NEONATAL INTENSIVE CARE UNIT - Northumbria … · 2010-02-01 · NEONATAL INTENSIVE CARE UNIT ... Layout of the unit Unit telephone number ... Neonatology is a fast growing speciality

Sasha Smith – updated 27th

January 2010 - 1 -

1

NEONATAL INTENSIVE CARE UNIT

STUDENT NURSE/MIDWIFE

Profile of Learning Opportunities

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST

STUDENT……………………………… MENTOR ………………………………


January 2010 - 2 -

2

WELCOME TO NICU

Welcome to our unit, we want you to enjoy your placement here

with us and that you benefit from your allocation here.

The staff on the unit aim to assist you in achieving your learning

outcomes/elements.

To help you fulfil this aim you would have been allocated a

trained mentor who has had the appropriate training to

undertake the assessment of students like yourselves, you will

also be allocated an associate mentor to help you also. Your

mentor will undertake the programme with you and will

regularly review your progress. This gives you the opportunity

to reflect on your learning and discuss your future

development. These reviews are for your benefit so please

express any concerns regarding your placement.

Part of this pack provides you with a list of topics which are to

be discussed with your mentor; this list is an informative guide

which will help you gain an insight into the field of Neonatology.

May we remind you that it is your responsibility to fill in your

documentation during your placement here with us.

You are advised to follow your mentor‟s shifts, which should be

clearly marked in the ward off duty book. We would like you to

work a variety of shifts during your placement, which may

include night shift rotation.


January 2010 - 3 -

3

ORIENTATION TO UNIT

Please photocopy this sheet once fully signed and give a copy

to your mentor.

Checklist

Student Mentor

Give student booklet Initial interview/learning needs

assessment Role of mentor

Student responsibilities

Layout of the unit Unit telephone number

Awareness of/introduction to team members

Emergency equipment/procedures Bleep system Disposal of;

Sharps Bodily fluids

Blood products Drugs, glass

Location of hospital policies Sickness policy

Complaints procedure Child protection file

Education link resource file Referral procedures

Ward routine


January 2010 - 4 -

4

UNIT PHILOSOPHY

We aim to provide a friendly relaxed atmosphere.

Encourage parental independence.

Listening to the needs of parents and families.

Communicating with parents, relatives and colleagues.

Ongoing assessment of family needs.

Maintaining high standards of care and best practice.

Educating parents and staff.


January 2010 - 5 -

5

WHAT IS NEONATOLOGY?

Neonatology is a fast growing speciality with many advances in

technology, techniques and treatments.

“The branch of medicine dealing with

disorders of the new born infant.”

(Baillieres Nursing Dictionary 2005)

“The art and science of caring medically

for the newborn.”

(Online Medical Dictionary 1998)


January 2010 - 6 -

6

WARD PROFILE

The unit comprises of 25 cots, 7 of which are allocated to

intensive care, with the remainder being for high dependency

and special care. We have two cubicles for admissions from the

community, within the neonatal period (10 Days) or for babies

who need isolation. We also have two mothers‟ and baby rooms

for parents to use overnight prior to discharge, to increase

their confidence in caring for their new baby. They are also

used for mothers when establishing breast feeding for more

privacy and for those mothers who are expressing milk.

We have babies admitted from the Sunderland area whose

mothers have booked at our delivery suite and also babies from

the northeast region who need intensive care. We have

intrauterine and extra uterine transfers. We have close links

with other neonatal units within the northeast region. We

regularly have babies from Cumbria, Hartlepool, Hexham,

Wansbeck and all the hospitals in the middle.

We are part of the Child Health Directorate as well as having

close links to the Obstetric and Gynaecology directorate. We

work closely with all midwives, paediatric wards and

community children‟s nurses.


January 2010 - 7 -

7

Who do we admit?

Babies of 34 weeks gestation and below as babies of less than

32 weeks gestation will show some evidence of Respiratory

Distress Syndrome (RDS). Babies of 33 & 34 weeks gestation

are likely to require assistance with feeding.

Some, not all, babies of 35 & 36 weeks gestation will require

admission for establishment of feeding.

Babies who weigh less than 1900grams at birth.

Babies who are unwell from the post natal wards/delivery suite,

this includes Transient Tachyapnoea of the Newborn (TTN),

grunting respirations, abnormal movements, some congenital

cardiac anomalies, intestinal obstructions, macrosomic babies

of diabetic mothers and babies who the midwives feel are not

handling well.

