Medical Assessment Unit
The Royal Gwent Hospital
We would like to welcome you to the Medical Assessment
Unit. We hope to provide you with an enjoyable working
environment.
Medical Assessment Units Vision
"Our aim is to provide high quality care to our patients and
their relatives. We aim to provide a clean, organised and
efficient department with happy, friendly and supportive
staff"
Introduction
Welcome to the Medical Assessment Unit (MAU), the unit serves the public living in South
Gwent.
The MAU operates under the Directorate of Unscheduled Care (Medicine). Our Directorate
Manager is Rachel Cartwright, our Business Manager is Diane Murray and our Senior Nurse
is David Timmins.
The Sisters and band 7 for the unit are Natalie Skyrme and Sian Forward. They are
responsible for the operational management of the department.
The Deputy Unit Managers and band 6s are Sian Coles, Louise Grandon, Rachel Stirling,
Leeann Moses, Artie Gonzalez and Erika Belesova. The Deputies are team managers for a
group of staff. You will be allocated a Team Manager.
The Advanced Nurse Practitioner for the unit is Yvonne Jordon. Yvonne works alongside the
on call medical Doctors in MAU. Also working alongside Yvonne and the medical Doctors is
Nurse Practitioner Pearl Tamolang.
The MAU has 7 Acute Care Physicians (ACPs); the Clinical Lead is Dr H Saleem. Also in the
department are Dr F Cavalle, Dr L Edwards, Dr P Mizen, Dr E Mason, Dr T Couzens and Dr H
Brothers. These consultants provide a 7 days a week presence in the Department. There is
an Acute Medical Team consisting of 3 doctors (FP1/2, CT2/3 and SPR) who support the ACPs
in caring for those patients defined to Acute Medicine.
Katie, Amy and Anne-Marie are our OTs who will assist you in facilitating early, safe
discharges for our patients.
The Unit based pharmacist is Farzana Mohammed and the technician is Louise Oldfield. The
Pharmacy team provide morning support and are a fantastic resource to the nursing staff.
Afternoon cover is also sometimes provided but if there is no cover we can contact the
pharmacy department.
The Medical Assessment Unit has 5 areas which are spread across 2 floors:
Triage Area
The Triage area is staffed by an experienced staff nurse and a Health Care Support Worker
who provide first line care to the ambulatory patients attending the Assessment Unit,
whether they are referred from their GP, A&E or other departments within the Hospital.
The Trolley Area
The trolley area consists of 15 trolleys and 6 of these trolleys have monitoring facilities. The
area is normally staffed with three qualified Nurses and 1 HCSW. This area again accepts
patients from GPs, A&E, other departments within the Hospital and also other Hospitals.
The Clinical Decisions Unit
This area is fairly new to our Unit but has been a welcome addition. The area consists of 12
trolleys, with 4 of these trolleys being monitored. The patients admitted to this area are
usually under the care of the Acute Medicine team and should be low dependency. The ACP
on for that day will highlight patients suitable for the CDU. These patients should not
normally stay more than 24 hours.
D1 West
D1 West consists of 2 bays of 6 patients each. The patients in these beds are waiting for beds
on the medical speciality ward, whether that be Endocrine, Respiratory, Gastroenterology,
Care of the Elderly, Stroke, Infectious Diseases or General Medicine.
D2 East
D2 East has recently changed to facilitate the care of patients suitable for FOPAL (Frail Older
Persons Assessment Link). Heidi Lewis is Deputy Ward Sister Band 6 with some permanent
staff on the ward, however as a member of staff on the Medical Assessment Unit you may be
allocated to work there to cover the temporary staffing deficit.
Visiting hours are 3-5pm and 7-8pm. However due to the pace of the ward and admissions
occurring on a 24 hour basis, it is sometimes difficult to adhere to these times.
A template system is in place so that patients can be placed appropriately on the correct
speciality ward. The wards are as follows:D2 East
FOPAL
D3 East/West
Cardiology
D4 East/West
Endocrinology
C4 East/West
Gastroenterology
C5 East
Stroke
C6 East/West
Respiratory
B3 East/West
Care of the Elderly
B6 North
Haematology
Shift Pattern
The shift pattern on the Medical Assessment Unit is 12 hour shifts, and but there may be
occasions when the shifts have to be split into 6 hours to cover the demands of the service.
All staff will be required to do internal rotation. The E-roster tool is now being used to
allocate shifts.
