Child Health for NHS Fife hosted within Dunfermline and West Fife Community Health Partnership Community Children’s Nursing Team Student Nurse Welcome Pack Children and Young People Community Nursing Service January 2014 1 Contents Page 1. Information for Students on Community Placements 3 2. Evaluation of Your Learning Experience 3 3. Quality Standards for Practice Placements 4 4. Philosophy for Providing a Positive Learning Environment for Student Nurses 4 5. Education Facilitator – Community Paediatrics 5 6. Practice Education Facilitator 5 7. Fife Community Children’s Nursing Team 6 8. Home Visiting Service 6 9. Advanced Paediatric Nurse Practitioner 6 10. Community Children’s Nursing – staff list 7 11. Children and Young People’s Community Nursing Service 8 12. Mission Statement of the Fife CCN Team 9 13. Principles of Service Delivery and Key Aspects of Care 9 14. Multi-agency Approach 11 15. Structure of Home Visits 12 16. Sick Leave 13 17. Confidentiality 13 18. Equality and Diversity 13 19. Family-centred Care 13 20. Appendix 14 21. References and National Drivers 17 Children and Young People Community Nursing Service January 2014 2 Information for Students on Community Placements Welcome to your placement within the Community Children’s Nursing Team which is hosted in Dunfermline & West Fife Community Health Partnership (D&WFCHP). This guidance aims to provide you with the resources you require to make the most of your community placement. The way in which nursing care is delivered is forever changing and recent political drivers such as Curam (SG 2009), Better Health Better Care (SG 2007), Delivering for health (SEHD 2006) and The Community Nursing Review (SEHD 2006) all identify the need to provide quality healthcare services that meet the needs of the individual patient by shifting the balance of care from secondary care to primary health care settings. This poses many challenges as medical and technological care advances increasing the dependency of children within the community setting. Many Specialist nurses and other Healthcare professionals work in roles within the community to provide services to empower families to care for their children / young person at home optimizing quality of care. Other national drivers which influence care delivered within our service are Getting Right for Every Child (2008) and Living and Dying Well (2008). During your allocated placement you will be given a named mentor who will be responsible for your learning experience. In line with the Quality Standards for Practice Placements (NES 2008) you will have a team approach to your learning experience and will work with many nurses and health care professionals during your placement. As a student you have a responsibility to contribute as a partner in the achievement of your required learning outcomes. Main office contact: Ward 12, Lynebank Hospital, Halbeath Road, Dunfermline, KY11 4UW, 01383 565359 Evaluation of Your Learning Experience You will be asked by your mentor to provide feedback at the end of your placement. Your feedback is welcome in order to evaluate and improve the learning environment within the clinical area. It is an NMC requirement for all mentors to reflect and review their learning environment to provide a positive learning experience for nursing students, your feedback is important to assist them to do this. Enjoy your Primary Care Placement! Children and Young People Community Nursing Service January 2014 3 Quality Standards for Practice Placements (NES 2008) These Quality Standards for Practice Placements have been created so that students and those individuals and organizations who support them understand their responsibilities and expectations in relation to practice placement learning. The standards have been distributed to all areas in NHS Fife, either as a poster or in leaflet form (pictured above) and should be available to all students on clinical placements. During your placement if you have any concerns that these standards are not being implemented fully, please discuss this with your mentor or nurse manager / mentor. Philosophy for Providing a Positive Learning Environment for Student Nurses Author: Community Children’s Nursing Team Version Number: 1 Date of Issue: 07/12/12 Next Review: 31/01/15 The community children’s nursing team recognises that a student’s practice experience is widely acknowledged as being one of the most important parts of their educational preparation to become healthcare professionals. We will make every effort to create a partnership with the students allowing them to translate theory into practice, by sharing our knowledge/skills and experience with them effectively. We aim to create opportunities to meet the students learning needs. Children and Young People Community Nursing Service January 2014 4 Education Facilitator The above post holder leads and facilitates education provision within the Children and Young People’s Community Nursing Service and supports staff to make necessary changes in their practice as required by the profession and the service. The Education Facilitator for the Children and young People’s Community Nursing Service in Fife is: Angela Waddell, Ward 12, Lynebank Hospital, Halbeath Road, Dunfermline, KY11 4UW Office: 01383 565145 Mobile: 07747762769 Please feel free to contact her if you have any questions / queries regarding your student nurse placement. Practice Education Facilitator The Practice Education Facilitator role is designed to enhance the quality of the practice