ACCU Trainees introduction to AHP services at RLH Sept 2019
Physiotherapy • Meet with Team A +B Consultant 3xpw at 9am (M, W, F) – Highlight any patient for PT discussion • Morning handovers • Trachy Ward Round – Tuesdays at 1pm • Long Term Ward Round – Thursdays 2:30pm – 4pm – CG83s – LTWR discussions and patient goals • Trachy and vent weaning – Majority therapy led wean plans – Not all ventilatory weans will need a plan – Discuss wean with us • ACCU MDT Daily sheets • Rehabilitation box (Resp, Seating, Rehab achieved) • Patient White boards – General management (Resp, Neuro, Personal) – Personal history sheets • Rehabilitation: minimum 3 x a week per patient • Weekends: Predominant chest service with reduced staffing. Rehab if capacity
Streams • ‘Medical’ specialising in: [Laura Walters] – Respiratory medicine, Cardio, Renal, Gastro, Liver – NIV specialism – Close links with wider respiratory MDT • ‘Surgical’ specialising in: [Will Kirby] – Colorectal, HPB, Gynae, elective ortho – ERAS specialism • ‘ Neurotrauma ’ specialising in: [Musie Tsehaye] – Neurosurgery, neurology and trauma and ortho – SCI weaning/disability management specialism *Morning handovers: reflective of 4E+4F boards*
Physio: how to contact us Office on 4E opposite side room 35 - Referrals? • Medical stream – Dect: 45878 – Email: laura.walters7@nhs.net • Surgical Stream – Bleep: 1607 – Email: william.kirby1@nhs.net • Neurotrauma Stream – Blp: 1141 / Dect: 45874 – Email: musietsehaye@nhs.net
Dietetic Service • Monday – Friday (8.30am – 4.30pm) • Staffing: – Lead ICU Dietitian : Anne Langan – Band 6 (rotational): Sarah Smith • Referrals: – Level 3 patients: Blanket referral system – Level 2 patients: MUST should be completed and referral, if required (can be verbal or on CRS)
Dietetic Service Prioritisation Priority 1 Priority 2 • Intubated and ventilated • Self ventilating and on NG feed • On feeding protocol for 48- • Poor oral intake (likely to 72hrs require enteral feeding or on • Poor tolerance of enteral supplementary enteral feeding feeding) • Patients on high doses of • Specific dietary advice (low propofol K+ diet, high stoma output, • High risk refeeding creon advice) syndrome
Dietetic Service • Parenteral Nutrition provided by Nutrition Team • Includes: Gastro Dietitian, Gastro consultant, Gastro SpR, PN Pharmacist & Nutrition Nurse) • Monday/Wednesday/Friday • Referrals must be received before 11am • Out of hours TPN is available at weekends • Not sure if a patient needs TPN?
Dietetic Service • Contact Details: – Extension 41129 – Bleep 1033/ 1653 • Nutrition Team: – Dietitian Bleep 1255 – Nutrition Nurse Ext 42223
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