Mortuary Orientation Programme (St Helier)
This orientation programme is intended for members of the portering team who will be required to undertake the transfer of deceased patients from hospital wards and departments to the mortuary on the St Helier Hospital site. If you work cross-site, you will also need to undertake the training for the Epsom Hospital site.
All staff have a responsibility to ensure that deceased patients are treated with dignity and respect at all times and that the security of the mortuary facility is maintained.
This programme gives a detailed overview of your role in transferring and admitting patients from wards and departments to the mortuary facility. It is important that you raise any concerns or questions you may have with the mortuary staff at the earliest possible opportunity.
If, once you have completed this programme, you feel you would benefit from a one-to-one training session, please contact Rachel Graves (Deputy Mortuary Manager) to make an appointment.
A booklet is also available for reference in the mortuary cold store room.
Some Important Information
Cameras and Mobile Phones
Cameras, mobile telephones and any other device capable of recording are strictly prohibited from use in the mortuary without the expressed permission of the mortuary manager.
You are expected to observe the same level of confidentiality with regards to your mortuary duties as you are with all of your other duties.
How Many Porters Does It Take?
Two Porters Are Required
In order to provide a safe, dignified and respectful service, two porters are ALWAYS required to transfer and admit a deceased patient to the mortuary.
No exceptions - ALWAYS TWO.
Accidents and Incidents
If an Accident or Incident Occurs
Report it without delay.
- Contact your General Manager;
- Contact the Mortuary Services Manager;
- Contact the Clinical Site Manager.
Do Not Be Afraid to Report Incidents and Accidents
The Trust has a statutory duty to report any incidents and accidents to the Human Tissue Authority. In many cases we can learn from incidents and accidents, so they should not be regarded as something to be covered up.
Access to the Mortuary
Access To The Mortuary
NO ONE is allowed access to the mortuary when the mortuary staff are off duty. The only exceptions are:
- The emergency services (including resuscitation teams and Clinical Site Managers) attending an emergency;
- Nurses or Clinical Site Managers conducting viewings;
- Portering staff engaged in transferring and admitting a patient to the mortuary.
Do Not Use The Deep-Freeze Units
DO NOT use the freezer spaces
If there are no other spaces, call the on-call mortuary technician for advice.
Admitting a Deceased Patient to the Mortuary
Admitting a Body to the Mortuary
When you are requested to admit a body to the mortuary
You will need the following equipment:
- The mortuary concealment trolley;
- Disposable gloves
Make your way to the mortuary and collect the equipment. Any additional Personal Protective Equipment can be supplied (as necessary) by the ward or department from where the deceased is being collected.
Remove the deceased from the ward or department according to the training provided by your employer.
Remember to collect the patient notes before you leave the ward
Admitting a Body to the Mortuary - Upon Arrival at the Mortuary
- Locate an unoccupied cold store space - look at the whiteboard to see where they are;
- Move the hydraulic trolley to the door of the cold store and raise it to the level of the unoccupied space;
- Lock the wheels of the trolley;
- One porter removes the tray from the cold store and onto the roller top of the hydraulic trolley - the other watches to ensure that if a problem occurs they can warn their colleague immediately.
Using the Hydraulic Trolley
The video content from the beginning to 1:30 applies.
Admitting a Body to the Mortuary - Transferring the Deceased
- Unlock the trolley wheels and move the trolley away from the cold store;
- Adjust the height of the trolley to the height of the concealment trolley;
- Laterally slide the patient from the concealment trolley to the cold store tray, as per your manual handling training, taking care not to hit the head of the deceased on any edge or surface.
Place the Deceased into the Cold Store
- Keep the level of the body tray NO HIGHER THAN YOUR WAIST - this ensures the trolley will not tip when moved;
- Move the trolley to the cold store, ensure there is a sufficient gap at the foot end to avoid the tray making contact with any other patient in the cold store and door furniture;
- Lock the wheels of the trolley;
- Carefully slide the tray into the cold store.
- Remember to watch out for problems at all times and stop immediately if anything is an issue.
Door Safety Reminder
Remember - One porter operates the hydraulic trolley, the other observes to make sure there are no problems.
Admitting a Body to the Mortuary - IMPORTANT REMINDERS
- One porter operates the trolley, the other observes for any problems and stops the operating porter immediately if a problem develops;
- Pay particular attention to door locks - the tray can become wedged under them and will tip;
- Ensure the door of the cold store is closed properly and the latch is firmly engaged.
Admission of Babies from Maternity and Delivery Suite
All perinatal cases are admitted to the mortuary in the burgundy baby carrier located in the entrance lobby of the mortuary
- Remember to collect the paperwork from the ward with the baby;
- Place the baby into the baby cold store unless otherwise instructed (remove the baby from the carrier);
- Write the details of the baby in the admission book, as per usual.