Babies from the community are often admitted for

phototherapy, poor feeding, apnoeic episodes and infections.

Babies do not need to be admitted from the post natal wards for

phototherapy alone as this can be delivered on the wards.

We have clinics on the unit held by our Consultants and our

Registrar.


January 2010 - 8 -

8

NAMED NURSE

We work in a named nurse system on the unit. Each baby is

allocated a named nurse on admission. She is responsible for

the assessment, planning, implementing and evaluating for the

baby. It may not be possible for the nurse to care for the baby

every shift due to skill mix and other patient dependency. She

will oversee all care from admission to discharge. She may also

be required to attend MDT meetings, Child Protection meetings

and be involved in any other discharge planning.


January 2010 - 9 -

9

STUDENT RESPONSIBILITIES

It is very important for your learning that you document your

progress in your portfolio.

Section two of the Education Resource File describes all your

responsibilities that have been set out by the university.

Please make yourself aware of the sickness policy.

Although you are a university student you MUST adhere to

Trust practice, procedures and policies. These can be found at

the nurses station in LDA

HOURS OF DUTY

You are expected to follow your mentor‟s shifts; this may

include night shift rotation. This is not appropriate for 1st year

students but is expected in 2nd and 3rd years.

You must work a minimum of 40% of your placement with your

mentor according to NMC guidelines but on the unit we strive to

achieve 100%.

You must negotiate your duty with your mentor and mark it

clearly in the off duty book.

Each student and mentor will be colour coded.


January 2010 - 10 -

10

HOURS OF DUTY

EARLY 7:15 - 14:45

LATE 12:45 - 20:15

LONG DAY 07:15 - 20:15

NIGHT SHIFT 20:00 - 07:30

EMERGENCY SITUATIONS

Fire Alarm

Every Thursday morning the fire alarms will be tested and an

intermittent tone will be heard.

If this tone is heard at any other time it indicates that an alarm

has been activated. At this time all doors and windows are to be

closed and remain so until stand down. No one is to leave the

unit area.

If hearing a continuous tone the alarm has been activated

within our area and needs investigation. All windows and doors

are to be shut and no one is to leave the unit until stand down. If

evacuation is necessary then directions will be given from the

fire officer/nurse in charge.


January 2010 - 11 -

11

MEDICAL EMERGENCY

Shout for help

Nurses will initiate resuscitation until medical staff attends.

A Doctor/ANNP is always present on the unit. All babies have

blow off valves, oxygen and suction at their cot space.

Resuscitation trolleys are located within the high

dependency area and outside the laboratory.

Crash bleep is NOT used unless it is for a visitor. If required,

switchboard is telephoned (2222) and A NEONATAL

EMERGENCY is stated, giving the area to switch staff.

EMERGENCY NUMBERS

CARDIAC ARREST 2222

FIRE 333

SECURITY 777


January 2010 - 12 -

12

MEDICAL STAFF/CONSULTANTS

Dr S Richmond

Dr M Abu-Harb

Dr L Gillespie

Dr R Geethanath

We have a paediatric registrar based within neonates for a 6

month period working within paediatric rotations.

We have 5 SHO‟s at any one time.

To work alongside the SHO‟s we have 5 ANNP‟s who work on

the doctor‟s rota, as well as working on the nurse‟s rota.

BUSINESS MANAGER

Joanna Clark

MATRON

Pauline Palmer

UNIT MANAGER/ANNP

Pam Jack


January 2010 - 13 -

13

USEFUL TELEPHONE NUMBERS

NICU 5699153 ext 42159

CCN‟s ext 41236

CAT 5108933

Dietician 5699013 bleep 51602

Education and Training ext 49633

IT help line ext 42705

Library ext 42430

Paediatric A & E ext 42135

Paediatric Wards

F63 ext 49763

F64 ext 49764

F65 ext 49765

Paediatric Liaison

Teresa Laidler ext 42419

Matron

Pauline Palmer bleep 52370

PDN

Kim Coxall bleep 55015

Child Protection Nurse

Marie Craig ext 45227

School Nurse Manager


January 2010 - 14 -

14

Sandy Tait ext 42487

Speech and Language ext 39935

PPF

Sonia Malt Ext 47210

Bleep 52273

Mobile 07769682053

Email [email protected]


January 2010 - 15 -

15

Recommended Structured Learning Experience for Pre-

Registration Students - Interprofessional Learning

Child Branch Students are allowed up to 2 weeks within

structured Learning Zones Areas (within an 8 week placement).