learning experience and positively contribute to the future nursing and midwifery workforce. The key focus of Practice Education Facilitator role is to: Enhance and support the role of the mentor within the practice placement area Provide robust communication networks between practice placement areas and higher educational institutions Suggest strategies to enhance the practice placement learning environment The practice education facilitators positively influence the quality of the clinical learning environment for all nurses, midwives, learners and health care assistants utilising lifelong learning strategies and continuous professional development. Addressing the training and educational needs of staff enhances the quality of the clinical learning environment resulting in improved patient care. The Practice Education Facilitator for this placement is: Julie Smith, Lynebank Hospital, Dunfermline, KY11 4UW, 01383 565387 Children and Young People Community Nursing Service January 2014 5 Fife Community Children’s Nursing Team The Fife Community Children’s Nursing Team is part of the wider Children and Young People’s Community Nursing Service based in Ward 12, Lynebank Hospital, Halbeath Road, Dunfermline KY11 4UW. This team consists of 1 x Nurse Team Manager, 2 x full time Community Children’s Nurses, 2 x part-time Community Children’s Nurses and 1 x Health Care Support Worker, who cover a geographical area from the Kincardine Bridge in the west, the Forth Road Bridge in the South up to Tayport in the north (this includes the East Neuk of Fife). See map on next page. As of January 2014, a Health Care Support Worker (HCSW) has joined the community children’s nursing team to support service delivery. This is an exciting new post which will be based in the community and also in the clinic environment carrying out specific aspects / episodes of care. Home Visiting Service (based Children’s Ward, Victoria Hospital, Kirkcaldy) As a result of a review of children and young people’s services in Fife (2011) an integrated approach to acute care from the Children’s Ward, Victoria Hospital, Kirkcaldy is providing a much more collaborative model of care. The aims of the service are: To facilitate early discharge from the ward / ambulatory care Prevent hospital readmission Enable parents to feel confident and competent when caring for their child at home Provide health promotion for the whole family Make effective links with the primary health care team and between hospital and community. The Home Visiting Service receives referrals from the children’s ward, Ambulatory care, G.P. assessment unit, A+E at the Victoria Hospital, Kirkcaldy. Other referrals include self referrals, minor injuries unit (QMH), other hospital (e.g. RHSCE + Yorkhill Hospital). Their contact number is: 01592 643355 ext 22889 Advanced Paediatric Nurse Practitioner (based Ward 12, Lynebank Hospital, Dunfermline) Following successful NDP funding we have the first community based APNP in Scotland. They have been in post since September 2012. The role of the Children and Young People Community Nursing Service January 2014 6 Advanced Nurse Practitioner is to undertake a care co-ordination approach for the exceptionally complex children operating across NHS Fife. The APNP works in close partnership with the community children’s nursing team in ensuring that children / young people and their families are identified and supported as early as possible ensuring the co-ordination of the appropriate care package across the multi-professional groups. Community Children’s Nursing Team – staff list Community Children’s Nurse Manager Lynn Mushet Community Children’s Nurses Gill Deaves Phyllis Davidson Louise Russell Health Care Support Worker Stephanie Scott Home Visiting Service Joanne Bruce Aileen Kyle Advanced Paediatric Nurse Practitioner David Smyth Children and Young People Community Nursing Service January 2014 7 Children and Young People’s Community Nursing Service The Children and Young People’s Community Nursing Service (CYPCNS) is part of Child Health for NHS Fife hosted within Dunfermline and West Fife Community Health Partnership. The goal of the CYPCNS is to promote health and prevent illness by providing family centred care for children / young people in their home, school / development centre or respite environment. Children and young people’s community nursing relies on effective planning to enhance positive links between the tiers of health, education, social work and voluntary services. The wider Children and Young People’s Community Nursing Service consists of 8 other specific areas and operates on a Fife-wide basis: Service areas: Children and Young People’s Home Care Team Glenmar Respite Care House Out of School Nursing Support Nursing within Special Education Schools Child Development Centre’s Service for Children and Young People with Learning Disabilities ADHD Nurse Specialists Although each service area has its own staff with differing group skills and responsibilities, the service as a whole is supported by the following management structure: Lead Nurse Nurse Team Manager Community Children’s Nursing Service Nurse Team Manager Child Development Centre’s ADHD Nurse Specialist Child Development Nurse Children and Young People Community Nursing Service January 2014 Advanced Paediatric Nurse Practitioner 8 Mission Statement of the Fife CCN Team As community children’s nurses, we consider the needs of the child / young person within the context of the family unit. We believe that parents and family