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breakdown of the ABCDE assessment:

A - Airway:

Ensures a clear and open airway, addressing any obstructions. This may involve techniques like head-tilt chin-lift or suctioning.

Are there any An oropharyngeal airway (OPA), also known as a Guedel. Or, nasopharyngeal airway (NPA), also known as a nasal trumpet or nose hose.

B - Breathing:

Assesses breathing effort, rate, and oxygen saturation. Interventions may include oxygen administration or assisted ventilation if needed.

C - Circulation:

Evaluates heart rate, blood pressure, and signs of perfusion (e.g., capillary refill). Treatment may involve fluid resuscitation or addressing the cause of circulatory compromise. Hourly urine out put and fluid balance

D - Disability:

Assesses neurological status, including level of consciousness and any focal neurological deficits using tools like the AVPU scale (Alert, Voice, Pain, Unresponsive).  GCS stands for Glasgow Coma Scale It's a neurological scale used to assess the level of consciousness in individuals, especially after a head injury or other trauma.

E - Exposure/Environment:

Ensures the patient is fully exposed to allow for a thorough examination and assesses the environment to prevent hypothermia or other environmental factors from worsening the patient's condition,

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We work as a Multidisciplinary team on c6 west a lot of our patients require referrals and nurse specialists to treat, manage and support their care needs.

Here are some of the Health care professionals we work together with

Tissue viability nurse (TVN)- Are specialised Nurses that diagnose wound type, treat and manage wounds above knee. They will create a wound care plan for the individual they assess, that the ward nurse will follow.

Lower limb Team- Are specialised healthcare professionals that diagnose the type of wound, treat and manage wounds below knee. For example a diabetic foot ulcer. They will create a wound care plan for the individual they assess, that the ward nurse will follow.

Dietician- Healthcare professionals that specialise in food and nutrition. They can provide specfic diet information. The WASSP risk assessment score indicates when a referral is needed. The dieticians that work on our ward provide specific diabetes education to individuals that require further education to help manage their diabetes .

Speech and Language Therapists (SALT) - Healthcare professionals that assess, diagnose and treat individuals with speech, language, communication and swallowing difficulties. Individuals can experience these type of challenges due to a various of conditions such as stroke, brain injuries, or progressive neurological disorders.

We refer to these specialists via Clinical work station completing the appropriate e-forms apart from the wound specialised nurses were we complete referral forms and email to the teams.

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Act professional at all times and work within your competency level

Research and familiarise yourself with endrocrine conditions.

Shadow HSCW for a few weeks to learn and gain knowledge about the fundamentals of care of c6 west patients, to learn about the essential role of HCSW and to further develop your teamwork skills.

Shadow your Practice supervisor. C6 West supervisors are:

Beth Salvador

Sarah Dormer

Joanna Wallace

Laura Cooper

Abigail Westerberg

Read patient files on you Practice supervisors case load to begin to understand the patients holistic care needs

Familiarise yourself with the ward paperwork and risk assessments.

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All the points in above years.

Develop knowledge in complications that can occur for patients with endocrine conditions

Start to take charge of patient care.

Able to complete risk assessments.

Assit in safe patient discharge

Organise additional learning days with endocrine nurse and diabetes specialist nurses, to support your development.

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All the above points in year 1

Begin to know and understand how to complete admission risk assessments. Find these in risk assessment section.

Participate in medication rounds, wound care under direct supervision from supervisor.

Start to be able to assess patients that are experience hypoglycaemia and Hyperglycaemia symptoms and gain the knowledge on how this should be treated. Always inform your supervisor so they can treat the patient appropriately.

Start developing communication skills with families and patients- observe best interest meetings, medical disciplinary team meetings

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Endocrine definition and endocrine conditions

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Endocrine definition and endocrine conditions

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The endocrine system, is our glands and organs that produce and control the release of hormones.

Endrocrine conditions arise due to hormone imbalance, Autoimmune diseases, tumors, trauma injuries to glands, infections and lifestyle factors i.e. diet.

Here are some of the endocrine conditions

Diabetes

Pancreas

Type 1 - beta cells unable to produce insulin

Type 2 beta cells unable to produce enough insulin or body does not respond to insulin

Pituitary gland conditions

Hypopituitarism

Hyperpituitarism

Pituitary tumors

Thyroid conditions

Hyperthyroidism

Hyperthyroidism

Autoimmune conditions- graves disease and hashimoto disease

Adrenal gland conditions

Addisons disease

Cushings Syndrome

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Act professional and work within your competency levels.

Please follow uniform dress code.

Please follow health and safety and infections control policies

Please liase with practice supervisior/assessor to arrange intial, mid way, and end point meeting.

Please Liase with practice assessor in regards to end point assessments.

Please inform ward by phone if absent.

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There is a variety of treatment of endocrine conditions which include hormonal therapy, medications, surgery and lifestyle changes.

