Title: Wounds, Charts and Medication:
1Wounds, Charts and Medication
- Tips on teaching nurses
- Virginia Allum
2Introducing ..Virginia Allum
- Co-author with Patricia McGarr of Cambridge
English for Nursing (Int Plus and Pre-Int) - Currently Staff Nurse in a private hospital (mix
of private and NHS patients) - Productive Ward Project Leader and Infection
Control Link Nurse
3Our session today
- Well look at Wounds (an example of a nursing
procedure ) / youll do some medical terminology
activities - Well look at Charts (example of common writing
skills needed by nurses) / youll complete a
Wound Chart - Well look at Medication (use of maths terms and
abbreviations) / you do a Find-a-Word
4Before we start , Why teach Specialist English
for Nurses?
- Nurses leave NHS for better life abroad
- Daily Mail 7 Nov,2010
- An increasing number of overseas nurses are
already arriving in Britain to fill the rising
number of hospital vacancies. - Last year Britain imported 8,500 nurses and
midwives - many coming from poor countries such
as India, Pakistan and the Philippines.
5What do stakeholders demand of overseas nurses?
- Ability to communicate effectively
- Safe practice
- High standards of technical knowledge
- Cultural sensitivity and awareness
- Good teamwork
- Ability to work with other Health Care
Professionals
www.nursepostcard.com
6Here to Stay? International Nurses in the UK
2003 (NMC)
- Four main areas of concern for hospital managers
who employ overseas nurses - 1. language
- 2. differences in clinical and technical
skills - 3. racism in the workplace
- 4. reaction of patients.
7Language areas of need
- Everyday communication
- Nurse-to-nurse communication
- Technical knowledge (medical terminology)
http//www.nursingtimes.net/pictures/182xAny/7/2/1
/1205721_1205409_nurse_talking_paperwork.jpg
8Lets look at wounds...
- Or any nursing procedure
- Specialised language (look at wound websites,
prefixes suffixes) (R, S, L, W) - Recycle general English (asking for info, giving
advice, assessing pain, giving directions) - Maths terms e.g dimensions of wound, amount of
discharge - Opportunity for role plays
9A word about role plays
- They are serious enough for ESP
- Perfect opportunity to use specialised language
in authentic situations (lots of handovers,
telephone referrals in nursing) - Ss can write them and own them
- Bring in guest speakers (e.g real nurses or
student nurses ) to confirm authenticity
10Wounds opportunity to look at...
- Verbal descriptions e.g. in handover
- Written descriptions e.g. Wound Chart
- Abbreviations
- Equipment e.g Dressings
- Documentation Care pathways
- Staff in specialty areas Infection Control
Nurse, Tissue Viability Nurse
11What is there to say about wounds?
- Types of wounds (surgical, ulcers, lacerations
- Position on body (on the right ankle)
- Description ( order of adjectives)
- Colour (of the surrounding skin, wound
discharge) - Size (width and depth)
- Amount of exudate (small, moderate, copious)
12What else?
- Presence of drains
- Equipment used (VAC)
- Dressings ,surgical tape, bandages
- Sutures, clips, staples and Steristrips
- Nursing jargon v medical term (healing v
granulating )
13Types of wounds
- Vocab use Pharmaceutical company websites e.g.
http//int.hansaplast.com/med-info/wound-care-bea
utiful-healing/types-of-wounds.html - Use pictures or diagrams match terms
- e.g. Match medical term to everyday term e.g
contusion bruise - Use nurse education on Pharmaceutical sites e.g.
T.I.M.E on Smith Nephew
14Warning Pictures of wounds on next slide
- Use authentic photos of wounds if possible
- Be advised that some are pretty awful!
- Next slide not too bad but..
1511
3
2
4
16Now, in pairs, do handout exercise 1.
Photo number Type of wound
1 Pressure Ulcer
2 b)Surgical wound
3 c) Cut or laceration
4 d) Bruise or contusion
17Describing a pressure wound What can you get
out of it for a lesson?
- Use body diagram (front and back) see WSheet
- Practice of body parts (everyday v medical term)
- Practice of Where is the wound? (Position of
the wound)- The wound is over the right lateral
malleolus (ankle) - Exercise Blank diagrams of the body with
numbered wounds. In pairs, Where is wound (!)?
18Body Diagrams
- Terminology (body position anterior, posterior
etc) on the back of.. - Parts of the body e.g where pressure ulcers may
occur - on her sacrum - Everyday terms versus medical terminology -
shoulder blade scapula
19Now, in pairs, do Exercise 2
- Look at the numbered diagrams of the body
- Complete the table using terms in the box below
- Further activities make up double-side cards
(everyday term one side, medical term reverse
side) pr work. - Speed work, 2 groups , complete table on WB .
