Orthogeriatric Rehabilitation (A21)

Welcome to Ward A21

A21 is a 30 bed ageing and health ward looking after orthogeriatric rehabilitation patients with a range of medical problems, focussing specifically on frailty and comprehensive geriatric assessment. The ward is located on the 2nd floor of A block.

Key Contacts

• Senior Charge Nurse – Barbara Ann Niven
• Nurse Practitioner – Dianne Brisbane
• Consultant – Dr Heather McCluskey
• Consultant – Dr Amy Wass
• Specialty Doctor – Dr Ahmed Turki

Day to Day

9:00– Handover from Nurse in Charge with a brief overview of issues from the night, if patients were reviewed, any patients going home, update whiteboard whilst going through handover.

9:15 – Divide jobs for the day, print the handover list (usually updated the afternoon before by the FY1). Ward is split by consultant usually. Patients to have medical review are usually decided the afternoon before.

9.30-12.30 – Ward rounds led by middle grade doctors or consultant. Below table shows current ward round and MDT plan per consultant. This is dependent on consultant’s on-call commitments and B23 orthogeriatric cover.

1.30-4.30 – Ward round jobs, chasing results, updating families or attending ward MDT meeting with AHP and nursing colleagues.

4:30 – FY1 to go to handover with any jobs for FY1 on call or sick patients requiring review. On Fridays FY1 and middle grade doctors will create handover for the weekend team and present this at 1630 meeting in cardiology seminar room 2.

Typical Staffing

The ward is normally covered by 2 middle grade doctors (FY2, GPST, IMT, Reg) an FY1 and nurse practitioner. On occasions where staffing is better there will be opportunity to attend clinic, QI, teaching or do specialty reviews.

Responsibilities by grade

FY1:

• Update handover list throughout the day to ensure it is up to date for the morning
• Usually goes on consultant ward round or has own ward round then discussed with senior
• Check bloods from the day
• Phlebotomy hand-backs or ward procedures
• Order bloods for the next day, put on end column of whiteboard
• IDLs, community transfer forms, transfer letters, discharge meds, death certificates
• Map of ward normally printed with IDLs that have been started
• All IDLs to be written prior to discharge and put into notes
• Update families- to be written on family dialogue sheets
• Review sick patients with senior input

Middle grade:

• Ward round on patients to be medically reviewed- if been reviewing same patients for few days best to go on that consultant ward round for feedback
• Update families
• Complex discussions with patients, carers and colleagues regarding AWI, DNACPR, ReSPECT
• Review new patients to the ward
• Liaise with consultant in charge regarding management of patients
• Take on leadership role for coordinating discharge planning
• Attend clinic in supervised capacity

Education

Friday 12:30-1:30: Ageing and Health Departmental Teaching. Lunch provided.

Useful Information

• Osteoporosis Guidelines

Plan to start regular ward teaching as staffing allows, will be led by junior medical team with consultant input.