STUDENT LEARNING PACKAGE
ORTHOPAEDIC OUTPATIENT DEPARTMENT
NINE WELLS HOSPITAL
DUNDEE
Version 1.0 May 2006
For Review May 2007
Author –
Mary Clark
Senior Staff Nurse
Welcome to the Orthopaedic Outpatient Department
The orthopaedic outpatient along with fracture clinic and plaster room sees
approximately 12,000 patients per year, the function of the department is primarily to
provide a specialist service to patients requiring elective, and non elective surgery and
immobilisation in plaster splints.
The service is offered to all patients regardless of age, sex, religion or race.
The patients are individuals and treated as such with both medical; and social aspects
being considered.
The members of the team provide information regarding treatment to the patient when
known and seek out the information if not shown.
Where necessary, relatives and their carers accompanying the patient are given a full
explanation of treatment and aftercare
The patient has the right to refuse any treatment if he/she so desires.
The team members increase their skills by continuing education in new materials and
method of treatment by inter-staff communication, ideas are exchanged and problems
solved.
Patient confidentially is observed at all times.
During your clinical placement here we hope you will have the opportunity to learn new
skills consolidating previous learning experiences and linking learning to practice.
The staff here hope you enjoy this clinical placement and that you gain a good
understanding of the experience and skills that are available to you
On your first morning we would be grateful if you could start at 8.45 am to meet your
mentor thereafter you will start at 9am and finish at 5pm. We do not have a staff room so
please bring a packed lunch, we usually go to level 9 for lunch at approximately
12.15pm.
Mary Clark
Senior Staff Nurse
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EMERGENCY PROCEDURES
For Fire
Phone Emergency Number 2222, state which department
For Cardiac Arrest
Phone Accident & Emergency 33904 state where in department patient is
Page System
> Dial 88 and wait for response
> Dial required page number, wait for response
> Dial your extension number followed by # sign, wait for response
> Replace receiver and wait for reply
i.e. To call page holder 4561 from phone extension 35261 Dial 88, then 4561, then 35261#,
hang up and wait for 4561 to call back to 35260.
It is vital you are aware of the fo1lowing
Date
Student Sig.
Mentor Sig.
Sign
Emergency
Equipment
Portable
Oxygen
Portable
Suction
Emergency
Box
Emergency
Buzzers
Fire Points
Fire
Extinguishers
Nurse Call
System
All of the above must be shown to the student on the first day in the department
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MEMBERS OF STAFF
Senior Charge Nurse
Helen Stuart
Senior Staff Nurses
Pat McLaren
Gail Grimmond
Margaret Barnett
Bertie Goodwin
Vera Moir
Linda Hall
Sandra Slidders
Mary Clark
Karen Mead
Joyce Keith
Enrolled Nurse
Irene Robertson
Nurse Care Assistant
Hilda Kerr
Elaine Worsley
Irene Wynne
Leah Watson
Receptionists
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MENTOR/ASSOCIATE MENTOR
During your placement within the Orthopaedic Outpatient Department you will be
allocated a Mentor and Associate Mentor.
On your first day you will meet your Mentor / Associate Mentor, who will facilitate an
initial interview to discuss and agree achievable learning outcomes.
You will meet with your Mentor / Associate Mentor for regular and consistent feedback
which will contribute to the achievement of the learning outcomes, resulting in fair and
objective assessment.
It is important that you identify your educational needs and provide ongoing feedback to
your mentors regarding your learning needs to progress towards your own goals, so that
we might provide a good sound learning opportunity for you.
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CLINIC TIMETABLE
DAY
CONSULTANT
MONDAY
Mr. Foubister
Mr. Wigderowitz
Mr. Alipour.
Mr.Avison
Mr Nassif
Mr. Jain
FRACTURE
CLINIC
ORTHOPAEDIC
CLINIC
9 am
Pre-assessment 13.00
13.30
13.30
Pre-assessment 13.00
Mr. Rickhuss/
Mr. Buckley
TUESDAY
Mr . Foubister
Mr. Clift
Prof. Rowley
General Orthopaedic
14.00
13.30
Mr. Alipour
Mr Avison
Mr Nassif
General Orthopaedic 9 a.m.
General Orthopaedic 13.30
General Orthopaedic 9. am.
Pre-assessment 13.00.
WEDNESDAY
Prof. Rowley
Mr Foubister
13.00
THURSDAY
Mr Jain
Mr Valentine
Mr.Alipour/Avison
Foot Clinic 9 a.m.
Preassessment 13.00
9 a.m.
Mr. Dent
Hand Clinic 9 a.m
FRIDAY
Mr. Clift
Ortho Review Bone 9 am.