Rather than leave these learning zone visits to ad hoc

"opportunistic" plan these within the 8 week placement.

Students will still have the responsibility to ensure these visits

take place - via negotiation with mentor. E.g. Students can

choose to follow a patient x-ray within that week of the

programme (patient journey). Opportunistic learning will still

take place, but the pre-planning ensures that minimum learning

zones are visited (to achieve the competencies).

Must work at least 50% of their shift with a trained mentor.

Testimony of Witness statement must be provided by the

member of staff who supervises the student within the learning

zone area- as evidence that learning objectives have been

achieved

This proposed timetable can be amended to incorporate

Mentor's holidays - so that the students utilise the learning zone

areas during this time to ensure the 50% protocol is adhered to.

Flexible to students needs - recommended only. Provides

structure for the student nurse.

Planning and organisation for the student placement - proactive

approach / forward thinking (increased support and direction

for the student - student feels valued as part of the team.


January 2010 - 16 -

16

There are two structured learning plans within this pack, one is

blank for you and your mentor to discuss and plan together.

The other is one that is one that has already been planned.

These are designed to help you plan how you are to achieve

your learning outcomes/elements.

LEARNING ZONES

TRANSFERS

CLINICS

CDU

ANNP

PHYSIO

XRAY

EEG

ECG

PHARMACY

HEALTH

VISIITORS

S/W

MIDWIFE

CCN

WARDS

EDUCATION

LINKS

RESOURCES

JOURNALS

LIBRARY

RESOURCE

ROOM

NICU


January 2010 - 17 -

17

PROFILE OF LEARNING OPPORTUNITIES

The NICU is an ideal place to develop clinical skills. You will

have the opportunity to manage care, improve your

organisational and management skills, communication skills

and have the opportunity to increase your understanding of the

physiology of the newborn.

KEY ELEMENTS INTERPERSONAL SKILLS

LEARNING OPPORTUNITY RESOURCE/RELEVANT

PERSONEL/DEPARTMENT

Communicating with families

Via telephone On unit

Confidentiality

Nursing staff Doctors

Interprofessional communication

Nurses Doctors ancillary staff MDT meetings Handovers ward rounds referrals

Nursing staff Doctor MSW Social worker Liaison health visitor Midwives Stoma nurses Physiotherapy Pharmacy x-ray EBME Electronics Porters Matron


January 2010 - 18 -

18

Business manager CCN Domestic Chaplaincy EEG ECG

Use of telephone answering calls making calls ring back facility bleep system

Nursing staff Switchboard

Use of computer hiss internet intranet email access

Nursing staff Doctors Library

CLINICAL SKILLS

LEARNING OPPORTUNITY RESOURCE/RELEVENT PERSONEL/DEPARTMENT

Physiological observations temperature heart rate respirations blood pressure pulse oximetry blood glucose blood gases blood results electrolyte balance oedema

Nursing staff Doctors Biochemistry Microbiology Haematology

Patient care Nursing staff


January 2010 - 19 -

19

mouth care skin care elimination hygiene pressure area care positioning nutrition

Doctors Physiotherapy Dietician

Drug administration oral rectal iv im sub-cut infusions calculations

Nursing staff Doctors Pharmacist Pharmacopoeia

Infection control source spread prevention treatment hand washing aseptic technique

Nursing staff Doctors Infection control team Link nurse – Donna Coppard Infection control file

Moving and handling correct procedures stance risk assessment

Nursing staff Manual handling advisor Link nurse – Sheila Middleton Manual handling file

Procedures cannulation venepuncture UAC UVC long lines lumbar puncture intubation catheterisation chest drain blood product

Nursing staff ANNP Doctors Blood transfusion department Blood product guidelines Unit guidelines Trust policy EEG department ECG department Dr Mellon Radiology


January 2010 - 20 -

20

administration exchange transfusion

Investigations EEG ECG USS ECHO ph study CT scan MRI Biopsies

Surgical Doctors

ANATOMY AND PATHOPHYSIOLOGICAL PROCESSES

LEARNING OPPORTUNITIES RESOURCE/RELEVANT PERSONEL/DEPARTMENT

Respiratory system RDS TTN PPH pulmonary haemorrhage pneumothorax diaphragmatic hernia tracheo-oesophageal

fistula

Nursing staff Doctors ANNP Literature X-ray

Nervous System Cerebral bleeds neonatal convulsions intrauterine/neonatal

hypoxia congenital malformations congenital/neonatal

acquired infections

Nursing staff ANNP Doctors Specialist nurses x-ray literature EEG

Liver and Bilary systems Nursing staff


January 2010 - 21 -

21

Haemorrhagic disease of the newborn

Jaundice Rhesus incompatibility ABO

Incompatibility obstructive disorders

Doctors ANNP Haematology Literature

Cardio vascular system Congenital cardiac

anomalies Cardiac arrhythmias

Nursing staff Doctors ANNP x-ray ECG technicians Dr Abu-Harb Literature Clinics

Gastro-intestinal tract Feed intolerance NEC obstructive disorders stoma care Hernias

