Rehabilitation Ward 2

Introduction

The Rehabilitation Wards are located to the right of the Tower Block on the 1st & 2nd floor.

Rehabilitation Ward 2 is a ward for male General & Old Age Medicine pateints with a focus on assessment and rehabilitation. The Ward Manager is Sue Merrett who is supported by Sister Maggie Harris and a nursing team. The ward has 28 beds and to concentrate on the delivery of care the nurses are divided into 2 teams. Our aim is to deliver a high standard of care in a safe environment for patients and staff where dignity and confidentiality is maintained.

What to Expect When You are Admitted to Our Ward

The majority of our patients are admitted as transfers from AAU, A&E Department, other hospitals and some transfers from other wards in GRH.

On arrival to the ward you will be welcomed and shown the ward facilities. Your property will be checked and an inventory made of particular items of value. We advise you to arrange for significant amounts of money to be taken home. There will be a trained nurse on duty who is responsible for your care. If your family have any questions or anxieties please do not hesitate to make an appointment to talk with the nurse in charge, as immediately on admission we need to settle patients into the ward. The Ward Manager is accessible and appointments can be made to see her via the ward clerk.

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 Rehabilitation Ward 2 are: -

Consultants

• Dr. Muhammad Ashgar
  

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 and navy trousers.
Male Staff Nurse: - Navy trousers, white tunic with blue epaulets.
Student Nurse: - Pale Blue
Nursing Auxiliaries / Health Care Assistants: - Green / white striped uniform.
Physiotherapist: - White tunic/blue piping and blue trousers.
Occupational Therapist (OT): - White tunic/green piping and green trousers.
Ward Clerk: - Turquoise blouse and black trousers.
Domestics staff: - Pink/white striped dress/tunic and trousers.

Consultant Ward Rounds / When Will I See a Doctor?

Patients are attended by a Junior Doctor each week day between 9.00am – 5.00pm.

At weekends and Bank Holidays a doctor on call can be contacted.

The Consultant ward rounds are on Monday afternoons and Thursday mornings with Multidisciplinary Team meetings during which time all patients are discussed.

If you or your family wish to speak with the Consultant, please contact the secretary who will arrange an appointment for you. The secretary’s contact telephone number is 08454 225619. Relatives are usually seen on Monday from 4.00pm and Thursday from 12.00 midday.

Medicine Rounds

These take place around the following times:

• 8.00am - 9.00am
• 12.30pm - 1.00pm
• 5.00pm - 6.00pm
• 10.00pm

During these times the nurse should not be disturbed unless it is an emergency. This is to ensure that maximum concentration is maintained at all times.

Facilities

• Bathroom

• Dayroom with Colour Television

• Staff Resource Room

Mealtimes and Catering

The ward operates a protected mealtime philosophy. Please support us by refraining from visiting or contacting the ward during these time periods unless absolutely necessary. Meals are ordered by menu cards the day before and are delivered on covered trays, except for breakfast which is served from a trolley. If you require a special diet please inform staff who will endeavour to accommodate your needs. In line with government recommendations we have protected meal times during which visiting is not allowed unless agreed by the nurse in charge.

Visitors

Visiting times are: - 3.00pm - 4.30pm and 6.00pm - 8.00pm

If these times are not suitable for you because of distance, work or child care problems, please discuss with the nurse in charge.

Two visitors per bed at any one time please. This is necessary not only because the patient will be overtired by more, but space is limited and overcrowding poses a health and safety hazard.

• It is helpful if as early as possible, your family/carers arrange to see your named nurse to explain the situation at home, and any problems that we should know about.

• Following this, the nurse may advise that they also speak to the doctor, the social worker, or other members of the team.

• Please follow strictly the hand washing regimes using the gel provided.

• If you have special dietary needs, and/or you think that your appetite would be helped by some food brought in for you, please discuss this with the named nurse to make suitable arrangements

• When patients are recovering from an illness, they will reach a stage when wearing their own clothes assists the psychological recovery. It also enables us to see if you can dress on your own without help. We are grateful if family can bring in some clean clothes for this purpose.

• Please report to us changes your family/carers see in your condition. They know you better than we do.

• Falls are a common hazard as one tries to recover strength and walking again. The risk can be minimised by :

o Minimising clutter around the bed and chair

o Making sure the call bell is left in easy reach when your visitors leave

o Having good slippers or shoes to wear while in hospital

o Making sure the walking aid (frame or stick) is near-to-hand when your visitors leave.

How to Contact the Ward

You and your family will be informed of the best time to telephone for news.

Telephone numbers: - 08454 22 5543

Or Telephone Switchboard on 08454 22 2222 and ask for the Ward.

Information given by staff over the telephone may be limited, but we are happy to give an overview of patient’s condition. To avoid many callers of a large family, it is appreciated if a spokesperson is appointed to relay progress to those concerned.

Going Home

During your stay with us minimal disruption to your lifestyle is our aim. To achieve this we will discuss the treatment plan and involve you at all times. Please can you ask your family to bring in toiletries and day clothes for continued rehabilitation.

The length of time spent on the ward will vary depending on your condition. All patients expected date of discharge is 25 days maximum.

You may also be transferred to another community setting if you no longer need the medical care and facilities of Gloucestershire Royal Hospital, but are not yet ready to go home. In this case we will try to transfer you to a community setting near your home. This could be an Intermediate Care setting or a Community Hospital.

On the day of discharge it is likely you will be transferred to the Discharge Lounge to wait for your transport home. This is located in the foyer of the tower block entrance on the ground floor and is staffed by a qualified nurse and volunteers. Seating, toilet facilities and refreshments are all available there. Final minor treatments may also be carried out by the nurse to expedite your discharge.

On the day, you will go home with at least 2 weeks supply of medication. Please be patient, our pharmacy is very busy and your tablets may take up to 4 hours to be prepared. Appointment to return to outpatients will be posted to you if appropriate.

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.

Visitors are requested not to sit on patients beds, this is to help minimise the risk of spread of infection and for other health and safety reasons.

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 coholt 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.

Additional Information

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.

Any Questions?

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