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STUDENT NURSE PLACEMENT DIARY
Student Name __________________________________
Mentor _______________________________________
Week Commencing ______________________________
Day
Monday
Week 1
AM
PM
Tuesday
AM
PM
Wednesday AM
PM
Thursday
AM
PM
Friday
AM
PM
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Week 2
Week 3
AIMS
Our aim is to provide the student with knowledge and understanding on the running of
Orthopaedic conditions and treatments including fractures and the running of the
Orthopaedic Outpatient Department along with Fracture Clinic and Plaster Room.
To provide instruction on the removal of sutures and all wound care, along with
application of plaster casts.
To integrate the theory you have obtained in the School of Nursing by providing
instruction within an Orthopaedic environment.
To gain knowledge and understand the treatment of acute and chronic orthopaedic
conditions.
OBJECTIVES
The overall objective of the Orthopaedic Outpatient Department and your period of
mentorship is:
1. To assist you in achieving identified learning outcomes.
2. To orientate you to the department and the multidisciplinary team.
3. To provide ongoing feedback to you on your progress.
4. To assess your performance, within the department.
5. To facilitate you in acquiring knowledge and skills in order to deliver Optimal patient
care.
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6. To demonstrate integration of theory and practice.
7. To maximise learning opportunities which will assist you to develop Competencies.
8. To provide you with individual support and guidance.
9. To create a supportive learning climate by maintaining effective interpersonal
relationships.
10. To outline the resources and support available to you in the department.
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ORIENTATION TO CLINIC AREA
 Introduction to members of staff and preceptor / associate preceptor
 Tour of department
 Receipt of teaching package, handout on Orthopaedic Terminology and
abbreviations, from this site or on commencement of placement.
 Introduction to department routine
 Fire alarms, fire exits, emergency telephone number and fire assembly points
 Consulting room layout
 Fracture Clinic
 Plaster Room
 Reception Area
 Location of policies, protocols and text books
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IDENTIFIED LEARNING OPPORTUNITIES
The following is a list of possible learning opportunities for you during your placement.
The list is not prescriptive and you do not have to participate in all the activities
identified, but it is hoped you will participate in most of them.
There may also be other opportunities for learning available that are not identified in this
list.
1. Wound Management
2. Removal of Sutures and clips
3. Pin Site Management
4. Patient Admission
5. Patient Discharge
6. Application of Plaster Cast and various splintage
7. Removal of Plaster Cast and various splintage
9. Fracture Management
10. Observe the Role of the Physiotherapist in the care of the Orthopaedic Patient.
11. Observe the role of the Occupational Therapist in the care of the Orthopaedic Patient.
10. Observe the role of the Radiographer in the care of the Orthopaedic Patient.
12. Observe the Role of the Nurse in the Orthotic Department with the Orthopaedic.
Patient.
13. Observe the Role of the Nurse in the safe running of Orthopaedic Clinics.
14. Observe the Role of the Nurse in the safe running of Orthopaedic Clinics.
15. Assist Medical and Nursing staff in the care of the Orthopaedic Patient.
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OBSERVE AND PARTICIPATE IN PATIENT CARE WHERE
APPROPRIATE
1. Maintain a safe environment for the patient
2. Assist where appropriate with:
 Removal of Sutures
 Cleaning of Pin Sites
 Wound Management
 Application of Plaster Cast
 Running of Clinics
 Apply and fit splints
3. Monitoring temperature, pulse respiration and blood pressure: With manual and electronic equipment.
4. Referral of patient to:
 Plaster Room
 X-Ray Department
 Physiotherapy
 Occupational Therapy
 Orthotics
 District Nurse
 Wards
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 Nuclear Medicine for Bone Scan
 Discharge letters or communication to GP or District Nurse
 Portering Staff
 Social Work Department
 Early Support Discharge
5. Organisational Role
 Referral system from GP
 Making appointments
 Ordering of transport e.g. ambulance
 Liasing with portering service
6. Control of infection
 Cross infection
 Wound care
 Aseptic technique
 Specimen collection
7. Mobilising patients
 Non-weight bearing
 Weight bearing
 Using aids i.e. crutches, zimmer frames etc.
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EVALUATION QUESTIONNAIRE
We are interested in obtaining your views on the Orthopaedic Outpatient! Plaster Room as a
learning environment. Please complete the following questionnaire before you leave the
placement by placing a (X) in the column that most accurately reflects your views.
Columns vary from 5= Strongly Agree to 1= Strongly Disagree
STATEMENTS
5 4 3 2 1
1. You received an introduction/orientation package on arrival to the
ward, was this of benefit
2. You were allocated a Mentor/Associate Mentor during this
placement.
