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Introduction
The Medical Admissions Unit is a very busy unit providing assesment and treatment for emergency medical patients who are admitted from both A&E and directly from their GP's.
MAU consists of a triage / examination area with four trolleys and an 18 bedded observational ward area. Both male and female patients are admitted to this area.
We aim to provide high quality nursing care and treatment for all our patients and welcome your comments and suggestions for improving our service.
MAU is located in College Road Wing.
What to Expect When you are Admitted to our Ward
On arrival all patients are assessed in the triage area. Some patients may have to wait to be seen if the doctor is busy with a particularly ill patient.
The assessment process will include having your blood pressure, pulse and respiration rate recorded. We will also need to take blood and will arrange a chest x-ray and perform an ECG (tracing of the heart). These are all routine procedures which will help staff to prioritise your care.
Once patients have been seen by a doctor and a decision has been made about care and treatment, the nurse in charge of the ward will move you to a bed on MAU.
If you were in A&E you will already have been assessed. We usually admit you directly into a bed on the ward area.
MAU is a short stay unit and we aim to transfer patients to an appropraite ward within 24 hours of arrival.
Although MAU is very busy we strive to provide the highest satndard of nursing care in a friendly and caring enviroment. On admission to the ward area you will be introduced to the nurse who will undertake responsibility for your care and who will be able to provide information about your planned treatment.
We have 12 consultant Physicians working within the medical unit, each has a particular speciality. On arrival on MAU you will be placed under the care of the consultant "on call" for all new medical admissions that day. You will be seen by a senior doctor from your consultant's team who will perform a comprehensive physical examination and plan your care and treatment. The consultant will review this plan on the ward round the following morning and you will have the opportunity to raise any concerns and ask questions about your care.
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 MAU 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 red piping and navy trousers.
Male Staff Nurse: - White tunic with striped epaulets and navy trousers.
MAU Technicians: - Green tunic and navy trousers.
Nursing Auxiliaries: - Green striped dress / tunic and navy trousers.
Bank Staff: - White 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.
Other staff involved in your care may include: doctors, cardiac technicians, cardiac rehab nurses, physiotherapists, occupational therapists, social workers, ward clerks, pharmacists and student nurses.
Mealtimes and Catering
With the exception of breakfast all meals are served from a hot trolley. You will be given a choice from a daily menu for all meals.
| Breakfast: - | 8.00am |
|---|---|
| Lunch: - | 12.30pm |
| Supper: - | 6.00pm |
Hot beverages are served at regular intervals throughout the day.
If you should be off the ward when meals are served sandwiches are available on request. We are unable to reheat meals.
If you have specific dietary requirements for medical or religious reasons please inform the nursing staff who will contact the kitchen and arrange for a special diet to be prepared.
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
Due to the emergency nature of MAU we have a policy of open visiting.
Visiting times are: - 3.00pm - 4.30pm and 6.00pm - 8.00pm
The purpose of this is to ensure that friends and relatives are able to visit at their convenience. However we do insist on no more then 2 people per visit as there is limited space.
We would ask you to remember that rest is an important part of the healing process for patients, particularly when they are acutely unwell. Flowers are discouraged on the ward as they pose a health and safety risk and many patients suffer with asthma and other breathing problems which are allergy based.
How to Contact the Ward
You and your family will be informed of the best time to telephone for news.
Telephone numbers: - 08454 22 3616 / 3617
Or Telephone Switchboard on 08454 22 2222 and ask for the Ward.
We are unable to give detailed information over the phone as this breaches patient confidentiality. As the ward can be very busy and the nurse’s priority is to perform patient care, please keep calls to a minimum by choosing a relative or friend who can act as your main point of contact and who will be able to keep the rest of the family informed.
All patients have bedside phones which enable relatives and friends to telephone them directly. Outgoing calls can be made by purchasing a phone card. These are available from dispensing machines in the corridor by the lifts.
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.