1. Select patient > Orders > Press Enter > Then type EO (Enter Order)
2. Under Category, type THB
3. Under Procedure, type THB again
4. Type name of operation required
5. Press F9 to choose urgency (within 1, 6 or 24 hours)
6. Y/N for anaesthetist informed/ starved and fitness
7. Press F9 to choose type of anaesthetic (GA or LA)
8. Press F9 to choose alerts and operating surgeon
9. Type comments (phaco/ vitrectomy kit/ diathermy)
10. Include your contact number/ ward telephone

Communication

Staff: Duty Anaesthetist if GA

Theatre 3 staff

Ward 55 nurses

If require a general surgical bed post-op inform emergency coordinator - bleep 2750

Patient: Confirm time of last meal/drink and keep NBM

Confirm if fit for an anaesthetic (liaise with anaesthetist)

Request pre-op bloods and ECG (required for GA)

Timetable

There is a new timetable every 6 months, your timetable is usually agreed before you join the team and sent to you via email.

Teaching

Wed pm - Liverpool Medical Institute, Mount Pleasant, Liverpool

College Tutor – Mr Jon Bhargava

Audit

If you wish to participate in an audit/ data collection please contact Mr Cazabon (Current Audit Lead).

Eye Library

There is a reference library available to all staff. Please apply to the Orthoptists for a key

Annual and Study Leave

You will need six weeks’ notice for annual and study leave. Your leave forms will need to be signed by the rota coordinator, at the moment Mr Kashif Ali prior to Mr Jon Bhargava’s signature. Study leave should be booked using the tracker system which can be accessed via the intranet homepage.

Sick Leave

If you are unable to come in to work due to illness please notify the manager and secretaries as well as medical staffing as soon as possible. Please let them know how long you expect to be off with your illness if appropriate.

Casualty cover on Rolling Half Days

You may be required to cover Ophthalmic casualties in rotation if clinics are suspended although at present the Ophthalmology department does not participate in the Hospital Rolling Half Days.

Listing patients for Surgery

There are specific forms for listing patients for Cataract surgery under local anaesthesia: Please complete all relevant sections. The forms are located in Outpatients please ask a member of the nursing staff.

There are purple listing forms for Cataracts under GA and all other procedures

Consent Forms

Please familiarise yourself with the consent forms specially:

Routine LA Cataract consent forms – Form 12

Adult procedures under LA (including lasers) -

Adult procedures under GA – Form 1

Paediatric consent forms – Form 2

FFA – a) Form 1 or b) Form Three – Single Stage Process

Treatment for Wet AMD (FFA/OCT/Injections) – see FFA b

Intravitreal Avastin injections – see FFA b

Review of Inpatients

You will be expected to review inpatients from time to time. The nurses in outpatients will normally bring to your attention if any inpatient needs to be reviewed. A portable slit lamp, perkins tonometre, portable snellen chart as well as direct and indirect ophthalmoscope is available.

Retrieval of eyes from Donors

There is an eye retrieval nurse available Monday – Friday 9am to 5pm to retrieve eyes. On working days, any retrieval out of hours can be left till the following morning. However, on Friday after 5 pm and weekends, you may occasionally be contacted to retrieve eyes. Eye boxes, containing sterile pots, plastic eye stands, plastic bags and UKTSSA Donor Information Forms can be obtained are boxes/kits available in Consulting Room C (Glaucoma Clinic).

Note: Retrieval of eyes from Donors who expire on Sunday can be left until Monday morning (unless bank holiday).

On-Call

We run a joint on-call rota with Arrowe Park Hospital. This on-call rota involves the hospitals taking emergencies one week at a time. This means that patient’s presenting for example to Arrowe Park A & E will be referred to see you when Chester hospital is on call. The reverse obviously applies when Arrowe Park is on-call. This system has been running for some time without major problems. There will obviously be exceptional situations that will demand that an ophthalmologist travels to the other hospital but we want to minimise this as much as possible.

We ask that you remain as flexible as possible and rather than causing diplomatic problems it will always be better to discuss the case with the consultant on-call if you see disagreements between staff.

There is also a standing arrangement, whereby a Chester trainee is responsible for running a clinic on Saturday and Sunday morning from 9am – 12 pm when Arrowe Park Hospital is on-call. This is designed to deal with follow-ups from the week, inpatients and other problems that should properly be dealt with at Chester rather than referred to an Arrowe Park trainee who may not know the patient. The same applies to Bank Holidays.

Medical students

Medical students are welcome to attend clinic please contact the secretaries to arrange this, we would ask for only one student per clinic.

Your learning objectives could include:

1) Red Eye

2) Loss of vision

3) Cataracts

4) Visual field defects

5) Glaucoma

Useful Guidelines

There is a folder for Ophthalmology guidelines which can be found on the ‘Shared drive’ (s:) using the following pathway:

Coputer > S: Drive> Clinical > Opthalmology > Eye Drive