Serving the people of north east Essex
HANDBOOK FOR NURSES & MIDWIVES
Colchester Hospital University NHS Foundation Trust Page 1 of 15 Nursing & Quality Revised July 2010 V9
CONTENTS
Page No. Subject 3 Introduction
3 Nursing & Patient Experience Department
4 NHS Healthcare Provision in North East Essex Bed Management / Policies & Procedures/ Clinical Nurse 6 Specialists/ Hospital Specialist Palliative Care Team/ Outreach Team Pharmaceutical Services. 8 Position Statement on Clinical Supervision
9 Data Protection Act 1984
10 General Information
11 Health & Safety at Work
Health and Wellbeing Service 12 North Essex Library & Information Services
15 Request form for Clinical Supervision
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Introduction
Welcome to the Trust, which serves the population of North East Essex. In partnership with the local Primary Care Trust (PCT) called NHS North East Essex
The Trust is committed to on-going professional development of all staff using in-house training facilities and our local education providers (Anglia Ruskin University, Essex University and Colchester Institute).
Colchester is a rapidly expanding regional centre of commerce and technology, with a population, which will grow at twice the national average over the next 10 years. It is 12 miles from the Essex coast and close to ‘Constable Country’. It is easily accessible from London by road or rail (55 minutes from Liverpool Street) and is close to Stansted Airport and the port of Harwich.
Nurses and midwives have an important role to play in ensuring the Trust achieves its aims and objectives. Its vision is to become the recognised leading provider of health services in Essex and Suffolk by demonstrating excellence in five key domains: • excellent patient satisfaction
• excellent financial performance
• excellent employee satisfaction
• excellent clinical performance
• excellent health partners' satisfaction
Nursing & Patient Experience Department
A Practice Development Nurse works within each division to support individuals, department/ward sisters/charge nurses and matrons to improve the quality of the patient experience in reaction to clinical incidents and proactively in improving nursing standards. This work may be undertaken in teams or on an individual basis and helps embed the values of all statutory healthcare bodies.
Clinical Skills Nurses have the prime responsibility for developing the clinical skills of nurses using the competency framework devised by the department. These nurses are based in clinical divisions and work under the professional guidance of the department.
Methods of Support Induction All new starters undertake a nursing induction programme, which ensures that requisite mandatory training takes place and that additional key information is provided. Local induction also takes place. Key aspects of the registered nurse induction include drug calculation and intravenous therapy, blood transfusion, venepuncture, cannulation, and recognition of the critically ill patient competences.
Similarly, for new healthcare assistants, there is an induction programme and competences that are underpinned by the National Vocational Qualification in Care. An NVQ coordinator leads this work and a peripatetic assessor supports both assessors and candidates in NVQ training.
Both programmes aim to provide the best possible preparation for new staff to undertake their professional role on the wards and set a professional standard.
Further preparation occurs at the ward and department level that includes an introduction to key personnel, specialist equipment and orientation to the local environment.
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Competency and Development Programmes
Health care assistants are able to access National Vocational Qualifications in Care and the aim is to have a standard whereby all new healthcare assistants will have an NVQ qualification in Care Level 2. Healthcare assistants are also supported to attain Level 3, which potentially allows access to other training such as a foundation degree in a health related pathway. A competency based development programme for staff nurses ensures the development of the appropriate skills.
Similar development programmes exist for team leaders and ward managers to ensure that they have the necessary skills/knowledge to perform their roles. There is a Trust education database accessible by each ward manager. It is used to record training and competencies, allowing the retrieval of data to aid analysis of both individual training needs and of departmental needs.
Mentorship and Supervision
All new starters will have an identified mentor to guide clinical practice.
The Department facilitates access to clinical supervision for all healthcare professionals. On induction new staff are informed how to access clinical supervision and provided with an application form for a clinical supervisor. All staff receive managerial supervision, which underpins performance review/appraisal, and the development of personal development plans. These in turn inform the education contracting process so that staff are able to access education/training and other opportunities which will help them achieve their potential and ensure that service objectives are met. Development review also provides an opportunity to encourage staff to access clinical supervision. This process is supported by the knowledge and skills framework (KSF),
Personnel Policies
The Trust commitment to the provision of a supportive environment is underpinned by the protective framework of personnel polices such as the Bullying and Harassment Policy, Equal Opportunities Policy and a commitment to the Improving Working Lives Agenda. The Health and Wellbeing Department and the services provided also support this framework. All the above strands come together into a supportive framework that helps staff to recognise that the Trust is a good place to start and a good place to stay. More importantly it supports the delivery of evidenced based care – our patients deserve no less. .
