BREIGHTMET DISTRICT NURSES

INDUCTION AND WELCOME PACK

Students Name ……………………………………

Mentors Name …………………………………….

October 26, 2017

CONTENTS

Welcome Statement & Philosophy

Safety Information

General Information

District Nursing Teams

Area Profiles

Learning Opportunities

Spoke Placements

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Student Induction Checklist

Student Learning Journal

Infection Prevention (hand washing)

Student Evaluation

Welcome to the Breightmet Community Nursing Team. We hope that you have an enjoyable placement and we hope you benefit from all of the learning opportunities provided.

Your Mentor for this placement is __________________________

Your associate mentor is _________________________________

The Placement Education Link is Christopher Davidson

District Nurse Team 01204 463807

The team at Breightmet consists of a Team Manager, Case load holders, Registered Nurses, Healthcare assistant and an Associate nurse practitioner. All of which you will work closely with during your time with us at Breightmet.

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Welcome to Breightmet Health Centre

We hope your placement with us will be an enjoyable and a positive learning experience.

This introduction pack aims to provide you with all the relevant information about the community environment, In order to form a basis for your clinical learning during this placement. We welcome your feedback and encourage you to honestly fill out an evaluation at the end of your placement as this allows for us, as a team, to improve our teaching and further our own skills.

On your first day we encourage you to exchange phone numbers with both your mentor and associate mentor.If you find that you are having issues during your time with us, please speak to a member of staff you feel comfortable with.

Philosophy of the Practice Placement Area

Our main aim is to provide a welcoming and supportive atmosphere, so that we establish a positive learning environment for all. We want students to feel they are valuable members of the team. We also encourage students to adopt a reflective practice to enable continued development.

District Nurses Philosophy

The philosophy of the Breightmet and Little lever team is to ensure we deliver high-quality evidenced based nursing care to our patients and continue to provide support to their families and carers. We continuously assess the care needs of our patients, planning appropriate interventions in a timely manner.Our aim is to enable patients and their carers to remain as independent as possible within their own environment.

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Safety Information

Fire Assembly Point

This is in the front main car park towards the right of the building.

Fire Exits

Main entrance and all stair wells. These will be shown to you on your induction.

First Aider

Main Reception (Although we are all first aid trained)

Mandatory Training

All staff must attend annual updates in Patient and Non Patient Manual Handling, Fire Safety, Basic Life Support, Mentorship and Risk Assessment.

Reporting absence

In the event of you not being able to attend placement please ensure that you contact the team directly on 01204 463807. It is important that you speak directly with a member of the team between 08.30-09.00. In the event that we are on another call there is an answer machine facility for you to leave a message. We understand that emergencies occur and that you may be unwell but it is important to keep us informed as we have a duty of care while you are working with us to ensure your welfare. Text messages are not an acceptable way of reporting absence. It is also important that you follow your university protocol for reporting absence to them also.

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General Information

Address

Breightmet Health CentreBreightmet Fold LaneBoltonBL2 6NT

Contact Numbers

01204 463366 (Main Reception)01204 463807 (District Nurses – Breightmet & Little Lever Team)

General Information

There is a notice board within the office, where you can display your programme for the week allowing the staff to locate and support you. There is an onsite library at the Health Centre that students are welcome to use; we also have computers and phones in the office.

Our working day is 8.30am to 5pm and lunch is normally 1pm-2pm. We have a kitchen fridges and microwaves that you are welcome to use. We have a staff room, but tend to eat our dinner in the office.

Parking at the Health Centre is limited, so early arrival is encouraged. There are also parking restrictions on the carpark at Morrison’s, Aldi carpark currently has no restrictions so you can park. There are a number of shops local within walking distance from the health centre.

There are a number of other professional teams based within the Health Centre such as the children’s nurses, INT, Bladder and Bowel specialist nurses to name a few.

Breightmet and Little Lever District Nurses cover a number of residential homes: Four seasons Starmount villa Southlands Abafields Shannon court We also cover Laburnum Lodge.

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What you can expect from us

During your time with us you will receive an induction into your placement area to ensure you are familiar with the environment and are able to practice safely.

You will discuss your learning needs and outcomes with your Mentor at the beginning of the placement, so an action plan can be formed.

Your Mentor will assess your performance against course learning outcomes and provide feedback during your meeting points.

We will ensure that you are supported throughout your time with us. We will take time to listen to any feedback you wish to provide to us making sure we apply, where necessary, to our practice and teaching.

What we expect from you

To arrive promptly. (9am on your first day, then 8.30 thereafter)

To ensure your Mentor is aware of your learning outcomes for the placement.

To act in a professional manner at all times.

To dress in accordance with both your university and Bolton NHS Foundation Trust uniform policy.

To maintain and respect confidentiality at all times.

To contact the office on 01204 463807, to report sickness and your university tutor.

Please ensure Mobile Phone use is kept to a minimum during your working day.

To abide by the social media policy set out by the trust.

