Cardiac Unit

Introduction

The Cardiac Ward is a 21 bedded ward divided into a 6-bedded monitored acute coronary care unit (CCU) and 15-bedded general cardiac/medical ward (comprising of 2 bays each with 6 beds, a single side room and a double side room).

The average stay in CCU is 2 days when you will then be moved to the main ward in either the red (female) or blue (male) bay. We endeavour to keep the bays single sex but on occasion it is unavoidable to have mixed-sex bays. Please ask your nurse for more information.

During each shift a nurse will be allocated to your care, please do not hesitate to ask him or her any questions you may have regarding your treatment. We do, however ask that where possible please do not disturb your nurse during a drug round.

The Cardiac ward is in St. Luke's Wing on the ground floor.

What to Expect When you are Admitted to our Ward

Most patients will be admitted straight into CCU and attached to a cardiac monitor. The average stay in CCU is 2 days when you will then be moved to either a male or female bay.

It is important for all cardiac patients to gain as much rest as possible as rest is a key factor in their swift recovery. With this in mind the Cardiac Ward encourages a strict visiting time policy. Visiting is between the hours of 3.00pm - 4.30pm and 6.00pm - 8.00pm only.

If you wish to use any electrical items e.g. laptops, DVD players etc. they MUST be tested by the hospital electrician prior to use. Please ask your nurse to arrange this. Mobile phone chargers cannot be tested by the hospital electrician so they MUST NOT be used on the ward. Please ask your relatives to charge mobile phones at home.

Please avoid the use of mobile phones in the CCU. Mobile phones are permitted otherwise, however we would ask you to keep your phone on silent and be mindful of other patients. Therefore, please restrict usage while in your bed space and avoid using your mobile during rest period and at night.

As a ward we encourage our patients to dress in the day in their normal attire rather than pyjamas/nightgowns where possible.

Please be aware that the Trust is now a smoke free NHS. Smoking is not permitted in any building or within the grounds of any of our sites. Information and support is available to any patients who wish to stop smoking. Nicotine Replacement Therapy is available to help reduce your cravings during your stay.

Our Staff

A variety of people will be responsible for your care whilst in hospital. Some of the staff you may come in contact with while on the Cardiac Ward are: -

Consultants

• Dr. Vivian Challenor
  

• Dr. Rafe Chamberlain-Webber
  

• Dr. Zafar Khan
  

For more information on the Consultants please click on their name.

Sister: - Navy blue dress / tunic / trousers.
Staff Nurse: - Blue and white striped dress / tunic with red piping and navy trousers.
Male Staff Nurse: - White tunic with striped epaulets and navy trousers.
Nursing Auxiliaries : - Green striped dress / tunic and navy trousers.
Bank Staff: - White dress / tunic and navy trousers.
Housekeepeing staff: - Pink and white stripped dress / tunic and trousers.
Domestics staff: - Pale green and white striped dress / tunic and trousers.
Yellow dress with blue tabard.

Other staff involved in your care may include: junior doctors, cardiac technicians, cardiac rehab nurses, physiotherapists, occupational therapists, social workers, ward clerks, pharmacists and student nurses.

Consultant Ward Rounds / When will I see a doctor?

Consultants have varying times for their ward rounds. Please ask your allocated nurse for this information.

Medicine Rounds

Medicine rounds take place at: -
8.00am, 12.00pm, 5.30pm and 10.00pm

if you have brought your own tablets into hospital these will be stored in your locked drug cupboard and returned to you with any new medications on discharge.

Facilities

Facilities on the ward include: -

Head phones and radio are available over each bed.

A television (Day room) is located just outside the main ward.

A relative’s room is available for those people whose relative is critically ill and require an overnight stay.

There is a shop located outside the ward. Opening times are 8.00am-7.00pm during the week with limited opening times at the weekend. In addition there is a trolley shop, which visits the ward in the morning selling essential items.

Mealtimes and Catering

Menu cards are filled in one day in advance. If you have any special dietary requirements please inform the nurse in charge.

