Recommended
More Related Content
What's hot
What's hot (14)
Similar to Hospital @ Night Induction
Similar to Hospital @ Night Induction (20)
More from JordanNapier1
More from JordanNapier1 (20)
Recently uploaded
Recently uploaded (20)
Hospital @ Night Induction
- 1. Hospital at Night Team “A multidisciplinary team who, between them have the full range of skills and competencies to meet patients’ immediate needs overnight” (Department of Health, 2005)
- 2. Why H@N? • European Working Time Directive • Junior Doctors New Deal • Modernising Medical Careers • Foundation Medical Training • Patient Safety
- 3. Aims of Hospital at Night • Right person • Right patient • Right time • Reduce non-urgent work • Work allocated depending on competency, not job title
- 4. Key Principles • Structured, clear, appropriate handover • Triage /prioritisation of calls/workload • Staff deployment • Utilisation of NEWS, SBAR • TEAMWORK
- 5. Ninewells H@N Model: 20:30 - 08:30 & weekends Medical Block Surgical Block West Block Registrar A Nurse Co-ordinator Registrar B Nurse Practitioner CMT/GPST A CMT/GPST B FY 2 FY1 FY1 FY1 Support Worker Nurse Practitioner Nurse Practitioner FY 2 FY 1 FY1 FY1 Support Worker FY1/2 FY1/2
- 6. How we work • Registrars / Consultants On-call • All calls for assistance go to Nurse Practitioner • Work delegated depending on skills / competencies • Cross-cover as necessary
- 7. H@N meetings overnight 20:30 HAN Hub, Corridor K, Level 7 Non-Covid wards 3 separate handovers (Med./Surg and Ortho./West) Combined Safety Brief 20:30 Improvement Academy, Seminar room A Medicine and Surgical covid wards 02:00 HAN Hub, Corridor K, Level 7 “catch up meeting” 08:00 – 09:00 Morning Handback See Morning hand-back slide H@N meetings overnight
- 8. H@N Handover WHAT? • Patient Name, CHI, Ward, Diagnosis • Outstanding NON- ROUTINE tasks • Admissions • Patient reviews • Potential deterioration • Escalation plan / 2222 status HOW? • Offgoing & oncoming medical staff present • Punctual • Led by NP’s • One speaker at a time • SBAR • Clear allocation of workload. • NO MOBILE PHONES at handover
- 9. Fall Admission What happens overnight? Cardiac arrest Urgent blood sample Chest Pain Aggressive patient Medication query Advice ECG Catheter insertion Pyrexia Painkillers IV fluids and the rest… High SEWS Venflon Handover
- 10. H@N Nurse Practitioner Role • Lead handover • Filter calls from wards • Referrals • Coordinate • Triage / prioritise • Delegate workload • Advanced skills - patient review • Independent prescribing • Clinical skills • Expert resource • Advice • Education
- 11. H@N Support Worker Role • Highly skilled in practical procedures • Cannulation • Venepuncture • Urinary catheterisation • ECG recording • Bladder scanning
- 12. H@N Foundation Doctor Role • If you do it by day, do it by night! • Allocated 3 or 4 wards • Redeployed • Not bleeped directly by wards • Supported by H@N Team • Protected breaks • Offer assistance when able • Night shift… NOT “On-Call”
- 13. H@N Registrar Role • Leadership at Handover • Cardiac arrest • Senior review • Support • Advice • Feedback
- 14. Morning Hand-back • Medical Non-Covid Wards 1, 2, 3 HAN Hub 08:30 (FY’s) • Surgical Covid Wards 10, 9, 8 08.00 walk through (FY/NP) • Orthopaedics Seminar room in the Emergency Department (FY) • West Block Surgery 23a, 23b, 27 and 26 HAN Hub 08:00 (FY’s/NP) • West Block Medicine 32, 33, 34, 36 HAN Hub 08.30 (FY’s) • Same handover principles apply
- 15. ANY QUESTIONS
Editor's Notes
- Experienced nurses from a range of backgrounds but all with experience of managing acutely unwell patients. Masters level study in clinical assessment and nurse prescribing Taking on roles which were traditionally doctors, but which experienced nurses can do safely and competently