Cardiac Surgery High Dependency Unit
| Links : Contacts, Consultants, CCU, CSHDU, CSITU, Liaison Team On this page : Patient Info - Visitor / Relatives Info - Staff Info
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 1st Floor, Purple Zone, Phase 2 Building Manchester Royal Infirmary |
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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
Contact: Senior Sister 0161 276 6630
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