The Baby Cold Store
The baby cold store is the triple door unit like the one shown in the picture above situated next to the mortuary whiteboard.
Place the paperwork that accompanies the deceased with the patient in the cold store.
Returning Babies to the Ward for Viewings
If you are requested to take a baby back up to the ward...
- Transfer the baby back to the ward in the baby carrier.
- Complete the perinatal internal transfer book (located on top of the perinatal cold store);
- Return the baby to the mortuary in the baby carrier when requested to do so;
- Record the return in the perinatal internal transfer book.
- Place the baby into the baby cold store space from which it was removed.
- Do not write the baby's details in the main mortuary register (they are already written in there from earlier).
- Return the baby carrier to the mortuary front lobby.
The Baby Carrier...
The baby carrier is NOT to be left on the ward for any reason.
Return it to the mortuary after EVERY use.
Completing the Paperwork and Whiteboard
Completing the Admissions Register
- Write the details of the deceased into the mortuary admissions register - as shown above.
- If you make an error, cross it through with a single line and make a fresh entry.
- Use black or blue ink, preferably ballpoint pen.
Completing the Whiteboard
Place an X in the cold store space you have just used
When You Receive a Viewing Request
Sometimes relatives of a deceased patient will ask them to view them out of normal working hours.
Portering staff ARE NOT responsible for conducting viewings. This is the role of the Clinical Site Manager or ward staff.
Portering staff are solely responsible for moving the deceased from the cold store to the viewing room, and returning the patient back to the cold store at the end of the viewing. All other tasks are the responsibility of the CSM or Ward Staff.
Placing a deceased patient into the mortuary viewing room
- Locate the deceased in the cold store - look in the mortuary register;
- Remove the deceased from the cold store (as per earlier instructions);
- Transfer the deceased (and tray) onto the roller trolley located in the viewing room - remember to LOCK THE WHEELS (this is VERY important);
- Place the deceased into the viewing room;
- Contact the ward (if the CSM or Nurse is not already present) and inform them that the deceased is ready to be prepared for the viewing;
- Wait for the arrival of the staff member.
- ENSURE THAT THEY COMPLETE A VIEWING RECORD FORM (located in a folder inside the viewing room).
Important Reminders Regarding Viewings
- If there are any discrepancies with the identification of the deceased - THE VIEWING MUST NOT GO AHEAD until the CSM or Senior Ward Sister has addressed the problem;
- Place the deceased back into the cold store when the viewing has finished.
Contacting Mortuary Staff
Need Advice? Have a Problem?
A member of mortuary staff is available at all times, if you need to speak to them.
- Contact switchboard and ask the operator to contact the on-call mortuary technician for the site you are working;
- Call 020 3891 1243 and choose option 2 from the option choices.
Who are Bariatric Patients?
There are patients whose physical size present challenges to providing a safe and dignified transfer from the ward to the mortuary. For this reason, the mortuary has additional equipment available to ensure that the portering staff can provide a safe and dignified transfer, and the mortuary staff can store the deceased in a manner which is also dignified and respectful. It is not acceptable to "make do".
Details of the procedure are given on the next few pages.
Before you attempt to transfer the deceased
Be guided by the nursing staff
The ward staff have nursed the patient for a period of time - be guided by their advice.
If you are not sure how to proceed - seek advice from your manager, and if necessary visit the ward to assess the physical size of the deceased - this saves you taking the concealment trolley to the ward and having to take it back to the mortuary if you need to transfer the deceased on their bed.
If the deceased can not not safely be transferred to the concealment trolley, you will need to transfer them to the mortuary on their hospital bed.
The mortuary has special bed covers for use in these instances.
It is NEVER acceptable to manipulate a patient to "make them fit" the concealment trolley - if the patient is too large for the concealment trolley, they must be transferred to the mortuary on their hospital bed.
Where are the covers?
The bed covers are blue in colour and are stored in the mortuary entrance lobby.
How to use the Bed Covers
There are two sizes of bed cover
Standard and Large. The standard sized cover is usually sufficient to cover a standard bariatric bed.
This is how the cover is applied to the bed:
1. Attach the strap
There is a red strap in the pocket of the bed over. Attach this to the side rails of the bed, or the head and foot board. This lifts the cover off of the deceased.
2. Apply the bed cover
Ensure that the whole bed is covered (as above), and that there are no gaps around the outside.
Upon Arrival at the Mortuary
Do nothing - assess your next action:
- Assess whether the deceased can be safely transferred to, and accommodated in the cold store.
