University Hospital Wales (UHW) Cardiff, Cardiac Intensive Care & High Dependency Units

Unit Information
  • Level 2 and 3 patients (approx. 800 patients per annum)
  • 13 bedded Unit specialising in care of patients following cardiac surgery
  • Operations include - CABG, heart valve repair and replacement, thoracic aortic surgery, ASD/VSD surgery, MAZE procedures and TAVI’s.
ACCP Information

Currently 1 qualified ACCP on the unit and one in training from September 2014; There are also 2 ACCPs on the General ITU.

Training Information

Training is carried out in conjunction with Cardiff University and consultant led teaching and assessments. ACCPs will qualify with an MSc in Advanced Clinical Practice.

Modules consisted of:

  • Research and its application to clinical practice
  • Advanced clinical assessment and diagnostic reasoning
  • Independent prescribing (two modules)
  • Portfolio module (replaces traditional dissertation module)

Portfolio module consisted of:

  • 76 page competency document based on the 2008 DoH ACCP Framework matrices
  • Two audits, one of which results in a clinical guideline and a change/improvement to Unit practice
  • 20 consultant assessed OSCE’s (10 formative, 10 summative)
  • 2000 word audit report
  • 4000 word assignment on leadership and management
  • 4000 word assignment on our learning journey
  • 10000 word assignment on situational analysis
  • Attend and deliver lectures at consultant led monthly clinical master-classes
  • Final VIVA/OSCA - 12x7 minute stations assessed by consultant intensivist and consultant anaesthetist
  • Develop a portfolio of learning and experience
  • Complete a logbook incorporating all practical skills undertaken and evidence of supervision, assessment and dates deemed competent in each skill
  • Deliver a one hour teaching session (assessed by Cardiff University) to a multi-disciplinary audience
Responsibilities:
  • Essential nursing care and advanced nursing care
  • Audit and service improvement
  • Teaching, support and supervision of nursing and junior medical staff
  • I admit and discharge patients on CITU/CHDU
  • I examine patients and make diagnoses
  • I write treatment plans for critically ill patients
  • I present patients on the morning ITU round
  • I prescribe medication independently
  • I undertake phlebotomy, insert venflons, arterial lines, central lines and vas-caths
  • I insert chest drains
  • I re-open chests on the Unit for cardiac arrest and cardiac tamponade
  • I perform advanced airway skills including endotracheal intubation, downsizing and decanulation of tracheostomy tubes
  • I perform transfer of critically ill patients from the operating theatre suite to the ITU or radiology departments
  • I frequently work in the cardiac anaesthetic rooms undertaking line insertion and intubation and work with the consultant anaesthetist in theatre for the duration of that case
  • I frequently scrub up during cardiac operations and close the leg following saphenous vein harvesting and close the chest (or assist) at the end of the operation.
  • I insert nasogastric tubes, urinary catheters and faecal management systems
  • I undertake Outreach on the post op cardiac ward

Information provided by Andy Roberts, ACCP