University Hospital of Wales, Acute Coronary Syndrome (ACS)Unit. Innovation and Research-Innovative models of care. Victoria Williams Cardiology Nurse Practitioner Louise Birch Cardiology Nurse Practitioner Michelle Ball Cardiology Nurse Practitioner Sarah Barnett Cardiology Nurse Practitioner
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University Hospital of Wales, Acute Coronary Syndrome
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University Hospital of Wales, Acute Coronary Syndrome
(ACS)Unit.
Innovation and Research-Innovative models of care.
Victoria Williams Cardiology Nurse Practitioner Louise Birch Cardiology Nurse PractitionerMichelle Ball Cardiology Nurse Practitioner
Sarah Barnett Cardiology Nurse Practitioner
Aims of the presentation
• To outline the expanding role of the nurse practitioner within Cardiology at University Hospital of Wales (UHW)
• To Describe and illustrate the development of the role through the establishment of a nurse led Acute Coronary Syndrome (ACS) service, demonstrating innovative ways of working to improve patient care.
Learning Outcomes
• To illustrate the role of the advanced practitioner within Cardiology at UHW
• To understand how the ACS service is run and how successful outcomes have been achieved
• To consider how the role and the service will evolve and develop in the future.
Background of the NP role within Cardiology
• Established in 2010• In response to European work Time
Directive (EWTD)• To streamline the patient Journey• Improve multi-disciplinary
communication• Improve patient outcomes and
satisfaction
• Cardiology Co-ordinator established role since 2004
• Roles merged 2010
• Both practitioners undertaking MSC Advanced Practitioner Pathway
• Team has expanded to include 2 further Part-time positions
• ACS service launched in September 2010.
University Hospital of Wales
• Tertiary Cardiology centre
• Contracted to provide tertiary services to District General Hospitals within south east Wales
Aims of ACS service
• Reduce patient length of stay in both DGH & tertiary centre
• Reduce waiting times for intervention
• Meet European and NICE guidelines
• Improve patient outcomes
• Improve patient journey
Collaborative working
Cardiology Nurse PractitionersCentral point of
contact.Co-ordinating the care pathway from point of referral to discharge.
Electronic referral system
Telephone triage of ACS/Complex
transfers.Advanced Clinical Assessment Skills.
Cardiac Catheter Theatre
Allocated catheter slotsRe-organisation of consultant rota
Flexi sessions to back fill for annual leave/study leave
Cardiology Ward
Protected beds within ward areaHigh turnover of ACS patients
Increased workload and expertise.Collaborative approach between nursing
staff, NPs & MedicsNurse-led discharge protocols.
District General Hospitals
Electronic referral within strict criteriaTraining and education re: ACS protocolsPre-operative workup and investigations
Repatriation of patients awaiting follow on services
Electronic ReferralPlease complete and save with patients name as file name [email protected]
2/7 hx of intermittent chest pain, initially on exertion, last episode @ rest raditing to Lt arm assoc SOB. ECG inferior TWI. PMH: Nil
CALL FOR HELP
GynaAnne
21 River St, Cardiff, CF123AB
564509/12/1958123456789
Llandough HospitalDr C Pain
CCU
Email with patient name in SUBJECT headingPLEASE NOTE: You are sending confidential patient information, this form should ONLY be sent from an NHS email address
110 to <120
Previous interventions
RISK
Major complications
History/Co-m orbidities
PATIENT DETAILS
University Hospital of Wales
Acute Coronary Syndrome Inpatient Referral form
Please complete and save with patients name as file name [email protected]
Age Creat CHFBP Heart Rate ArrestST deviation Troponin DiabetesHypertensionFamily Hist
BLOODS
HbPltWbcTrop I/T
CRPCreatinine
DATE (DD/MM/YYYY)
Free text:
Email with patient name in SUBJECT headingPLEASE NOTE: You are sending confidential patient information, this form should ONLY be sent from an NHS email address
130 to <140
Previous interventions CABG (Please include graft details)
RISK
Major complications Tachyarrythmia (not AF) (echo mandatory)