General and Fracture Orthopaedics Rehabilitation (Ward 1)

What is the Nightingale facility at Whiteabbey Hospital?

The Nightingale facility at Whiteabbey Hospital (also known as the Whiteabbey Nightingale or Ward 1) is a regional facility that opened in November 2020 in preparation for a second wave of the COVID-19 pandemic to provide extra beds to assist with discharge of patients from acute hospital care. From November 2020 – April 2021 it operated as an Enhanced Nursing and Therapies Rehabilitation and Step-Down unit.

As cases of COVID-19 decreased across Northern Ireland, the facility changed its model and started providing Non-COVID General Rehabilitation in April 2021.

From 6 September 2021, the facility has transitioned to a Fracture Orthopaedic Rehabilitation model, while also remaining open to Non-COVID General Rehabilitation patients.

What regions will the facility service?

Whiteabbey Nightingale operates on a regional basis for all five health and social care trusts in Northern Ireland, offering 7-day rehabilitation/therapy.

What is the bed capacity?

Whiteabbey Nightingale has overall bed capacity of 28 beds; currently there are 23 beds in use.

If required, Whiteabbey Nightingale is available to revert to its COVID-19 rehabilitation pathway.

How are wards structured?

Provision of accommodation is a combination of single rooms and multi-bedded bays.  A typical ward has five single rooms and a number of five or six bedded bays depending on space.

The grouping of patients by bays and single rooms is a clinical decision.  We are also mindful of how we place people in wards according to gender. Currently, we are endeavouring to keep single gender bays in Whiteabbey, but this may prove challenging and there may be instances where clinical need outweighs this preference.

How is the ward ventilated?

In Whiteabbey Nightingale, emphasis has been focused on providing good ventilation so there is a dilution of anything in the air that would increase the risk of infection. Additional cooling has also been installed to provide additional comfort during the summer months.  There are six air changes per hour which is the recommended level which should be provided for ward-based patients.

Patients

Who will be referred to this facility?

This facility will have specific entry criteria for Fracture Orthopaedic and General Patients in need of rehabilitation.  The target length of stay is a maximum of 14 days and referrals will be assessed against this to maintain patient flow.

Admission Criteria

1.) Aged 16yrs or over

2.) Must be assessed as requiring Multi-Disciplinary rehabilitation.

Patients with delirium/dementia will be considered on an individual basis
For dementia/delirium, there should be evidence the patient is capable of engaging in active rehabilitation
Patients with any condition that may interferes with their ability to participate in active rehabilitation will be considered on a case-by-case basis e.g. significant postural hypotension
Patients with established NG feeding may be considered

3.) Must be assessed as capable of being discharged from the WAH step-down unit back to their usual Trust services within 14 days or less

Patients requiring greater than 14 days will be considered on an individual basis as per current protocol

4.) No longer requires acute hospital medical treatment or care.

Patient appears clinically well
Bloods provided with referral must be up to date within 48hrs prior to acceptance (repeat bloods will not be request once accepted)
Patient’s early warning score should be stable

5.) Patients are required to have a negative COVID-19 swab 48hrs prior to transfer

IPC measures should continue.
Absence of fever (> 37.8°C) for 48 hours without the use of medication
No underlying severe immunosuppression

6.) Stable oxygen saturations either on room air or on prescribed oxygen therapy

The patient can be admitted for rehabilitation if still requiring oxygen therapy either as ambulatory or long term oxygen therapy
Ongoing need for oxygen therapy assessed prior to transfer and oxygen prescribed as required, prior to transfer and admission to the WAH step-down unit (The patient does not require oxygen flow at greater than 5ls/min)

7.) Capability to actively take part in an active rehabilitation programme

How will patients be referred to the facility?

Patients will be referred via a central hub; they may be referred from their home Trust or from another Trust where they are receiving treatment in, for example, a patient from Southern Trust could transfer to Whiteabbey Nightingale from Belfast Trust.

What rehabilitation is available?

The service includes a specialist team including; Doctors, Nurses, and Allied Health Professional (AHPs) – Physiotherapists, Occupational Therapists (OTs), Speech and Language Therapists (SLTs), Dietitians, Social work, Pharmacist and Therapy Assistants.

This is a multi-disciplinary team led unit and you will receive input from the professions beneficial to your individual needs. You may not need input from all of the team professions.

Individual rehabilitation goals will be planned with you and your family where possible and your progress will be reviewed daily.

How will patients get to Whiteabbey Nightingale?

Transfer will be by the Northern Ireland Ambulance Service (NIAS) or another appropriate transport provider, taking account of both the Infection Prevention and Control status and each patient’s safety and care requirements

How long will a patient remain in the Whiteabbey Nightingale?

Since opening, Whiteabbey Nightingale has maintained an average length of stay of under 14 days, Individuals often discharge within a shorter time frame once their rehabilitation goals achieved.

What happens after a patient is discharged from care?

The multi-disciplinary team work closely with patients’ families and home Trusts to ensure they can be discharged into an appropriate care pathway, with the necessary level of support.   Individuals will be referred to their own Trust if necessary.

What should patients bring with them?

We recommend that you bring the following items with you:

• Comfortable clothing for day wear including comfortable footwear (secure fit, good support and sturdy sole)
• Nightwear such as pyjamas
• Any personal belongings that may support your recovery such as photos or reading materials
• Personal toiletries such as toothbrush and toothpaste, brush, face cloth, deodorant etc.
• Hearing aid, glasses and dentures as required.
• Please refrain from bringing valuables into the hospital.

What is the visiting protocol?

Visiting arrangements will align with guidance from the Department of Health.  The team will keep in close contact with your family.

Workforce and Recruitment

What is the workforce model?

Whiteabbey Nightingale is a new delivery model of care led by highly skilled and experienced Nursing and Allied Health Practitioner team.  Medical input is provided by doctors from Primary Care – GPs.

Whiteabbey Nightingale operates through a Multi-Disciplinary Team, with patients being cared for by a combination of Doctors, Nurses and Allied Health Professionals (AHPs) over a 14-day average length of stay.

AHPs, including Physiotherapists, Speech and Language Therapists (SLTs), Occupational Therapists (OTs) and Dietitians, Pharmacist and Social workers who provide input for the rehabilitation and discharge planning.

What roles can I apply for?

Visit www.jobs.hscni.net for more information on vacancies including job descriptions, personnel specifications and to apply.

Does the facility provide a 7-day service for all disciplines?

The Whiteabbey Nightingale Hospital is a 24/7 service which includes evening and weekend working. The majority of roles will be expected to support this service model. For more information please review the job description for the role you are applying for and/ or seek clarity from the chair of the panel at interview.