Cardiovascular Disease (Specialist Nurses)
This service provides a clinical assessment, secondary prevention and early post discharge support service to patients admitted to the Queen Elizabeth Hospital, Kings Lynn with Acute Coronary Syndromes (ACS). The assessment service is predominantly limited to patients with troponin positive ACS who do not meet the clinical criteria of acute myocardial infarction but remain at high risk for further acute cardiac episodes. The early post discharge support is offered to these patients and also patients with acute myocardial infarction who have declined the cardiac rehabilitation programme and will therefore not be followed up by this service. We aim to:
- Offer clinical expertise, support and be an specialist resource for patients with Acute Coronary Syndrome (ACS), their families and other healthcare professionals
- Work collaboratively as part of a larger multi-disciplinary team in order to provide the best care and support to patients and their families
- Provide ‘vision’ and take a lead role in the promotion and development of new services for patients across the primary/secondary care interface
- Improve the standards of care delivery to patients with ACS through clinical governance and by modernising the services available to them
- Promote efficiency of the care pathway, prioritising and expediting urgent transfer to the regional tertiary centre, so aiming to reduce Length of Stay in hospital
- To educate and support patients and their relatives to take responsibility of their Long Term Condition, so helping to prevent further acute cardiovascular events and resulting admissions to hospital
The Cardiac Assessment Nurse works autonomously to prioritise a caseload determined by direct referrals from A&E, MAU and hospital wards, together with daily acquisition of a listing from Chemical Pathology of Troponin positive patients at the QEH. The CVD Specialist Nurse will contact patients in the early post-discharge phase to monitor symptoms, assess for signs of further acute episodes and provide support to the patient and relatives for pharmacological and non-pharmacological secondary prevention of CVD. Support from the CVD Specialist Nurse is provided via telephone support and home visits as appropriate.
Key elements of the service include:
- Advanced clinical assessment and advanced electrocardiogram skills to direct ACS patients to the appropriate pathway.
- Development and implementation of a risk assessment score to determine appropriate pathway of care, e.g.: high risk patients are expedited to the Coronary Care Unit for urgent investigation at the Tertiary Centre. Low risk patients discharged home promptly with appropriate out patient appointment investigations, education and support.
- Secondary Prevention: Cardiovascular risk factors are measured and discussed with the patient and relatives. Motivational discussion for risk factor modification takes place in hospital and is followed up in the early post discharge phase. A risk profile with agreed goals is handed over to the CVD Specialist Nurse and communicated to the patients GP practice to inform long term management and secondary prevention and facilitate entry to the practice CHD register.
- Referral on to specialist services to optimise risk factor modification e.g. Smoking Cessation/Dietician/Diabetes Specialist Nurse/Cardiac Rehabilitation.
- Education on the Acute Coronary Syndromes and cardiovascular risk to member of the multi disciplinary team across the primary/secondary care interface to promote awareness of patho-physiology, treatment and prevention of this long term condition.
- Pathway of transfers to the Tertiary Centre at Papworth hospital - the Cardiac Assessment Specialist Nurse maintains a caseload of high risk patients transferring directly to the tertiary centre. The main aims are:
- Minimise length of stay in the QEH by risk assessing and expediting by way of direct communication with Papworth via the Electronic Referral and Messaging Service. Specialist knowledge is essential for appropriate prioritisation
- Early Supported Discharge directly from tertiary centre helping to minimise length of hospital stay
- Safe Ambulance Transfer, with prior risk assessment and adherence to recently introduced ’Inter Hospital Transfer Guidelines’
- Induction and on-going education to Doctors and Nurses using this referral and communication system.
Who this Service is for
This service is for those admitted to QEH with suspected Acute Coronary Syndrome, and for all in patient transfers to Papworth Tertiary Centre.
LocationQueen Elizabeth Hospital, Kings Lynn and West Norfolk Locality How to Find UsSources of ReferralReferrals are accepted from: A&E, CCU, MAU, Wards GP admissions directly to MAU Consultant Physicians Cardiac Rehabilitation Team Referral Contact Number01553 613321 |
Hours of ServiceThis service operates from 9.00 am to 5.00 pm, Monday to Friday |