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Team roles

Team leader: Each District Nursing team has a team leader. They all hold an additional qualification of Specialist Community Nurse Practitioner (SCNP) and have received additional training that allows them to manage the team as front line managers while combining their experience to plan care for patients with complex needs and provide support and advice for the team.

District Nursing Sister: like the team leader a lot of the DN sisters/ charge nurses hold the SCNP qualification. They manage a caseload of patients derived from their designated GP practices. It is the role of the case load holders to plan and review care given to these patients as well as to offer a means of support for more junior clinical staff.

Band 5 staff nurses: staff nurses undertake all aspects of nursing care, feeding back and raising concerns to the caseload holder as appropriate. Band 5 staff nurses offer support to other staff and student nurses.

Assistant practitioners/ HCA: staff in these roles offers an invaluable support to the other clinical staff, they regularly undertake wound care and are able to administer some medication. Some staff hold additional qualifications and training that allow them to complete tasks traditionally deemed as nursing tasks such as compression bandaging.

Breightmet and Little Lever District Nurses cover a number of residential homes:Four seasonsStarmount villaSouthlandsAbafieldsShannon courtWe also cover Laburnum Lodge.

We see patients registered with the following GP practices:

SPRING VIEW MEDICAL CENTREDr Shiri Kant and Partners, Tel- 01204 578128

LITTLE LEVER HEALTH CENTREDr Jain and Partners, Tel- 01204 462988Dr Hallikeri, Tel- 01204 462640Dr Dysart, Tel- 01204 462525

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BREIGHTMET HEALTH CENTREDr Ariff and Partners, Tel- 01204 463800Dr Whittakers and Partners, Tel- 01204 463777

Tonge FoldDr Lowe, Tonge Fold Health Centre , Tel- 01204 521574Dr Zarrouck Bradford St Surgery, Tel- 01204 521061Dr Lyon- Lever Chambers (OUTLYING PATIENTS IN OUR AREA ONLY) Tel- 01204 462600

Area Profiles

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Breightmet/ Tonge fold

The Breightmet area is one of twenty wards in Bolton.

The name Breightmet is derived from the Saxon and means “Bright Meadows” as the present area was once an abundance of green fields.

Present day Breightmet consists of two main council estates with several thousand dwellings and several thousand privately built dwellings. There are many empty properties with the council estates, despite waiting lists for properties to be allocated.

The transport networks in Breightmet are adequately served by arterial roads and local bus routes. There are also school bus services and ‘dial a Ride’ services for elderly people.

The area has plenty of amenities in the Bury Road area, including Morrisons Supermarket, Home Bargains, small local grocers, newsagents, hairdressers, bakeries, post office and other shops. There are a few recreational facilities Breightmet, the St. Catherine’s Academy has leisure facilities. There is also a bingo hall, golf club and several public houses.

There are several residential care homes in the area mainly privately owned and one social services home. Breightmet has a mixture of affluent and poorer areas, due to a high incidence of unemployment. There is a relatively low proportion of ethnic minority groups and a high proportion of single mothers and elderly people. There is a high mortality rate due to various cancers and coronary heart disease, associated with smoking and diet. This is reflected within the caseload of patients.

Little Lever

The name Lever is derived from the old English laefre, which means place where the rushes grow. Little Lever is described as a large village with the Bolton ward.

It is a mainly affluent area with pockets of deprivation. There are plenty of amenities within the village. There are local grocers, bakers, hairdressers,

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beauticians, flower shops, post office and a number of high street smaller supermarkets.

The area is serviced with local bus routes, going to Bolton Radcliffe and Bury.

It has a large elderly population, however over recent years younger people have moved into the area due to new housing developments. Within the area there is a privately owned residential care home. There are also a number of warden controlled properties throughout the village.

Like Breightmet, there is a relatively low proportion of ethnic minority groups. Again, like Breightmet, patients with cancer account for a large proportion of the case load.

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Learning Opportunities

Whilst we will make every effort to arrange for you to spend time with other health care professionals, it is important for you to gain an understanding and confidence in caring for Clients in their own home.

During your placement with our teams, we hope you will witness a variety of nursing skills and also have the opportunity to practice some of them under supervision. Some of the services provided by district nurses are listed, please not this list is not exhaustive as our role is ever expanding:

Wound care Post operative care Leg ulcer management and treatment Doppler test Skin care Pressure area care and provision of specialist mattresses, cushions etc

Continence care Assessment and management of incontinence Catheter and bowel care

Administration of medicines (including) Insulin injections Vitamin b12 injections Anti-coagulant injections Administration of eye drops Administration of medicines via PEG Care of Central and PICC Lines

Palliative care Symptom control which includes pain relief, management of nausea/ vomiting,

terminal restlessness Syringe drivers Observation and support visits Provision of advice/ support for patients, their family and carer’s Referrals to specialist services in the MDT as necessary FAST TRAK assessments

Liaison with other healthcare professionals Involvement in discharge planning Continuing health care Referrals to other professionals/ agencies including physiotherapy, OT, social

services and dieticians

SPOKE PLACEMENTS

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Please note this list is not exhaustive and should you wish to complete a spoke placement not listed please discuss the appropriateness of this with your

mentor.