Medications- Hormone replacement

therapy and hormone suppression

Surgery-Removing tumors

Lifestyle changes- diet, exercise, smoking cessation and stress reduction

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Diabetes is one of the most common endocrine conditions.

There is wide range of complications that an individual can have due to diabetes.

Hypoglycaemia (blood sugar is below 4).

Signs are confusion, blurred vision , dizziness, headache, pale and agitation.

This is caused by too much insulin, not eating enough and too much exercise. If not treated it can cause seizures, coma, brain damage and death.

Treatment depends of severity of the low blood sugar .

Mild and moderate- glucose tablets or glucose juice.

Severe- IV dextose or

IM Glucagon injection can be used, but not suitable for all patients e.g liver, starved patients.

Recheck blood sugar within 15 minutes. If below 4 repeat hypo treatment and recheck after 15 minutes. When blood sugar is

above 4 give 15-20g of carbohydrate

Fill out hypo sticker placement in medical notes, document and hand over

Hyperglycaemia ( blood sugar above 14) and always check ketones.

This caused by missed insulin, Late insulin, Poor injection technique,

Insulin pump failure, Lipohypertrophy

Signs - Increased thirst , increased urine output. Fatigue, blurred vision, feel hungry, weight loss, nausea, vomiting, increased heart rate, fast breathing , drowsy, difficulty concentrating, confusion

Treatment- Encourage to drink water,

ensure medication has been administered,avoid eating carbohydrates, IV fluids might require a variable rate scale

Alway inform the doctors about blood sugar and ketone levels as Hyperglycaemia can lead to a medical emergency called diabetic ketoacidosis (DKA) which requires a specific IV treatment.

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Diabetes 10 point Training Inpatient ONLINE PRF1

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Welcome to C6 west.

This is a guide to provide essential information about the ward, diabetes and endocrinology.

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We are a dedicated team of health care professionals that work on a 29 bedded ward based in the Royal Gwent hospital that specialises in diabetes and endocrinology. We treat, manage and provide high standards of care to patients that have acute, long term and complex endocrine conditions and general medicine conditions.

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Diabetes inpatient Care and education team (DICE)

They educate patients with diabetes about their condition and how to recognise symptoms of hypoglycaemia and Hyperglycaemia. They train patients how to administer insulin safely guiding their technique and site rotation.

They also provide training to healthcare professionals to ensure staff can support and manage diabetes well.

Physiotherapist - are healthcare professionals that are trained to improve movement and function after and injury or illness. They can provide aids such as overloading shoes for patients that suffer from osteomyelitis.

Occupational therapist

Diabetic and Endrocrine Doctors

Pharmacy

Endrocrine nurse

Discharge liasons- healthcare professionals that lead safe discharge of patients to home by coordinating care packages, supporting families and finding out complex cases.

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Location of the ward and contact information

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Location of the ward and contact information

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We are based at the Royal Gwent Hospital, C block on floor 6

Telephone numbers: 01633234117

01633234116

Ward manager office number: 01633238963

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We will provide:

Orientation of the ward.

Assign you a Practice supervisor and assessor.

Fire safety information, where fire exists are, fire extinguishers, fire alarm break points etc

Infection control information

Learning opportunities

You will be working in a ward environment providing holistic care to patients with a variety of acute, chronic and complex care needs. You will be working closely with Healthcare support workers, nurses and other students.

We can arrange Additional learning days with pharmacy, diabetic nurse specialist team [DICE], TVN, Physiotherapist. Additionally you can follow a patient experience when appropriate for example going with a patient to x-ray, endoscopy, endrocrine tests, clinic appointments etc.

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Staff car park is free and located around the back of hospital off friars road. There is also a carpark by the doctors surgery across the road from the hospital which you are also able to park in.

Staff room

There is a staff fridge, freezer, microwave, toaster and facilities to make tea and coffee with cups available.

There are lockers to put all your belonging in.

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We have a student nurse sign in book to document the days you work and hours. This helps to ensure your time sheets are signed off correctly. It is located in the MDT room on the ward

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Day shift times:

0700-1320

0700-1940

0700-1940

Day shifts you can do half days or full days.

Night shift:

1900-0740

Handover starts in the MDT room on the ward at the start of shift time.

Breaks

Breaks are allocated at certain times of the day by the nurse in charge on that day. If you have any medical conditions which affect what time you need to have your break, please let the nurse in charge know so we can accommodate this.

Breaks can either be taken in the staff room where we have facilities or in the restaurant on level 3 or Costa coffee on level 1. The restaurant and Costa are only open in the day. There are vending machines around the hospital which you can access anytime.

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Aneurin Bevan Nursing Education Resource Pad.

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Aneurin Bevan Nursing Education Resource Pad.

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https://padlet.com/abigailwesterberg/c6-west-student-information-pack-m3ehjbw31ar4n4sl/wish/KxJvag9ABLk8ZAg0

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March 2023Practice Learning Framework Version 2.0 07 02 23 (002)

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Diabetes UK - Know diabetes. Fight diabetes. | Diabetes UK

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We are Diabetes UK, the leading charity for people living with diabetes in the UK. Our vision is a world where diabetes can do no harm.

