Cardiac Surgery High Dependency Unit - Closed - September 2010
|
Links : Contacts, Consultants, CCU, CSHDU, CSITU, Liaison Team On this page : Patient Info - Visitor / Relatives Info - Staff Info
|
|||||||
 |
|||||||
Closed - September 2010
Cardiac Surgery High Dependancy Unit (CSHDU) provides continuing post operative critical care following both Cardiac and Thorasic surgery. It acts as a transistion point between Cardiac Surgery Intensive care Unit (CSITU) and Ward 3 where the staffing ratio is higher than a general ward but less than CSITU, to ensure a more intensive level of nursing care.
CSHDU operates all year round.Admissions can occur at any time day or night from 3 clinical areas: Ward 3, CSITU or A&E.
Operating days are Mon - Fri for Cardiac Surgery and Thursday & alternate Monday for thoracic Surgery
All patients who have undergone major cardiothoracic surgery within the MRI are generally admitted to CSHDU these include: Coronary artery bypass, Aortic Valve replacement / repair, Mitral valve replacement / repair, Repair of atrial septal defect, Ross procedure and most major Thoracic cases. Although some Thoracic cases are nursed on the General HDU rather than CSHDU a decision on this is made on the day of surgery according to bed allocation in the General HDU.
Currently CSHDU has 8 beds within the unit which are funded and staffed, although plans are in place to expand the unit to capacity which is 10 beds. It is an open planned unit with 1 designated isolation room, this does mean that the unit is mixed sex. There is full monitoring at all bed areas which includes ECG, invasive and non- invasive monitoring and there are facilities to provide advanced respiratory support such as Continuious Positive Airway Pressure(CPAP)assistance and High Flow O2 therapy.
The staffing ratio for the unit is generally 1 nurse: 2 patients although this will alter according to patients within the unit.
Current staff numbers are:1 x Senior Sister/Unit Manager
5 x F Grade Sister/Charge Nurses
4 x Core E Grade Senior Staff Nurses
2/3 x Rotational Senior Staff Nurses
5 x D Grade Core Staff Nurses
5 x D Grade Rotational Staff Nurses
4 x Assistant practioners
2 x Clinical Support Workers
The staff within both Ward 3 and CSHDU are allocated to either Sister Fitton or Sister Hill, senior sisters for the clinical area, who are responsible for ensuring appraisals are performed, non- attendance is monitored, educational needs are met and that objectives of rotational nurses are achieved within the allocated time scales.
We have active groups developing evidence based care/practice through clinical benchmarking and Essence of Care, improving documentation and communication of the multi-disiplinary team through the use of Integrated Care Pathways and improving patient partisipation through the active patient forum within the clinical area.
On Arrival on the ward
All patients admitted from CSITU are welcombed by the CSHDU nurse allocated to care for them and settled into the bed area. The nurse then, once all clinical parameters are assessed as being stable, recieves a handover from the CSITU nurse and will make an assessment of the patients current and potential needs.On the whole 4-5 patients are admitted and/or discharged on a daily basis so the unit can on occatuions get very busy and noisy but we aim to keep this noice at a tolerable level.
We would discourage all patients from bringing large amounts of property into hospital as storage space is limited, we wpould especially discourage valuables and large amounts of money from being brought in. Within CSHDU there is very little storage space all we encourage is 1 set Pyjamias, washbag, slippers +/- dressing gown.
Length of Stay
Typical length of stay is 24 - 48 hrs if recovery is uncomplicated. Occasionally patients remain on the unit as the level of care required is greater than can be offered within a ward environment, and even more occasionally a patients clinical condition deteriorates and patients are required to be transfered back to CSITU for continuing care. Due to pressures for beds within the ward there are occations where a patient remains on the CSHDU because beds are unavailble - this doesn't delay the discharge process, patients can also be transfered striaght from CSITU to the Ward if CSHDU beds are occupied.
Ward Routine
Each patient is assessed according to both their personal and clinical needs and they are cared for in accordance to identified care in the Integrated Care Pathway.
The general routine includes: Consultant Ward Round occurs at 8am each morning Routine includes - shower/wash, bloods being taken, physiotherapy and any other further clinically indicated care. Rest Period from 1 - 2pm. Visiting starts at 2pm and care is arranged according to indivdual needs - any specialist tests or procedures may be performed during this time. Medical staff will perform a round at ~8pm in order to ensure problems are solved before the night.
Ward Movements
Cardiac Patients go from Ward 3 to theatre, then to Cardiac Surgery Intensive therapy Unit, then on to Cardiac Surgery High Dependency Unit, then return to Ward 3. Thoracic patients go to theatre after which some are transfered to the General High Dependency Unit or Cardiac Surgery High Dependency Unit, and again return to Ward 3. Some patients return directly to the Ward 3 after theatre depending on their individual needs.
Visitor Information
Rules-
Patient sleep time 1-2 pm.Visiting 2 - 8 pm, seven days a week.Two visitors per bed, unless by prior arrangement with the ward staff.
Children are discouraged from visiting especially if under 7 yrs old - Please discuss issues with the Sister in Charge -
And please NO flowers
Relative Facilities
Accomadation is available in Cobbett House if you or your famly require it, details of which can obtained by speaking to the nurse in charge of the ward when you visit.Staff Information
CSHDU is a dynamic,friendly and at times very busy unit, where we actively enourage staff professional development through the dedicated staff development team within Cardiac Surgery. There is an established multidisiplinary team who's aim is to provide a high standards of care regularly updated and adjusted according to current best pracice and standard setting. All members of the team work towards ensuring the patient journey occurs a smoothly as possible. We work in a 'no blame' environment where incidents are openly discussed and we strive to learn from these incidents. There is an excellant working relationships between all clincial areas, medical staff, support staff and the nursing staff. All forms of research are encouraged and any new ideas in changing practice are discussed and taken forward if practical
Staff Mix
Current staff numbers are:
1 x Senior Sister/Unit Manager
5 x F Grade Sister/Charge Nurses
4 x Core E Grade Senior Staff Nurses
2/3 x Rotational Senior Staff Nurses
5 x D Grade Core Staff Nurses
5 x D Grade Rotational Staff Nurses
4 x Assistant practioners
2 x Clinical Support Workers
On average each shift is managed by a Sister or Senior Staff Nurse, supported by up to 3 other nurses, we have within the team established Assistant Practioners who at times will replace the 4th Nurse. Currently the shift co-ordinator is included in the numbers but we are actively recruiting to fill current vacancies in order to allocate shifts so on our busier days the co-ordinator is out of numbers. The nursing team are offered the opportunity to rotate from Ward 3 to the Cardiac Surgery High Dependency Unit to further develop their critical care skills. We currently do have 'core' staff for CSHDU and are able to offer an opportunity to rotate into CSITU for a period of 4 weeks to either develop critical care skills further or to update clinical skills of the senior staff.
Contact: Senior Sister 0161 276 6630
Return to Top.