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Introduction
Battledown ward provides a comprehensive medical and day case surgical service for children and young people aged 0 - 16 years of age. It also offers shared care services with Bristol Children’s and Birmingham Children’s Hospital.
Battledown Ward is located in Cheltenham General Hospital, Level 1, College Road Wing. Adjacent to the ward is the Radiology Department and on the floor below is the Emergency Department (ED). The total number of 18 beds are divided as follows; a 8 bedded PAU, an area with 4 beds designated for Investigations and Diagnostic tests, and a 6 bedded paediatric day surgery area. Children on this ward will have the advantage of full medical attention until 10.00pm. We do however stop accepting admissions after 8.00pm. After this time children will either be seen at Gloucester or offered an appointment the following day if it is felt appropriate that the child can wait until then. Children who require overnight admission will be transferred to Gloucestershire Royal Hospital CIP.
The Paediatric Assessment Unit consists of 6 beds and 2 cubicles. It is open weekdays from 07.30am – 10.00pm, and 8.45am - 10.00pm at weekends.
The investigation unit has 4 beds and is open between 09:00am - 5:00pm Monday to Friday. Here, children who require blood tests, sedation and scans, reviews by Doctors, challenge clinics and vaccination clinics are seen.
The remaining 6 beds open from 08.00am - 10.00pm seven days a week for children undergoing surgery for:
• Orthopaedics
• Ophthalmology
• Maxilo-facial
• Urology
Battledown Ward - Philosophy of Care
The staff of Battledown strive to provide the highest standard of care possible for children, adolescents and their families.
Visiting is open to friends and family depending on the child’s wishes and condition.
With full explanations and support, we wish to develop a partnership of care with parents and children making informed choices and playing an active part in their care.
We constantly endeavour to create a happy, safe, friendly environment, offering activities for all ages and ability and so reducing the fears associated with a clinical setting.
Play and education are very important aspects of child development. We therefore provide facilities for schooling and play to continue throughout the child’s stay on Battledown. This is also reflected in the staff’s approach to treatments and investigations.
Open communication between a large multi-disciplinary team enables all aspects of the child and families’ well-being to be cared for. This will encompass their physical, psychological, emotional, social and spiritual needs.
Each child and family unit is seen as individual, with their own experiences and expectations. These shall be met with respect and flexibility in accordance with current guidelines.
Continuous training and updating ensures staff are appropriately qualified and motivated to deliver up-to-date care and professionalism.
We aim to make the stay in hospital as enjoyable as possible, maintain and improve quality of life, promote independence and aid the transition home again.
Please be aware that the Trust is now a smoke free NHS. Smoking is not permitted in any building or within the grounds of any of our sites. Information and support is available to any patients who wish to stop smoking. Nicotine Replacement Therapy is available to help reduce your cravings during your stay.
Our Staff
A variety of people will be responsible for your care whilst in hospital. Some of the staff you may come in contact with while on Battledown Ward are: -
Consultants
For more information on the Consultants please click on their name.
Sister: - Navy blue dress / tunic / trousers.
Staff Nurse: - Blue and white striped dress / tunic with white piping and navy trousers.
Nursing Auxiliaries: - Green striped dress / tunic and navy trousers.
Housekeepeing staff: - Pink and white stripped dress / tunic and trousers.
Domestics staff: - Pale green and white striped dress / tunic and trousers.
Yellow dress with blue tabard.
Consultant Ward Rounds / When will I see a Doctor?
Children arrive on the ward either from their GP or from the Emergency Department. On arrival to the ward your child will be assessed by the on call Doctor and the plan of treatment will be discussed with you. Ward rounds take place on the ward throughout the day. If a decision is taken to keep your child overnight then they will be transferred to the Children’s In-patient Unit at Gloucester Royal Hospital.
Medicine Rounds
We do not have any designated medicine rounds, instead we feel it is better to administer medicines as and when you child requires them.
Facilities
Facilities located on the ward are: -
• A play room
• A baby change area
• Parents room where meals can be heated in a microwave and eaten. Tea and coffee facilities are provided.
• Bedside phones
• TV and videos
• Play stations
• Meals/ feed kitchen
Mealtimes and Catering
The Catering Staff are an integral part of the meal delivery service at Cheltenham General Hospital. The staff are visible on the ward throughout most of the day, serving food, washing up and cleaning in the ward pantry as well as delivering stock. The Catering staff are easily recognised by their uniform; royal blue polo shirts, navy blue baseball caps and trousers and, of course, a smile.
Visitors
Children love having visitors and it helps with their recovery, keeping them happy and cheerful. Therefore, we have an ‘open visiting’ policy, unless the child is in isolation- please check with a nurse first.
All we ask in return is for you to be honest with your child. If you are going to leave your child for any amount of time please tell them and say where you are going and and say when you will be returning.
How to Contact the Ward
You and your family will be informed of the best time to telephone for news.
Telephone numbers: - 08454 22 4129 / 4381 / 4462
Or Telephone Switchboard on 08454 22 2222 and ask for Battledown Ward.
Going Home
The doctor from the team responsiable for your childs care will assess their progress throughout the day with you. When your child is ready for discharge they will write a letter for your GP and prescribe any medicines for you take with you. The nursing staff will arrange any follow-up appointments.
Cleanliness and Infections in Hospital
Some people are admitted to hospital with infections that require them to be cared for away from other patients to prevent the spread of that particular infection. Please follow the instructions given to you by staff.
You will be nursed in a single room; the door may need to remain closed, depending on the nature of your infection. Please pay particular attention to hand washing and general cleanliness at all times, especially when leaving the room.
