PAEDIATRIC ORIENTATION BOOKLET HOUSE OFFICERS
1 2 4 3 5 7 10 8 6 9 CONTENT DEPARTMENT MISSION, VISION, GOALS AND OBJECTIVES ORGANISATION CHART DUTIES AND FUNCTIONS POLICIES CPG TRAINING PATIENTS FAMILY RIGHT ASSESSMENT TOOLS INFECTION CONTROL/ SAFETY PROCEDURES
FLOW OF ORIENTATION Specific detail of work area’s orientation will be done by sister
FLOW CHARTS TAGGING 2 weeks duration 7am till 10pm 1 day off each week (1 week ward / 1 week NICU) to complete logbook and submit on time by the end of tagging period START ROTATION IN PAEDIATRIC TOTAL 4 MONTHS
1.Paediatric Department Operational Policies To be an excellent department in providing high quality, safe and effective medical care. VISION To provide safe, high quality, effective and efficient medical services via: A competent, disciplined and ethical work force. Establish an organization driven by knowledge, innovation, integrity and trust. Establish patient-friendly hospital environment. Work in partnership with the community to promote health. MISSION
1.Paediatric Department Operational Policies To provide a high-quality care that incorporates all aspects of health promotions, prevention, diagnostic, curative and rehabilitation to all children below 12 years old based on latest evidence. GOAL To encourage continuous professional development amongst our staff thus improving our services. To continuously audit our performance, services and treatments in the hope of improving them in the future. OBJECTIVES
2. ORGANISATION CHART
ORGANISATION CHART
IN CHARGE OF HOUSEMAN SPECIALIST MEDICAL OFFICER MEDICAL OFFICER
Policies and Procedures PENCULIKAN KANAK-KANAK AMBER CODE PAIN AS 5TH VITAL SIGNS PAIN POLICY Semua ibu digalakkan menyusui anaknya dengan susu ibu sahaja dari lahir sehingga berumur 6 bulan dan meneruskannya sehingga mencapai umur 2 tahun. Makanan pelengkap perlu diberikan mulai umur 6 bulan BFHI POLICY NEONATAL EMERGENCIES PINK CODE
AMBER CODE Sumber rujukan; Public Folder - AMBER Code
PINK CODE sumber rujukan: Public folder - PINK Code
PAIN POLICY sumber rujukan Public folder > unit kualiti
PAIN ASSESSMENT TOOLS This is used in adults and in children more than 7 years old. This use in children less than 7 years old and cognitively impaired adults,
ASSESSMENT TOOLS This is used in children 1month-4years old
ANALGESIC LADDER FOR MANAGEMENT OF ACUTE PAIN Interpretation for pain scores for FLACC, revised FLACC, revised FACES, Numerical scale
NEONATAL / INFANT PAIN SCALE (NIPS) PAIN SCORE INTERPRETATION 1-2 MILD PAIN 3-4 MODERATE PAIN 5-7 SEVERE PAIN use for age 0-1 year old for children older than 1month old, continue NIPS as long as patient still not discharge from NICU
Management of neonatal pain MILD PAIN (NIPS 1--2) IV or IVI Opiods IV or IVI Ketamine MODERATE PAIN (NIPS 3-4) Non Pharmalogical -swaddling/ tucking -skin to skin -oral sucrose -non nutritive sucking -breastfeeding Oral or IV Paracetamol SEVERE PAIN (NIPS 5-7)
BFHI POLICY