The Catering Staff are an integral part of the meal delivery service at Cheltenham General Hospital. The staff are visible on the ward throughout most of the day, serving food, washing up and cleaning in the ward pantry as well as delivering stock. The Catering staff are easily recognised by their uniform; royal blue polo shirts, navy blue baseball caps and trousers and, of course, a smile.

Visitors

It is important for all cardiac patients to gain as much rest as possible as rest is a key factor in their swift recovery. With this in mind the Cardiac ward encourages a strict visiting policy.

Visiting times are: - 3.00pm - 4.30pm and 6.00pm - 8.oopm

Visitors are limited to no more than two per patient at any one time.

Please can visitors be encouraged to use the alcohol gel provided before and after entering the ward, and to kindly refrain from sitting on patient’s beds. There are visitor chairs provided in the ward corridor.

Please note: No flowers in CCU

Only immediate family are permitted to visit patients admitted to CCU outside these hours. Please check with the nurse in charge.

The staff are more than happy to discuss alternative arrangements but your co-operation is appreciated.

How to contact the Ward

You and your family will be informed of the best time to telephone for news.

Telephone numbers: - 08454 22 4011

Or Telephone Switchboard on 08454 22 2222 and ask for the Ward.

There are no bedside phones in CCU. However it is possible for immediate next of kin to phone the mobile number in order to speak to a relative. The number is: - 08454 22 2958.

Bedside phones are available within the main ward and a card may be purchased from the machine located outside the ward. Calls should be restricted between the hours of 8.00am - 8.00pm, and not at all during the hours 1.00pm - 3.00pm when patients are encouraged to rest.

Relatives are welcome to phone and speak to a nurse, but we encourage families to assign one family member to act as spokesperson in order to cut down on the amount of time a nurse spends dealing with phone calls.

Going Home

If you have any pending discharge problems please speak to your allocated nurse.

Cleanliness and Infections in Hospital

Some people are admitted to hospital with infections that require them to be cared for away from other patients to prevent the spread of that particular infection. Please follow the instructions given to you by staff.

You will be nursed in a single room; the door may need to remain closed, depending on the nature of your infection. Please pay particular attention to hand washing and general cleanliness at all times, especially when leaving the room.

If you have been in contact with chickenpox, measles or mumps within 3 weeks of your admittance to hospital, please inform a member of staff.

We ask that visitors suffering from minor infections such as a cold avoid visiting if possible, for their sake as well as the patients. We do not recommend babies being brought in to visit, again for their own protection.

Hand washing. The most common means by which infection is transmitted is by hand, therefore handwashing is a very basic, yet vital infection control measure. Alcohol hand gel is kept at the entrance of the ward and at each bedside for all the visitors to use before and after visiting. For hygienic hand disinfection apply 3ml (3 shots) to physically clean hands for 30 seconds ensuring all areas are covered, until dry.

What is clostridium difficile? Also called c diff

It is a bacteria that normally lives in the intestine. Up to 5% of the population are thought to carry this without any problems. It is usually kept in check by other bacteria in the intestines, which are normally present in our gut.

What problems does clostridium difficile cause?

Some strains of c.diff produce toxins, these toxins (poisons) cause diarrhoea. It can only do this when the balance of the normal gut bacteria has been disturbed. This can happen when antibiotics are given for infections. This enables the c-diff bacteria to multiply and produce more toxins that damage the cells in the intestines causing diarrhoea.

How is it Diagnosed?

A sample of diarrhoea is sent to the microbiology lab within the hospital. The laboratory looks for c-diff the toxins produced by some strains of the bacteria

How can it be treated?

If it is possible the antibiotics that have contributed to the disease will be stopped. Sometimes other antibiotics will be given, which are effective against the c-diff bacteria

What should happen if someone has diarrheoa?

Whenever possible you will be moved into a side room, before the microbiology result of the diarrhoea specimen is known This is to help prevent the spread of this bacteria. Not all patients can be placed in side rooms. it will depend on the condition of the patient and the availability.