NHS HEALTHCARE PROVISION in NORTH EAST ESSEX
Colchester General Hospital Turner Road Colchester Chest Medicine & Infectious Diseases E.N.T. Surgical Plastic Surgery Trauma / Orthopaedics Critical Care Unit. Urology Outpatients Department Paediatrics Emergency Department Maternity Unit (Ante / Post-Natal, GP Mat.) Medical Special Care Baby Unit Care of the Elderly Well Babies Gynaecology Day Care (Endoscopy, General Surgery, Postgraduate Medical Centre – Haematology, Gastroenterology) Main Library Colchester Hospital University NHS Foundation Trust Page 4 of 15 Nursing & Quality Revised July 2010 V9
ESSEX COUNTY HOSPITAL Lexden Road, Colchester, Essex
Radiotherapy Dental (Outpatients) Dermatology G.U. Medicine E.N.T. (Outpatients) Care of the Elderly Audiology (Outpatients) Oncology Ophthalmology (In / Outpatients) Rehabilitation
SEVERALLS HOSPITAL SITE Boxted Road, Colchester, Essex
Chestnut Villa Biochemistry / Histopathology Departments
NORTH ESSEX PARTNERSHIP NHS FOUNDATION TRUST (Mental health services )
Birchwood Villa - Trust Headquarters Rehabilitation (18 – 65 age group) THE KINGSWOOD CENTRE Psychiatry of Old Age – over 70
THE LAKES Acute Psychiatry
LONGVIEW ADOLESCENT CENTRE
NHS North Essex Various Residential/Group Homes plus treatment and assessment centre for people with learning disabilities CLACTON & DISTRICT HOSPITAL -
HARWICH HOSPITAL –
HALSTEAD NHS HOSPITAL –
Organisational structure A copy of the senior management and executive structure is available through the Trust Internet at http://www.colchesterhospital.nhs.uk/organisational_structure/CHUFTExecDirsstructurefinalMa y2010.pdf
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BED MANAGEMENT
The Bed Information Bureau is based in the Medical Secretaries office at the Colchester General Hospital and is staffed from 8.30 a.m. to 4.30 p.m. Monday to Friday. The present function of the bureau is to provide information regarding the whereabouts of patients within the Trust.
Information regarding the availability of acute beds is collated and published by the Site Matron who can be contacted on Bleep 333 and/or Ext 2672. This service is available continuously.
POLICIES & PROCEDURES
Please note that the policies are available on the intranet. You need to ensure that you are familiar with these. In particular you should read the following policies, which can be accessed via the Intranet or via the policy manual in your ward/department.
• Bleeping Junior Doctors Policy (code no. 013) • Protocol for Verification of Expected Death by Nursing Staff (code no. 025) • A Multi-Disciplinary Policy on Staff Uniforms (code no. 007) • Nursing Policy: The Scope of Professional Practice and the Enhancement of the Nursing/Midwifery Role (code no. 003) • Policy Statement for the Escorting and Transfer of Patients (code no. 098) • Guidelines for Clinical Record Keeping (code no. 002) • Telephone Policy (code no. 133) • Mobile Phone Policy (code no. 134) • Discharge Policy (code No. 119) • Incident Reporting (code No.063)
CLINICAL NURSE SPECIALISTS
The Trust has a variety of Clinical Nurse Specialists who provide specialist advice to other nurses and services to patients. Please check Trust telephone directory for details. As part of your local induction find out the names and contact details for the specialists who provide a service to patients in your ward/department.
HOSPITAL SPECIALIST PALLIATIVE CARE TEAM (MACMILLAN NURSES)
The Team works within the hospital and are here to advise and support you in caring for any patient with either a suspected or confirmed diagnosis of cancer or other life-limiting illness. We are also available for advice about the control of symptoms from any other illness.
Our contact details are:
Hospital Specialist Palliative Care Nurses Essex County Hospital Lexden Rd
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Colchester CO3 3NB
Phone: 01206 744018 Fax : 01206 744511
We work Monday to Friday 09.00 – 17.00 and make every effort to respond within one working day to messages left on our voicemail.
Our aim is to support you and help you develop your care. It is not the intention to take over the care of your patients.
How to refer:
We are very happy to discuss your patients with you on an informal basis. However we would encourage you to use the referral form, which can be found in the e-library.: Referral and Application Forms. This form contains contact details for palliative care services at Chelmsford, Colchester and Ipswich. You can use the form to refer to any of the palliative care services within any of these three areas. (Please Note: The Hospital team only works within the hospital. Should you want support for your patients when they are at home you should refer to the relevant community team).