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Diabetes is a condition that causes a person's blood sugar level to become too high.
There are 2 main types of diabetes:

type 1 diabetes - a lifelong condition where the body's immune system attacks and destroys the cells that produce insulin

type 2 diabetes - where the body does not produce enough insulin, or the body's cells do not react to insulin properly

Type 2 diabetes is far more common than type 1. In the UK, over 90% of all adults with diabetes have type 2.

High blood sugar that develops during pregnancy is known as gestational diabetes. It usually goes away after giving birth.

Non-diabetic hyperglycaemia (pre-diabetes)

Many people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is known as non-diabetic hyperglycaemia, or pre-diabetes.

People with non-diabetic hyperglycaemia are at greater risk of developing type 2 diabetes, but the risk can be reduced through lifestyle changes.

If you have non-diabetic hyperglycaemia, you may be eligible for the NHS Diabetes Prevention Programme. The programme helps people make lasting lifestyle changes and has been shown to help prevent type 2 diabetes.

People with non-diabetic hyperglycaemia are also recommended to have a blood test every year to monitor their blood sugar levels.

It's very important for diabetes to be diagnosed as early as possible because it's likely to get worse if left untreated and can cause long-term health problems.

When to see a GP

Visit your GP as soon as possible if you experience the main symptoms of diabetes, which include:

feeling very thirsty

peeing more frequently than usual, particularly at night

feeling very tired

weight loss and loss of muscle bulk

itching around the penis or vagina, or frequent episodes of thrush

blurred vision

Type 1 diabetes can develop quickly over weeks or even days.

Weight loss is common in people with type 1 diabetes when it first develops and before it's treated, but it's less common in people with type 2 diabetes.

Many people have type 2 diabetes for years without realising because the early symptoms tend to be general, or there are no symptoms at all.

Causes of diabetes

The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).

When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce energy.

However, if you have diabetes, your body is unable to break down glucose into energy. This is because there's either not enough insulin to move the glucose, or the insulin produced does not work properly.

There are no lifestyle changes you can make to lower your risk of type 1 diabetes.

You can reduce the risk of type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight.

You may be more at risk of type 2 diabetes if you:

are living with overweight or obesity

do not have a healthy diet

have a family history of type 2 diabetes

are of Asian, Black African or African Caribbean origin

take certain medicines such as steroids for a long time

have high blood pressure

have had gestational diabetes during pregnancy

Living with diabetes

If you're diagnosed with diabetes, you'll need to eat healthily, take regular exercise and have regular checks including blood tests.

You can use the BMI healthy weight calculator to check whether you're a healthy weight.

Try to quit smoking if you smoke, and cut down on alcohol.

People diagnosed with type 1 diabetes also require regular insulin injections for the rest of their life.

Type 2 diabetes can get worse over time and people living with type 2 diabetes often need medicine, usually in the form of tablets or injections.

However, some people can put their type 2 diabetes into remission by losing weight, where their blood sugar is reduced below the diabetes range. Some people are able to do this through a low-calorie diet, but this is not suitable for everyone, so it's important to get medical advice first.

Read about:

Diabetic eye screening

Everyone with diabetes aged 12 years old or over should be invited to have their eyes screened regularly.

If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it's not treated.

Screening, which includes a 30-minute check to examine the back of the eyes, is a way of diagnosing diabetic retinopathy and detecting the condition early where possible so it can be treated more effectively. In many people, this can stop it affecting their vision or reduce the chance of it getting worse.

It's important to see a doctor if you notice any problems with your eyesight. Do not wait for your next screening appointment.

Read more about diabetic eye screening.

Diabetic foot problems

Diabetes can damage the nerves in your feet and cause a loss of feeling. It can also reduce the blood supply to your feet. This means you may not notice if your foot is sore or injured, and foot injuries do not heal as well. This can lead to ulcers and infections, and sometimes amputations can be needed in serious cases.

Adults with diabetes should have their feet checked every year by a healthcare professional.

It's important to see a healthcare professional as soon as possible if you notice any problems with your feet.

You can read more about diabetes and foot problems on the Diabetes UK website.

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Read about the main types of diabetes, a condition that causes a person's blood sugar level to become too high.

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“The Six Steps to Insulin Safety”, a free e-learning module from the PCDS - DiabetesontheNet

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Insulin is recognised as a high-risk medication worldwide. There are now over 30 different insulin preparations and many of these have differing actions but

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When patients are admitted to C6 west we complete risk assessments and these are updated weekly or if there are any changes in the patients care needs

These assessments are:

Purpose T

Falls and bones

WASSP

Diabetic foot assessment

self-administration insulin policy

Mouth care

Continence

Daily nursing assessments

Skin bundle

Hordi

PVC

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Variable rate protocol and administering form 

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Variable rate protocol and administering form 