Weekdays
Days
07.00 - 19.30
1 Qualified Nurse in Charge
1 Triage Nurse & 1 HCSW
3 MAU Qualified Nurses & 1 HCSW
2 CDU Qualified Nurses & 1 HCSW
2 D1 West Qualified Nurses & 2 HCSW
3 D2 East Qualified Nurses & 3 HCSW
Nights
19.00 - 07.30
1 Qualified Nurse in Charge
3 MAU Qualified Nurses & 1 HCSW
1 CDU Nurse & B Bay split between Qualified Nurses in A,
C & D Bay & 1 HCSW
2 D1 West Qualified Nurses & 1 HCSW
2 D2 East Qualified Nurses & 2 HCSW
Weekends
Days
0700 – 1930
1 Qualified Nurse in Charge
3 MAU Qualified Nurses & 1 HCSW
2 CDU Nurses & 1 HCSW
2 D1 West Qualified Nurses & 2 HCSW
3 D2 East Qualified Nurses & 3 HCSW
Nights
1900 – 0730
1 Qualified Nurse in Charge
2 MAU Qualified Nurses & 1 HCSW
1 MAU Qualified Nurse (Twilight 1900-0130)
1 CDU Nurse & B Bay split between Qualified Nurses in A,
C & D Bay & 1 HCSW
2 D1 West Qualified Nurses & 1 HCSW
Admission Process
GP referrals are screened and accepted by a Clinical member of staff who is based in bed
management. The referral is faxed through to the MAU reception; this referral contains
patient’s details and their presenting condition.
The patients either report to reception themselves or are brought in by ambulance
depending on their clinical condition or mobility. The aim is to commence a triage
assessment within 10 minutes of admission. The Triage system is of prioritisation depending
on a patient’s clinical condition and not on times of arrival.
Patients may also be referred from A&E or speciality clinics if they are deemed as needing
further medical assessment.
Initial investigations include baseline observations and NEWS scoring, routine bloods, ECG
recording and MRSA screening. Patients arriving from A&E either to the Triage area or main
trolleys may have already had some of these investigations completed (e.g. bloods, ECG) and
therefore may not need them repeated. They do however need another set of observations
and NEWS scoring to ensure no deterioration has occurred and MRSA screening.
If patients are to be admitted into the Trolley area the ‘red’ section of the Unified
Assessment booklet and all of the Risk Assessment booklet should be completed. TCAB
(transforming care at bedside) documentation should be initiated immediately. Once a
patient has been an in-patient for 24 hours the ‘yellow’ section of the Unified Assessment
booklet should also be completed.
If a patient is admitted to an MAU, CDU or D1 West trolley/bed space, their name, date and
time of admission needs to be written in the appropriate area on the white boards. If the
patient is awaiting consultant review (PTWR) their details are to be entered in green. Once
seen by the consultant they then their details need to be entered in red if defined Acute
Medicine or black if defined any other speciality. The Nurse in Charge (NIC) will allocate a
consultant of that speciality to the patient. The patients’ Waterlow and MUST score also
needs to be documented on the board and any patients at risk to be highlighted to the NIC.
Post Take Ward Round (PTWR): This is facilitated throughout the day by the Acute Care
Physicians and also by the consultant on call for that day. They will decide whether the
patient needs to be admitted and if so to a ‘defined’ speciality. They may also discharge
patients the same day.
Some patients may become Virtual Inpatients (VIPs) where the consultant decides that the
patient is stable enough to go home and return for further investigations at a later date
(usually the next day). If the patient is allowed home by one of the ACPs, they will remain
under their care. Please notify the ward clerks to ensure that the patient is placed on the VIP
list so not to be missed on follow up. Patients’ notes need to be kept on the Unit.
If the patient is made a VIP by the on call consultant then the patient needs to remain under
their care. The on call ANP needs to be contacted on bleep 0356 to facilitate this and notes
then left in the VIP tray in the ward office for them to collect.
There is also a Cardiologist of the Day (COD) who reviews patients who have been
highlighted by the medical doctors to have possible cardiac issues. Ward rounds occur
everyday to ensure appropriate treatment is initiated quickly.
Emergency procedures:
In the event of a cardiac arrest, please contact 2222. Remember to speak clearly and
identify the problem accurately and the location of where you are calling from. To raise the
alarm in an emergency situation, pull the red button nearest to your location. Resuscitation
trolleys are situated on both MAU and D1 West.
In the event of a fire, please contact 3333. Again remember to speak clearly and identify the
specific location of where you are calling from. Please also ensure you activate the fire
alarm closest to you. The locations will be identified to you on initial orientation to the ward.
Learning Resources and Educational Opportunities:
There are many learning resources within the unit, please do not hesitate to ask a member
of staff to direct you. Study days can be applied for to build your clinical skills. We hope you
find everyday as a learning opportunity!
Sickness:
Please familiarise yourself with the Trust protocol and ensure you are aware of the
appropriate reporting of any sickness or absence.
Uniform:
Appropriate uniform and identification badges must be worn at all times. Again please refer
to the Trust policy if unsure.
Smoking:
Aneurin Bevan Healthcare Trust adheres to a NO smoking policy anywhere within the
hospital grounds.
Any questions or anxieties you may have please speak to a member of staff and they will be
only to willing to help. We warmly welcome you and hope you gain new knowledge and
skills!
Phone Numbers:
Main Reception: 01633 238030
MA: 01633 238117/238064/234049
D 1 West: 01633 234047/8
Ward Office: 01633 234046
Due to the nature of the unit it may be difficult at times to get through to staff on the Unit.
We would suggest if you need to speak to the Nurse in Charge it is best to contact the main
hospital switchboard and ask them to bleep 0845 where in most circumstances you will get
an immediate response.