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Clinical Placement Information

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Clinical Placement Information Powered By Docstoc
					                 NEUROLOGY / ELDERLY

 PHYSIOTHERAPY STUDENT PLACEMENT
                      BLYTH COMMUNITY HOSPITAL



    Northumbria Healthcare
          NHS Trust
                   Physiotherapy Services

                Blyth Community Hospital

Superintendent II Physiotherapist:   Lynn Henderson

                                     Tel: 01670 395632

Hospital Address:

Physiotherapy Department
Morpeth Cottage Hospital
South Road
Morpeth
Northumberland
NE61 2BT

Tel: 01670 395632
                          Clinical Placement Information

Placement/Speciality: Care of the Elderly/ Neurology

Clinical Educators: Helen Price

Contact Address:
Morpeth Cottage Hospital (MCH)              Blyth Community Hospital (BCH)
South Road                                  Thoroton Street
Morpeth                                     Blyth
NE61 2BT                                    NE24 1DX
01670 395632                                01670 396431

Trust Website: www.northumbria-healthcare.nhs.uk

First day, who to report to: Lynn Henderson, Helen Price

Where: Physiotherapy Dept at the hospital site to be arranged prior to placement.

When: 08:45 a.m.

Access by rail: MCH – Yes. BCH – No    Bus: MCH/BCH – Yes (see included
timetables. www.uk.bus.co.uk).   Road: see included maps www.multimap.com

On site parking: Both sites available free of charge.

Maps included: Yes

Normal Working Hours: 08:45 a.m. to 16:30 p.m.

Uniform Requirements: Regulation physiotherapy trousers and tunic, (polo shirt and
trainers are acceptable)

Canteen facilities: Both sites have small dining rooms serving a selection of hot and
cold meals (Tea and coffee free in the department!)

Common conditions to be treated:
Neurological (in/out-patients) including; stroke, Parkinsons, M.S. Multi-pathology
within elderly care (in/out-patients) including; ortho-geriatrics, falls, general
medicine, palliative care.

Suggested Reading:
National Service Framework for Older Person (Dept of Health Publication)
Bamford Stroke Classification Scale (see included)
Neurological Physiotherapy – A Problem Solving Approach. Susan Edwards.
Recent journal articles dealing with elderly care/neurology

Student can expect to treat first patient on: day 2
Average number of patients per day: 4-6
                              Student Induction Sheet

Name of Student:

Inducted by:                                               Date:

                                                                   Completed
House Keeping

Lockers
Keys
Car Parking
Restaurant
Equipment
Other

Personnel

Introduction to Clinical Team
Introduction to Physiotherapy Technical Instructors and duties
Introduction to Wards/ Department
Introduction to Multi-disciplinary team (MDT)

Policies/Procedures/Protocols

Documentation
Assessment forms
Outcome Measures
Standards
Clinical Protocols
Patient Information
Equipment Loan Service
Reference to Trust and Department Policy Files
Other

Documentation

Referral System
Standards of Documentation
MDT notes/ Medical and Nursing Documentation
SOAP Notes
Statistics
Photocopier
Other

Training and Resources

Discussion of previous learning/Knowledge/learning style
Discussion of placement hopes/concerns
Discussion of Placement Learning Outcomes
Discussion of Specific Learning Opportunities
Discussion of Specific Learning Outcomes
IST
Learning Resources
Other

Health and Safety

Fire alarms/ Evacuation Procedure
Manual Handling Policies
Equipment orientation
Other
                                IN-PATIENT STAFFING AT MORPETH AND BLYTH HOSPITALS


                                                       Lynn Henderson
                                                            Supt. II
                                                    Split between Morpeth
                                                           and Blyth



                                                          Helen Price
                                                       Clinical Specialist
                                                  Split between Morpeth and
Kim Ferguson             Lorna Kirk Snr 1                    Blyth                           Sandra Armstrong
  Senior I               Viv Scott Snr 1                                                         Senior I
                         (part time)



               1 x Rotational                                                    Carol Walker              Steven Clements
                  Senior II                                                   Technical Instructor         Physio Assistant
                                                                                  (Part-time)                 (Part-time)

               Dawn McCurley
                 Technical
                 Instructor


                        Diane Meynell
                       Physio Assistant
Learning Opportunities Specific to Morpeth Cottage and Blyth Community
Hospitals

      To develop an understanding of the role of community hospitals within the
       patients seamless care plan

