Induction Sanjay Suri RCPCH Tutor Children and Young People’s Health Service Rotherham 4 Feb 2015.
-
Upload
shavonne-sparks -
Category
Documents
-
view
214 -
download
0
Transcript of Induction Sanjay Suri RCPCH Tutor Children and Young People’s Health Service Rotherham 4 Feb 2015.
Induction
Sanjay SuriRCPCH Tutor
Children and Young People’s Health Service Rotherham4 Feb 2015
SERVICE
We are…
• 8 consultants
• Different speciality interests
• Areas of work
CW/CAU/SCBU/Wharncliffe/Clinic
CDC/Comm clinics/Special schools
• Hospital/community split
You are…
• Ist on call9 ST 1-3s(5 VTS ; 3 Career ;1 F2)
• 2nd on call9 ST 4-8(including 2 community)
Ward-based practice
• 1:7 ward based rota
• 1630-1630 Friday – Friday
• All admissions under WBC
• Weekend handover at 1230 in CAU SR
• On call – different Consultant
• Child protection under on call Consultant unless admitted
Guidelines
CLICK ON DR TED ICON ON SOME COMPUTERS OR
GO TO INSITE (RFT INTRANET) HOME PAGE
CLICK ON APPLICATIONS
CLICK ON C&YPS
CLICK ON CHILDRENS WARD/NEONATAL GUIDELINES
GUIDELINES ARE ORGANISED ACCORDING TO SYSTEMS
How To Access The Shared Drive
MY COMPUTER
PAEDIATRICS ON THE ‘TRFTSTORE00\DEPT_HOME’ (I:)
PCS
FILES AND FOLDERS
Handover
• Start on time
• 3 handovers a day – update sheets
• 0830 ; 1600 ; 2030
• Morning handover WBC led
• Sickest (CHDU) and newest first, then old
• Who can be discharged….
• Staffing and bed situation
Middle grade support
• ST1-3/F2 – do not work beyond your expertise
• Crash calls/Deliveries – middle grade to accompany
• If in doubt, please ask
Children’s Assessment Unit
• Single point of referral into the Children’s ward (A&E and GPs)
• 0800 – 2000 7 days a week• 1xST1-3/F2 and 1x Registrar• 1xtrained nurse/1xHCA• Ward based Consultant cover • Key performance indicators (Standards)• Discourage ward attenders
Spotting the sick child
CHDU
• On the children’s wards
• Use of the PEW tool
• Criteria = sick enough to require 1:2 nursing
• Inform anesthetist
Discharge letters
• Discuss all clinic follow up decisions with WBC• End of the ward round • Behind nurses station opposite CHDU• Cover ST1-3/F2 to action • >10 summaries – ward clerk WBC• > 20 summaries – divide equally • Number on the handover sheet • CW – complex and SCBU – Badger by middle
grade
Lab results
• E-folder for urgent outstanding results • Process for the actioning of paper results • Normal – sign • Abnormal – check the e-folder – actioned – sign • Abnormal – not actioned – “notes please” – don’t
sign • > 10 sheets ward clerk to inform WBC • > 20 sheets ward clerk to divide up and inform
team leader and WBC
Photopheresis
• Medical procedure for GvHD• One of 3 centres in the country• Haematology lead : Dr Taylor/Dr Alfred• Paediatric lead : Dr Suri • Joint initial assessment • Daily ward round for day cases (Registrar
responsibility)• Rarely as inpatient• Audit of documentation this house
Rapid Access Clinic
• 4 days of the week (Tuesday – Friday)
• 1330 – 1530
• Consultant delivered
• Child protection cases can be seen if slots
• New urgent (non emergency) referrals by GP/A&E
Day Area
• Located within the Children’s clinic
• Investigations and patient education
• Junior doctor’s role in day area
• Not for ward reviews/clinics/emergency work/child protection medicals
Clinics
• Middle grade do supervised clinics
• ST1-3/F2 observe in clinics
• Middle grade guide to clinic in Induction folder
• Clinic information on the monthly rota
SCBU
• 14 cots (2 x ICU; 2 x HDU ; 10x SCBU
• Consultant and middle grade led
• BADGER summaries
• Consultant ward round – Tues and Thurs
Communication
Email accounts All must access Trust email
accounts
Baton bleeps are carried by Neonatal RegistrarPostnatal tier 1 doctor Sister SCBU
Paediatric RegistrarPaediatric tier 1 doctor
Wharncliffe
• Postnatal ward
• ST1-3/F2 responsibilty
• Middle grade supervision
• Ensure letter for all referrals
• Baby checks in a timely manner
• Paediatric alerts
Consent 0-18y
Datix
• Incident reporting
• Insite Applications Datix web
• Self explanatory
Infection control policy
• Hand-washing
• Bare below the elbows
• Follow guidance
TRAINING
Introduction
• You are in a training post
• Team working
• Training vs Service
• Use all educational opportunites
• Keep e-portfolio uptodate
Clinical supervision
DO NOT WORK
BEYOND YOUR EXPERTISE
• Allocation to Consultants for appraisal
• Day to day supervision is different
Appraisal meetings
• Minimum 3 meetings – your responsibility
• Initial meeting within 2 weeks (30 mins)
• Mid-post meeting 3 mo into the job ( with mid-post feedback forms) (45 mins)
• Final meeting end of post (30 mins)
Educational programme
• Weekly programme• Vocation-specific
GP VTSSPROG/SPRAT/DiplomaF2
• Additional training sessionsCRUMPET (Faye Marshall)Ventilator training (Bev Lomas)Resuscitation training (Bev Lomas)Safeguarding level 3 (Carol Boote)Audit meetings (Dr Harrison) (1st Monday of the month)Perinatal meetings (Dr AlSafi) (4th Monday of the month)
We all work in an NHS that places huge demands on us .
Working with babies & sick children, busy workloads & challenging situations has a personal impact on us every day.
It can feel hard to keep our care and compassion alive.
Monthly multidisciplinary meeting for all direct care staff
Facilitated by Catherine Wright (psychologist) with the support of local managers.
Confidential meeting, for colleagues to discuss their work together6 month pilot and if successful will continue and perhaps be extended to other clinical settings.
Weekly programme
Day Session Time Sign Register
Attended by
Monday X-Ray meeting 1300-1400 √ All
Tuesday ST4-8 teaching 1230-1330 √ ST4-8 only
Wednesday ST1-3/F2 teaching 1230-1330 √ ST1-3/F2 only
Thursday Clinical meeting/
Medication DATIXes
1230-1330 √ All
Friday Problem of the week
1230-1245 x All
Feedback
• Informal may have to seek when things go well/wrong
• Formal work place assessments (CbD ; CEXs)in-house MSF mid-postmid-post Consultants and senior nurses meeting Evaluation forms
• Junior Doctors forum once/monthbilateral issues
Support
• Clinical supervisor
• (Educational supervisor/GP trainer)
• RCPCH Tutor – Dr Sanjay Suri
• PGME Director – Dr Alison Cooper
• Service Manager – Faye Marshall
• Team leader – Denise Brookes