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Hospital work experience: electronic discharging on the stroke and cancer wards

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I spent some time with a senior technician, a directorate pharmacist and a pharmacist new to the hospital who were discharging patients.  We therefore went to many different wards validating electronic discharge notices (eDN) which entailed checking that the medication and the doses were suitable and that the patients had enough of everything to take home/at home and if not the dispensary would arrange more supplies for them. The hospital aims to send patients home with a minimum of fourteen days supply. We started in the cancer ward which has a hand wash station outside, a buzzer and two air lock doors as infection control. In addition, the doors onto each of the ward rooms were closed so I did not actually see any patients. I was told that a particularly unpleasant line many cancer patients have is a Hickman line in the neck.  It is useful as the patient does not have to be injected multiple times to take blood or to give medication. To prevent clots forming in the line it is often flushed with heparin and it is also flushed with vancomycin or gentamycin to treat any infections.  In cancer patients neutropenic sepsis is common due to chemotherapy treatment and a potential site of infection is the Hickman line.  Hence the very rigorous  infection control for visitors to the ward.We then moved to the acute stroke ward – NICE actually recommends provision of an acute stroke ward as part of treatment guidelines for stroke.   I learnt that there are two different types of stroke; haemolytic and thrombolytic.  Before any treatment can commence a scan is needed to ascertain which type is present as they have different treatment regimes. Interestingly, when treating a stroke patient a slightly higher than normal blood pressure is acceptable as more blood will be reaching the brain to repair any damage.

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