      To develop an understanding of the role of a community hospital as a care
       setting with in a large NHS Trust

      To experience working over two sites, with the combined support from
       clinical educators

      To become a member of a wider physiotherapy team, liasing with members of
       the acute team and continuing care team to enable a seamless care package for
       the individual patient

      To become a member of a Multi-disciplinary team that encompasses many
       professions in the holistic care of individual patients

      To gain experience of the Multi-disciplinary Stroke Care Pathway developed
       by Northumbria Healthcare Trust as part of its Beacon Trust Status

      To be involved in innovative developments such as a MDT Falls Assessment
       Programme

      To gain experience of Community Rehabilitation Teams and Intermediate
       Care Teams treating patients within a flagship Care Trust

      To develop knowledge of Trust-wide physiotherapy assessment tools and
       outcome measures in areas such as Stroke, Falls and Parkinsons, devised from
       evidence-based practice

      To develop assessment, treatment plan, goal-setting and discharge planning
       skills for patients in an in-patient, out-patient and Day Hospital Setting

      The opportunity to develop an understanding of models of care from acute to
       community settings, Day Hospital, Domiciliary, Community Rehabilitation
       and Intermediate Care settings

      There is the potential to work with Palliative Care patients and Psychi-geriatric
       Patients

      Close working links with other members of the MDT will allow the
       opportunity for multi-professional learning opportunities.
                                              Student Learning Plan at Morpeth and Blyth

Expected levels of Learning Outcomes

                Year 1                                         Year 2                                        Year 3
      Develop skills of                      Develop skills of assessment, analysis and      Develop skills of assessment, analysis,
       communication, handling and             treatment of patients                            and treatment
       basic assessment                       Frame and analyse patient problems              Frame and analyse patient problems
      Gain experience in the                 Apply evidence in making informed               Apply evidence in making informed
       physiotherapeutic management            decisions related to the selection of            clinical decisions
       of elderly/neurological patients        appropriate interventions                       Able to compare models of
      Carry out subjective/objective                                                           physiotherapy within different
       assessments of selected patients                                                         healthcare settings
      Opportunity to implement                                                                Extend experience of physiotherapy in
       simple treatment procedures                                                              management of patients with complex
                                                                                                problems
                                                                                               Develop transferable skills and
                                                                                                clinical reasoning
                                                                                               Negotiate realistic and achievable
                                                                                                goals
                                                                                               Formulate effective plans and
                                                                                                strategies




                                                                     7
The following is a guide to the placement structure, but is flexible to the student’s course stage, learning needs, length of placement and
learning opportunities. The numbers and complexity of patients may be expected to increase with the student’s progression through the
course. The level of support required by the student through the placement will progress at a rate consistent with their learning needs,
level of course and through continued informal and formal evaluation of the students development.

  Week 1              Induction Period (see included)
                      Discussion with student about learning outcomes, areas of interest/concern and learning styles
                      Observation of assessment/ treatment with clinical educator (in/out-patients)
                      Feedback on clinical assessment form, including additional learning outcomes for the placement and dates to remember:
                       half-way appraisal, end-of-placement appraisal, patient study assessment (year3) and date for visiting tutor
                      Ongoing informal/formal opportunities to talk with clinical educator
                      Independent subjective assessments (in-patients)
                      Introduction to MDT and observation at daily ward report, MDT meeting and any Care Planning Meetings
                      Introduction to discharge planning and continuing care options
                      Familiarisation with documentation, Care Pathway and Physiotherapy written records
                      Attend IST if appropriate
                      Supervised/independent objective assessment (in-patients)
                      Ongoing discussion of assessment findings
                      Independent Study Time
                      Opportunities to observe Technical Instructors and assist in basic treatments
  Week 2              Ongoing informal/formal opportunities to talk with clinical educator
                      Observation of assessment/ treatment with clinical educator (in/out-patients)
                      Independent subjective and objective assessments (in-patients)
                      Supervised subjective and objective assessments (out-patients)
                      Supervised analysis of assessment and formulation of problem lists
                      Discussion and development of treatment plans
                      Development of a small in-patient caseload (appropriate to level of study)
                      Attendance at ward reports and MDT meeting with reporting on own patients (with support)




