Bringing the nurse to the patient (plenary)
1
of the LCP and excellent care providers, can ulti- mately lead to a dignified death. Intended learning outcomes: Consider how a change in culture can enhance end of life care in an acute hospital setting. Reflect on how using an evidenced based care pathway can facilitate dignified end of life care. Recognise the importance of multidisciplinary involvement in end of life care for patients and their families. Recognition of the importance of effective com- munication, interdisciplinary teamwork and com- prehensive documentation in end-of-life care. Recommended reading: British Orthopaedic Association, 2007. The Care of Patients with Fragility Fracture. BOA. London. Department of Health, 2003. Building on the Best: End of Life Care Initiative. Department of Health. London. Kanis, J.A., Oden, A., Johnell, O., De Laet, C., Jonsson, B., Oglesby, A.K., 2003. The components of excess mortality after hip fracture. Bone 32 (5), 468–473. National Hip Fracture Database. <http:// www.nhfd.co.uk>. National Institute for Health and Clinical Excel- lence, 2004. Improving Supportive and Palliative Care for Adults with Cancer. London. NICE. Nolan, M.T., Mock, V., 2004. Integrity of the person: a conceptual framework for end-of life care. Journal of Professional Nursing 20, 351–360. doi:10.1016/j.joon.2009.07.010 Bringing the nurse to the patient (plenary) Susan Elliott, Anna Cronk, Sarah Langfield South West London Elective Orthopaedic Centre, UK Aim: To give insight into how we can meet the needs of the patients in new an innovative ways. Abstract: This presentation will explain about the Elective Orthopaedic Centre which is a sector wide resource for the whole of South West London serving 4 Acute Trusts and 7 PCT’s. We will take you through the existing patient pathway from the point of referral to discharge and follow up along with some of the issues and difficulties that have arisen along the way. Then we will show you our new vision for the future and how we see this developing over time. With the Advent of the 18 week target the time between referral and surgery has reduced consider- ably. With the Orthopaedic Centre being a sector wide resource, patients had to travel across South West London for initial consultations, pre-assess- ment and follow up appointments. This meant that the pathway was not very patient friendly. The Pathway was re-visited and ‘One-Stop’ Clin- ics were developed to run along side Orthopaedic Consultant clinics with the patient attending their initial consultation. There were many hurdles to leap in order to achieve these but none were insur- mountable. This process smoothed the front of the pathway so we began looking at the end of the path- way. We asked the question why couldn’t an Ad- vanced Nurse Practitioner see patients at 6 weeks in their own home? This is an area in development which will be explained in our presentation. Intended learning outcomes: To understand the impact of the 18 week target. How did we change the Orthopaedic Pathway and what were the pitfalls. What are the future plans for the role. Recommended reading: Carnwell, R., Daly, W.M., 2003. Advanced nurs- ing practitioners in primary care settings: an explo- ration of the developing roles. Journal of Clinical Nursing 12 (5), 630–642. Davies, B., Hughes, A.M., 2002. Clarification of advanced nursing practice: characteristics and com- petencies. Clinical Nurse Specialist 16 (3), 147–152. Johnson, S.A., Kalairajah, Y., Moonot, P., Steele, N., Field, R.E., 2008. Fast-track assessment clinic: selection of patients for a one-stop hip assessment clinic. Annals of the Royal College of Surgeons of England 90 (3), 208–212. doi:10.1016/j.joon.2009.07.011 The other side of the fence (plenary) Amanda Broom Royal United Hospital, Bath, UK Aim: To discuss the importance of careful prep- aration of the elective orthopaedic patient for ma- jor surgery. Abstract: How many times, in many different situations, have we been told ‘‘preparation is everything’’? Or ‘‘planning is vital’’? Having been an orthopaedic nurse for over 20 years and having cared for those undergoing total hip replacement for the majority of this time, experiencing this from ‘‘the other side of the fence’’ has given new meaning to planning and preparation. 134 Abstracts
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Transcript of Bringing the nurse to the patient (plenary)
of the LCP and excellent care providers, can ulti-mately lead to a dignified death.
