ACUTE CARDIOLOGY DEPARTMENT
31
PROFILE OF LEARNING OPPORTUNITIES (POLO) FOR ACUTE CARDIOLOGY DEPARTMENT
Transcript of ACUTE CARDIOLOGY DEPARTMENT
PROFILE OF LEARNING OPPORTUNITIES (POLO)
FOR
ACUTE CARDIOLOGY DEPARTMENT
Educational Lead Sharon Park
SERVICE PROFILE
DIRECTORATE: Emergency Care
SPECIALITY: Cardiology
BEDS: 7 Coronary Care
18 Cardiology Step-down
10 Chest Pain Assessment Unit
STAFF
Nursing:
Ward Manager B22 Ann Roper
Ward Manager CCU/CPAU Andrea Bell
Cardiac Rehabilitation Nurses Chris Thompson
Joan Armbruster
Nurse Consultant Alun Roebuck
Matron Gill Charlton
Research Nurse Lisa Cowell
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Emergency Care Practitioners: X 10
Senior Staff Nurses: X 5
Staff Nurses: X 35
Auxilary Nurses: X 15
Ward Clerks Dorothy Blench
Jennifer Coulson
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LEAD NURSE** / LINK NURSE*
Wound management Alison Gollan** Sandra Graham* / Zoe Kyle
CHD Collaborative Sharon Park** Andrea Bell**
PGD Neil Barry** / Margaret McGrath** Sharon Park*
Educational Link Sharon Park**
Budget Andrea Bell** Ann Roper*
Lifting / Handling Annette Bainbridge** Madie Fox*
Documentation Neil Barry** Annette Bainbridge*
CPR Graham Pike** Kathryn Miller*
Health Promotion Margaret McGrath** Ann McMahon*
Research Chris More** Niki Day*
Discharge Planning Chris More** Kerry Richardson *
Audit Coordinator Helen Godfrey** Suzi Guerrero* / Sharon Park*
Clinical Supervision Kathryn Miller**
Angio Neil Barry** Niki Day*
Health and Safety Frank Campbell ** Barbara Warren*
Rehab Pat Blakelock** Eva Rontas
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SIA Sandra Cunningham** Darshini Naidoo*
Holidays Sandra Cunningham** Denise Ward*
Stock Management Sharon Buttle** Dawn Pennington*
COSHH Frank Campbell** Pat Blakelock*
Nutritional Link Annette Bainbridge** Barbara Warren*
Diabetes Angela McDermott** Darshini Naidoo*
Infection Control Sharon Buttle** Denise Ward*/Sandra Graham*
GRASP Graham Pike** Jan Whitwood*
Clinical Governance Alison Gollan** Maureen Gallagher*/Zoe Kyle
Named Nurse Sharon Buttle**
Essence of Care Jan Ayre**/ Ann Roper*Frank Campbell**
Smoking Cessation Jan Ayre**
Continence Margaret McGrath**
Waste and Recycling Jan Ayre** Denise Ward*
Pharmacy Sharon Buttle**
Palliative Care Maureen Gallagher**
Pressure Area Sharon Buttle**
Troponin Link–wards Jan Ayre**
Mandatory Training Jan Ayre** Dorothy Abuda*
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Medical Staff
Cardiologists: Dr Pugh
Dr Farrer
Dr Junejo
Dr Agrawal
Dr Olszewski
Dr McClure
Registrar: Change every 6 - 12 months
SHO: 1 based on CCU, B22 and CPAU
Change every 3 months
Allied Health Professionals
Pharmacist Kirsten Shearer
Dietician Anna Pickings
Physiotherapist Christine Scott
Occupational Therapist Tracey Rumfitt
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ACUTE CARDIOLOGY DEPARMENT PHILOSOPHY OF CARE
The staff of the Acute Cardiology Department will endeavour to deliver the highest
standard of nursing care to patients under their care.
This will be achieved by creating an optimum environment in which skilled nurses using
a recognised model of nursing will address issues of individual and holistic care without
prejudice.
Each Practitioner will be accountable for delivering nursing care that promotes and
maintains the optimum health of individuals. Constantly seeking to improve quality of
care and implementing evidence-based care. Continually updating skills to ensure the
advancement of knowledge, skills and practice.
