30 bedded general ITU, case mix ITU & HDU, elective surgical patients including: hepatobiliary, vascular, renal, upper GI, bowel surgery, maxillo facial, & any other high risk surgical patients. The hospital is the neurosurgical centre for South Wales, admitting any neuro patients requiring ITU care (neurosurgical HDU also falls within the critical care footprint but is run by the neurosurgical team). The hospital is also the Renal and Pancreatic Transplant Centre and the Haematology Centre for South Wales. We have one of the busiest EUs in the country and admit a full range of patients e.g. out of hospital cardiac arrests, polytrauma, overdoses, COPD, asthma, and anything else that comes through EU requiring critical care. The unit also admits all in house emergencies requiring ITU or HDU care. The critical care footprint also includes a 5 bedded ITU/HDU across the city at University Hospital Llandough (UHL) staffed with rotating medical and nursing staff, principally caring for long term weaning patients and patients preparing for home ventilation. This unit also admits post op elective patients requiring short stays, emergencies in house and via the emergency admissions unit. Any acute patients requiring ventilation past 24 hours are usually transferred across to the main unit at UHW. Currently ACCPs do not work within UHL, however, once qualified this may change; Chris has completed solo transfers of patients between the units.
Currently 1 qualified ACCP (Chris Williams) and 1 trainee (Nia Bromage) on the General ITU plus 1 qualified ACCP in the Cardiac ITU (Andy Williams). The boys are the first ACCPs in Wales.
Training & Development
All ACCPs in Cardiff are supernumerary for 2 years training within critical care, which allows attendance to any study days, conferences and off unit training required. ACCPs all have a Consultant medical mentor, monthly educational master classes, are included in all junior doctor training in house, as well as receiving clinical support in day to day practice and clinical skill development.
All Cardiff ACCPs are affiliated with Cardiff University, completing either an MSc or PGCert in Advanced Clinical Practice’ this was created bespoke for ACCPs initially, utilising the Scottish Toolkit, Welsh Assembly Government Guidelines for Advanced Practice and The National Educational Framework for ACCPs. The course now welcomes other Advanced Practitioners from other specialities with bespoke competencies created with local Consultants based on the pillars of advanced practice.
The critical care unit will be expanded within the next 6 months opening a post anaesthetic care unit for overnight elective surgical patients with expected high input from the ACCPs. There is also a possibility that the main unit will expand to 38 beds.
Information provided by Nia Bromage, ACCP Trainee