If the deceased cannot be accommodated in the cold store, or you are not sure - STOP!
Contact the on-call mortuary technician (as detailed earlier) and seek advice at once.
Contact the on-call technician as a matter of urgency.
Place the deceased in a private area of the cold store room and cover them completely with a sheet or blanket.
Preserving the dignity of the patient is your priority until the mortuary staff arrive to take over.
Returning the Bed to the Ward
The Bed Stays in the Mortuary...
Until such times as the deceased is either transferred to the cold store OR until the deceased is collected by the funeral director.
Any enquiries from ward staff regarding the return of the bed should be referred to the mortuary staff.
Hygiene and Security
Before you leave the mortuary
Wash your hands before you resume your normal duties
There are advice posters on the walls around the department.
Hand sanitiser is freely available at all points of exit.
Biohazard Spill Kits
Urine and Vomit Spill Kit
Biohazard spill kits are available in the cold store room. Each kit contains instructions for use - please read them before use. Report the use of the kit to the mortuary staff.
Use the correct kit for the correct type of spill.
Lock the doors and turn out the lights...
Ensure the cold store door is closed and the latch engaged.
Turn the lights off.
Close the cold store room door.
Make sure the code locks are cleared down.
The doors are locked.
End of Programme Assessment
How much respect should you give to a deceased patient?
- Exactly the same amount of respect I would give to any other patient.
- Not much respect, they've died.
- It depends on who's around.
You are placing a deceased patient into the cold store when your mobile telephone rings. What would you do?
- Stop what you are doing and answer the call. Your colleague can complete the task.
- Ignore the call and return it when you have completed the task and have left the mortuary.
- Complete your task and return the call before you leave the mortuary.
- Leave the mortuary and take the call and complete the task when you return.
How many porters are required at all times when transferring and admitting a patient to the mortuary?
You have been asked to transfer a baby from the maternity unit to the mortuary. What do you need to do?
Choose three or more answers.
- Telephone the on-call mortuary technician.
- Collect the baby carrier from the mortuary.
- Collect the notes and paperwork when you collect the baby.
- Place the baby, in the carrier into the main cold store.
- Book the admission into the mortuary admissions book.
- Place the baby into the baby cold store.
You arrive on the ward to transfer a patient to the mortuary. The patient is physically very large and has been nursed on a bariatric bed. Which of the following statements are True and False?
- I should transfer the patient to the concealment trolley, even though you need to manipulate their arms and legs to make them fit.
- I should telephone the on-call mortuary technician and let them attend the hospital and perform the transfer.
- I should call the clinical site manager and hand the task over to them to complete.
- I should return the concealment trolley to the mortuary, collect the bed cover and remove the patient from the ward on the bed they were being nursed on, using the cover to maintain dignity and respect.
You are transferring a patient between the concealment trolley and the cold store tray. You accidentally forgot to lock the wheels, and the patient falls between the two trolleys to the ground. What do you do?
- Lift the patient from the floor onto the tray and proceed as normal.
- Assess whether the body has been damaged. Lift the patient from the floor to the tray and proceed as normal.
- Assess whether the body has been damaged, lift the patient onto the tray, place them in the cold store, and contact the mortuary manager, clinical site manager and your general manager immediately to report the incident.
You admit a bariatric patient to the mortuary. You assess that the patient is physically too large to transfer into a cold store space. What things do you need to do?
Choose one or more correct options.
- Call the on-call mortuary technician at once and inform them of the situation.
- Place the patient, on the bed, in the corner of the room - covered with a blanket or sheet to maintain their dignity.
- Call your general manager to request extra staff to assist you in placing the deceased into the cold store.
You are requested to take a baby back to the maternity unit for a viewing. Where would you record that you have made this transfer?
- The baby internal transfer book
- The mortuary admission register
- On a piece of paper, and leave it near the admission register for the mortuary staff to see when they return to work
Select the potential hazards to watch for when loading a tray into the cold store
- Other bodies in the cold store
- Door latches
- Other protruding door fittings
Which of the following statements are true and false?
Choose one or more choices.
- Doctors and nurses are allowed access to the mortuary to look at notes without the permission of the mortuary staff.
- Clinical Site Managers and Ward Staff are allowed access to the mortuary to facilitate viewings of patients in the mortuary viewing room.
- The emergency services, including resuscitation teams and Clinical Site Managers are allowed access to the mortuary without the permission of the mortuary staff if they are attending an emergency.
- Family and friends of deceased patients are allowed access to the cold store room to say "goodbye" to their loved one.
When moving the hydraulic lifting trolley with a patient loaded on a tray, what is the highest level the tray should be?
- Knee height
- Waist height
- Shoulder height
- Level with the top cold store tray