Ultimately providing an effective and efficient Cardiology Service.
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Hours of Duty
Whilst on placement Student Nurses will be allocated a Mentor, and will work with their Mentor during a variety of shifts across a 24 hour period. By working days, nights, and weekends it will allow quality time to be spent with their Mentor, providing great opportunities for learning, to ensure all aspects of Cardiology Care are experienced.Learning during the placement is the Student’s responsibility; their Mentor will facilitate this learning to help them achieve the objectives set.Any problems or recurring issues experienced by the Student Nurse should be expressed to their Mentor or Ward Manager during the placement so they can be resolved before the end of the placement. Hopefully, this will create an atmosphere conducive to learning, and make the experience an enjoyable one.
Early 7.30 am - 4.15 pm
Early half day 7.30 am - 1pm
Late 12.30 pm - 8.30 pm
Reverse half day 3 pm - 8.30 pm
Thirteen Hour 7.30 am - 8.30 pm
Night Duty 8.15 pm - 7.45 am
Referrals / Admissions
Direct admissions from Ambulance Service
GP Direct
Accident and Emergency Department
Clinical Decisions Unit
Admission Wards
Any other ward or patient area within CHS
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Ward Rounds
At least twice daily on CPAU by the Cardiologist on call.
Daily on CCU:
Monday Dr Farrer
Tuesday Dr Pugh
Wednesday Registrar
Thursday Consultant Cardiologist of the week
Friday Dr Junejo
B22:
Tuesday Dr Pugh
Thursday All Cardiologists
Friday Dr Junejo
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GLOSSARY OF ABBREVIATION USED WITHIN
ACUTE CARDIOLOGY DEPARTMENT
ACS Acute Coronary Syndrome IV Intra VenousAF Atrial Fibrilation LBBB Left Bundle Branch BlockAnt MI Anterior Myocardial Infarction LVF Left Ventricular FailureAnt-Lat Anterior Lateral Myocardial MI Myocardial Infarction
InfarctionAPTT Activated Partial Thromboplastin MSU Mid Stream Urine
TimeAV Atrio-Ventricular MSW Medical Social WorkerBP Blood Pressure NAD No Abnormality DetectedBM Boeehringer Mannheim NBM Nil By Mouth
Mellitus (Blood Glucose) NIDDM Non-Insulin DependentDiabetes
CABG Coronary Artery Bypass Graft NPU Not Passed UrineCCU Coronary Care Unit NSAID Non-Steroidal Anti
Inflammatry DrugCE’s Cardiac Enzymes OT Occupational TherapistCHB Complete Heart Block PAWP PulmonaryArtery Wedge
Pressure CO Cardiac Output PE Pulmonary EmbolismCOPD Chronic Obstructive Pulmonary PEA Pulseless Electrical Activity
DiseaseCPAU Chest Pain Assessment Unit Post MI Posterior Myocardial
InfarctionCPR Cardio-Pulmonary Resuscitation PU Passed UrineCVP Central Venous Pressure PVD Peripheral Vascular DiseaseC&S Culture and Sensitivity Px PrescribedCXR Chest X-ray RBBB Right Bunble Branch BlockDC Direct Current SVT Supra-Ventricular
TachycardiaDU Duodenal Ulcer Sync SynchronisedECG Electrocardiograph TNK TeneceplaseECHO Echocardiogram U/A Unstable AnginaETT Exercise Tolerance Test U&E’s Urea and CreatinineFBG Fasting Blood Glucose VE Ventricular EctopicsFWT Full Ward Test VF Ventricular FibrillationGTN Glycerine Tri Nitrate VT Ventricular TachycardiaHR Heart Rate V/R Ventricular RateInf MI Inferior Myocardial Infarction VSD Ventricular Septal DefectInf-Lat Inferio-Lateral WPW Wolff-Parkinson-WhiteMI Myocardial InfarctionIM Intra Muscular
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LEARNING OPPORTUNITIES
Frequent physiological conditions
M I
Angina
Heart Failure
Arrythmias
Cardiomyopathy
Pericarditis
Endocarditis
Cardiogenic Shock
Clinical Procedures
Insertion of Central Venous Pressure Line
Insertion of Temporary Pacing Wire
Pericardiocentesis
Insertion of Intra Aortic Balloon Pump
Synchronised Cardioversion
CPAP
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Diagnostic Tests
