Transcript SA Health PowerPoint Template - Blue

Assistant in Nursing
Extended Orientation Program
– Rehabilitation Services
(AiN)
Janet Trotta 2014.
Brief Introduction to
Rehabilitation Services
and your role
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Welcome to rehabilitation services
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Fire exit
Toilets
Tea and coffee facilities
Mobile phones
Respectful classroom behaviours
Todays session
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Inpatient Rehabilitation Services
are committed to
This is a shared
responsibility
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Staff Development Department & staff
development consultant role
> Staff Development Opportunities
> My role
• Background
• Role
• Support
Janet Trotta
Staff Development Consultant
HRC
> Educational opportunities at HRC
• Ward based in-service
• HRC Nursing in-service
• Capacity to attend education through RAH and
TQEH (? Cost associated for causals)
• Moodle education
 Artist in residence art groups
 Other disciplines
 Grand rounds and forums etc.
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Our history
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Hampstead Rehabilitation Centre - History
> Started life as an infectious diseases hospital –
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Opened & first patients 7th October 1932
Collect overflow patients from RAH in Australia's first large
scale poliomyelitis epidemic (1930’s)
”Metropolitan Infectious Diseases Hospital (MIDH) ”
Polio, scarlet fever, measles and diphtheria.
> By 1945 mass immunisations decreased new
outbreaks considerably. The number of
immunisations to disease grew
Diphtheria
Polio
Whooping cough
Measles
Scarlet fever
> Also – there were new drugs to
combat illness
- penicillin
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Hampstead Rehabilitation Centre - Progress
> Focus changed to convalescence for lasting effects of
disease. Became known as “Northfield wards”
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Predominantly polio
Came under the annex of RAH
> With time, people requiring convalescence from other
long term chronic health problems also came to
Northfield
> Large scale review commenced in 1970’s
> 1980s Northfield wards closed doors to clients with
infectious disease. Became Hampstead
Rehabilitation Centre - a modern progressive
centre for rehabilitation and extended care
> Affiliated with St Margaret's Rehabilitation Centre
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Our services
> Provides a range of services for people requiring rehabilitation,
including but not limited to:
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Post medical illness
Following surgical intervention.
Post trauma,
after orthopaedic and spinal injury
In association with health problems associated with aging
Nursing role is Rehabilitation Focused
• Subacute presentations
• Patient centred Individualised care
• Goal focused
Predominant nursing care issues revolve around: independence,
education, quality of life, safety, mobility, continence, skin integrity,
wound care
• Discharge and community focus and liaison
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Main part of the
Hospital
Seminar room
Reception area
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Spinal Injury Unit (SIU,
2CD)
• spinal cord injury
• no admission age
limitation
• Services: SA, Northern
Territory, parts of NSW &
a small section of
Victoria
• does not take people
with a bony fracture
where there is no
neurological loss
Outpatients Department OPD spinal & brain injured
clients
• Podiatry
• X-ray
• Botox clinic
• Wound clinics
Educator office
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Brain Injury
Rehabilitation unit –(BIRU
, 2B)
• people with an acquired
brain injury, (generally
traumatic brain injury)
• average presentation is
male, in the 40s, often
attributable to MVA assault, or
drug abuse.
• Clientele often have
physical and cognitive
deficit.
• Focus: developing
independence for
placement (not
Orthopaedic, Amputee and Burns rehabilitation unit–(OABRU,
2A) always
home) orthopaedic
• specialist inpatient rehabilitation service for people following
surgery (trauma or joint replacement), amputation• orpotential
burns for
unpredictable behaviour
• assists with the provision of prosthetic limbs.
and
aggression
within
• focuses on assisting optimum level of functioning post
surgery
or injury
&
this unit SA Health
assists with developing independent living skills
Stroke rehabilitation unit
–(Ward 1C )
• post CVA and also those
with neurological
deficits, Guillain-Barre
syndrome, Multiple
Sclerosis, or people who
are deconditioned after
surgery etc.