                                                                      8
            Development of discharge planning and continuing care options
            Opportunity of shared learning with other student professions
            Completion of MDT records and Physiotherapy written records (with support)
            Attend IST if appropriate
            Independent Study Time
            End of week discussion/tutorial – possibly inter-disciplinary
Week 3      Ongoing informal/formal opportunities to talk with clinical educator
            Half-way appraisal
            Patient study assessment (if applicable)
            Visiting Tutor
            Observation of assessment/ treatment with clinical educator (in/out-patients)
            Independent subjective and objective assessments (in-patients) – gradually increasing caseload
            Independent subjective and objective assessments (out-patients) – with support
            Development of treatment plans/goal setting
            Progressions of treatments – with support
            Active participation in MDT meetings/ Discharge planning
            Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
             round with Nurse sister, spend time with Nurse Assistants
            Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group
            Completion of MDT records and Physiotherapy written records
            Attend IST if appropriate
            Independent Study Time
            End of week discussion/tutorial – possibly inter-disciplinary
Week 4      Ongoing informal/formal opportunities to talk with clinical educator
            Observation of assessment/ treatment with clinical educator (in/out-patients)
            Independent subjective and objective assessments (in-patients) – gradually increasing caseload
            Independent subjective and objective assessments (out-patients)
            Development of treatment plans/goal setting – in and out-patients



                                                           9
            Progressions of treatments – in and out patients (with support)
            Active participation in MDT meetings/ Discharge planning
            Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
             round with Nurse sister, spend time with Nurse Assistants
            Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group
            Completion of MDT records and Physiotherapy written records
            Attend IST if appropriate
            Independent Study Time
            Presentation of student-chosen article (appropriate to caseload)
            End of week discussion/tutorial – possibly inter-disciplinary
Week 5      Final Assessment
            Student assessment of placement
            Patient study (if applicable)
            Tutor visit
            Ongoing informal/formal opportunities to talk with clinical educator
            Observation of assessment/ treatment with clinical educator (in/out-patients)
            Independent subjective and objective assessments (in-patients)
            Independent subjective and objective assessments (out-patients)
            Development of treatment plans/goal setting – in and out-patients
            Progressions of treatments – in and out patients
            Active participation in MDT meetings/ Discharge planning
            Additional learning opportunities with other members of the MDT e.g. home visit with O.T. or Attend ward round/drug
             round with Nurse sister, spend time with Nurse Assistants
            Observation of MDT contributions to condition-specific patient/carers groups e.g. Parkinsons Disease Group
            Completion of MDT records and Physiotherapy written records
            Attend IST if appropriate
            Independent Study Time




                                                          10
             Portfolio of Learning Opportunities
                          (POLO’S)

Placement:              Neurology / Care of the Elderly

Base:                   Blyth Community Hospital
                        Northumberland

Clinical Educators:     Iain Laing / Helen Price



POLO Learning Zones – See Diagram


Middle:         (clinical educator speciality)

Iain Laing –
      Neurological rehabilitation
      General elderly medicine
      Orthogeriatric Rehabilitation
      Vestibular Rehabilitation


Helen Price –
     Clinical Specialist Elderly Care
     Neurological rehabilitation
     General elderly medicine
     Orthogeriatric Rehabilitation




Zone I:         (extended physiotherapy team)

Parkinson’s Disease Specialist
Stroke Specialist
Palliative Care Specialist
Community Rehabilitation Teams (CRT) – Stroke service
Community Rehabilitation Teams (CRT) – Falls service
Domiciliary Services
Technical Instructors (TI’S)
Admin. Support


Zone II:        (health multidisciplinary team)

SALT (speech and language therapy)
OT (occupational therapy)
Dietician
Nursing/ NPs (nurse practitioners)


                                              11
Zone II (cont.): (health multidisciplinary team)

HCAs (health care assistants)
Medical staff – Ward and Day Hospital
Day Hospital Nursing Staff
Community Rehabilitation Teams
Pharmacists
Wheelchair therapist (specialist seating and wheelchair assessments)
Orthotist

MDT meetings
Ward rounds
Clinics
Planning Meetings
Home visits (HAVs)

Zone III:               (social services)

Care manager/social workers
    Elderly Persons Team
    Younger Persons Team
    Mental Health Team


Planning meetings
Home Visits
Case Conferences


Zone IV:                (others)

