STUDENT
LEARNING
PACKAGE
ORTHOPAEDIC OUTPATIENT
DEPARTMENT
NINEWELLS HOSPITAL
SOUTH BLOCK
LEVEL 4
Revised by
SSN Goodwin
Aug 2012
WELCOME TO THE ORTHOPAEDIC
OUTPATIENT DEPARTMENT
(South Block, Level 4, Ninewells Hospital)
To gain the most from this placement the student is
advised to have a basic understanding of the
Musculoskeletal System prior to commencement.
The Orthopaedic Outpatient Department (OOPD) is a busy area providing a
service for approximately 12,000 orthopaedic patients per year in Tayside.
There are three main sites:
Ninewells Hospital, Perth Royal Infirmary and Stracathro Hosptial.
Your placement will be concentrated at Ninewells.
Student hours of work are 9.00am – 5.00pm Monday – Friday.
Please phone SCN Helen Stuart on 01382 740013 for any absences.
If unable to contact this number please phone the Plaster Room between the
hours of 08.30-18.00 on 01382 660111 ext 35260.
You will also need to inform the university.
As with all clinical areas, adherence to confidentiality/equality and
diversity/uniform policy is expected.
You will be assigned to your mentor/s on your arrival and your first day will
be given to orientation of the department, with particular attention paid to fire
and safety regulations.
The OOPD at Ninewells consists of:
PLASTER ROOM
FRACTURE CLINIC
ORTHOPAEDIC CLINIC
TORT CENTRE (Tayside Orthopaedic Rehabilitation Therapy)
The Plaster Room is where casts are applied. This may be for a variety of
reasons – emergency casts (back slabs), definitive casts (often in different
colours) or serial casts (used to manipulate position).
The three principals of a cast are to:
1. immobilise
2. maintain alignment
3. give pain relief
The Fracture Clinic sees all patients who have sustained a fracture within
24-48 hours. Their treatment may require the facilities of the Plaster Room or
possibly surgery. These patients have follow up appointments here until they
are fit to be discharged.
The Orthopaedic Clinic sees patients who have been referred from their GP
following longer term complaints. These patients may be treated
symptomatically, for example injecting joints with a local anaesthetic or they
may possibly require elective surgery. Again all these patients will have
follow up appointments until they are fit for discharge.
The TORT Centre sees patients requiring Orthotic or Prosthetic intervention.
The Orthotist works with the patients requiring splints and aids to improve
impaired mobility, whilst the Prothetist aids the patients’ mobility with the use
prosthetic (false) limbs.
NURSING PHILOSOPHY OF THE OOPD
At the OOPD we strive to deliver the best possible care to the patient.
By employing the art of caring alongside the science of applying
knowledge, this ethos is adhered to.
We accommodate on-going evidence-based changes to improve the care
and safety of the patient and provide a learning environment suitable for
both students and staff. We value this learning in our endeavour to
achieve what is important to the department – best patient care.
Equality and diversity are recognised and valued in both patients and
team members. Each team member has an individual background and is
empowered to share their experiences to the benefit of the team.
Reflection plays a large part in the OOPD as it such a diverse area with
knowledge, expertise and learning continually growing. Reflection is very
much encouraged with students and time is allocated to this within their
schedule.
One definition of philosophy is:
‘Love of wisdom.’
The OOPD always tries to gain and share wisdom in its attempt to
deliver the best possible care.
ORIENTATION CHECKLIST
Must be completed within first 48 hours commencing placement
Mentor
Introduction to
 Mentor(s)
 Other members of nursing/midwifery staff
 SCN/SCM/Team Leader and key members of
team
Show
 Location of emergency equipment
 Location of other placement equipment
 Location of key guidelines /policies/ procedures
 Orientation to placement layout including fire
exits
Discuss
 Uniform policy (or dress code)
 Changing facilities
 Shift patterns
 Philosophy of care
 Philosophy of education
 Reporting sickness/absence
 Fire and safety procedures
 Emergency procedures
 Lines of communication (including emergency
numbers)
 Manual handling policies and procedures
 Incident reporting procedure
 Daily routine of placement (e.g. meal breaks )
 Area specific information (e.g. lone worker policy
for community) specify below:
 Educational opportunities and agree learning
outcomes (document in assessment booklet)
Date of midway
assessment
Date of final assessment
Mentor Signature ____________________________
Student Signature____________________________
Orientation completion date ____________________
Student
Date
EMERGENCY PROCEDURES
For ALL emergencies phone 2222.
