Services Provided (Inpatient and Outpatient Care)

Inpatient Care

Outpatient Care

The Paediatric Department caters for both inpatients (admissions) and outpatients.

The inpatient service is provided for by four general and two neonatal wards. The ambulatory patients are seen either by the Paediatric outpatient department (POPD), or are attending one of the sub-specialty clinics.

INPATIENT CARE

General Wards

The general wards have patients ranging in age from birth to 13 years. These patients fall under the care of the four units as noted below. Each unit is responsible for their designated patients.

A unit comprises of a consultant, a registrar, one medical officer and two interns. For most of the year there is at least one or two junior interns (GEMP IV) attached to each unit. The Units share the intakes by being on call alternately every fourth day.

Unit Consultants

Unit 1 – Nicole van Wyk

Unit 2 – Tim De Maayer

Unit 3 – Gill Sorour & Fikile Mabena

Unit 4 – Gary Reubenson & Judy Rothberg

Wards

Ward 17 – “Little Angels” Admission ward (Ground floor) Ward 1 – admits children from birth to 6 months.

Ward 2 – admits children between the ages of 3 years and 13 years and 11 months. Ward 3 – infectious diseases ward: Gastro-enteritis and Isolation ward.

Ward 4 – admits children between the ages of 6 months and 3 years.

Neonatal Unit

Dr Joy Fredericks, Dr Elizabeth Ho, Dr Delania Lawrence, Dr Khakhu Mathivha and Dr Loshnee Nair run the neonatal division of the inpatient section.

Ward 16A – Paediatric Intensive Care Unit (PICU) + High Care Area Ward 16B/C – Premature unit and Kangaroo Mother Care (KMC)

(See Separate Neonatal Handbook for more information about the Neonatal Unit)

OUTPATIENTS

Rahima Moosa has a busy POPD that is open on weekdays from 8am to 4pm. There are three full time and two part time staff members working in POPD. There are also 4-5 interns/MOs in POPD at any given time. Interns will rotate through POPD and spend two weeks in the department. The POPD staff see all ambulatory paediatrics, so if you have plans to run a GP practice one day, this is exactly what you will do there, so make the most of this opportunity to learn.

The GOLDEN rule in POPD: ASK IF YOU ARE NOT SURE WHAT TO DO!!!

When you are not sure, there are always senior staff around to give second/third opinions! You should also discuss ALL referrals to Little Angels (Ward 17) with one of the senior doctors.

There exists a good working relationship between the outpatient and the inpatient divisions. Underlying this relationship and vital for its continued success is communication. By this is meant that there should be good communication both ways when staff consider referring patients from one to the other and also when providing feedback on further progress on patients. We function as a team and all teams need good communication to win the game.

General rules and guidelines

Working hours in POPD are from 8am to 4pm. Tea can be taken from 10h30 to 11h00 and lunch anytime from 12h30 to 14h00 for 30 MINUTES, but please always discuss with your seniors before leaving! Tea and lunch breaks are to be taken in turns so that there are always doctors present in POPD. During busy times, doctors are expected to take shorter breaks in order to facilitate the load of patients. If you are ill or late, please let Mrs Karen Marshall or Dr Ahila Sothylingam know in good time! As a rule the person to inform is your immediate supervisor.

The telephone number at the nurses’ station is: 011 470 9078.

POPD is a MEDICAL facility. All trauma - and urgent surgical cases (including abscesses) must be seen in casualty.

To lessen queues; please make use of the down-referral and TST (Tuberculin Skin Test or PPD/Mantoux) reading forms where appropriate.

Pharmacy: Please date and sign all your prescriptions including the TTOs (take-home meds), and remember to add your qualifications and name, legibly! It is also a good idea to put the weight of the child on the left hand column of the prescription card below the date, to assist the pharmacists in checking the accuracy of the doses prescribed.

Laboratory: Doctors take their own bloods and do TSTs. There is an NHLS collection box in POPD that gets emptied regularly, but if you have an urgent specimen, you can also take it up to the lab yourself for a speedier service.

Road-to-Health Booklet: Use these! Document your patient’s weight, check whether their immunization and vitamin A schedule is up to date, and make a note of their current illness. (This also needs to be done on discharge from the ward; there is a section for hospital admissions on the inside!) RTHBs also contain HIV specific information about the mother and her PMTCT. Make sure to look out for this, as well as to take a good history about this.

HIV: An HIV test with pre and post-test counseling should be offered to ALL patients whose status is unknown. If a child’s HIV result comes back positive, be sure to offer the parents counseling and testing for themselves as well as all other siblings. Empilweni clinic staff needs to be notified of all newly diagnosed cases of HIV or suspected cases under investigation.

Collection of POPD statistics: All doctors are required to fill out a stats sheet daily, reflecting all patients seen and their diagnoses. Interns are required to assist with monthly collection and collation of POPD statistics. Details will be provided during your rotation.

REMIND PARENTS OF PATIENTS WITH MINOR ILLNESSES TO USE THEIR LOCAL CLINICS! Where to refer your patients?

WARD 17: Patients needing admission or more extensive investigations are referred to Ward 17 (Little Angels) for further assessment, investigations, sleepover or admission.

SPECIALIST CLINICS: Patients needing specialist care and after having discussed with a senior staff member from one of these clinics may be booked by calling 011 470 9359/9360