Personal hygiene must be very strict. Everyone must wash their hands with soap and water after going to the toilet and before eating.

What is MRSA?

The organism Staphylococcus aureus is found on many individuals skin and seems to cause no major problems. However if it gets inside the body, for instance under the skin or into the lungs, it can cause important infections such as boils or pneumonia. Individuals who carry this organism are usually totally healthy, have no problems whatever and are considered simply to be carriers of the organism.

The term MRSA or methicillin resistant Staphylococcus aureus is used to describe those examples of this organism that are resistant to commonly used antibiotics. Methicillin was an antibiotic used many years ago to treat patients with Staphylococcus aureus infections. It is now no longer used except as a means of identifying this particular type of antibiotic resistance.

Individuals can become carriers of MRSA in the same way that they can become a carrier of ordinary Staphylococcus aureus which is by physical contact with the organism. If the organism is on the skin then it can be passed around by physical contact. If the organism is in the nose or is associated with the lungs rather than the skin then it may be passed around by droplet spread from the mouth and nose. We can find out if and where Staphylococcus aureus is located on a patient by taking various samples, sending them to the laboratory and growing the organism. Tests done on any Staphylococcus aureus grown from such specimens can then decide how sensitive the organism is to antibiotics and if it is a methicillin resistant (MRSA) organism. These tests usually take 2-3 days.

Why bother with MRSA?

MRSA organisms are often associated with patients in hospitals but can also be found on patients not in a hospital. Usually it is not necessary to do anything about MRSA organisms. However if MRSA organisms are passed on to someone who is already ill, then a more serious infection may occur in that individual. When patients with MRSA are discovered in a hospital, the hospital will try to prevent it from passing around to other patients. This is known as infection control.

How do we prevent the spread of MRSA?

Measures to prevent the spread of organisms from one person to another are called isolation or infection control. The type of infection control or isolation required for any patient depends on the organism, where the organism is found on an individual and the patient.

The most important type of isolation required for MRSA is what is called Contact Isolation. This type of isolation requires everyone in contact with the patient to be very careful about hand washing after touching either the patient or anything in contact with the patient. If the organism is in the nose or lungs it may also be necessary to have the patient in a room to prevent spread to others by droplet spread. Because dust and surfaces can become contaminated with the organism, cleaning of surfaces are also important.

What do visitors need to do?

Provided relatives and friends of patients with MRSA are healthy there is no restriction on visiting and it carries no risk. Visitors are not required to wear special clothing BUT we would ask you to help us prevent this organism spreading around our hospital by keeping the patients' door closed at all times and always washing your hands whenever you leave the room.

What about MRSA at home?

In patients who are otherwise well the organisms often disappear once the patient leaves the hospital. Sometimes they do not however, and this may mean that when a patient has to go back into hospital the isolation precautions need to be used again. Provided everyone at home is healthy special precautions are not required at home.

What can be done about MRSA?

In certain situations it may be a good idea to try to get rid of the organism from a patient and this can be done with various creams and shampoos or on occasions combinations of antibiotics taken by mouth or by injection depending on the health of the patient.

Additional Information

If English is not your first language, and you may require the services of an interpreter, please let the ward know before your admission, if at all possible.

If you are hearing impaired and need to sign, we may also be able to provide someone to help with this.

A Hairdresser, Dietician, Chiropodist, Dentist and Pharmacist are all available on site and the staff will inform you of these in more detail should you wish.

Physiotherapy, Occupational Therapy and Social Services can be accessed via referral from Ward staff. Chaplaincy staff visit the Ward, or you may arrange for your own spiritual advisor to visit.

A relative's room is available for those people whose relative is critically ill and require an overnight stay.

Any Questions?

Please feel free to ask your allocated nurse or the ward Sister if you have any questions / problems during your stay. He / she can make arrangements for you to discuss your care with other members of staff, e.g. Doctors, Social Workers, etc. should you wish.