the chance to be involved in these procedures and events whilst being 100% supported and guided by our very experienced team of nurses. 10 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

12 D6 West - Bluebell ward Sister: Lis Welton. Telephone Number: or Bluebell ward is a 14-bedded ward, which cares for children aged 0-3 years. We have 12 single-occupancy cubicles with one 2-bedded cubicle. The ward cares for babies and infants with a wide range of acute and chronic conditions. This can include children with complex medical, educational, social or safeguarding needs. D6 West also cares for children of this age group requiring surgery, although this is less common. Our Ward Vision is: In a caring and sensitive environment, we will work together to promote health and well-being for all. D6 East Sapphire ward Sister: Cheryl Marasco Telephone Number: or We are a 19-bedded ward, which cares for children aged 3yrs to 11yrs. However, we often take overflow from other wards so we could be nursing any age from 0 to 19years. We have 7 single-occupancy cubicles with three 4- bedded bays. The ward cares for children with a wide range of acute and chronic conditions, from all specialities including Medicine, Trauma and ENT. Our Ward Vision is: Giving the best standards of care in a family centred environment. Maintaining a calm and peaceful environment to help restful recuperation. Maintaining a safe environment for children, families, staff and visitors. Working together in warm and supporting team. Maintaining standards of cleanliness on a tidy and organised ward. Paediatric Unit Student Induction Pack: EB/AT Sept

13 D7 West Emerald ward Sister: Joanne Spokes Telephone Number: or We are a 19-bedded ward that cares for children and adolescents from aged 11 years up until their 19 th birthday. The ward has 3, 4 bedded bays that are single sex and 7 cubicles. Our ward cares for these patients who can come from any speciality. The specialities are: Paediatrics, Orthopaedics, Surgical, Maxillofacial, Ear Nose and Throat, Medical and Child and Adolescent Mental Health Services. Paediatric High Dependency Sister: Lis Welton Telephone Number: The Paediatric High Dependency Unit, (PHDU), at The Royal Gwent Hospital accepts Paediatric patients aged 0-16 years. Admissions can come from any of the paediatric wards, the Children s Assessment Unit, Theatre or Accident and Emergency. The children and young people nursed in HDU are those that require a higher level of nursing observation or intervention than those on the general ward. The nursing ratio is either 1:2 patients or 1:1 depending on each patients needs. There are criteria for admission to HDU, which can be viewed on the intranet. Due to the nature of the patients and the workload, PHDU is quite unpredictable. During the quieter times PHDU staff work on the general Paediatric wards. The daily routine in PHDU is patient dependent. The general routine however follows that of D6 West. Patients are transferred out of PHDU when their condition improves sufficiently to be supported on a general ward. This is always in agreement with the multidisciplinary team. If at any time during your ward placement you wish to work in PHDU this can be arranged. 12 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

14 Example of typical daytime ward routine We always work as a team and will offer assistance to colleagues wherever we can. 0700: Ward handover from night to day staff. Nurse in charge allocates patients Allocated nurses introduce themselves to patients and parents or carers. Assess the children, review nursing documentation or medical notes, ensure medication is given as requested and needed Prepare pre-operative children & young people for theatre Breakfast is served by the ward hostess around 8am. Menus are given to the patients and they are helped to fill them in by their parent/carer or staff member. Ensure children who are nil-by-mouth remain appropriately starved Staff breakfast break to be take following assessment of patients and prior to doctors ward rounds 0900: Paediatric doctors handover, located in the seminar room on D7 West. Nurse in charge attends. The patients across the children s unit, and any bed or staffing issues, are discussed Accompany the paediatric consultant ward round for allocated patients and give input as needed. On some wards the nurse-in-charge will aim to attend the whole ward round but if this is not possible, please inform them of the assessment and plan from the ward round as soon as possible Around this time, many doctors from different specialities can arrive on the ward at the same time to review patients on their ward rounds. Please be aware of doctors visiting your patients, or circumstances where an allocated nurse is busy elsewhere. There should be a nurse present for each child/ young person who is being reviewed Change bed linen on beds/cots, and parents beds as needed or required Encourage patients and family to wash and dress, assisting as needed Reassess patients as needed and ensure documentation is up to date, including drug, observation and fluid charts Be prepared that at any time of day there might be other patients needing admission to the ward Organise discharges of allocated patients as needed. Liaise with ward pharmacist to arrange medicines to go home with. Check if transport is needed and arrange accordingly Paediatric Unit Student Induction Pack: EB/AT Sept

15 Liaise with the doctors if any further investigations are required, or update them with on-going assessment findings/concerns Liaise with play room staff as needed, they can help prepare patients for procedures and assist with distraction Check the daily and weekly cleaning schedules kept in the duty room and carry out tasks as needed : Lunchtime It is the responsibility of individual nurses to ensure their patients are given the correct meal at lunchtime. For patients on floor 6, the food trolley will be located on D6East. One member of each ward will help ward hostess to serve lunch. Assist the children and families as needed and be aware of children who are Nil by Mouth, are restricted to fluids only or have a special diet. Patients and breast-feeding mothers are served first, and then resident parents can buy a meal from remaining food on the trolley. Parents and staff can take the trays back to where the food trolley is located : D6 West Quiet Time : D6 East Quiet Time All lights turned down or off, curtains closed and visitors asked to leave. Parents only can stay. Patients and parents are encouraged to rest, sleep, play quiet games or read. The playroom on D6 East is also closed. Quiet Time as a general rule is protected. We try not to allow any interruptions where possible. This is part of Transforming Care Staff Lunchtime 1400: Reassess allocated patients as needed throughout the afternoon, filing in all necessary documentation Discharge patients. Complete and file documentation in the notes, discharge the patient from the computer and diary located at the reception desk. Ensure any relevant referrals are made, e.g. health visitor or community nurse. Ensure follow-up appointments have been requested/ arranged Strip and wash beds and notify domestic staff of areas that need cleaning 14 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

