Northumbria Endoscopy Service
STUDENT NURSE AND NEW STAFF
TRAINING AND INDUCTION PORTFOLIO
Surgical Directorate - Endoscopy
Learning Zones
Intensive Care MAU Theatre
HDU Medical Endoscopist Surgical Endoscopist Respiratory Endoscopist Wards
Endoscopy Manager
Diabetic Liaison Nurse GP Endoscopists Nurse Endoscopist Pharmacy
Infection Control Haematology X-Ray Urology Nurse Specialist
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.
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
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 Referred directly from their GP
Waiting list Referred by a Consultant
Urgent referrals Patients seen within 2 weeks of GP referral
Emergency cases 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.
ENDOSCOPIC PROCEDURES
Diagnostic Procedures
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
.KEY ELEMENTS
MANAGEMENT OF CARE
LEARNING OPPORTUNITIES RESOURCE/PERSONNEL/ DEPARTMENT
Use of nursing model Philosophy of care Documentation used
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
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
Trained/specialist/practice placement facilitation nurse Trained nurses Trained nurses Sources of information Patient/relatives.doctors.pharmacist/notes/district nurses/specialist nurses Trained nurses
Trained nurse/Risk assessor Link nurses Specialist nurses MDT/trained nurses Doctors/nurses/GPs Trained nurses Trained nurses/GPs Trained nurses Nurse specialists
Trained nurses/sister/charge nurse/doctors Trained nurses
Trained nurses/sisters/BSG Trained nurses/Infection Control
Trained nurses/Royal Marsden Handbook/Risk Management
Professional bodies
Trained nurses/sister/charge nurse Trained nurses/doctors
Trained nurses Trained nurses/sister
Trained nurses/doctors/nursing manager Trained nurses
Trained nurses/doctors Trained nurses/doctors
KEY ELEMENTS
INTERPERSONAL SKILLS
LEARNING OPPORTUNITIES RESOURCE/PERSONNEL/
DEPARTMENT 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
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
KEY ELEMENTS
ORGANISATIONSAL AND MANAGERIAL SKILLS
LEARNING OPPORTUNITIES RESOURCE/PERSONNEL/DEPARTMENT
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
Trained nurse/nurse managers Sisters/ E Grades
Trained nurses/doctors
Trained nurses/HCA/Reception staff Sister/charge nurse
Sister/charge nurse/E grade staff nurse Trained nurses
Trained nurses/audit tools/specialist nurses Trained nurses/practice placement facilitator Trained nurses/practice placement facilitator
Sisters/nurse manager Sisters Trained nurses/doctors Trained nurses/doctors Trained nurses Trained nurses/doctors Trained nurses/pharmacists/reps Trained nurses/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 Trained nurses/switchboard
Trained nurses/security officer Fire officer/trained nurses Trained nurses/Call Centre
KEY ELEMENTS
CLINICAL SKILLS
LEARNING OPPORTUNITIES RESOURCE/PERSONNEL/
DEPARTMENT
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 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
Trained nurses/doctors
Trained nurses/radiographer Trained nurses/HCA
KEY ELEMENTS
PATHOPHYSIOLOGICAL PROCESSES
LEARNING OPPORTUNITIES RESOURCE/PERSONNEL/
DEPARTMENT
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 Endoscopists/gastroenterologists Trained nurses ERCP sessions Books Trained nurses/doctors Pharmacists BSG guidelines Clinical monitoring BSG guidelines/doctors Trained nurses/doctors Respiratory nurses