Nursing staff Doctors ANNP x-ray Specialist nurses Stoma link nurse – Literature

Blood Transfusions Clotting disorders

Nursing staff Doctors Haematology Literature Policy‟s

HEALTH DEVELOPMENT

LEARNING OPPORTUNITY RESOURCE/RELEVANT PERSONEL/DEPARTMENT

Healthy life style in relation to;

Parent craft

Nursing staff ANNP CCN


January 2010 - 22 -

22

SIDS Alcohol abuse drug abuse Breast feeding Diet healthy eating

patterns pain assessment and

management child protection

Health visitors Social workers Midwife Community addiction team Dietician Chaplaincy Consultants Literature Internet Intranet Child protection nurse

Child development Nursery nurses Nursing staff CDC ANNP Doctors

MANAGEMENT OF CARE

RESOURCES/RELEVANT PERSONEL/DEPARTMENT

Nursing process Assessment

who what why where how

Planning care plans discharge planning referrals risk assessment tools

Implementation/evaluation

Nursing staff Nurse in charge ANNP Doctors Literature Health Visitor Liaison Chaplaincy Unit manager Internet Intranet


January 2010 - 23 -

23

ward rounds documentation best practice policy procedures standards protocols communication prioritising care

Nursing model Philosophy of care Nursing documentation Dealing with difficult situations Time management Religious needs/beliefs

ORGANISATIONAL AND MANAGERIAL

LEARNING OPPRTUNITIES RESOURCE/RELEVANT PERSONEL/DEPARTMENT

Organisational and managerial skills

delegation leadership prioritising care time management off duty managing patient

workload quality standards of care implementing change

Nursing staff Doctors ANNP Unit sisters Unit Manager Library Resource room Literature Internet Intranet

Risk management policy and procedure moving and handling

Registered nurse ANNP Policy‟s


January 2010 - 24 -

24

infection control equipment safety

checks

Health and safety officer Electronics Support worker Infection control team Infection link nurse – Donna Coppard Moving and handling advisor Moving and handling link

Communication with staff doctors parents/carers members of MDT other departments

Nursing staff ANNP Doctor

Emergency situations Medical

Emergency Fire Untoward incident Security Fast bleep system Missing infant

Registered nurses Fire officer Security officer Switchboard Doctors ANNP

Staff development clinical supervision reflective practice appraisal

Nursing staff ANNP Unit manager Sisters Policy Clinical supervision link nurse

Resource management budget control drug ordering non-stock items stock control stationery establishment skill mix

Unit manager Nursing staff Support worker Pharmacy Stores Secretaries ANNP


January 2010 - 25 -

25

DRUG AND FLUID CALCULATIONS There are guidelines on the unit regarding fluids which should be referred to. The guidelines state that fluids for infants on the unit are, Day one 100mls/kg Day two 120mls/kg Day three 150mls/kg IV FLUIDS Weight x mls/kg = mls/hr Hours Work out how many mls/hr these baby‟s require, Baby a weighs 1 kg and is one day old, how many mls in 24 hours does she require and how many mls/hr? Baby B weighs 500gms and is two days old, how many mls in 24 hours does she require and how many mls/hr? Baby C weighs 3.9kg and is 3 three days old, how many mls in 24 hours does she require and how many mls/hr? Baby‟s also have a mixture of IV fluids and enteral feeds. Work out how many mls/hr of IV fluids they require to ensure full fluid requirement.