If you have been in contact with chickenpox, measles or mumps within 3 weeks of your admittance to hospital, please inform a member of staff.
We ask that visitors suffering from minor infections such as a cold avoid visiting if possible, for their sake as well as the patients. We do not recommend babies being brought in to visit, again for their own protection.
Hand washing. The most common means by which infection is transmitted is by hand, therefore handwashing is a very basic, yet vital infection control measure. Alcohol hand gel is kept at the entrance of the ward and at each bedside for all the visitors to use before and after visiting. For hygienic hand disinfection apply 3ml (3 shots) to physically clean hands for 30 seconds ensuring all areas are covered, until dry.
What is clostridium difficile? Also called c diff
It is a bacteria that normally lives in the intestine. Up to 5% of the population are thought to carry this without any problems. It is usually kept in check by other bacteria in the intestines, which are normally present in our gut.
What problems does clostridium difficile cause?
Some strains of c.diff produce toxins, these toxins (poisons) cause diarrhoea. It can only do this when the balance of the normal gut bacteria has been disturbed. This can happen when antibiotics are given for infections. This enables the c-diff bacteria to multiply and produce more toxins that damage the cells in the intestines causing diarrhoea.
How is it Diagnosed?
A sample of diarrhoea is sent to the microbiology lab within the hospital. The laboratory looks for c-diff the toxins produced by some strains of the bacteria
How can it be treated?
If it is possible the antibiotics that have contributed to the disease will be stopped. Sometimes other antibiotics will be given, which are effective against the c-diff bacteria
What should happen if someone has diarrheoa?
Whenever possible you will be moved into a side room, before the microbiology result of the diarrhoea specimen is known This is to help prevent the spread of this bacteria. Not all patients can be placed in side rooms. it will depend on the condition of the patient and the availability.
Personal hygiene must be very strict. Everyone must wash their hands with soap and water after going to the toilet and before eating. If diagnosed as c-diff you may be transferred to the Cohort Ward (6A). this is a 16 bedded infection control ward dedicated to the management of patients who have or are suspected to have c-diff.
What is MRSA?
The organism Staphylococcus aureus is found on many individuals skin and seems to cause no major problems. However if it gets inside the body, for instance under the skin or into the lungs, it can cause important infections such as boils or pneumonia. Individuals who carry this organism are usually totally healthy, have no problems whatever and are considered simply to be carriers of the organism.
The term MRSA or methicillin resistant Staphylococcus aureus is used to describe those examples of this organism that are resistant to commonly used antibiotics. Methicillin was an antibiotic used many years ago to treat patients with Staphylococcus aureus infections. It is now no longer used except as a means of identifying this particular type of antibiotic resistance.
Individuals can become carriers of MRSA in the same way that they can become a carrier of ordinary Staphylococcus aureus which is by physical contact with the organism. If the organism is on the skin then it can be passed around by physical contact. If the organism is in the nose or is associated with the lungs rather than the skin then it may be passed around by droplet spread from the mouth and nose. We can find out if and where Staphylococcus aureus is located on a patient by taking various samples, sending them to the laboratory and growing the organism. Tests done on any Staphylococcus aureus grown from such specimens can then decide how sensitive the organism is to antibiotics and if it is a methicillin resistant (MRSA) organism. These tests usually take 2-3 days.
Why bother with MRSA?
MRSA organisms are often associated with patients in hospitals but can also be found on patients not in a hospital. Usually it is not necessary to do anything about MRSA organisms. However if MRSA organisms are passed on to someone who is already ill, then a more serious infection may occur in that individual. When patients with MRSA are discovered in a hospital, the hospital will try to prevent it from passing around to other patients. This is known as infection control.
How do we prevent the spread of MRSA?
Measures to prevent the spread of organisms from one person to another are called isolation or infection control. The type of infection control or isolation required for any patient depends on the organism, where the organism is found on an individual and the patient.
The most important type of isolation required for MRSA is what is called Contact Isolation. This type of isolation requires everyone in contact with the patient to be very careful about hand washing after touching either the patient or anything in contact with the patient. If the organism is in the nose or lungs it may also be necessary to have the patient in a room to prevent spread to others by droplet spread. Because dust and surfaces can become contaminated with the organism, cleaning of surfaces are also important.
What do visitors need to do?
Provided relatives and friends of patients with MRSA are healthy there is no restriction on visiting and it carries no risk. Visitors are not required to wear special clothing BUT we would ask you to help us prevent this organism spreading around our hospital by keeping the patients' door closed at all times and always washing your hands whenever you leave the room.
What about MRSA at home?
In patients who are otherwise well the organisms often disappear once the patient leaves the hospital. Sometimes they do not however, and this may mean that when a patient has to go back into hospital the isolation precautions need to be used again. Provided everyone at home is healthy special precautions are not required at home.
What can be done about MRSA?
In certain situations it may be a good idea to try to get rid of the organism from a patient and this can be done with various creams and shampoos or on occasions combinations of antibiotics taken by mouth or by injection depending on the health of the patient.
If English is not your first language, and you may require the services of an interpreter, please let the ward know before your admission, if at all possible.
If you are hearing impaired and need to sign, we may also be able to provide someone to help with this.
A Hairdresser, Dietician, Chiropodist, Dentist and Pharmacist are all available on site and the staff will inform you of these in more detail should you wish.
Physiotherapy, Occupational Therapy and Social Services can be accessed via referral from Ward staff. Chaplaincy staff visit the Ward, or you may arrange for your own spiritual advisor to visit.