Mempunyai polisi penyusuan susu ibu yang disampaikan kepada semua anggota kesihatan secara berkala. 1 Polisi Penyusuan Susu Ibu Secara Bertulis Melatih semua anggota kesihatan dalam kemahiran yang diperlukan untuk melaksanakan polisi ini. 2 Latihan Kepada Anggota Memberitahu semua ibu hamil tentang kebaikan susu ibu dan pengurusan penyusuan susu ibu 3 Pendidikan Kepada Ibu Hamil Memastikan semua ibu dan bayi mendapat sentuhan kulit ke kulit sejurus selepas kehadiran untuk sekurangkurangnya selama 1 jam. Ibu digalakkan mengenalpasti tanda-tanda bayi mahu menyusu dan dibantu memulakan penyusuan jika perlu. 4 Bantu Ibu Memulakan Penyusuan Susu Ibu Polisi Penyusuan Susu Ibu & Pemakanan Bayi, Hospital Shah Alam
Memberi tunjuk ajar kepada ibu cara menyusu dan mengekalkan penyusuan walaupun mereka terpisah daripada bayi 5 Tujuk Ajar Ibu Teknik Penyusuan dan Mengekalkan Laktasi Tidak memberikan bayi baru lahir makanan atau minuman selain susu ibu kecuali atas sebab-sebab perubatan 6 Tiada Pemberian Makanan Atau Minuman Selain Susu Ibu Memastikan ibu bersama bayi setiap masa (rooming in) selama 24 jam sehari 7 Amalkan Rooming In Menggalakkan penyusuan susu ibu mengikut kehendaj bayi dengan mengenalpasti tandatanda bayi ingin menyusu. 8 Penyusuan Dengan Kerap Polisi Penyusuan Susu Ibu & Pemakanan Bayi, Hospital Shah Alam
Tidak memberikan putting tiruan atau putting kosong kepada bayi yang menyusu susu ibu 9 Tiada Penggunaan Putting Tiruan Penyusuan Susu Ibu Mengukuhkan kumpulan sokongan penyusuan susu ibu dan merujuk ibu kepada mereka sebelum keluar dari hospital atau klinik. 10 Kumpulan Sokongan Makanan Bayi dan Produk Berkaitan Semua anggota kesihatan perlu mematuhi Tata Etika Pemasaran Makanan Bayi dan Produk Berkaitan 11 Tata Etika Pemasaran Semua ibu HIV positif menerima runding cara dan sokongan daripada anggota kesihatan tentang pemakanan bayi (jika berkaitan) 12 HIV Polisi Penyusuan Susu Ibu & Pemakanan Bayi, Hospital Shah Alam
-Menggalakkan ibu mempuyai teman sepanjang proses kelahiran ·Membenarkan ibu mengambil minuman atau makanan ringan semasa proses kelahiran (bagi ibu berisiko rendah) -Menggalakkan ibu untuk memilih kaedah penahan sakit bukan ubatan ·-Menggalakkan ibu berjalan dan bergerak sebelum kelahiran serta memilih posisi kelahiran mengikut kesesuaian -Menggalakkan kelahiran secara semula jadi. -Mengelakkan prosedur invasif kecuali atas sebab perubatan 13 Penjagaan Mesra Ibu Mengamalkan Penjagaan Mesra Ibu (Mother Friendly Care) Polisi Penyusuan Susu Ibu & Pemakanan Bayi, Hospital Shah Alam 14 Amalan Penyusuan Susu Ibu Semasa Pandemik Semua ibu yang disahkan atau dalam siasatan jangkitan penyakit sewaktu pandemic akan menerima runding cara serta tunjuk ajar tentang penyusuan dan pemakanan bayi mengikut tatacara penjegahan dan kawalan jangkitan di fasiliti kesihatan tersebut. (infection prevention and control)
PROCEDURES Ensure presence of an assistant (SN/HO/MO/specialist) during procedures Only two attempts of blood taking/ branula insertion is allowed. To call senior (MO/ specialist) for help if needed. No HO allowed in NICU acute cubicle Ensure gloves are worn during procedures and remove after procedures Ensure the procedure room is clean at the end of every shift Practice appropriate of hand hygiene
4. DUTIES & FUNCTION
GENERAL DUTIES House Officers are expected to do round, clerk new cases, set branula and blood taking. 1. During tagging period, house officer should clerk as many patients as possible and perform procedures. 2. 3.House officer need to follow specialist’s round AM/PM/Night House officer will be in charge of brown code in GOT/MOT/LR once done NRP megacode 4.
