Patient recruitment for Med2 Neurology Clinical Skills

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This page documents how the Undergraduate Patient Recruiter recruits patients for the Med2 Neurology Clinical Skills Sessions at HSC and St. Boniface Hospital.

Objective

To recruit patients for Neurology Clinical Skills sessions in a timely fashion at Health Sciences Centre (HSC) and St. Boniface Hospital.

What is a Neuro Clinical Skills Session?

A Med2 Neuro Clinical Skills session give students the opportunity to become well versed, organized and professional when taking Neuro histories and performing physical examinations on patients. The Patient Recruitment Coordinator (PCR) will provide suitable patients for these sessions. The students are allocated 1.5hrs for each session. The sessions help the student transition from classroom to clinic and are an important part of the educational experience.

Program Overview

Patients from both hospitals will be needed for the students to perform these assessments. Each assessment will follow the same protocol:

  • Each patient will be visited by a group of students – usually three to four.
  • Patient should expect a visit from their assigned group at approximately 1 pm (1300 hrs.) on their appointment day. Appointment days are usually a Tuesday during October.
  • Students will ask a series of questions regarding the medical history of the patient.
  • Students will then perform a physical examination.
  • Patient History / Physical should take about 1hr to 1.5hrs
  • Patients must be recruited and assigned no later than 12 noon of the appointment day.
  • The students are allocated 1.5hrs per session.
  • Group returns to the patient with their preceptor at 1500hrs to present their findings.

Criteria

The PRC provides suitable patients for students. Patients are deemed suitable should they be:

  • Lucid and Conversant – with good grasp of the English language.
    • Neuro patients presenting with stoke symptoms may have limited control of their tongue and may not be able to vocalize and, as such, may not be suitable for this exercise.
  • On Neuro service, or have significant neuro findings.
  • Alert and oriented / not cognitively impaired.
  • Recently admitted and available on the day of the session – usually a Tuesday afternoon.
  • Not overly medically compromised. VRE / MRSA / Isolation may be used if necessary. Patients requiring a N95 would not be acceptable.

Recruiting Patients at Health Sciences Centre for Neuro Clinical Skills Program

Overview

  • The PRC will visit patients admitted with neurology findings and obtain consent from the patient to participate in an H & P (History and Physical).
  • Suitable patients may / will be found in different units throughout the hospital as there is no designated neurology ward in HSC;

The Procedure

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  • The PRC will receive the student assignment lists via e-mail from the Undergraduate Program Education Coordinator, Ms. Janet Labarre, at least one full day ahead of the recruitment dates.
  • Recruitment will take place on – or at least one full day ahead of – the appointment date.
  • Final schedules must be posted by noon on the day of the students’ assigned date.
  • Patients are usually needed at both hospitals. Manage time accordingly.

The Procedure – Day Of

  • Arrive at hospital. All parking expenses must be paid for up front by the PRC.
  • Consult with the Neuro Attending as soon as possible via office visit or phone call.
  • Visit GF-543 – the neuro students room – to:
    • Consult with neuro attending and / or attending resident for suitable candidates
    • print a copy of the neuro service list
  • If the neuro attending or resident attending is not available visit the following wards and consult with the charge nurse and / or attendings on duty that day:
    • A5 – Neuro Surgery
    • A4
    • GH7
    • CCU (located beside GH7)

The Procedure – Patient Interviews

Once a suitable number of recommendations is received from staff, visits may begin. It is recommended to follow a script during visits (see below). When interviewing patients:

  • Introduce yourself.
  • Explain your role and the purpose of recruiting patients.
  • Request their participation in the program.
  • Obtain Verbal Consent (See notes below).
  • Make appropriate notations in the Patient Chart (See notes below).
  • Assign the patient to a student group.
  • Ensure two extra patients have been recruited in the event of a cancellation, discharge or similar circumstance where the original patient is not available.
  • Post the completed list on the bulletin board beside GF328.
  • Verbal Consent: Please note that a ‘yes’ from the patient does not mean unconditional consent. It is important to ensure that the Patient:
    • Understands and is giving informed consent.
    • Is volunteering to participate.
    • Can opt out at any point of the session.
    • Is aware the session is not part of their care.
    • Is informed the session won’t interfere with any tests or other treatments scheduled.
    • Will not have to undergo pelvic or breast exams.
    • Can deny any other exam they do not want done.
    • Must receive consent from their legal guardian If under 18 years of age.