First team to get rid of cards, wins
20 21 Humerus Outside ankle bone back of the
head calcaneus inside ankle
bone Thigh bone pinna shoulder
blade hip bone lower back
Olecranon process spine flank
Number Everyday term Medical terminology
1 Heel (Heels)
2 Lateral Malleolus (Malleoli)
3 Medial Malleolus (Malleoli)
4 Greater Trochanter (s)
5 Sacrum
6 Ischial Tuberosity (Tuberosities)
7 vertebrae
8 Occiput
9 Ears
10 Shoulders
11 Scapula (Scapulae)
12 Elbow (Elbows)
13 Iliac Crest
Humerus Outside ankle bone back of the
head calcaneus inside ankle
bone Thigh bone pinna shoulder
blade hip bone lower back
Olecranon process spine flank
Humerus Outside ankle bone back of the
head calcaneus inside ankle
bone Thigh bone pinna shoulder
blade hip bone lower back
Olecranon process spine flank
22Matching cards - example
Haemat- -oma erythr- Ven-
Necro- -itis Ser- Esch-
scab red blood Swelling
plasma dead Inflammation of Vein
23Using websites for inspiration
- http//news.bbc.co.uk/1/hi/health/1751163.stm
'Living bandages' for wounds The technology for
the 'bandage' was adapted from drinks cartons
24Online BBC Radio Transcripts
- http//www.bbc.co.uk/radio4/science/casenotes_tr_2
0050208.shtml - RADIO SCIENCE UNITCASE NOTES 9. - Wound
Healing
25Use clips on websites Wounds UK
http//www.wounds-uk.com/
- Use demonstration videos as Listening Practice.
- Prepare worksheets (missing terms)
- Vocab matching
- Ss design a teaching session e.g. How to set up a
negative pressure wound treatment / in prs teach
each other
26Charts and Documents
- Legal documents
- Completed each shift
- Used as communication between shifts
- Nursing Care Plans
- Integrated Care Pathways (Wound Charts)
- Policies and Procedures
27What are Nursing Care Plans?http//www1.us.elsev
ierhealth.com/MERLIN/Gulanick/Constructor/index.cf
m?plan32
- Use the online resource to create a printable
Care Plan - Use as vocab resource
- Use as Handover Resource S (nurse) gives
information about wound care during handover e.g
Ive encouraged increase intake of protein-rich
foods to help healing.
28Integrated Care Pathways Wound Chart
- ICPs require nurse to tick correct box
- Reading gt Writing
- Specific terms used
- Assessment often uses grading system (Grade 1
not too bad ? Grade 5 very serious
29Wound Chart on p2 of worksheet
- Vocab work prefixes and suffixes - flashcards
- Description of wounds recycle descriptive
language, order of adjs - Grade of pressure ulcer match photos
- Wound drainage (discharge) jargon- purulent
discharge pus, discharge ooze
30Example of wound chart
31Now, Exercise 3 Where is the wound?
- Complete the Wound Chart using information in the
scenario
32WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924 WOUND CHART NAME Mrs A. Patient DOB 30/ 11/ 1924
WOUND TYPE TICK WOUND APPEARANCE Tick Wound Drainage Tick Pain Tick
Abrasion Blister Purulent (pus) Site
Haematoma Erythema (Redness) Haemoserous (Blood-stained fluid) Dressing change
Laceration Inflammation Nil continuous
Ulcer Maceration (over-moist) intermittent
Surgical incision Slough When limb elevated
Eschar (black, hard scab) Nil
Epithelialisation (healing tissue)
Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change.
33The Wound Chart ex can be ..
- A practice of handovers (write a dialogue using
given info / complete missing terms in dialogue/
practise as a role play ) - Used for different scenarios (dog bite, fall ,
burn, operation) - Used to recycle language ( Shes got a .. , The
ulcers on her sacrum...) - A practice of vocab of body parts / areas
34Scenarios..here is another
- Mr D Hatworth was repairing his fence when he
accidentally dropped a piece of wood which grazed
his right lower leg. He left the wound untreated
for two weeks apart from dabbing on a bit of
antiseptic cream. Now, the wound is painful to
touch and is red and inflamed. There is a small
amount of blood-stained discharge
35Answers students complete wound chart
- Wound abrasion
- Wound Appearance erythema, inflammation
- Wound Drainage Haemoserous
- Pain Site
36Also, wound charts are a chance to..
- Do vocab exercises e.g prefix and suffixes e.g
necro-, -osis, haemat- , -oma, erythro- , ven-, - Make matching cards / flashcards
- Practise communication skills e.g Advise patient
on after care of wound dressing - Its important
to keep the dressing dry, Youll have to come
back next week for a new dressing ? make an
appointment / make a phone call to confirm
appointment with patient
37Wound Chart language
- Wound Type Its a ..
- Wound Appearance - Its got.. , Its got an
area of.. - Wound Drainage Theres a small amount of..
- Pain - Is it painful? , Do you have any pain?
When is the wound painful?
38Medications important area!