January 2010 - 26 -

26

Baby D weighs 750gms and is three days old. He is having 1.5mls/hr of enteral feed. What is his total fluid requirement and how many mls/hr of IV fluid does he require? Baby E weighs 1.9kg and is three days old. He is having 3.0mls/hr of enteral feed. What is his total fluid requirement and how many mls/hr of IV fluid does he require? Baby F weighs 900gms and is two days old. He is having 0.75mls/hr of enteral feed. What is his total fluid requirement and how many mls/hr of IV fluid does he require? FEEDS Mls/kg can vary in enterally fed infants. There are guidelines relating to the fluid requirement of infants of 34-36 weeks gestation and their plot on centile charts. Infants can therefore have varying mls/kg according to there gestation and age. 30mls/kg 100mls/kg 40mls/kg 120mls/kg 50mls/kg 150mls/kg 60mls/kg 165mls/kg 80mls/kg 180mls/kg 90mls/kg 200mls/kg


January 2010 - 27 -

27

Weight x mls/kg = feed amount Number of feeds Work out the feed requirement for these infants. Baby G weighs 3.9kg and requires 165mls/kg and is 4 hourly fed. How much does she require for each feed? Baby H weighs 1.875kg and requires 150mls/kg and is 3 hourly fed. How much does she require for each feed? Baby I weighs 1.400kg and requires 150mls/kg and is 3 hourly fed. How much does she require for each feed? Baby J is 34weeks gestation and weighs 2.1kg, requires 60mls/kg and is 3 hourly fed. How much does she require for each feed?


January 2010 - 28 -

28

DRUGS Each drug is prescribed according to the baby‟s weight. The dosages can be found in the neonatal pharmacopoeia. The drug administration policy for the trust must also be adhered to. Work out the following drug calculations using the calculation below. 1000mcg = 1mg 1000mg = 1g What you want x what it‟s in What you got Baby weighing 1.2kgs is prescribed 6mgs of oral caffeine. The caffeine solution is 50mgs/5mls. How many mls of the solution is to be administered? Baby weighing 2.2kgsis prescribed 66mgs of IV penicillin. IV penicillin solution is 100mgs/ml. How many mls of the solution is to be administered? Baby weighing 2.2kg is prescribed 132mgs of IV penicillin. IV penicillin solution is 100mgs/ml. How much of the solution is to be administered?


January 2010 - 29 -

29

Baby weighing 0.6kg is prescribed 3mg of IV Gentamicin. IV Gentamicin solution is 20mg/2mls. How many mls of the solution is to be administered/ Baby weighing 2.6kg is prescribed 130mgof IV Flucloxacillin. IV Flucloxacillin solution is 100mg/ml. How much of the solution is to be administered? Baby J is prescribed 1mmol of 30% sodium chloride. The solution is 50mmols/10mls. How much of the solution is to be administered? Baby k is prescribed IM Konakion (vitamin k). She is prescribed 500mcgs. The solution is 2mg/0.2ml, how much of the solution is to be administered? Baby L is on opiate withdrawal treatment and is requiring 200mcgs of oral morphine solution. The solution is 10mg/5mls. How much of the solution is to be administered? Baby M is administered 1.5mls of IV penicillin. The solution is 100mgs/ml. How many mgs of Penicillin has been prescribed?


January 2010 - 30 -

30

Baby N is administered 0.9mls of IV Flucloxacillin. The solution is 100mgs/ml. How many mgs of Flucloxacillin has been prescribed? Baby O is given 0.85mls of oral caffeine. The solution is 50mg/5ml. How many mgs of oral caffeine is he prescribed?


January 2010 - 31 -

31

Neonatal Intensive Care Unit practice placement evaluation

Please hand to you mentor when completed, thankyou. Please circle, rating 5 as the highest and 1 as the lowest.

How would you rate the opportunity 1 2 3 4 5 to work with your mentor? (We aim for 40% contact time)

Have you completed your required 1 2 3 4 5 learning outcomes?

How would you rate the quality of the 1 2 3 4 5 mentor support in achieving your required outcomes?

How do you rate the NICU as a learning 1 2 3 4 5 environment?

How do you rate the opportunity 1 2 3 4 5 to access the identified learning zones?

How could we improve our learning environment? Please feel free to make any additional comments you wish.


January 2010 - 32 -

32

GLOSSARY OF TERMINOLOGY WITHIN NICU

OBSTETRIC ANS - ANTENATAL STEROIDS APH - ANTE-PARTUM HAEMORRHAGE EUT - EXTRA-UTERINE TRANSFERS HELLP - HAEMOLYSIS, ELEVATED LIVER ENZYMES AND LOW PLATELETS IUT - INTRA-UTERINE TRANSFER LSCS - LOWER SEGEMENT CAESAREAN SECTION PIH - PREGNANCY INDUCED HYPERTENSION PROM - PRE LABOUR RUPTURE OF MEMBRANES SROM - SPONTANEOUS RUPTURE OF MEMBRANES SVD/NVD - VAGINAL DELIVERY HOSPITALS DUH - DURHAM UNIVERSITY HOSPITAL JCUH - JAMES COOK UNIVERSITY HOSPITAL QEH - QUEEN ELIZABETH HOSPITAL RVI - ROYAL VICTORIA INFIRMARY NUTRITIONAL A/F - ARTIFICIAL FEED B/F - BREAST FEEDING CONT - CONTINUOUS EBM - EXPRESSED BREAST MILK LBW - LOW BIRTH WEIGHT PEPTI/JR - PEPTI JUNIOR TPN - TOTALPARENTAL NUTRITION