We are here to support you, your patients and your patients’ families. Here are some of the things we can offer:
• Advice and information on controlling pain or other symptoms. • Support in integrating the physical, psychological, social and spiritual aspects of care. • Advice and support on informing young children or family dependants about your patient’s illness. • Support in helping your patients through what many find a confusing and complicated time. • Support by acting as a resource for you and your patients. • Formal and informal teaching about any aspect of palliative care. • Teaching about the Liverpool Integrated Care Pathway for the Dying Patient.
Discharges:
• We are not a discharge planning service; however, we are available to provide advice on complex palliative care issues. Please note that the first stop for discharge advice should be the Discharge Planning Team
The Liverpool Integrated Care Pathway for the Dying Patient (LCP)
This pathway is to help you provide excellent care to patients who you look after and who are dying. A copy of the Pathway and tools to help you implement it are available on the Hospital’s Intranet site. It can be found in the e-library under Care Pathways.
The Preferred Priorities of Care (PPC)
The PPC is a patient-held record that helps patients and carers to discuss and agree the care they would like and where they would like to be cared for at the end of their life. It records the
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patient’s thoughts about their illness and the choices available to them. It particularly empowers patients to express what they do not want to happen. Information concerning this can also be found in the e library.
The Gold Standards Framework (GSF) The GSF promotes care of patients in the community nearing the end of life.
OUTREACH TEAM
A Critical Care Outreach Team is available to provide advice and assistance with the acutely deteriorating patient. Please ensure that you familiarize yourself with the Patient at Risk Scoring System and the call out cascade. The Outreach Team can be contacted via bleep 247. PHARMACEUTICAL SERVICES
Chief Pharmacist: Dr Richard Needle Patient Group Directions (PGD) Various drugs can be issued/administered using a Patient Group Direction. Please check with your Manager, which PGD’s are relevant to your area. You will be expected to become competent in the writing and administration of these. Dr Richard Needle (Chief Pharmacist).
POSITION STATEMENT ON CLINICAL SUPERVISIONO Clinical Supervision is available to all nursing staff to facilitate the development of professional expertise, safeguard standards of nursing practice and provide support to ensure the delivery of quality care. , professional staff wishing to access supervision should complete an application form and send it to Mrs Tina Leppard, Practice Development Nurse at Trust Headquarters for processing.
Supervision is distinct from management and the staff development and review process; although it may support identified personal objectives. Management will support clinical supervision arrangements.
Guidelines
• An experienced nurse should facilitate supervision. Pay Band 6 nurses and above may consider peer supervision.
• Supervision, which is accessed using the Trust database, is provided on a one-to-one or group basis dependent upon the supervisor’s experience.
• Ground rules should be agreed between the supervisor and the supervisee at the beginning of the supervisory relationship e.g. regarding time, regularity of meeting, and context of sessions, boundaries.
• Confidentiality will be maintained at all times except when a breach of the law or of the NMC Code of Conduct occurs.
• The Trust supports staff that attend clinical supervision by giving paid study leave. The frequency of such supervision sessions is open to debate between the supervisor and supervisee and the appropriate manager. When the supervisory relationship is forming,
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frequent meetings may be required, and the dates and times of these meeting need to be agreed in advance, so that the ward manager can meet off-duty requirements. The venue must be private and free of disturbance for the duration of the session. • Both parties should maintain a record of the sessions. In any reflective writing it is essential that no names, dates or places be recorded which could identify the specific situation. The supervisor will keep a record of dates and length of supervision sessions.
• The supervisory relationship should be reviewed annually or earlier in the event of any party wishing to terminate the relationship prior to this. (Head of Professional Practice (Nursing) October 2008)
THE DATA PROTECTION ACT 1984
This notice is being issued to all staff in pursuance of our obligations under the aforementioned Act. It will be issued routinely to all new employees.
Protection of data about individuals is now a requirement of the Law. The Data Protection Act which, is now in force lays down that:
Data shall be obtained and processed fairly and lawfully.
Data shall be held only for specific purposes and not used or disclosed in any way that is incompatible with those purposes.
All persons that use information on the computer or produced from the computer have an obligation to see that it is not passed on in any unauthorised way. This means, among other things, that printouts must be treated carefully and staff should not disclose personal data outside the line of duty.