You are located in the
Orthopaedic Outpatient Department
Ninewells Hospital
South Block
Level 4
Your contact phone number will be written on the phone.
The Cardiac Trolley and Defibrillation are kept in the treatment room.
To page On-call Registrar for lesser emergencies:
 dial 88 and follow instructions
 on-call page number is 4561
 number of telephone you are using (written on phone)
 end with #
MEMBERS OF THE TEAM
Senior Charge Nurse
Helen Stuart
Staff Nurses
Pat McLaren
Bertie Goodwin
Margaret Barnett
Sandra Slidders
Joyce Keith
Karen Mead
Morag Anderson
Lesley McNicol
Vikki Ross
Linda Hall
Health Care Assistant
Hilda Kerr
Mary Thomson
Angela Hammond
Gordon Galloway
Patricia Rodgers
Receptionist
Ashley McGregor
Angela Wilkie
Kerri Murphy
Kathleen Barclay (relief)
CLINIC TIMETABLE
MONDAY
FRACTURE
ORTHOPAEDIC
MR FOUBISTER
MR AVISON
MR ALIPOUR
TIMES
09.00
MR WIDGEROWITZ 1:2
MONDAY PM
MR NICOLL
MR JAIN
TUESDAY
MR SRIPADA/
PROF ROWLEY
MR PILLAI
MR FOUBISTER 1:2 09.00
13.30/13.45
MR VALENTINE1:2
TUESDAY PM
MR CLIFT
MR CAMPBELL 1:2
WEDNESDAY
MR AVISON/
MR AVISON/
MR ALIPOUR
MR ALIPOUR
09.00
MR PILLAI 1:2
MR NICOLL 1:2
WEDNESDAY PM NURSE-LED
MR FOUBISTER 1:2
MR NICOLL 1:2
13.30
MR RICKHUSS 1:2
THURSDAY
THURSDAY PM
MR VALENTINE/
MR JAIN -
MR BUCKLEY
FOOT CLINIC
CW HAND CLINIC
FRIDAY
09.00
13.30
MR CLIFT
09.00
FRIDAY PM
SATURDAY
REVIEW CLINIC
09.30
SUNDAY
REVIEW CLINIC
09.30
SUGGESTED PLACEMENT DIARY
MONDAY AM
PM
TUESDAY
AM
PM
WEDNESDAY
AM
PM
THURSDAY
AM
PM
FRIDAY AM
PM
WEEK 1
WEEK 2
ORIENTATION
FRACTURE CLINIC
1.30PM BONE SCAN
WEEK 3
PLASTER ROOM
ORIENTATION
MR JAIN
AUDIT NURSE
FRACTURE CLINIC
PROF ROWLEY
TORT
PLASTER ROOM/
FRACTURE CLINIC
FRACTURE
CLINIC/
MR CAMPBELL
FRACTURE CLINIC/
MR CAMPBELL
PLASTER ROOM/
FRACTURE CLINIC
THEATRE
PLASTER ROOM
ELECTIVE
THEATRE
NURSE-LED CLINIC
ELECTIVE
FRACTURE CLINIC
FOOT CLINIC
PLASTER ROOM
PLASTER ROOM
HAND CLINIC
HAND CLINIC
ORTHO CLINIC/
BONE INFECTION
CLINIC
PLASTER ROOM/
PAEDS THEATRE
ORTHO CLINIC/
BONE INFECTION
CLINIC
REFLECTION/
STUDY
REFLECTION/
STUDY
REFLECTION/
STUDY
ACTUAL PLACEMENT DIARY
WEEK 1
MONDAY AM
PM
TUESDAY
AM
PM
WEDNESDAY
AM
PM
THURSDAY
AM
PM
FRIDAY AM
PM
WEEK 2
WEEK 3
OBJECTIVES
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.