January 2010 - 33 -

33

RESPIRATORY/CARDIVASCULAR ASD - ATRIAL SEPTAL DEFECT BP - BLOOD PRESSURE BPD - BRONCHO-PULMONARY DYSPLASIA BPM - BEATS PER MINUTE BPM - BREATHS PER MINUTE CMV - CYCLED MANDATORY VENTIALTION CPAP - CONTINUOUS POSITIVE AIRWAY PRESSURE CRT - CAPILLARY REFILL TIME CXR - CHEST X-RAY ETT - ENDOTRACHEAL TUBE FFP - FRESH FROZEN PLASMA FIO2 - INSPIRED OXYGEN HFOV - HIGH FREQUENCY OSCILLATION VENTILATION HR - HEART RATE IVH - INTRAVENTRICULAR HAEMORRHAGE IVT - INTRAVENOUS THERAPY O2 - OXYGEN PDA - PATENT DUCTUS ARTERIOSIS PPHN- PERSISTENT PULMONARY

HYPERTENSION OF THE NEWBORN PTV - PATIENT TRIGGER VENTILATION PX - PNEUMOTHORAX RDS - RESPIRATORY DISTRESS SYNDROME RR - RESPIRATORY RATE UAC - UMBILICAL ARTERIAL CATHETER UVC - UMBILICAL VENOUS CATHETER VSD - VENTRICULAR SEPTAL DEFECT INVESTIGATIONS ABG - ARTERIAL BLOOD GAS BC - BLOOD CULTURE


January 2010 - 34 -

34

BG - BLOOD GLUCOSE C&S - CULTURE AND SENSITIVTY CBG - CAPILLARY BLOOD GAS CRP - C-REACTIVE PROTEIN CSF - CEREBRAL SPINAL FLUID FBC - FULL BLOOD COUNT FENa - FRACTIONAL EXCRETION OF SODIUM HB - HAEMOGLOBIN K - POTASSIUM LFT - LIVER FUNCTION TEST Na - SODIUM SBR - SERUM BILIRUBIN U&E - UREA AND ELECTROLYTES USS - ULTRASOUND SCAN WCC - WHITE CELL COUNT BLOOD GASES PO2 - PARTIAL PRESSURE OF OXYGEN PCO2 - PARTIAL PRESSURE OF CARBON

DIOXIDE Ph - POTENTIAL HYDROGEN BE - BASE EXCESS GENERAL BD - TWICE DAILY BNO - BOWELS NOT OPEN BO - BOWELS OPEN BW - BIRTH WEIGHT CW - CURRENT WEIGHT C - CENTIGRADE D/W - „DISCUSSED WITH‟ HDA - HIGH DEPENDENCY AGENCY /C - „WITH‟


January 2010 - 35 -

35

LDA - LOW DEPENDENCY AREA NAD - NO ABNORMALITIES DETECTED NPU - NOT PASSED URINE PU - PASSED URINE P&W - PINK AND WARM OD - ONCE DAILY QDS - FOUR TIMES A DAY TDS - THREE TIMES A DAY TEMP - TEMPERATURE WR - WARD ROUND STAFF ANNP - ADVANCED NEONATAL PRACTITIONER CONS - CONSULTANT EN - ENROLLED NURSE GP - GENERAL PRACTITIONER HV - HEALTH VISITOR MSW - MEDICAL SOCIAL WORKER NN - NURSERY NURSE SHO - SENIOR HOUSE OFFICER SN - STAFF NURSE SR - SISTER SSN - SENIOR STAFF NURSE SPR - SPECIALIST REGISTRAR SW - SOCIAL WORKER

NEONATAL INTENSIVE CARE UNIT - Northumbria … · 2010-02-01 · NEONATAL INTENSIVE CARE UNIT ... Layout of the unit Unit telephone number ... Neonatology is a fast growing speciality

Documents