Family
Carers
Voluntary Services
Chaplaincy




                                             12
                                                                          IV


                                                                                                                               Family/Carers
                                                                          III         Elderly
                                         Young Persons Care                           Persons C.M.
                                         Manager                                                               Home
                       Planning                                                                                Visits
                       Meetings                                           II         Nurse Practitioner
                                                  Orthotics                          Parkinsons Disease
                                                                                                                 Specialist
                           MDT                                                                                   Wheelchair
                           Meetings                                       I
                                                                                                                 Assessment
                                                      Falls Specialist                  Stroke
                                                                                        Specialist
            Medical                                                                                                            Occupational
            Ward                  PD                                                                                           Therapist
            Rounds                Specialist                              Middle
                                                                  Neuro-elderly                                 Comm.
                           Palliative                             Ortho-geriatric                               Rehab.
      Medical              care                                   General Medical                               Team
      Clinics                                                                                                                   Community
                           Specialist                             In-patients                                                  Rehab. Team
                                                                  Out-patients
                                                                  Day Patients
        Ward
        Nursing                    Technical
                                   Instructors                                                        Domiciliary
        Staff
                                                                                                                              SALT
                      Day                                     Admin.
                      Hospital                                Support
                      Staff
                                   HAVs
                                                                                                          Dietician

                                                 Planning Meetings              Pharmacist

Voluntary
Services                                                                                                                               Chaplaincy
                                                              Mental Health C.M.
                                                                               13
KEY ELEMENT

Specialist Knowledge



 LEARNING OPPORTUNITIES                      RESOUCE/RELEVANT
                                             PERSONNEL/DEPARTMENT



 Physiotherapy - role within the MDT and Clinical Educators and other members of the
 approaches       to  assessment     and neuro/elderly    physiotherapy  team     as
                                         appropriate.
 rehabilitation in neurology and elderly
 client groups.

 Speech and Language Therapy - role          Fiona Hinshelwood
 within the MDT and perspective on           Senior Speech and Language Therapist
 problems in patients with swallowing        Melissa Potter
 and/or communication difficulties.          Speech and Language Therapist

 Occupational Therapy - role within the Senior Occupational Therapist
 MDT and perspective on problems in Position Currently Advertised
 patients following stroke

 Occupational Therapy - role within the Michelle Turnbull/ Julie Taylor
 MDT and perspective on patients with Senior Occupational Therapists
 complex problems

 Occupational Therapy - role within the Katherine Knox
 MDT and perspective on rehabilitation Occupational Therapist Assistant
 patients

 Occupational Therapy - role within the
 MDT and perspective on problems in Mike Ridley
                                             Occupational Therapist Community
 patients following stroke in the community.
                                             Rehabilitation Team
 Dietician - role within MDT and Can vary
 perspective on problems in patients with
 nutritional needs.

 Nursing Team - role within the MDT and Diane Rutherford
 perspective on problems in patients with Ward Manager Stroke Unit
 stroke and complex nursing needs.        Joyce Foggert/ Diane Headley
                                             Ward Sisters Stroke Unit
                                             Nursing Team Members Ward One
 Nursing Team - role within the MDT and
                                          Suzanne Burbridge
 perspective on problems in patients with Ward Manager Ward Two
 Mental Health and complex nursing Nursing Team Members Ward Two
 needs


                                             14
Nursing Team - role within the MDT and Kath Parry
perspective on problems in patients with Ward Manager Ward Three
Palliative care and complex nursing Nursing Team Members Ward Three
needs

Nursing Team - role within the MDT and
                                         Shirley Fairley
perspective on problems in patients with Ward Manager Thomas Knight Day Hospital
continuing needs, 24 hour blood pressure Nursing Team Members
and cardiac monitoring

HCAs – role within the MDT and HCAs All Wards and Day Hospital
involvement with patients with caring
needs.

Consultant Physician in Stroke – role
within the MDT and medical perspective Dr. Chris Price
                                       Dr. Richard Curless
on the management of stroke and
multipathology in the elderly.

Consultant Physician in Parkinson’s Dr. Brian Wood
Disease – role within the MDT and
medical perspective on the management
of PD and multipathology in the elderly.

Consultant Physician in Falls – role Dr. Nigel Stout
within the MDT and medical perspective
on the management of Fallers and
multipathology in the elderly.

Consultant G.P. – role within the MDT Dr. Georgina Smith
and medical perspective on the
management of multipathology in the
elderly.

Consultant Physician in Old Age Dr. Celia Marshall
Psychiatry – role within the MDT and
medical perspective on the management
of Mental Health and multipathology in the
elderly.