Cardiac Enzyme Troponin T
Exercise Tolerance Test
Echo
Angiography
Myocardial Perfusion Scan
Cardiomemo
24 Hour Tape
Journals, Books etc
A selection of Cardiac Journals can be found in the Research Office on B22
Selected titles of recent Cardiology Books are available - see Sr Bell / Roper
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LEARNING OPPORTUNITIES
KEY ELEMENT
INTERPERSONAL SKILLS
LEARNING OPPORTUNITIES RESOURCE / RELEVANTPERSONNEL / DEPARTMENT
Use of the telephone:Answering callsMaking callsRing back etcBleep system
Use of computer to obtain:Patient investigation resultsPatient information
Talking to:PatientsRelativesDoctorsOther nurses including specialist nursesMulti-disciplinary team referrals
Ancillary staffMDT meetingsDoctors ward roundConsultant ward roundsBooking transport
Facilitating investigationsNurses handoversManagerial structure in TrustTeam workingPatient transfer in TrustPatient transfer outside the Trust
Ward clerk / ward staff
Ward clerk / ward staff
Ward manager / Clinical LeadRegistered / Auxiliary nurseDoctors, Multi-disciplinary team
Registered nurses / OT / Physio / Social worker / Specialist nursesDomesticsRegistered nursesDoctors / registered nurses / pharmacists
Ward clerk / Ambulance control / Hospital transport DeptRegistered nurses / Doctors / ward clerkRegistered nursesWard managerObservation of rolePatient / relative / registered nurse / bed manager / porter / ambulance crew.
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KEY ELEMENT
CLINICAL SKILLS
LEARNING OPPORTUNITIES RESOURCE / RELAVANTPERSONNEL / DEPARTMENT
CORE SKILLS:
Patient hygiene
Mouth careHair / nail careSkin carePressure care prevention (Braden Scale)
Recording of physiological observations:Blood PressureTemp, Pulse, RespsWeightBlood GlucoseUrine OutputMaintaining accurate charts
Giving medications - OralIntramuscularSubcutaneousIntravenousRectal
Intravenous infusionsCannulation / Care of venflonsMedical devices - Infusion pumpsSyringe drivers
Phlebotomy / venepunctureAdministration of blood / blood productsAseptic techniques, i.e. dressings
Risk assessmentNutritional intakeBMIFalls assessment
Registered / auxiliary nurse / occupational therapistRegistered / auxiliary nurse
Registered / auxiliary nurse / Doctor
Registered nurse / Diabetic nurse specialistRegistered / auxiliary nurse
Registered nurse / Pharmacist / Doctor
Registered nurse / Infection control nurse
Registered nurse / Medical electronics
Registered nurse / Phlebotomists / path labRegistered nurse Registered nurse
Registered nurse
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Moving and handlingUse of aidsHoists
Infection ControlIsolation of patientsCatheter insertion and careTest urine
Central venous pressure lines
Patient safetyChecking equipment
Preparation for investigationsConsentInformationInvasive radiologyNon-invasive radiology
SPECIALIST SKILLS
Nurse ThrombolysisTemporary Pacing wiresSynchronised Cardioversion PericardiocentesisIntra Aortic Balloon PumpCPAP
Investigations:Cardiac enzymes - Troponin TExercise Tolerance TestEchocardiographyAngiographyMyocardial Perfusion Scan
Cardiomemo24 hour tape
Registered nurse / Physiotherapist / Moving and Handling Advisor
Registered / Auxiliary nurse / Control of Infection nurseRegistered nurse Registered Auxiliary / nurse
Registered nurse
Registered nurse Registered nurse / Medical electronics / works deptRegistered nurse / Doctor
Registered nurse / Radiology nurse / Doctor
Emergency Care Practitioner (ECP)Registered nurse / DoctorRegistered nurse / Nurse ConsultantRegistered nurse / DoctorRegistered nurse / Nurse ConsultantRegistered nurse / Nurse Consultant
Registered nurseRegistered nurse / Doctor / ECG DeptRegistered nurse / Doctor / ECG DeptRegistered nurse / Angiography nurseRegistered nurse / Medical Physics nurse / DoctorRegistered nurse / ECG DeptRegistered nurse / ECG Dept