members are the primary carers, and that effective care delivery depends upon negotiation and partnership between ourselves and the family. The provision of support and education from the team is based upon respect for the child / young person and their family. Each child / young person and their family have individual needs which will be assessed and a jointly agreed, appropriate plan of care will be offered to them in partnership with the family. Principles of Service Delivery and Key Aspects of Care: To assess and plan care in conjunction with the child / young person and their family To facilitate early discharge through inter-agency and multi-disciplinary liaison To reduce unnecessary hospital admissions and provide co-ordination and continuity of specialist paediatric care provide continuity of care at home for children / young people with additional and complex health needs teach and support children / young people and their families, enabling them to become as independent as possible offer co-ordination and collaboration of care continuously assess and evaluate care delivery to meet the individual needs of the child / young person and their family The CCN service is provided in the family’s home, or in community settings for children / young people requiring: Wound care, post-operative care, support and advice on discharge from hospital Administration of SC injections for children with Crohn’s disease or rheumatoid arthritis e.g. Methotrexate. Support to oncology children / young people and their families in Fife e.g. regular blood sampling Support of home enterally fed children / young people in collaboration with the multi-disciplinary team. Children and Young People Community Nursing Service January 2014 9 Support of preterm infants and children / young people on home oxygen. Support to children / young people at home with compromised airways requiring assisted support with NP airways or tracheostomies. Support, advice and co-ordination of care for children / young people with complex health needs. This role encompasses that of the key-worker and links closely with education, social work and voluntary services. Care and support for children / young people with chronic illnesses and their families Orthopaedic home traction care Teaching and education for children / young people, parents and staff Additional support and education for schools and other professionals involved in the child / young person’s care Palliative care at home, supported by our pathway. Short-term acute conditions requiring nursing intervention: e.g. diarrhoea / Bronchiolitis / Asthma Children up to the age of 16 years, or young people who still receive extended education can be referred to the team (we would not consider any new referral to the team if they are over 16 years and not already on the caseload) by any professionals, parents and / or carers. Each child / young person will be individually assessed by the receiving community children’s nurse and parental consent is always required before a referral can be accepted. Referrals can be made to the CCN team in writing via fax / hard copy. Children and Young People Community Nursing Service January 2014 10 Community Children’s Nursing Here is a list of the different services and agencies that the community children’s nurses are in regular contact. G.P. Special Health Visitor Schools Child Community Protection Pharmacist Service Glenmar Acute & Tertiary Respite Services House Community Nursing Team Rachel Social Work House Nurse Voluntary Specialist Services Nurses CDC’s AHP’s Children and Young People Community Nursing Service January 2014 11 Structure of Home Visits Community work is very different than the day to day workings of an acute area. There is a structure that the community children’s nurses follow when they visit a child / young person’s home to deliver care. For you to fully appreciate and understand this process we will be asking you to complete a mini reflection after complex visits. There are mainly 2 types of visits’:1. Simple visits – requiring minimal input requiring only one or two visits e.g. day cases. 2. Complex visits – Requiring longer term intervention and CCN making contact with one or more agencies. Structure 1. Introductions – Introduce yourself and state the purpose of your visit in a welcoming manner, respecting at all times that you are a visitor in the family’s home. 2. Overall health / social assessment or clinical intervention dependant on the purpose of the visit. 3. Main Body of the visit – where you maybe fact finding, gleaning information and planning with the family for effective care at home. Allowing the family / child / young person the opportunity to express how they are feeling. Key considerations would be: Care planning in relation to the child / young person’s age, ability and condition. Utilising appropriate resources for the family and home circumstances: e.g. support at home from statutory & voluntary agencies, respite care, equipment. Education and support needs of the family and other carers. Funding and financial issues e.g. application for PIP (Personal Independence Payment) etc. Responsibility for medical supervision (liaising with G.P.s, Hospital Consultants) and liaising with the wider multi-agency team. “Summing up” – You would discuss fully with the family the main points covered in the visit, if there are outcomes of items requiring to be taken forward you would state these and explain what you will do as a result. If there are members of the Children and Young