• focuses on assessing
and developing
independence as well as
assisting clients to
relearn or find new ways
of doing activities or
functions lost as a result
General rehabilitation unit–(Ward 1D)
of the Stroke
• general medical rehabilitation with diverse group of clientele
• No set age range for admission, ages have ranged from 30 – 90.
• Most clientele come present with multiple complex co-morbidities.
• Predominant nursing issues are as diverse as the client group.SA Health
Integrated inpatient, outpatient and ambulatory
services. HRC = HUB in hub and spoke model
State-wide
rehabilitation
service plan
2009 - 2017
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FUTURE
PAST
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Your Role
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Your role
> Understand what is expected of you as an
AiN
• Familiarise yourself with your job and person
specifications
• Understand exactly which duties come under
the remit of the AiN
• Understand the core values and philosophies of
rehabilitation services
> Know where you can get help if needed
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Your role – job specification
> Your job specification outlines the
expectations for you as an AiN. Read all of
this and become familiar with it
> Carry it to work with you, at least to begin
with.
• You cannot assume that others will always know
what you can and cant do
• You need to be sure you are performing within
your
scope of practice.
To provide routine care
as delegated
and supervised by the RN and
perform tasks
• Considered standard and unchanging
• With expected predictable results
• With minimal potential for risk
Your role – in a nutshell
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Reporting/Working Relationships
The Assistant in Nursing:
> Reports to the Nurse Clinical Services
Coordinators ( CSC / Level 3) on a ward level
and the Nurse Management Facilitators form
an administrative focus ( NMF / Level 3)
> Works under the direct supervision of a
Registered Nurse
> Works with workplace supervisor or
preceptor
> Maintains cooperative and productive
working relationships within all members of
the health care team
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Support Systems
The adoption of this new role may hold
challenges for you:
> Confusion about your role
> Feelings of inadequacy or “just not
coping”
> Pressure from University and working
commitments may build-up
> Adoption of the role may take time
> Expectations from clinical staff may
be foreign to your experiences…
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Support Systems
There are a number of alternatives for support
open to you:
> Peer support from other AiN’s within
rehabilitation services
The RAH endorses a respectful behaviours framework
> Support from the ward preceptors / mentors
for all employees and service users.
> Support from your ward L2 nurses and the CSC
for clinical issues or staff issues
> Support from the AiN Program Coordinator for
some issues & debriefing
> The Nurse Management Facilitators ( available
on all shift but predominantly after hours
> The staff development consultant
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Support Systems
Employee Assistance Program – RAH
Access-OCAR
45 Wakefield Street Adelaide SA 5000
ph: 1300 667 700 (free call)
Converge
174 Pulteney Street Adelaide SA 5000
ph: 1800 337 068 (free call)
More information available:
http://intra.sahs.sa.gov.au/sahs/our_organisation/adelaide_health_service/eap.jsp
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Things you
should know
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Emergencies
> Know the
> emergency procedures & roles:
Know where the
emergency trolley
& equipment is on
any ward you work
in
• Emergency assistance
In a calm rationale way state
• nature and location of the
emergency
• who you are
• answer any specific
questions
Code Black
All emergencies
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Security
Consider your
> Personal security
• Wear identification at all times
• Walking grounds / parking etc.
• Security of belongings
 Personal equipment & accessories
 Car safety
> Security of the workplace
• Security of keys etc.
• Report concerns / unusual events
• Personal Protective equipment
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Security
Consider your
> Client safety
• Clients personal equipment &
accessories
• HRC / ST Margaret's Equipment
– report issues or potentially
unsafe equipment
• SLS reporting : Cleints, staff and
near
miss or hazards
pressure
injury, general risk factors
• Client Confidentiality
in
a
rehabilitation
environment
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• Report concerns or unusual
events
Patient risk assessment (i.e. falls,
Address issues and SPEAK UP IF CONCERNED
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Uniform code
> Please make sure you wear full uniform
> Present to work every day: clean and with a tidy
appearance
> Hair should be pulled back
> No earrings, rings jewellery – why?
(wedding rings allowed)
> Please make sure you wear your identification
badge.
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No Mobile Phones!