Parkinson’s Disease Nurse Specialist – Annette Bowman
role within the MDT and nursing Nurse Specialist
perspective on the management of PD

Wheelchair Therapist - assessment and Alistair McCord
prescription of specialist seating.   Head of Wheelchair Services


Orthotist - assessment and provision of Jan Glover
                                        Senior Orthotist
orthotics.


                                          15
Pharmacist – role in the monitoring of Various members of pharmacy team visit the
patient medications and advice on wards
polypharmacy

Social Worker – role within the MDT and
                                         Narinda Kaur
involvement with patients complex needs.
                                         Liason Social Worker Ward 1
                                         Care Managers for individual Patients




                                         16
KEY ELEMENT

Clinical Skills



 LEARNING OPPORTUNITIES                     RESOUCE/RELEVANT
                                            PERSONNEL/DEPARTMENT


 Stroke Rehabilitation (in-patient)         Helen Price (Clinical Specialist Elderly Care)
                                            Carol Walker (TI)


 General Elderly Medicine                   Helen Price (Clinical Specialist Elderly Care)
                                            Carol Walker (TI)
                                            Sandra Branley (TI)


 Neurology and Elderly (out-patient)        Lynn Henderson (Supt II)
                                            Helen Price (Clinical Specialist Elderly Care)


 Orthogeriatrics                            Helen Price (Clinical Specialist Elderly Care)
                                            Sandra Branley (TI)


 Parkinson’s Disease Rehabilitation         Helen Price (Clinical Specialist Elderly Care)

 Vestibular Rehabilitation                  Iain Laing (Senior I)

 Palliative Care                            Jane Laffan (Senior I)

 Community Rehabilitation Team for          Lorna Kirkham (Senior I)
 Stroke

 Community Rehabilitation Team for Falls Joan Kirkpatrick (Senior II)

 Physiotherapy Domiciliary Services         Lorna Kirkham (Senior I)
                                            Nanda Bailey (Senior I)




                                          17
KEY ELEMENT

Organisational and Managerial Issues



 LEARNING OPPORTUNITIES                 RESOUCE/RELEVANT
                                        PERSONNEL/DEPARTMENT


 Managing a caseload

 Organisational skills                  Clinical Educators
 Delegation skills                      Clinical Educators
 Prioritisation skills                  Clinical Educators
 Time management                        Clinical Educators
 Standards of care                      Clinical Educators/Standards file

 Giving information to

 Ward staff                             Clinical Educators
 Patient                                Clinical Educators
 Relatives/carers                       Clinical Educators
 Doctors                                Clinical Educators
 MDT members                            Clinical Educators

 Resources

 Ordering of special equipment          Clinical Educators/ TIs
 Re-ordering of standard walking aids   Clinical Educators/Physio assistant/TI's
 Ordering of standard wheelchairs       Clinical Educators/Physio assistant/ TI's
 Ordering of specialist wheelchairs     Clinical Educator
 Re-ordering of stock                   TI

 Managing risk

 Policies and procedures                Policies and Procedures file
 Equipment safety checks                Clinical Educators/equipment reps
 Daily environmental checks             Clinical Educators
 Infection control                      Infection control policy/ nurse/ Infection Control
                                        Liason
 Moving and Handling                    Clinical Educators/ Moving and handling file

 Emergency situations
                                        Clinical Educators will discuss in induction refer
 Cardiac arrest
                                        to relevant procedure documents
 Fire
 Room alerts

 Staff Developments
 Reflective Practice/CPD                Clinical educator will provide guidance



                                        18
KEY ELEMENT

Interpersonal Skills




 LEARNING OPPORTUNITIES                       RESOUCE/RELEVANT
                                              PERSONNEL/DEPARTMENT

 Use of telephone

 Answering calls                              Clinical Educators/TI’s/Clerical staff
 Making calls                                 Clinical Educators
 Taking messages                              Clinical Educators/TI’s/Clerical staff

 Talking to

 Patients                                     Clinical Educators/MDT members
 Carers/relatives
 Doctors
 Other members of MDT
 Staff on other sites re patient transfers

 Writing reports

 Moving and handling risk protocols           Clinical Educators/standard report formats
 Discharge letters
 Discharge summaries
 Referral letters to other services

 Administration

 Booking ambulances                           Clerical staff/TI’s/Clinical Educator
 Booking out-patient appointments




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