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PAEDIATRIC DEPARTMENT Hospital Tengku Ampuan Rahimah, Klang INTRODUCTION Patients from neonatal age group to 12 years Neonatal wards – below age of 1 month Paediatric wards/Isolation/PHDU from age of 1 month to 12 years 6D NICU 32 6B GENERAL PEADIATRIC WARD PHDU PICU 6 FUNCTION NO OF BEDS WARD 36 6C 7D BOR of all wards exceeded 80%. Wad 6BGeneral Paediatric Ward BOR 94.8120%. Now 200% BOR Wad 6C (SCN) 110.76% 6D(NICU) 91.5%.
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PAEDIATRIC DEPARTMENTHospital Tengku Ampuan Rahimah, Klang
INTRODUCTION Patients from neonatal age group to 12 years Neonatal wards – below age of 1 month Paediatric wards/Isolation/PHDU- from age of
1 month to 12 years
WARD FUNCTION NO OF BEDS6A SCN 206B GENERAL
PEADIATRIC WARD
36
6C SCN 426D NICU 32PHDU PICU 67D ISOLATION
WARD10
6C
7D
WORKLOAD BOR of all wards exceeded 80%. Wad 6B-General Paediatric Ward BOR 94.8-
120%. Now 200% BOR Wad 6C (SCN) - 110.76% 6D(NICU) - 91.5%.
CLINIC MONDAYS TO FRIDAYS
About 2,810 patients were seen in 2008.
OTHER ACTIVITIES
CHALLENGES Crowded wards. Increasing bed occupancy rates Shortage of staffs Lack of subspecialists
FUTURE NEW MATERNITY AND CHILD COMPLEX
HOUSEMANSHIP IN PAEDIATRICS 4 months Tagging period- observe and supervised for
procedures and clerking of patients.
5pm to 10.30pm on weekdays 8am to 5.30pm on weekends and PH
Working hours – 7a.m to 5p.m. Morning and afternoon rounds
Calls. 8 houseman on call Night rounds Rotation through all wards except PICU Labour room cover Newborn screening
CME Houseman teaching once a week Journal club meetings Grand ward round weekly Monthly mortality meeting Perinatal meeting
PROCEDURAL SKILLS Blood sampling Peripheral venous sampling Exchange transfusion Catherisation
MANAGEMENT SKILLS 6C/6D
Gestational age assessment Fluid requirement Feeding - amount, method Recognize an ill infant
COMMON ADMISSIONS TO 6C/6D
Presumed sepsis Neonatal jaundice Hypoglycemia Infants of diabetic mothers Newborn with respiratory distress Preterm infants
MANAGEMENT SKILLS WARD 7D Hydration status Shock Oral rehydration Common admissions
AGE Dengue fever and DHF
MANAGEMENT SKILLS IN 6B Common admissions
Respiratory infections Asthma Febrile fits Acute glomerulonephritis/nephrotic syndrome Poisons
ASSESSMENT
Throughout the posting Attitude Knowledge Skills
Viva NRP Log books
ISSUES WITH HOUSEMAN Strict and satisfactory hand washing is a
moral obligation Sharps disposal Punctuality Proper usage of equipment Be contactable Follow guidelines in each ward
Summaries within 48 hours Knowledge of patients in wards Acquiring knowledge Clinical practise guidelines Entries in patient notes improper and
incomplete Soft skills
FINALLY Ensure time is utilised effectively Clear doubts as they arise Take pride in your work Work as a team Acquire basic skills and knowledge Houseman are the eyes, ears and our hands
when we are not there Learning has just begun