Northumbria Healthcare NHS Foundation Trust Northumbria Endoscopy Service STUDENT NURSE AND NEW STAFF TRAINING AND INDUCTION PORTFOLIO FOR ENDOSCOPY

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1 Northumbria Healthcare NHS Foundation Trust Northumbria Endoscopy Service STUDENT NURSE AND NEW STAFF TRAINING AND INDUCTION PORTFOLIO FOR ENDOSCOPY

2 Northumbria Healthcare NHS Foundation Trust Surgical Directorate - Endoscopy Learning Zones Intensive Care MAU Theatre HDU Medical Endoscopist Surgical Endoscopist Respiratory Endoscopist Wards Diabetic Liaison Nurse GP Endoscopists Endoscopy Manager Nurse Endoscopist Pharmacy Infection Control Haematology X-Ray Urology Nurse Specialist Health Promotion Histopathology Moving & Handling

3 Northumbria Healthcare NHS Foundation Trust PHILOSOPHY OF THE ENDOSCOPY UNIT We believe in treating our patients as individuals and we acknowledge and respect the individual s rights and needs. We believe in good team work between all disciplines within which each patient has a named nurse to enhance communication. We believe effective nursing involves good communication from pre-admission to discharge and health education to be a major part of our role. In conjunction with each patient we believe in identifying his or her psychological, spiritual and social needs, as well as physical problems. We believe in creating a friendly and safe environment. We believe nurse should assist patients towards a level of independence. We value the need for continuing education of ourselves and believe in motivation and commitment suing mentorship and teamwork. We value individual staff projects and research based care that is implemented in practice.

4 Northumbria Healthcare NHS Foundation Trust NURSE INDUCTION CHECKLIST This programme is a guide for student assessors and managers to aid the integration of student and new nurses into their new working environment. It is good practice to have the document completed within the first 2 days of commencement. Student nurses must be allocated an assessor at least 1 week before the commencement of placement. At this time an off-duty is produced around the assessor s shifts to allow the first day of placement to be together. NB. It must be remembered that the student must work 50% of the week with his/her assessor. Name: Start Date: Orientation Check List Signature Date Shown around the working environment Introduced to staff members Introduced to clients/patients Off-duty organised Procedure for reporting sick Discuss dress code Given student nurse profile (if applicable) Given unit philosophy Introduction to ward/department HAPS (Handling Advisor Patient Services) To be Shown Signature Date Health and safety file Hospital policies Control of Infection policies Nursing care plans and relevant documentation Nursing standards file Risk assessment file Royal Marsden Handbook (where applicable) Emergency exits Fire drill Fire extinguishers Restaurant Parking

5 Northumbria Healthcare NHS Foundation Trust WANSBECK ENDOSCOPY UNIT PROFILE Wansbeck Endoscopy Unit comes under the Surgical Services of Northumbria Healthcare NHS Foundation Trust. We are situated on the first floor, between Intensive Care and Main Theatre. Wansbeck Endoscopy welcomes students and hopes that the time spent ont the Unit will be enjoyable and interesting. You will be allocated a mentor and associate mentor prior to commencing your placement and are welcome to visit the Unit and meet your mentors before you commence your placement. The Endoscopy Unit is open between 8am to 6pm Monday to Friday. Shifts will be flexible within these times. Off-duty is usually organised 6 weeks in advance. Event though you are supernumerary, you will need to request specific off-duty in advance. The Unit consists of 3 treatment rooms and 2 admission/recovery areas containing 16 trolleys. The Unit offers a service for patients undergoing endoscopic investigations. See list. Patients who attend the Unit can access the department via different routes: Open Access Waiting list Urgent referrals Emergency cases Referred directly from their GP Referred by a Consultant Patients seen within 2 weeks of GP referral Patients who are referred via inpatient referral All members of staff within the Endoscopy Unit follow strict guidelines which are set out clearly by professional bodies. A multi-disciplinary approach is taken when planning care to ensure a safe and effective service. You will be able to work within this multi-disciplinary team, whose members are part of the Learning Zone, enabling you to achieve your clinical competencies.

6 ENDOSCOPIC PROCEDURES Diagnostic Procedures Northumbria Healthcare NHS Foundation Trust Gastroscopy Examination of the oesophagus, stomach and duodenum. Colonoscopy Examination of the whole of the large bowel, rectum, sigmoid colon, transverse colon, ascending colon and caecum. Flexible Sigmoidoscopy Examination of the left side of the large bowel, rectum and sigmoid colon, ERCP (Endoscopic retrograde cholangio-pancreatography) Examination of the biliary tree under fluoroscopic control. Bronchoscopy Examination of the upper respiratory tract. Therapeutic Procedures PEG (Percutaneous endoscopic gastrostomy) a feeding tube inserted through the abdominal wall directly into the stomach. Polypectomy Removal of polyps from the GI tract using a heated wire snare. Argon plasma coagulation Cautery of tissue in the GI tract using argon gas. Gold probe electro cautery a spiral probe for coagulation of bleeding vessels. Injection of bleeding vessels - a vaso constricting drug is injected into a bleeding vessel in order to stop bleeding, e.g ulcers and varices. Insertion of stents These are inserted to hold open areas where a stricture has developed e.g. oesophagus or colon. Dilatation Stretching of an area where a stricture may have formed. Removal of foreign bodies This may be a swallowed object or a food bolus, grasping forceps are used to retrieve foreign bodies.