If an individual is found to have permitted unauthorised disclosure, they, as well as the organisation, can face prosecution. Breaches of confidence may well result in disciplinary action, which could involve dismissal.
If you are in any doubts as to which disclosures are authorised, ask to see a copy of registered particulars, which is kept by the Data Protection Officer (Information Management and Technology Services Department).
TREAT PERSONAL DATA WITH CARE
DON’T PASS ON PERSONAL INFORMATION TO UNAUTHORISED PERSONS
The Law gives each person the right to see the data concerning himself held on computer. Any such requests should be passed on to the Data Protection Officer immediately.
IM&T
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GENERAL INFORMATION
Holidays:
Please refer to individual rules when booking any leave. However, it is essential to book early to allow efficient use of resources by your line manager.
Sick Leave:
Notify your line manager or the nurse in charge immediately if you need to take sick leave. Any sickness lasting more than three days must be covered by a self-certificate and by a medical certificate after seven days.
Uniforms:
These will be provided on receipt of your completed uniform request form. Please see uniform policy No. 007 Salary:
You will be paid on the 26th of each month, with timesheets running from the 25th of the month to the 24th of the next month. Your salary is paid by credit transfer direct into a Building Society or Bank account. It is not possible to be paid by cheque.
Security Name Badges:
These must be worn at all times. If you miss having your photograph being taken for your badge at General Induction, please contact J Gregory, Facilities Management Department on Extension 2010 to arrange for this to be done.
Mandatory Training Training in the following is mandatory and must be undertaken on induction and updated at the intervals described below. It is your responsibility to ensure that you attend.
1. Resuscitation Training Yearly update 2. Moving and Handling Training 2 Yearly update 3. Health and Safety/Security 2 Yearly update 4. Fire Safety 2 Yearly update 5. Medical Gases 2 Yearly update 6. Infection Control Yearly 7. Blood Transfusion Yearly 8. Legal & Professional Issues in Healthcare 3 yearly 9. Child Protection 10. Adult protection 11. Alert 12. Patient Safety
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HEALTH & SAFETY AT WORK
The Trust recognises the high profile that a nurse has within the hospital environment. It is important, therefore, that your actions are seen to demonstrate a commitment to the highest standards of health and safety at work.
The Health & Safety at Work Act 1974 and supporting Health & Safety Regulations are produced to ensure your health, safety and welfare at work, as well as the health and safety at work of others who may be affected by your acts or omissions.
You should read the Trust’s Health & Safety Policy, the Control of Substances Hazardous to Health Manual (COSHH) and The Manual Handling Procedure
Each department / ward has completed a series of ‘Risk Assessments’ where hazards such as needle- stick injury or use of medical gases etc. exist. It is your duty to read the risk assessments and comply with the requirements.
Trust employees may only perform work for which they are authorised, and must adhere at all times to Trust rules and procedures.
You must co-operate with the Trust in discharging its’ statutory duty and not intentionally or recklessly interfere with or misuse anything provided for health, safety and welfare reasons.
Security within the healthcare environment is essential, not only in the safeguarding of Trust property, but also in the interests of staff and patient welfare. You should always wear your identification badge when on duty and challenge those not wearing I.D. badges that you do not know. You should report all security and potential security incidents.
If a fire occurs within the hospital the action you subsequently take will affect your own personal safety and safety of the patients in your care. Ensure that you are familiar with the fire alarm sounders, “Fire Action Notices” and evacuation procedures.
Should you discover a fire, you must activate the fire alarm system by operating the break glass call point in your ward or area and notify the hospital switchboard using 3333. If the fire is at its early stages it may be possible to attempt to extinguish the fire using a portable fire extinguisher, however, do not put yourself at risk but be prepared to evacuate the patients and yourself to a place of safety either inside or outside the building.
All incidents including personal injury, fire, theft, damage or ‘near miss’ and any ‘untoward’ incident causing death or injury to a patient, must be reported on the DATIX electronic incident reporting system via the Trust Intranet.