Intended learning outcomes:
� Consider how a change in culture can enhanceend of life care in an acute hospital setting.� Reflect on how using an evidenced based carepathway can facilitate dignified end of life care.� Recognise the importance of multidisciplinaryinvolvement in end of life care for patients andtheir families.� Recognition of the importance of effective com-munication, interdisciplinary teamwork and com-prehensive documentation in end-of-life care.
Recommended reading:British Orthopaedic Association, 2007. The Care
of Patients with Fragility Fracture. BOA. London.Department of Health, 2003. Building on the
Best: End of Life Care Initiative. Department ofHealth. London.
Kanis, J.A., Oden, A., Johnell, O., De Laet, C.,Jonsson, B., Oglesby, A.K., 2003. The componentsof excess mortality after hip fracture. Bone 32(5), 468–473.
National Hip Fracture Database. <http://www.nhfd.co.uk>.
National Institute for Health and Clinical Excel-lence, 2004. Improving Supportive and PalliativeCare for Adults with Cancer. London. NICE.
Nolan, M.T., Mock, V., 2004. Integrity of theperson: a conceptual framework for end-of lifecare. Journal of Professional Nursing 20, 351–360.
doi:10.1016/j.joon.2009.07.010
Bringing the nurse to the patient (plenary)Susan Elliott, Anna Cronk, Sarah Langfield
SouthWest London Elective Orthopaedic Centre, UK
Aim: To give insight into how we can meet theneeds of the patients in new an innovative ways.
Abstract: This presentation will explain aboutthe Elective Orthopaedic Centre which is a sectorwide resource for the whole of South West Londonserving 4 Acute Trusts and 7 PCT’s. We will takeyou through the existing patient pathway fromthe point of referral to discharge and follow upalong with some of the issues and difficulties thathave arisen along the way. Then we will show youour new vision for the future and how we see thisdeveloping over time.
With the Advent of the 18 week target the timebetween referral and surgery has reduced consider-
ably. With the Orthopaedic Centre being a sectorwide resource, patients had to travel across SouthWest London for initial consultations, pre-assess-ment and follow up appointments. This meant thatthe pathway was not very patient friendly.
The Pathway was re-visited and ‘One-Stop’ Clin-ics were developed to run along side OrthopaedicConsultant clinics with the patient attending theirinitial consultation. There were many hurdles toleap in order to achieve these but none were insur-mountable. This process smoothed the front of thepathway so we began looking at the end of the path-way. We asked the question why couldn’t an Ad-vanced Nurse Practitioner see patients at 6 weeksin their own home? This is an area in developmentwhich will be explained in our presentation.
Intended learning outcomes:
� To understand the impact of the 18 week target.� How did we change the Orthopaedic Pathwayand what were the pitfalls.� What are the future plans for the role.
Recommended reading:Carnwell, R., Daly, W.M., 2003. Advanced nurs-
ing practitioners in primary care settings: an explo-ration of the developing roles. Journal of ClinicalNursing 12 (5), 630–642.
Davies, B., Hughes, A.M., 2002. Clarification ofadvanced nursing practice: characteristics and com-petencies. Clinical Nurse Specialist 16 (3), 147–152.
Johnson, S.A., Kalairajah, Y., Moonot, P.,Steele, N., Field, R.E., 2008. Fast-track assessmentclinic: selection of patients for a one-stop hipassessment clinic. Annals of the Royal College ofSurgeons of England 90 (3), 208–212.
doi:10.1016/j.joon.2009.07.011
The other side of the fence (plenary)Amanda Broom
Royal United Hospital, Bath, UK
Aim: To discuss the importance of careful prep-aration of the elective orthopaedic patient for ma-jor surgery.
Abstract: How many times, in many differentsituations, have we been told ‘‘preparation iseverything’’? Or ‘‘planning is vital’’? Having beenan orthopaedic nurse for over 20 years and havingcared for those undergoing total hip replacementfor the majority of this time, experiencing thisfrom ‘‘the other side of the fence’’ has givennew meaning to planning and preparation.
134 Abstracts