Learning opportunity:

Suitable for: Expected outcomes & relevance to patient journey

Tissue Viability nurse

Year 1,2 and 3 students.

Specialist wound care service; this would give an in depth insight into wound care, identifying the role of the specialist nurse. Highlighting referral pathways to and from the district nurse service who have concerns re wounds.

Bladder and Bowel service

This would be particularly helpful to third year students and those on management placements.

Specialist nurses dealing with continence care and health problems relating to bladder and bowel conditions. This would allow opportunity to observe specialist nurses employing communication skills to discuss sometimes difficult and sensitive subjects with patients. It will also give insight into the referral criteria and pathway for patients.

Single Point of Access (SPA)

This would be particularly useful to second year and third year students (especially management placement)

SPA is where all the referrals and communication both internally and externally are received, triaged and sent on. This is appropriate to students particularly those nearing the end of second year and third year students (especially if on management placement) as it will allow you to understand the mode of referral from acute to community services and the triage pathway employed by staff.

Macmillan Nurses Appropriate to students across all years

This spoke will allow you to observe palliative care specialists who employ high level communication skills to manage patients symptoms as they near end of life, including discussion of a sensitive and sometimes upsetting nature with patients and families. This spoke will also give insight into how patients on the GSF and nearing end of life are effectively managed by the MDT and link with DNs.

Hospice at Home/ Hospice

Appropriate for 3rd year students

This would be appropriate for students in their third year (particularly, but not inclusively those who have a desire to work in the community and/or hospice setting). These nurses are palliative care specialists and this spoke would allow you to gain an insight of how the five priorities of care works in practice for patients nearing end of life are cared for and how as an MDT we work together at this stage in a patients journey. This spoke gives a specialist insight into symptom control, management and end of life medicine.

HCA/ AP Students across all years

Working with other members of the team in all roles allows you to understand and appreciate the roles and responsibility of each team member. It would also allow students to develop an understanding and appreciation of the importance of all team members role in providing holistic care as an MDT.

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GP/ Practice nurse Students across all years

This spoke would demonstrate the referral criteria and rationale for referrals from GPs to district nurses. It would also give an idea of the general patient demographic of the area.

Admissions avoidance

Students across all years

This service aims to keep patients at home and avoid unnecessary admissions to hospital. It will demonstrate the complexity and unpredictability of patient’s needs. This service has a direct impact on the acute and community settings and working with this team would offer a very important insight in to how the nurses’ role in the community has changed and developed over recent years.

Evening/ night DN service

Students across all years

This will demonstrate how the DN service is a holistic 24-hour service. It would also allow give an insight into how the skill mix and demands of staff in this service are different.

Treatment room service

Students across all years

A spoke with this service will allow you to see the referral rationale to this service and how the patient journey differs in comparison to that of a patient who uses the district nursing service.

Integrated Neighborhood Team (INT)

Students across all years

This service incorporates multiple health and social care professionals into one team in order to seamlessly support some of the most vulnerable members of society. Services include nurses, physiotherapy, OT, Mental health nurses and social workers and a spoke here would allow you to understand their referral pathway and criteria and how this service works alongside the DN service.

Podiatry Students across all years

A spoke placement with this service will demonstrate the referral criteria and pathway between podiatry and district nurses. It would also allow students to understand how DN and podiatry share the care of some patients.

Diabetes centre Students across all years

This is a specialist service that manages the care of some of the diabetic patients both on our caseload and across Bolton. It would allow you to understand the patient journey and how specialist services support and guide the practice of the DN teams.

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STUDENT JOURNAL

Week beginning

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

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Hand washing

Healthcare associated infections can occur in otherwise healthy individuals, especially if invasive procedures or devices are used. For example, indwelling urinary catheters are the most common cause of urinary tract infections.

Healthcare associated infections are estimated to cost the NHS approximately £1 billion a year and, £56 million of this is estimated to be incurred after patients are discharged from Hospital.

Hand Rub

When decontaminating hands using alcohol hand rub, hands should be free from dirt and organic material. The hand rub solution must come into contact with all surfaces of the hand. The hands must be rubbed together vigorously, paying particular attention to the tips of the fingers, the thumbs and the areas between the fingers, until the solution has evaporated and the hands are dry.

Reference

NICE (2012) Infection: Prevention and Control of Healthcare Associated Infections in Primary and Community Care CG139

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FIRE REGULATIONS

On commencement of your placement, fire regulations will be discussed. This is routine practice and involves the following,

Any person discovering a fire should sound the fire alarm by smashing the nearest fire alarm point, usually found by a fire escape.Then call the fire brigade by dialling 9 if inside building then 999 from a place of safety.

On hearing the fire alarm sound staff should assist visitors to leave the building by the nearest safe exit route. All doors should be closed and report to the assembly point which is the in the Main car park.

DO NOT RETURN TO THE BUILDING UNTIL IT IS SAFE TO DO SO.

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Please fill this in and return to your mentor, this is for your safety and for use in an emergency.

Name and telephone number

Car registration

Personal tutor email/ telephone number

Next of kin

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