Patient Chart: Consent is verbal. Once secured, the PRC must go into patient’s chart and document a patient’s verbal consent in the Integrated Progress Notes (IPN) section. See below for the following example of a chart note:

00 Aug 2017 08:45: Patient consented to H&P from a 2nd year med student Tuesday 00 Aug 2017 ~13:00 if available. J. Smith (signature) J. Smith (printed) Patient Recruiter, University of Manitoba

Recruiting Patient at St. Boniface Hospital for the Neuro Clinical Skills Program:

Overview:

  • There is no neurology ward at St. Boniface Hospital
  • E5 and E6 are the two teaching wards however, the PRC may need to visit other wards.

The Procedure – Day Of

  • Arrive at hospital. All parking expenses must be paid for up front by the PRC.
  • Consult with the Neuro Attending as soon as possible via office visit or phone call.
  • Visit E5 and / or E6:
    • Check in with the unit clerk desk.
    • Locate any Attendings and / or the Charge Nurse of the day to:
      • Introduce yourself.
      • Explain your role.
      • Receive suitable patient recommendations.

The Procedure – Patient Interviews

Once there are a suitable number of recommendations from staff, patient visits may begin. It is recommended to follow a script during visits (see below). When interviewing patients:

  • Introduce yourself.
  • Explain your role and the purpose of recruiting patients.
  • Request their participation in the program.
  • Obtain verbal consent (See notes below).
  • Assign the patient to a student group.
  • Ensure up to two extra patients have been recruited in the event of a cancellation, discharge or similar circumstance where the original patient is not available.
  • Post the completed list on the bulletin board outside Room C5105.

Please note – Patient charts are not available at St. Boniface Hospital. Once consent has been given, leave a note with charge nurse of respective unit indicating which patients will be visited and when.

Additional Important Information

Read the notes from the service list & use your judgment.

  1. EMU epilepsy watch patients are not usable
  2. Very ill patients are not the best, such as CCU, ICU (GH7 is closer to ICU setting, although you can find good patients here)
  3. Speaking limitations may be noted

To figure out which patients to use: Plan a: Page neuro attending/ resident and get them to make recommendations

Plan b: Ask charge nurse on E5 and E6 for recommendations; make sure you specify that you are looking for neuro patients

Plan c: Page Internal medicine attending/ resident for recommendations

Plan d: Page screening medicine for recommendations

Plan e: Visit charge nurse in emerg and see if there any new neuro admits (if you get a patient from here, make sure you make a note for the student that the room may change by the time they come to visit

Script

Follow the Undergraduate Patient Recruiter Script

  • Depending on answers:
    • Yes: Once consent is given, review (repeat if necessary) what the patient has agreed to. Suggested wording: “Thank for agreeing to take part. A student will be by to visit you around 1 pm on the day of your appointment.”
    • Maybe: If the patient is unsure, advise them of the backup list. Also, advise that they are free to stop the process at any time if they not wish to continue any further.
    • No: Should the patient not wish to participate (no), thank them for their time, wish them well, politely excuse yourself and move on to the next potential participant.

Post Recruitment:

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  • If a list is not completed, for whatever reason, E-mail or phone the Undergraduate Education Coordinator , Ms. Janet Labarre – 204–787–8696 or the Program Administrator & Education Coordinator, Ms. Suzanne Doyle – 204–789–3888.
  • Once all lists are completed for the week, submit hours to Ms. Doyle. Add one hour to your timesheet to compensate for out–of–pocket parking expenses.

Of Note:

  • Lockers are not provided at either hospital. On weekdays, office space may be available for your belongings. If recruiting outside regular office hours, storage permission may be granted at the staffing areas of the various wards. Check with duty staff.

Lockers

  • Lockers are not provided at either hospital. On weekdays, office space may be available for your belongings. If recruiting outside regular office hours, storage permission may be granted at the staffing areas of the various wards. Check with duty staff.

Confidentiality

It is important for the patient recruiter to keep in mind that privacy rules govern all contact with patients during the recruitment process.

  • Do NOT approach family and friends admitted to the hospital.
  • Do NOT answer any questions about patient test results.
  • Do NOT speak to nurses on a patient’s behalf about anything to do with the patient.
  • Do NOT discuss patients outside of the work environment.

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