SHIFT SYSTEM AM shift: 7AM - 5PM ( 10H) PM Shift: 7AM - 9PM (14H) Night Shift: 8PM - 12MN (4H) Post Night : 12MN - 9AM (9H) 1 day off will be allocated each week Total working hour average 60 hours per week
HOUSE OFFICER LEAVES 1.All leaves ( AL/EL/MC) must be inform to HO leader, Doctor in-charge 2.Annual Leaves: entitled for 8 days of annual leave per posting / total 10 days including MC may combine off -days and leave days, max days allowed is 2 Application for leave must be submitted 2 weeks earlier to HO leader and signed by MO / specialist in charge. Leaves will not be entertained if application forms are submitted late if MC / leave is more than total leaves entitlement, then posting duration will be extended based on the number of leaves exceeded.
5. CLINICAL PRACTICE GUIDELINES
CPG 1.Management of Type I Diabetes Mellitus in Children and Adolescent 2.Use of Growth Hormone in Children and Adults 3.Management Of Haemophilia 4.Management of Transfusion Dependent Thalassaemia 5.Management of Immune Thrombocytopenic Purpura 6.Management of Dengue in Children (Second Edition) 7.Management of HIV Infection in Children Management of Attention-Deficit/Hyperactivity Disorder in Children & Adolescents (Second Edition) 8. 9.Management of Autism Spectrum Disorder in Children and Adolescent 10.Management of Chronic Kidney Disease 2nd Edition 11.Management of Otitis Media with Effusion in Children 12.Management of Neonatal Jaundice (Second Edition) 13.Withholding and Withdrawing of Life Support in Children 14.Withholding and Withdrawing of Life Support in Children 15.Childhood Immunisation Management of Postnatal Corticosteroids for the Prevention of Chronic Lung Disease In Preterm Infants 16. 17.Management of Tuberculosis (4th Edition) 18.Management of Atopic Eczema https://www.moh.gov.my/index.php/pages/view/3962?mid=1570
LOCATION OF CPG FILES CLINIC: ROOM 1 WARD 12: COUNTER NICU: COUNTER INTER NICU
6. INFECTION CONTROL/ SAFETY POCEDURES
HAND HYGEINE
HAND HYGEINE
HAND HYGEINE
NEEDLE STICK INJURY sumber rujukan Public Folder > JKKP
FIRE SAFETY
FIRE SAFETY
MALAYSIAN PATIENT SAFETY GOALS 2.0
NRP Megacode will be arranged through out paediatric posting. Every HO needs to pass NRP to pass the posting. HO teaching (CME Presentation by HO) every Wednesday Get the syllabus from specialist 2 weeks before fixed date and show to specialist in charge 1 week before presentation HO are encouraged to ask questions during rounds regarding patient’s diagnosis and management. 7. TRAINING
Assessment by Specialist within 2nd and at 3rd month of posting To make appointment with specialist in charge at least 1 week before dateline To see Paediatrician in charge of HO at least 2 weeks before last day to review log book and make sure assessment is completed, otherwise you will be given extension letter for 2 months 8. ASSESSMENT
Paediatric protocols latest edition Frank Shann Calculator Name stamp (name with MMC number) 9. TOOLS
10. PATIENT AND FAMILY RIGHTS Parents/guardian and patients shall be given appropriate information to encourage and permit them participate in the care given. 1. 2. The Baby Friendly and Child Friendly Policy shall be in practised. 3. Patient’s need for privacy shall be respected during clinical interviews, examinations, procedures/ treatment and transport. 4. The institution shall be respectful of the patient/ carers personal values and beliefs. 5. Patients shall receive appropriate protection while in the hospital.
Welcome to Paediatric Team