7 KEY ELEMENTS MANAGEMENT OF CARE LEARNING OPPORTUNITIES Use of nursing model Philosophy of care Documentation used Northumbria Healthcare NHS Foundation Trust RESOURCE/PERSONNEL/ DEPARTMENT Trained/specialist/practice placement facilitation nurse Nursing process Assessment Who assesses How is assessment carried out/open or closed questions What is assessed Where does it take place Planning Nurse clerking documentation Risk assessment tools Care pathways Multidisciplinary plan/working Discharge planning Referrals to other agencies D/N Discharge liaison Specialist nurses Macmillan nurse Sources of information Patient/relatives.doctors.pharmacist/notes/district nurses/specialist nurses Trained nurse/risk assessor Link nurses Specialist nurses MDT/trained nurses Doctors/nurses/GPs /GPs Nurse specialists Implementation/Evaluation Daily assessment of unit workload MDT Documentation Standards Protocols Policies Guidelines Communication/relative/patient Time management Planning priorities Dealing with difficult situations Deceased patients Patient property/valuables Self discharge Religious needs/arranging priest/communication/etc /sister/charge nurse/doctors /sisters/bsg /Infection Control /Royal Marsden Handbook/Risk Management Professional bodies /sister/charge nurse /doctors /sister /doctors/nursing manager /doctors /doctors /hospital chaplain/priest

8 KEY ELEMENTS INTERPERSONAL SKILLS LEARNING OPPORTUNITIES Use of telephone Answering calls Making calls Ring back Bleep system Talking to: Patients physiological preparation Relatives Doctors Other nurses, including specialist nurses GP referrals Emergencies Facilitating investigations Booking transport Ancillary staff Team working Managerial structure in Trust RESOURCE/PERSONNEL/ DEPARTMENT Reception staff/ward staff Unit Manager, sisters, qualified nurses, HCAs Multidisciplinary team GP surgeries, endoscopists Ward staff, ITU, HDU, Theatre Radiology and Haematology Ambulance Liaison/crew Porters, domestics Observation of roles Service/assistant managers, sisters

9 KEY ELEMENTS ORGANISATIONSAL AND MANAGERIAL SKILLS LEARNING OPPORTUNITIES Managing a team Organisational skills Delegations skills Prioritising skills Time management Leadership Off duty Managing patient workload Quality Standards of care Implementing change Giving information to: Staff Doctors Patients Relatives Multidisciplinary team members Other departments Resources Stock control Drugs Materials management Non-stock Stationery Establishment/skill mix Budget control Managing risk Policies and procedures Equipment safety checks Quality control Weekly environment checks Infection control Moving and handling Emergency situations Cardiac arrest Fast bleep service Violent incidents Fire Bed management Staff developments Clinical supervision Reflective practice RESOURCE/PERSONNEL/DEPARTMENT Trained nurse/nurse managers Sisters/ E Grades /doctors /HCA/Reception staff Sister/charge nurse Sister/charge nurse/e grade staff nurse /audit tools/specialist nurses /practice placement facilitator /practice placement facilitator Sisters/nurse manager Sisters /doctors /doctors /doctors /pharmacists/reps /stores department Sister/charge nurse/supplies distribution Sister/charge nurse/ward clerk Sisters Unit Manager Sisters/trained nurses/risk assessor Nurse/Health & safety officer/electronics Health & safety officer/risk assessor Auxiliary nurse Infection control Moving and handling co-ordinator Cardiac arrest team/trained nurses /switchboard /security officer Fire officer/trained nurses /Call Centre /practice placement facilitator

10 KEY ELEMENTS CLINICAL SKILLS LEARNING OPPORTUNITIES Recording of physiological observations to include admission of Day Case patients using the Endoscopy Nurse clerking documentation O² Sats BP Pulse Wt Cannulations Medical devices Giving medication Oral Rectal Intravenous IV infusions CONSENT Investigations Phlebotomy INR ECG Blood glucose Infection Control Autodisinfectors Endoscopes & accessories Ultrasonic machine Steriliser Isolation of patient Risk Assessment BMI M&H assessment Sedation/local anaesthetic spray ASA (classification of clinical state) CSS (conscious state of sedation) Radiology Checking equipment Use of aids Hoist RESOURCE/PERSONNEL/ DEPARTMENT Trained nurse/doctor Trained nurse Trained nurse Trained nurse/pharmacist Doctors Haematology ECG technician Trained nurse/diabetic nurse Trained nurse/hca Infection Control nurses BSG guidelines Risk Assessment Advisor M&H Advisor BSG Guidelines /doctors /radiographer /HCA

11 KEY ELEMENTS PATHOPHYSIOLOGICAL PROCESSES LEARNING OPPORTUNITIES Liver and Biliary Systems Anatomy and Physiology Jaundice Tumours Alcoholic liver diseases Nutrition Treatments Cardiovascular system Cardiac arrest MI Hypertension Angina ECG Central nervous system Sedation Drugs Prophylactics Nebulizers, inhalers Oxygen therapy COPD Anaemia Macro Micro RESOURCE/PERSONNEL/ DEPARTMENT Endoscopists/gastroenterologists ERCP sessions Books /doctors Pharmacists BSG guidelines Clinical monitoring BSG guidelines/doctors /doctors Respiratory nurses Gastroscopy referral forms