- Safe and accurate practice is essential
- Legal and patient health implications
- Oral medications (tablets, liquids)
- Nebulizers and inhalers
- Injections IMI ,IVI,
- IV fluids
- PR medications (suppositories, enemas)
- Oxygen
39Language skills needed
- Abbreviations (R, W, L and S) e.g bd, tds
- Maths terms e.g. Morphine 15mg pronun. practice
- Measurement terms e.g ml, mcg, 80, mg/ml, units
- Medication use e.g Read entries in BNF or MIMS
e.g side effects - Check for interactions with other drugs e.g (R)
literature on drug in blurb or on internet - Handover information e.g (S) intolerance to pain
killer
40Medications opportunities for?
- Research practice journals, EBP online
- Writing practice e.g develop a Public Health
Poster on Hypertension drugs ? present to class
(speaking practice) - Reading and comprehension practice e.g. Compare
drugs used for diabetes- small group work,
present to class ? teamwork
41Medication language practice
- Abbreviations e.g sc, prn
- Terms e.g nocte, mane
- Instructions e.g. Take this medication after food
- Polite advice e.g It would be a good idea to..
- Warnings e.g you must keep the medication in the
fridge
42The Medication Chart
- Understand terms used in the chart
- Get a copy of a medication chart for practice
- Latin terms
- Maths terms
- Use flashcards, cross-words, Find-a-Word to
practise terms
43Drug Chart - example
Allergies Adverse Drug Reactions
BD QDS TDS
Anti-coagulants
Slow Release
44Ex 4 Medication Table
- Read through the terms in the medication table
- Ask your teacher if you dont understand any
terms - Now, take turns to find a term explain the
meaning to your partner - Hint break into chunks or students will not
survive this exercise!
45Medical terms for medications Meaning
a.c Before meals
amps. Ampoules . This is the container for liquid medication for injection.
b.d (or b.i.d) Twice a day (bi two)
Inh. Inhaler e.g Salbutamol inhaler
IM or IMI Intramuscular ie an injection given into a muscle
IV or IVI Intravenous ie an injection given into a vein
IV Fluids Fluids given through an IV cannula. Also called a drip
mane In the morning
Neb. Nebulizer e.g Salbutamol nebulizer
Needle gauge Size of the needles eg 19g (drawing up needle) 21g (IM injections ) 23g (fine for sc injections)
NI Nurse Initiated medication e.g. Paracetamol, Coloxyl with Senna.
nocte At night
OD or daily Once a day
oral By mouth
p.c After meals
per NG through the nasogastric tube (through nose into the stomach)
pr Per rectum e.g. a suppository
prn whenever needed ( for pain, indigestion, constipation)
q.i.d or qds Four times a day (quad 4) .Doesnt have to be in 6 hour intervals.
R Refused by the pt. (written on the medication chart)
s.c Subcutaneous ie an injection given into the subcutaneous layer of skin
s.l Sublingual or under the tongue
stat (statim) immediately e.g. a stat dose of insulin
t.d.s Three times a day (Ter in diem)
top. Topical ie a cream or ointment e.g antibiotic cream
units Insulin is prescribed in units. E.g. 24 units of Insulotard
Venflon Type of intravenous cannula. Abbrev to IVC .
W Withheld (written on the medication chart) e.g. Digoxin because the pulse was 58.
1/24 or 10 Hourly or every hour
2/24 or 20 Second hourly or every two hours
4/24 or 40 Fourth hourly e.g. 4/24 T P R (Note this is 6 times a day)
6/24 or 60 Every six hours (Note this is 4 times a day)
46Medication Find-a-word
- In pairs, find a word relating to medication
administration in the Find-a-Word - Tell your partner what it means
- Use previous glossary to help you
47In pairs, identify a term in the Find-a-Word
below using the table above. Explain the meaning
of the term to your partner.
A N E B
M O O S
P E R R E C T U M
O A T B A
U L O E L N
F L U I D S I E
E N N C I N H
I J G
T E U
S C Q D S A
T R L A
A N T I B I O T I C
O P
V E N F L O N
48Good medication calculation sites for nurses
lots of related terms
- Medication Terms
- http//home.sc.rr.com/nurdosagecal/Conversions.htm
- http//www.jcu.edu.au/cgi-bin/nursing/test.cgi
(if you have problems go to www.jcu.edu.au and
Search Nursing Calculations Practice
49Other medication activities
- Reading a Medication chart use scenario
- The IV Prescription Chart
- The 5 Rights of Drug Administration research
and make an educational poster - Practice of role plays for medication
administration / recycle questions / asking for
information Do you need something for pain? /
giving advice Its best to take this tablet
with food
50Tips Use websites
- http//www.bhf.org.uk/living_with_a_heart_conditio
n/treatment/medicines_for_the_heart.aspx - http//www.proprofs.com/flashcards/story.php?title
types-wounds
51Invite guest speakers
- Nursing lecturers
- Nursing students
- Nurses
- Ask them to show authentic charts and
documentation (make sure any identifying
information is obscured first) e.g hospital logo
52Any questions?
- Thank you for having me
- PS answers to the exercises are on my blog
- http//englishfornursingandhealth.blogspot.com/