REMEMBER: The Health & Safety Executive (HSE) has the power to prosecute individual employees who fail to discharge their safety responsibilities in an effective manner. SAFETY IS YOUR RESPONSIBILITY Mike McCarron Health and Safety Adviser July 2010
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HEALTH AND WELLBEING SERVICE
The Health and Wellbeing Service (H&W) provides services to protect health at work, assess and advise on fitness for work and to ensure that health issues are effectively managed. For some people a health issue will affect their ability to work or the type of work they can do. In other cases the work itself may have the potential to affect people’s health. Health and Wellbeing provides a range of services and medicals including:
• Pre-placement health assessments to ensure that employees are fit for the job they will be doing
• Immunisations to ensure that both patient and staff are protected against communicable and infectious diseases
• Health Surveillance. Targeted medical checks to ensure that employees remain in good health and are not being harmed by their work
• Health risk assessment. Find out what to do about health hazards at work
• Evaluate work pressure and the risk of stress related illness
• Well person screening, stress management and health promotion
The Health and Wellbeing Centre is based at Villa 3 Colchester General Hospital
The service is open 8.30 to 16.30hrs Monday to Friday 01206 -745284).( Satellite clinics are held at • Essex County Hospital • Clacton Hospital • Harwich Hospital
Head of Health and Wellbeing June 2010
North Essex Hospitals Library & Information Service
Where is the library? The library service is part of the Colchester General Hospital Resource Centre in the Postgraduate Medical Centre, which is in Villa 8 on Turner Village. The Library is on the first floor. If you are unable to visit the library please contact us by ‘phone, fax or e-mail.
North Essex Hospitals’ Library & Information Service Colchester General Hospital Turner Road Colchester CO4 5JL Tel: (01206) 742146 /Fax: (01206) 742107 E-mail: [email protected]
Who can use the library? Everyone! As long as you are employed by the NHS, or are a student on a clinical placement, you can use the library. Please note that not all services are available to students – please ask for full details.
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When can you use the library? You can use the library at any time during the opening hours. When the library is closed please email us, fax us or leave a voice-mail message. We will deal with your query as soon as we open. We have a big blue overnight box outside the PGMC where you can leave books when the library is closed. The open hours are as follows:-
Monday 9:00 -17:00 Tuesday – Thursday 9:00 -19:00 Friday 9:00 -16:30
Who runs the library? The library is part of the Resource Centre and has a team of staff who are all here to help you with your queries and are currently as follows
Health Specialist Librarian Andy Richardson Senior Library Assistant Eileen Scrivens Library Assistant Claire Kelly e-Learning Manager Dafni Dean e-Learning Technician Dorian Goldsmith
What can the library do for you?
Books! We have books on everything from angina to x-rays, for everyone from consultants to students. As well as clinical subjects we also cover audit, clinical governance, management, communication, law, ethics, research, statistics and study skills. You can borrow up to six items at one time, for three weeks. If nobody else wants them you can renew the books by ‘phone or in person up to two times – but don’t forget we charge fines on overdue books! If you cannot see the book you are looking for, please ask us. We have links with other hospital libraries in the area, including the medical library at Cambridge University, and we can borrow books from them on your behalf. We can also borrow books for you from the BMA library, and the British Library.
Journals We have many journals on a variety of subjects. We don’t have room to keep every journal title, but we can use our links with other libraries to get hold of photocopies of articles from almost any journal.
ATHENS Username and Password To get many electronic resources such as bibliographic databases (MEDLINE, CINAHL, British Nursing Index etc) you will need to register for an NHS Athens username and password. You can also access many journals free full text online via ATHENS and some online books. Sign up for NHS Athens resources on a Trust computer at https://register.athensams.net/nhs/nhseng/
Other Electronic Resources The hospital has electronic access to Royal Marsden Manual which can be accessed via the hospital intranet (link on main page) or outside the Trust from you NHS Athens username and password
Literature searches Literature searches are an essential part of preparation for research, and can also be used to help with audit and evidence-based care. Major nursing, clinical and medical bibliographic databases are available on the internet – from work or home – via your NHS Athens password. We teach you how to do a literature search using the resources and can help with patient focused problems which require a literature search. If you are doing research on behalf of your academic course work, we may give you advice but literature searches have to be produced by yourself!
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Computers The computers in the library are on the Trust’s network so you need a network password to make use of them. Computers have Microsoft Office, intranet and internet access. There is also a scanner and all the PCs print through our digital, full colour copier/printer.
Library online The library has web pages on the Trust’s website at www.colchesterhospital.nhs.uk . Our book catalogue can be found at www.elms.nhs.uk . From the “library” drop down list select CGH. In Autumn 2010 you will be able to renew your books online.
(Updated June 2010)
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Request for Clinical Supervision Name
Profession
Present Position/Specialist Practice Area
Work Address
Name of Line Manager
Work Telephone
Work email
Home Telephone
Have you had any previous supervisory relationships? Yes/No If yes, please give brief details and dates.
Please return to Mrs Tina Leppard , Practice Development Nurse , THQ, Colchester General Hospital
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