16 1715: Tea Time The same procedure applies as at lunchtime 1800: Reassess patients Update documentation in readiness to handover to the night shift Ensure the patients are comfortable and ready for bed as appropriate Tidy up the ward in readiness for the next shift 1900: Handover from day to night staff Paediatric Unit Student Induction Pack: EB/AT Sept

17 Orientation Checklist Please ensure you are orientated to each element of this checklist with your Mentor in the first two weeks of your placement with us. Please remember that you are to act within the NMC Guidance on professional conduct for nursing and midwifery students (2011) at all times. Orientation Objective Ward layout and introduction to staff Mentor sign/ date CAU D6W D6E D7W Ward security system Uniform policy Shift patterns and times Breaks for Staff and Students Confidentiality Policy and Procedures Use of mobile phones by Nursing Staff Resuscitation procedures, trolley location, emergency call bell locations and resuscitation telephone number Use of the telephone system, making calls and using the bleep system Fire procedure Location of ward policies and guidelines. Particularly basic life support, health & safety and risk folder, fire safety, manual handling and child protection Processes for incident reporting and escalating concerns Daily job allocation 16 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

18 Admission, discharge & transfer procedures and paperwork Other relevant documentation Taking basic observations. Using and storing basic and specialised equipment Drug administration guidelines, drug locations, storage and disposal Completing menus; location and ordering of snacks & additional/ special meals Storage and preparation of infant/ specialised milk Enteral feeding equipment and procedures Collecting, storing and sending specimens Receiving telephone specimen results Cleaning and preparing rooms and beds for admission and discharge Disposal of clinical and domestic waste and linen Barrier nursing and hand washing guidelines Daily and weekly cleaning procedures Cleaning of toys and equipment Ordering store items and putting stock away Facilities available for families & visitors: Meals & restaurant facilities Hygiene facilities Overnight residency Visiting hours Chaplaincy service Information/ discharge leaflets Interpreting service Paediatric Unit Student Induction Pack: EB/AT Sept

19 Facilities for patients: Playroom/ activity room T.V s/ game stations Hygiene facilities Drinks/ snacks Interpreting service Sickness policy. Telephoning the ward to register sickness, telephoning the ward to restart work. Making up sick days Off duty requirements and process to request or change off duty Location of student information and allocation 18 Paediatric Unit Student Induction Pack: EB/AT Sept 2014

20 Learning and Development Opportunities Link Nurses: Each ward area has nurses with specialist interests who provide information, resources and updates on their specific link topics Hospital Play Specialists Specialist Nurses: Safeguarding, Respiratory, Asthma, Diabetes, Epilepsy, Stoma (adult based), Palliative care and Orthopaedic (adult based) CAMHS (Child and Adolescence Mental Health Services) Paediatric Outpatients: Clinics, specialist services and investigative procedures run from clinics situated within CAU. These may include: General Paediatrics, Cardiology, Dermatology, Gastroenterology, Feeding clinic, Dietetics and diabetes. Community based services: Children s Centres: Physiotherapy, Speech Therapy and Community Services School Nurses Health Visitors Community Nurses SCBU (Special Care Baby Unit) and NICU (Neonatal Intensive Care Unit) cares for babies born prematurely or very unwell Theatres and Recovery Accident and Emergency, and Paramedics If you would like to work with or visit any of the above services please talk to your mentor. Paediatric Unit Student Induction Pack: EB/AT Sept

21 Reference list ABUHB (2014a). Welcome to Aneurin Bevan University Health Board. Available at: Last accessed: 11/08/2014 ABUHB (2014b). About us. Available at: Last accessed: 11/08/2014 ABUHB (2014c). Royal Gwent Hospital. Available at: Last accessed: 11/08/2014 ABUHB (2014d). Nevill Hall Hospital. Available at: Last accessed 11/08/2014 ABUHB (2014e). Family and therapy services. Available at: Last accessed: 11/08/2014 NMC (2011). Guidance on professional conduct for nursing and midwifery students. London: NMC Available at: Publications/NMC-Guidance-on-professional-conduct.pdf Last accessed: 11/08/ Paediatric Unit Student Induction Pack: EB/AT Sept 2014

22 Evaluation of the Student Induction Pack This questionnaire is designed to evaluate the student induction pack in order to identify any improvements required, to make sure it is meeting the needs of students on placement within the paediatric unit. Please complete the following questions once you have read through the pack and return this page via internal mail to Liz Burnett or Anna Taylor on D6West. 1. Year of course (please circle): Have you been on placement at the paediatric unit at RGH before? (please circle): Yes No 3. Did you receive this pack during the first week of your placement? Yes No 4. Do you think this pack is easy to read and understand? Yes No 5. What have you found most useful about this pack? 6. What have you found least useful about this pack? 7. Is there anything else you think you should be in this pack?.. Thank you for your time. Paediatric Unit Student Induction Pack: EB/AT Sept