OET Reading Part B
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| Storage of oxygen cylinders |
| Following a recent incident in which an unsecured cylinder fell and damaged a valve, staff are reminded that all oxygen cylinders, whether full or empty, must be stored upright in the racks or stands provided and must never be left standing freely against walls, beds or trolleys. Empty cylinders are to be segregated from full cylinders and clearly labelled, so that an empty cylinder is never selected in error during an emergency. Once labelled, empty cylinders should remain secured in the racks until they are removed during the scheduled weekly collection. Cylinders must be kept at least three metres from any source of heat and away from oil and grease. Any cylinder found unsecured should be made safe immediately and the ward manager informed. |
| To: All clinical staff Re: Resuscitation training |
| A large number of Basic Life Support certificates are due to expire over the next few months. As you will be aware, staff whose certificate has lapsed cannot work unsupervised shifts until it has been renewed. To help colleagues avoid this situation, the resuscitation team has added six extra sessions during July. Places are limited to twelve per session and will be released on the intranet booking page at 9 am this Friday, so anyone whose certificate expires before 30 September should book as soon as booking opens. If you are unsure of your expiry date, you can check it under My Training on the staff portal. Line managers have been asked to release staff for these sessions wherever the rota allows. |
| Manual extract: Infusion pump blockage alarm |
| A blockage alarm indicates that the pump has detected resistance in the line; it does not necessarily mean that the cannula has failed. Silencing the alarm mutes the sound for two minutes but does not restart the infusion. The infusion rate must never be increased in response to the alarm, as this can mask a partial blockage and cause a sudden large dose to be delivered once the resistance clears. Kinks, closed clamps and trapped tubing account for most blockage alarms, so the whole length of the line should be checked before any other action is taken. If no mechanical cause is found, examine the site at which the cannula enters the skin. Only once the cause has been resolved should the infusion be restarted, at the prescribed rate; a pump that continues to alarm after these checks should be withdrawn from use and returned to the equipment library, with the fault recorded. |
| Extract from guidelines: Storage of refrigerated medicines |
| Medicines that require refrigeration must be stored at between 2°C and 8°C. The maximum and minimum temperatures shown on the fridge display must be read and recorded once a day, and the display reset after each reading. A reading outside this range does not always mean that the contents are unusable, as brief rises can occur while the fridge is being restocked. Any medicines affected by an out-of-range reading should be labelled ‘do not use’ and moved to a separate area of the fridge rather than discarded. Pharmacy staff will advise whether they remain fit for use once they have been sent a record of the highest and lowest temperatures reached and how long the excursion lasted. The fridge itself should be taken out of service only on the advice of the estates team. |
| Memo |
| To: All ward staff From: Chief Pharmacist Re: Electronic prescribing system upgrade |
| The electronic prescribing system will be unavailable between 02:00 and 06:00 on Sunday 7 September while the supplier installs an upgrade. Prescriptions already on the system will remain viewable in read-only form throughout, so medication lists do not need to be printed in advance. Any new prescriptions or dose changes made during this period must be written on the paper charts that will be delivered to every ward by Friday. Once the system is restored, these entries must be transcribed onto it by the prescriber before the paper charts are returned to pharmacy. The upgrade will not alter the way prescriptions are entered; the only visible change will be to the way allergy warnings are displayed. Queries should be directed to the pharmacy helpdesk rather than the IT service desk. |
| Guidance notes: Telephone enquiries about patients |
| Because the identity of a caller can never be certain, staff answering the ward telephone should not discuss a patient’s condition when first asked. On admission, each patient is asked to nominate one person to receive telephone updates; that person’s name and number are recorded in the notes, and enquiries from anyone else should be redirected to the nominated person rather than answered. A regular time for update calls can also be agreed with the nominated person. Before an update is given, staff should take the caller’s name, end the call, check the number against the notes and ring back, using the hospital switchboard where any doubt remains. Messages containing clinical information must never be left on answering machines. Enquiries from journalists must be passed to the communications team without comment. |
| Weekly fire alarm test |
| The fire alarm system is tested every Wednesday at 10 am, when the sounders operate for about 20 seconds. Staff are not expected to evacuate or to move patients during the test, but should use it to satisfy themselves that the sounder is audible in every part of their area. Fire doors are released automatically by the system and close on their own. Any door that stays open, and any sounder that is inaudible, should be reported to the estates helpdesk; the fire safety officer records every test centrally, so the helpdesk needs to hear only about faults. If the alarm continues for more than 30 seconds, or sounds at any other time, it must be treated as genuine and the fire procedure followed. Staff on duty should tell patients and visitors beforehand what to expect. |
| Protocol: Patient identification wristbands |
| Every inpatient must wear a wristband showing their full name, date of birth and hospital number, printed from the administration system on admission. Handwritten bands are permitted only in the emergency department, and a printed band must be fitted on transfer to a ward. A band that carries an error is removed and a new one printed. The band is checked before medicines are given, blood is taken or the patient leaves the ward, by the member of staff carrying out the task, who confirms two of the printed details with the patient. Where medicines are involved, the same person also checks the allergy record in the notes. If a patient declines to wear a band, the reason is recorded and the same two details are confirmed verbally each time. |
| Memo |
| To: All ward staff From: Director of Nursing Re: Mealtimes on the wards |
| A recent audit found that a third of lunches on the medical wards were collected untouched, most often because no one had been free to help the patient. From 1 October, therefore, the existing lunch hour, from 12 pm to 1 pm, will be protected time on every inpatient ward. Ward rounds, routine investigations, cleaning and non-urgent visits from other departments will be paused, and patients will leave the ward during the hour only for a procedure that cannot be delayed. Nursing and support staff are expected to remain on the ward, to assist anyone who cannot manage a meal unaided and to complete the food charts of patients who have one. Relatives who regularly help a patient to eat are welcome to stay; other visitors will be asked to return after 1 pm. |
| Extract from the staff handbook: Absence due to sickness |
| Staff who are too unwell to attend work must telephone the ward and speak to the nurse in charge at least one hour before the shift begins, or two hours before a night shift. Cover is arranged as soon as the call is received; where a message arrives by any other route, the absence is logged from the time of the call that confirms it. The caller should say how long the absence is likely to last and must call again on each further day of absence. On return, staff complete a self-certification form, which is accepted on its own for absences of up to three days; longer absences must also be covered by a certificate from a doctor. Every member of staff also has a brief conversation with their line manager, which takes place before the first shift back whatever the length of the absence. |
| Extract from policy: Gifts from patients and relatives |
| Staff may accept modest gifts from patients and relatives, such as flowers or confectionery, that can be shared with the whole ward team. Gifts of cash, vouchers or anything that can be exchanged for money must always be declined, however small the sum, and the person offering should be told how to donate to the hospital charity instead. Any other gift whose value the recipient estimates to exceed the figure given in the finance handbook must be declared to the line manager and entered in the department’s gifts register within seven days, whether it was offered to an individual or to the ward. Gifts must never be sought, and any offer that appears to be linked to a request for preferential treatment must be reported to the ward manager. |
| To: All ward staff Re: Blood glucose meters |
| Since the new blood glucose meters were introduced last month, the medical devices team has received many calls reporting that a meter has locked and will not take a reading. In almost every case the meter is functioning as intended. It is designed to refuse a test until the operator’s barcode has been scanned, and a barcode is activated only once the online competency module has been passed, so a meter that rejects your barcode is showing that your training record is incomplete. Please check your status on the training portal before contacting us, and speak to your ward’s link trainer if you believe the record is wrong. Meters with a genuine fault, such as a cracked screen or a failure to switch on, should still be sent to us with the usual form. |