6. To demonstrate integration of theory and practice.
7. To maximise learning opportunities which will assist your
development.
8. To provide you with individual support and guidance.
9. To create a supportive learning environment by maintaining effective
interpersonal relationships.
10. To outline resources and support available to you in the department.
IDENTIFIED LEARNING OUTCOMES
1. Fracture management and bone-healing
2. Wound management
3. Removal of sutures and clips
4. Pin-site management
5. Application/removal of splints
6. Observation of plaster cast application/removal
7. Patient admission/discharge
8. Written communication to areas outwith the hospital
9. Observation of multidisciplinary team members, eg:
 Radiographer
 Orthotist
 Prosthetist
 Physiotherapist
 Medical staff
10. Increase orthopaedic knowledge:
 Bone healing
 Types of fractures
 Compartment syndrome
 Orthopaedic conditions
THE SKELETON
(BEGINNERS GUIDE)
BONE HEALING
AFTER
FRACTURE
1 WEEK
3WEEKS
6-12 WEEKS
TYPES OF
FRACTURES
AFTER 1
YEAR
COMPARTMENT SYNDROME
Signs and symptoms of compartment
syndrome – NOT to be ignored even if only
one present:
PAIN (EXCRUCIATING ESPECIALLY ON EXTENSION)
PARATHESIA (NUMBNESS/PINS AND NEEDLES)
PARALYSIS (INABILITY TO MOVE LIMB)
PULSELESSNESS (NO PULSE – LOSS OF BLOOD SUPPLY)
PALOR/PURPLE
COMMONLY USED ORTHOPAEDIC
TERMS
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.
Anterior – situated at or facing the front.
Arthritis - inflammation of the joints.
Arthrodesis – the surgical fixation of a joint or bone fusion.
Arthroplasty – surgical reconstruction or replacement of a malformed or
degenerated joint.
Arthroscopy - examination of a joint using an endoscope.
Back slab - non-circumferential plaster cast used to immobilise a fracture
(allows for swelling after initial trauma or post op).
Calcification - the deposit of calcium as cartilage as part of bone
healing.
Distal – located away from the centre of the body.
Epiphysis - the growth area or growth plate near the end of a paediatric
bone (these fuse as an adult).
External Fixation - fixation of fractures using pins manipulated by a
metal frame outside the skin.
Fracture - a break, crack.
Hallux - the big toe.
Hemiarthroplasty - the replacement of one surface or one side of a joint
with artificial material (usually metal).
Inferior – position is towards the feet (lower)
Internal Fixation - fixation of fractures inside the skin (plates, wires,
screws).
Lateral - the side that is farthest from the centre.
Mal union – healing of a fracture in an unacceptable position.
Medial – the side that extends to the centre.
Non Union – failure of bone union.
Open Fracture – the fractured bone has broken the skin.
Osteotomy -the cutting into or through a bone to correct a deformity.
Proximal – nearest to the midline.
Posterior – situated behind or to the rear.
ABREVIATIONS
AFO – Ankle Foot Orthosis
AK – Above Knee
BK - Below Knee
AE - Above Elbow
BE - Below Elbow
BAS - Broad Arm Sling
HAS - High Arm Sling
ACL - Anterior Cruciate Ligamant
PCL – Posterior Cruciate Ligament
CPM - Continuous Passive Movement
CSM - Colour, Sensation & Movement
DCS - Dynamic Cannulated Screw
DHS - Dynamic Hip Screw
#
- Fracture
FWB - Fully Weight Bearing
NWB - Non Weight Bearing
TWB – Touch Weight Bearing
IM Nail - Intramedulary Nail
MC - Metacarpal
MT - Metatarsal
NOF - Neck of Femur
NOH – Neck of Humerus
POP - Plaster of Paris
THR - Total Hip Replacement
TKR – Total Knee Replacement
EVALUATION
We are interested in obtaining your views on the Orthopaedic Outpatient
Department 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
1= Strongly Disagree
STATEMENTS
1. You were able download an OOPD Student Package prior
to arrival – did you find this beneficial?
2. You were allocated a Mentor during this placement.
3. You and your Mentor 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 Mentors 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.
5 4 3 2 1