3. Your Mentor and you discussed and identified learning objectives
and opportunities at your initial meeting
4. You were given the opportunity to identify your own specific
personal learning objectives.
5. You worked with your Mentor/Associate Mentor more than two
shifts per week During your placement
6. You had a planned midway placement evaluation with your
Preceptor.
7. You achieved your set objectives by the end of this placement.
8. You found the placement friendly and conducive to learning.
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Most Commonly used Terms and Abbreviations
Terminology
Abduction the movement of the limb away from mid-line of the body.
—
Adduction the movement of the limb towards the mid-line of the body.
—
Arthritis inflammation of the joints.
—
Arthrodesis fixation of a movable joint by surgery.
—
Arthroplasty formulation of a movable joint, reconstructive surgery to a joint.
—
Arthroscopy examination of a joint using an endoscope.
—
Back slab plaster or plaster splint used to support the limb.
—
Calcification the deposit of like salts in cartilage as part of bone formation.
—
Charnley Wedge triangular piece of foam used to keep legs abducted following a THR to
—
reduce risk of dislocation.
Epiphysis a piece of bone separated from the long bone by cartilage in early years, later
forming part of the bone.
—
External Fixation
Fracture
—
—
fixation of fractures using a framework outside the skin.
a break in the continuity of the bone.
Hallux the big toe.
—
Hemiarthroplasty partial removal of the head of the femur and replacement by a Metal
—
prosthesis.
Internal Fixation fixation of fractures inside the skin.
—
Mal union faulty repair of fracture.
—
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Non Union failure of the two pieces to unite.
—
Open Fracture the fracture causes loss in continuity of the skin.
—
Osteotomy the cutting into or through a bone, sometime to correct a deformity.
—
COMMONLY USED ABBREVIATIONS
The following are abbreviations sometimes used within the orthopaedic directorate, but it is
important to make sure that they can be legally documented
AK – Above Knee
BK - Below Knee
AE – Above Elbow
BE – Below Elbow
BAS - Broad Arm Sling
HAS – High Arm Sling
ACL — Anterior Cruciate Ligamant
CPM — Continuous Passive Movement
CSM — Colour, Sensation & Movement
DCS — Dynamic Cannulated Screw
DHS — Dynamic Hip Screw
# - Fracture
FWB — Fully Weight Bearing
IM Nail — Intramedulary Nail
MC – Metacarpels
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MT - Metatarcels
NOF — Neck of Femur
NWB — Non Weight Bearing
POP — Plaster of Paris
THR — Total Hip Replacement
TKR — Total Knee Replacement
TWB — Touch Weight Bearing
Locations
Proximal — nearest point considered to be the centre of the system
Distal — situated away from the centre of the body
Posterior - situated behind a part.
Anterior — situated at or facing the front.
Superior — the upper of two parts.
Inferior — the lower of two parts
Medial — situated in the centre.
Lateral — situated at the side, away from centre.
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QUESTIONNAIRE
The following questions are for you to do at your leisure, the answers
sheet is attached for your perusal. Please try to answer the questions
before looking at the answers.
1. If a patient has a distal radius fracture where would this be?
2. What are three signs and symptoms of a fracture?
3. Name three complications of fractures.
4. What would be the initial treatment for a patient with a distal radius fracture that was
undisplaced.
5. Where are your metatarsal bones?
6. Where will you find the strongest bone in the body?
7. Where does it extend from and to?
8. Name the bones of the lower limb.
9. What is the name of the long bone in the upper arm.
10. What is the classical treatment for fracture of shaft of humerus?
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ANSWERS TO QUESTIONNAIRE
1. Fracture of the distal radius would be at the wrist.
2. The signs and symptoms of a fracture are: pain, swelling, deformity, loss of function,
abnormal mobility, crepitus.
3. Complications of a fracture: pain, shock, mal-union, delayed union, non-union, fat
embolism, nerve injury, vascular injury, compartment syndrome, swelling cast sores,
infection, myositis ossifications, joint stiffness, Sudeck’s atrophy, osteoarthritis.
4. Undisplaced distal radius fracture would be treated initially in: a below backslab.
5. The metatarsal bones can be found in the : foot.
6. The strongest bone in your body is the: Femur.
7. The longest bone extends from: the knee to the hip.
8. The bones of the lower limb are: Tibia, Fibula, Tarsals, Metatarsals, Phalanges.
9. The name of the long bone in the upper arm is: the Humerus.
10. The classical treatment of fracture of the shaft of Humerus is: Collar and cuff alone,
U Slab and collar and Cuff, Humeral brace.
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