     
PATIENT CARE UNIT:
Scope of Service:
The
orthopedic clinic is an ambulatory care unit providing care to patients of all
ages. The patients seen in this clinic in the main have Musculo-skeletal
problems i.e. Trauma, Congenital Abnormalities, Spina Bifida, Bone Malignancies,
Muscular Dystrophy and Atrophy Scoliosis, Sports related injuries, Polio, Hand
cases, Rickets and Idiopathic Bone Disease ( e.g. Osteoartities). They are seen
prior to admission for surgery and after discharge from surgery for follow-up as
well as for diagnosis and treatment. The clinic is governed by hospital policies
and procedures are standardized in line with JCIA requirements.
Frequent
Procedures/Services/Functions:
·
Orthopedics: *
General orthopedics and surgery
* Sarcoma clinic
* Sports injury and joint surgery
* Spina Bifida
* Paediatric and Adult Orthopedic clinics
* Protocol Orthopedic clinics
·
Nurse:
* Orthopedic Wound Care
* Teaching clinic
·
Orthopedic Technician:
* Removal/ Application of casts
*
Assists in assembling overhead bed traction frame with Monkey bar for
in-patient wards
*
Assists in applying various types of traction for inpatients/ outpatients
* Offers
assistance to OR and Home Health Care
Procedures:
·
Joint aspiration/ injection
·
Medication Administration
·
Incision and Drainage
·
Removal of external fixators,
K-wire and pins
·
Measurement/ Assessment of
Braces
·
Dressings and wound debridement
·
Trigger finger release
·
Removal of foreign bodies
·
Biopsy
·
Application of Pavlic Harness to
paediatric patients
·
Removal of drains, clip and
sutures
·
Management of chronic wounds and
pressure sores
·
Application of various body/
joint support devices
Hours of operations:
Saturday
– Tuesday : 0800 – 1800 hrs
Wednesday : 0800 – 1700 hrs
CRITERIA FOR
ADMISSION TO THE SERVICE
·
Patients approved for tertiary
care with the need for surgical interventions through Medical Eligibility/ Royal
Order
·
Referrals from CCC, ER,
In-patients and other Outpatient areas, employees and dependants
STAFFING PLAN
Number and mix of staff:
Total
FTE’s 8
Staff Nurse I 2
Staff Nurse II 2
Staff Nurse III 2
Orthopedic Technician 1
PCA 1
Shift assignments are made by the charge
nurse and based on the following:
There are 4 examination rooms, 2
consulting offices, 2 plaster rooms and a dressing room.
The team leader oversees the total needs
each clinic working together with the physicians/ team to provide quality
delivery of patient care.
The orthopedic Technician removes and
applies different types of casts according to the patient’s needs for both
clinic patients and in-patients. The technician also applies different types of
traction. He is a resource to assist in ER, OR, Home Health Care, Case
Management and In-patients.
In the Nurse Clinic, nurses
apply the Pavlic Harness to paediatric patients with hip dislocation and provide
all education regarding care and management of this at home. The teaching clinic
provides both practical and written information for various orthopedic or wound
care.
Method of adjusting to staffing
variances:
The
head nurse makes adjustments in staffing on a daily morning and afternoon
assessment based on the volume of patients/ procedures, skill level of staff and
number of bilingual or non-bilingual physicians attending the clinic. When
additional staff are needed, adjustments in assignments are made from different
units within surgical clinics that are cross-trained.
Orthopedic clinic nurses generally float to the following units:
·
Surgical Clinic
QUALIFICATIONS OF STAFF:
- Current license from Saudi Council
-
Current license from the country
of origin
-
Bachelor of Nursing for certain
nationalities
-
Mandatory Education i.e. Fire
safety, Infection Control, Performance Improvement, Wound Care, Pressure Ulcer,
Customer Service Care
-
BCLS
-
Orthopedic technician training
-
Fire & Safety
-
Community CPR
-
Fire & Safety
-
Community CPR
HOW ARE
INSERVICES/CONTINUING EDUCATION PROGRAM PROVIDED TO MAINTAIN STAFF COMPETENCY?
·
Staff meeting is held monthly
and additional meetings are scheduled as needed.
·
Staff Development courses/
in-services offered by Training and Development, New Horizons, Nursing Education
and Research or clinical departments are posted on the bulletin board to
encourage staff to see what is available and how to apply to attend.
·
Staff is encouraged to give/
coordinate educational programs for their peers and colleagues. SNI's are
required to give two in-services annually.
·
Competency based practice
check-offs are an annual requirement assessed by the Clinical Instructor.
·
Attendance at Skills Marathons
where applicable.
·
Using the hospital Intranet and
completing all on-line mandatory courses.
·
New polices or review of
policies and procedures require an in-service facilitated by either one of the
clinic staff or the Clinic Instructor.
·
Staff learning needs are
identified and relevant in-services are then arranged.
·
Annually staff identify a list
of in-services on topics they would like covered and this is then given to the
Clinical Instructor to facilitate.
·
Symposium and workshops
sponsored by Academic Affairs where applicable.
·
All Ward Clerks and PCA’s are
facilitated to attend during working hours up to grade 3 level English Language
classes.
·
Training as required for Saudi
nationals.
Required Competencies:
·
Adult/ Paediatric Physical
Assessment
·
Oxygen Therapy
·
Cast removal
·
Suctioning
·
Computer Skills
·
Medications Administration
·
Aseptic technique
·
Age Specific Care
METHOD OF COMMUNICATION WITH OTHER
DEPARTMENTS:
Internal and External Methods of
Communication:
·
Internally, direct communication
between physicians and other team occurs throughout each day.
·
Bulletin boards, APP/ IPP,
Management Notifications and Memorandums folders. Minutes of Meetings folder.
·
Monthly scheduled staff meetings
and others as needs dictate.
·
Collaborative Practice meetings,
usually department specific. New initiative will start Orthopedic Clinic
Collaborative Practice meetings.
·
Ambulatory Care Management Team
Meetings monthly.
·
Externally, the Orthopedic
clinic communicates with nursing units and multiple other departments via phone,
fax, cc-mail, e-mail, internal mail and written memos. Certain staff
representing Orthopedic Clinic sits on other committees and attends those
meetings (e.g. Wound Care Committee, C2 Collaborative Committee) and feed back
to all staff at our monthly meetings.
Describe Collaborative Relationships
with Other Departments:
·
The Orthopedic clinic strives to
maintain open communication with all departments.
·
Staff from the orthopedic clinic
participate in clinics pathway development with personnel from other
departments.
·
Social service personnel and
Patient Relations are readily available for the clinic as needed.
·
An Appointment clerk is
available in the clinic to facilitate registration, opening encounters and
changing or making of appointments.
·
Some of the clinics are combined
clinics offering a combination of professionals to see the patients and families
on that clinic day (e.g. Sarcoma, Brachial Plexus injury).
·
Case Manager attends some of the
clinics to facilitate pre-operative admission preparation etc.
Goals of Department:
·
Provide consistent, safe and
high standards of care.
·
Support the Mission Statement of
the hospital.
·
Empower staff to develop
leadership and critical thinking skills.
Plan to Improve Quality of Service:
·
To participate in JCIA
accreditation preparation.
·
To participate in the
development and implementation to improve patient care and support the
installation of ICIS phase II.
·
To locate and provide a more
suitable environment in which wound care can be delivered at a high standard.
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