People Community Nursing Service January 2014 12 multi-agency team you would liaise with you should state that you will be making contact. Final opportunity for any further questions from family / child / young person is offered. Return Visit – Arrange a subsequent visit at that time or advise when you will be back in contact by telephone if required. Give CCN information leaflet with the teams contact details. Sick Leave Please give as much notice as possible when requesting sick leave. During office hours please speak to someone in person. Do NOT leave a message as it may not be picked up. When you are fit to return to work you must let the office know. You must also follow University Policy for Sick Leave over and above informing the office. Confidentiality We cannot stress the importance of maintaining confidentiality. Due to the nature of the job it is very easy to discuss confidential matters verbally or via text / social networking sites with parents and members of staff. Under no circumstances should this happen and if confidentiality is broken your programme leader will be informed. Equality and Diversity Equality and diversity are at the heart of the NHS strategy. Investing in the NHS workforce allows us to deliver a better service and improve patient care in the NHS. Equality is about creating a fairer society in which everyone has the opportunity to fulfill their potential. Diversity is about recognising and valuing difference in its broadest sense. (1) See Appendix 1 for more information. Family-centred Care Family-centred care can be defined as: ‘The professional support of the child and family through a process of involvement, participation, and partnership, underpinned by empowerment and negotiation’. (2) We, as care givers, have to remember to take into account everyone’s feelings / suggestions, including parents + siblings, in the giving and planning of care for each child / young person in our care. Children and Young People Community Nursing Service January 2014 13 Appendix 1 Equality and Diversity Children and Young People Community Nursing Service January 2014 14 Equality and Diversity in NHS Fife NHS Fife is committed to the promotion of equality for staff and service users in Fife. To improve our health care services we want to communicate effectively and to be accessible and open. We believe that diversity should be celebrated as strength so that we can create conditions where all staff are treated on the basis of their merits, abilities and potential. We want NHS Fife to be an employer of choice. NHS Fife aims to ensure that individuals are treated fairly, with dignity and respect, regardless of Race, Disability, Gender, Sexual Orientation, Age, Religion and Belief. A fundamental value of NHS Fife is equity of access, everyone should have equal access to our services and these should be sensitive to individual needs. The vision is that equality becomes central to NHS Fife with: Everyone committed to the goal of equality and diversity underpinning all service delivery. That all staff feel involved and motivated to have equality and diversity central to all work undertaken That at all times NHS Fife considers and respects people’s similarities and differences. Why be committed to Equality and Diversity? We must make informed decisions that achieve effective health outcomes We know that equality effects all service users and employees By law we must not discriminate on the grounds of the six groups listed above. What is Equality and Diversity? Equality is about affording everyone equal access to opportunities, resources and services. It does not mean treating everyone in exactly the same way. It is about creating a fairer society where everyone can participate and have the same opportunity to fulfill their potential and is backed by legislation. Children and Young People Community Nursing Service January 2014 15 Diversity – The concept of diversity encompasses acceptance and respect. It means understanding that individuals and groups are unique and recognising and valuing differences. It is about generating a workforce who have their full potential utilised. We will do this by: Involving local communities by building on existing trust identifying, sharing and embedding good practice continuing to provide a high quality service respond to and develop policy and practice getting rid of discrimination communicating effectively creating a common understanding of people’s similarities and differences Children and Young People Community Nursing Service January 2014 16 References (1) www.nhsemployers.org (1) Smith et al (2002) as cited in Coleman, V, (2003) Enhancing consumer participation using the Practice Continuum Tool for family-centred care. Paediatric Nursing, Vol 15, No 8. pp 28 – 31 National Drivers Better Health Better Care (2007) http://www.scotland.gov.uk/Resource/Doc/206458/0054871.pdf Curam – Scotland Cares (2009) http://www.scotland.gov.uk/Resource/Doc/254463/0075344.pdf Delivering for Health (2006) http://www.scotland.gov.uk/Resource/Doc/76169/0018996.pdf Getting it Right for Every Child (GIRFEC) (2008) http://www.scotland.gov.uk/Resource/Doc/1141/0065063.pdf Living and Dying Well (2008) http://www.scotland.gov.uk/Resource/Doc/239823/0066155.pdf Quality Standards for Practice Placements (2008) http://www.nes.scot.nhs.uk/media/323817/qspp_leaflet_2008.pdf Visible, Accessible and Integrated Care (2006) http://www.scotland.gov.uk/Resource/Doc/181958/0051706.pdf Children and Young People Community Nursing Service January 2014 17