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KEY ELEMENT
HEALTH DEVELOPMENT OPPORTUNITIES
LEARNING OPPORTUNITIES RESOURCE / RELEVANTPERSONNEL / DEPARTMENT
Healthy lifestyle strategies in relation to:
Smoking cessationAlcoholic Liver DiseaseBowel disordersCancerObesityDiabetesEating for a healthy heartDrug and alcohol abusePromotion of exerciseStroke rehabilitationHealthy heartPulmonary rehabilitation
Health education and health promotion literature
Models of health promotion/ education
Interface between hospital and community care
Counselling
Smoking cessation advisor / pharmacistDietician / Gastroenterology nurseDietician / Upper GI nurseMacmillan nurse / HospiceDietician / Practice nurseDietician / Diabetic nurse specialistDietician / Registered nurse / rehab nurseDrug and alcohol teamPhysiotherapistStroke unit / Physio / OTCHD nurse / Heart failure specialist nurseRespiratory specialist nurse
Health Promotion UnitCity Hospitals Web siteInternet
Specialist nurse clinicsDiscussion with mentor
HAZHealth Promotion UnitSpecialist nursesCHD Community nurse
Macmillan nurse specialistsHospiceClinical psychology
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KEY ELEMENT
MANAGEMENT OF CARE
LEARNING OPPORTUNITIES RESOURCE / RELEVANTPERSONNEL / DEPARTMENT
Use of nursing modelPhilosophy of careDocumentation usedChest Pain Assessment
Nursing process:
Assessment -
Who assesses?How is assessment carried out / open or closed questions?What is assessed?Where does it take place?
Planning -
Care plans Risk assessment toolsCare pathwaysMulti-disciplinary plan / workingDischarge planning
Referrals to other agencies -
OTPhysioSocial workerDistrict nurseDischarge liaisonSpecialist nursesCritical Care Outreach nurseMacmillan nurseHospiceRelevant departments
Registered nurseRegistered nurseRegistered nurseEmergency Care Practitioner
Registered nurseSources of informationPatient, relatives, doctor, pharmacist, notes, district nurses, specialist nurses
Registered nurseRegistered nurse / Link nursesRegistered nurse / specialist nursesMDTDischarge liaison nurse
Registered nurse
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Implementation / Evaluation -
Ward roundsMDTDocumentationStandardsProtocolsPoliciesPatient Group DirectionsCommunication / patient / relativesTime managementPlanning prioritiesDealing with difficult situationsDeceased patientsPatient property / ValuablesSelf dischargeReligious needs / arranging priest / communication etc
Registered nurse / DoctorsRegistered nurseRegistered nurseRegistered nurseRegistered nurseRegistered nurseRegistered nurseRegistered nurse Registered nurseRegistered nurseRegistered nurseRegistered nurse / DoctorRegistered nurse / General officeRegistered nurse / DoctorRegistered nurse / hospital chaplain / priest
KEY ELEMENT
ORGANISATIONAL AND MANAGERIAL ISSUES
LEARNING OPPORTUNITIES RESOURCE / RELVANTPERSONNEL /DEPARTMENT
Managing a team:
Organisational skillsDelegation skillsPrioritising skillsTime managementLeadership
Registered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / manager
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Off dutyManaging patient workloadQualityStandards of careImplementing change
Giving information to:
StaffDoctorsPatientsRelativesMulti-disciplinary team membersOther departments
Resources:
Stock controlDrugsTSSUMaterials managementNon - stockStationaryEstablishment / skill mixBudget control
Managing risk:
Policies and proceduresEquipment safety checksQuality controlEnvironment checksInfection ControlMoving and HandlingCOSHHHealth and Safety
Emergency situations:
Cardiac arrestFast bleep systemViolent incidentsFireBed alertsPatient falls
Team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / manager
Registered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / managerRegistered nurse / team leaders / manager