> Never use or carry your mobile phone when in
active client based care provision. It is like any
other personal item or activity, it should only be
used on allocated breaks
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Parking Arrangements
If you wish to arrange parking payment options –
please see Haile Elkins - 82221643.
Contracted
hours
If parking
Fortnightly
on site in an ad
hoc deductions
way you have the
option of paying
Post tax deduction
> daily rate (up to $13 Pre-tax
day)
0-25 per fortnight
$6.69
$7.36
> or a weekly pass ($38 p/week).
More than 25 less than 48 per
fortnight
> than
weekly
tickets
More
48 per fortnight
$12.95
$14.22
available
$19.63from auto pay
$21.59stations.
The user presses the information button and the
control room will talk them through the process.
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Professionalism
Please:
> Be punctual
> Arrive with enough time to ensure you are ready to work
from the shift start time
> to and from breaks
> (reputations are easily gained / lost in a workplace)
> Always let someone know if you need to leave
the ward (communicate)
> Call in to report you will be off if you are sick or
have personal issues that prevent you from
coming to work
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A rehabilitation framework. While on shift at
HRC
HRC supports partnering with consumers
Safety
Comfort
Dignity
Respect
Choice
Advocacy
Client centered approaches
Quality best practice care provision
Admission to discharge
Focus on factors that are central to ensuring
a positive outcome for the client
• OWI (Organization wide instruction)
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OWI – what is it, why is it there?
Your care
provision
The RAH  HRC has policy and procedure or OWI’s to
guide all of the common processes within the
organisation.
This allows for
> Consistency
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Evaluation of care and processes within the organisation
Guidance to new and existing staff’
 risk of missing important things
 Quality service for all
If you would like to have a look, ask the staff to
advise you on location in the first instance . It
can be tricky manoeuvring around the intranet
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What about rehab?
As this is a rehabilitation setting there may be
“extra” things to consider
Independence
Self care
Optimal functioning
Client Choice and participation
Multidisciplinary teams
Assessment of functioning
Risk management
The clients perspectives
least restrictive options / promote
“normalisation”
• Liaison, networking, referral and other services
• Breaking down stigma and discrimination
• Different ways of caring
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Multidisciplinary team approaches
What is a multidisciplinary team?
A group of professionals working together for the common good of
the client.
The team may consist of any relevant professional who has
important input that will benefit the client’s current treatment and
future wellbeing.
Multidisciplinary teams can have varied membership but may
include
Medical officer
Nursing staff
Psychologist
Social worker
Occupational therapist
Physiotherapist
Psychiatrist
Special therapist
Speech pathologist
Case manager
Dietician
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Rehabilitation Nursing
The goals of rehabilitation nursing are Tell me in your own
words what this means
• the maximisation of self-determination;
to you?
• the restoration of function; and
• the optimisation of lifestyle choices for their clients.
(Australasian Rehabilitation Nurses’ Association, 2002)
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Rehabilitation Nursing
Professional body for Rehabilitation
Nursing in Australia
ARNA :
Australasian Rehabilitation Nurses
Association Inc
http://www.arna.com.au/
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Important
considerations !
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The checklist
We need evidence of your successful
completion of
Basic Life support
Medication Competencies
Manual Handling.
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The role of the staff member at HRC
> To work to your relevant scope of practice
> To work within the professional guidelines of your profession if you are unaware of these – please ask!
> To provide safe and efficient quality care for patients
> To seek support and assistance if unable to meet clinical
requirements
> To provide a physically safe and culturally sensitive
environment for consumers and staff
> To observe and communicate respectfully within the team
and others
> To work ethically and safely
> To respect therapeutic relationships and professional
boundaries at all times- if you are unaware of these – please
ask!
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Using this time wisely
Just a reminder …
> Your scope of practice is different to others on
the unit
Don’t let others coerce you into
doing things that are outside your
scope
Don’t fall into a false sense of security that
you can do things outside your scope and
“it will be okay” or “I was helping out on a
busy day” or that you won’t get caught out
It could end your career before you begin
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Any questions
For your attention
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