Registered nurse / Pharmacist / storesRegistered nurse / PharmacistRegistered nurse / TSSURegistered nurse / storesRegistered nurse / storesRegistered nurse / ward clerk / storesWard managerWard manager
Registered nurse Health and safety officer / electronicsHealth and safety officer and link nurse Domestic supervisorControl of infection sisterMoving and handling co-ordinatorLink nurseLink nurse
Registered nurse / arrest teamRegistered nurse / switchboardRegistered nurse / Security officerRegistered nurse / Fire officerRegistered nurse / Bed managerRegistered nurse / health and safety officer
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Staff Developments:
Clinical supervisionReflective practice
Registered nurse Registered nurse
KEY ELEMENT
PATHOPHYSIOLOGICAL PROCESSES
LEARNING OPPRTUNITIES RESOURCE /RELEVANTPERSONNEL / DEPARTMENT
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Infection:
Inflammatory processSourceNature spreadTreatment
Immunological factors:
AntigensAutoantigensSuppression of immune systemDrugsDisorders
Disturbances in water and electrolyte balance:
Normal electrolyte balanceReading and understanding blood resultsDehydrationWater excess (ADH)Acidosis
Oncology:
EpidemiologyAetiologyPathologyTreatments chemotherapy, radiotherapy, Drugs
Cardiovascular system:
Anatomy and physiologyConduction system and ECGInvestigationsTreatmentsMyocardial infarction
Registered nurse / Doctor / Pharmacist / books / articles
Registered nurse / Doctor / Pharmacist / books / articles
Registered nurse / Doctor / Pharmacist / Renal team / books / articles
Registered nurse / Doctor / Pharmacist / books / articles / Macmillan nurse / HospiceChemotherapy unit / Radiotherapy dept
Registered nurse / ECP / Doctor / ECG / books / articlesRegistered / Angiography nurse Registered / ECP / DoctorRegistered / ECP / Rehab nurse
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AnginaHeart failure, CCF, LVFCardiac arrestHypertensionCardiac ArrhythmiasCardiogenic shockDrugs
Respiratory system:
Anatomy and physiologyInvestigationsInfectionsTreatmentsChest infectionsCOPDAsthmaEmphysemaFibrosisDrugs Nebulisers, inhalers, oxygen therapy
Liver and Biliary system:
Anatomy and physiologyJaundiceTumoursAlcoholic liver diseaseNutritionTreatments
Kidney and Genitourinary system:
Anatomy and physiologyInfectionsDrugsInvestigationsTesting urinePyelonephritisFluid balance Diseases of the blood:
Blood formation and destruction processRed blood cellsWhite blood cellsPlateletsAnaemia's
Registered / ECP / DoctorHeart Failure nurseRegistered nurse / DoctorRegistered nurse / DoctorRegistered nurse / DoctorRegistered nurse / DoctorRegistered nurse / Doctor / Pharmacist
Registered / Respiratory nurse / DoctorPulmonary technicianDoctor / Pharmacist
Registered nurse / Doctor / GI nurse / Endoscopy unitMacmillan nurseDrug and alcohol unitDietician
Registered nurse / Doctor / Continence nurse / Radiology
Registered nurse / Doctor / books / articlesHaematology unit
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Blood transfusionsMalignant disordersLymphomasLeukaemia'sMyelomaHaemorrhageThrombosis
Endocrine and Metabolic disease:
Diabetes mellitusThyroid problemsLong term use of steroidsPituitary problems
Nervous system:
EpilepsyTumoursHeadachesCVAInfections
Connective tissue, joints, bones:
ArthritisLupusOsteoarthritisOsteoporosisHow bones healInfection
Acute poisoning:
CausesTreatmentsDrugs
Registered nurse / Doctor / Diabetic nurse / Endocrine nurse / Pharmacist
Registered nurse / Doctor / Pharmacist
Stroke unit / Specialist nurseControl of Infection nurse
Registered nurse / Doctor / Pharmacist / Specialist nurse / Physio / books / articles
Registered nurse / Doctor / Pharmacist / Poison unit
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