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CRITICAL CARE UNIT

SPECIALITY

Information about postgraduate doctors placements within the Critical Care Unit at Medway NHS Foundation Trust.

Welcome

We have a busy 25 bedded critical care department, admitting around 1800 patients/ year, comprising a separate 9 bedded ICU, 10 bedded surgical HDU and 6 bedded medical HDU.

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Being one of the busiest critical care units in the region, the department provides postgraduate doctors with opportunities to gain experience in a diverse case mix of critically ill medical patients alongside a large number of elective and emergency post-surgical patients The case mix for the level 3 admissions is approximately 90%-10% emergency: elective split and approximately 70:30 medical: surgical split.

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The hospital houses the local vascular and ENT services and therefore we receive the casemix associated with these specialties.

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Ventilators (Draeger Infinity C500) with advanced modes including APRV are in use in the unit. Citrate anticoagulation (Nikkiso Aquarius) is first line for CVVH and we use Edward’s EV 1000 and PiCCO for cardiac output monitoring. There is an active interventional radiology department and we take advantage of this service to deliver unique modalities of therapy (e.g. catheter directed/ ultrasound assisted thrombolysis for intermediate risk pulmonary embolism).

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The emergency department is the busiest in the region and treats wide ranging acute illnesses. Respiratory medicine department has a comprehensive range of services (TB, lung cancer including interventions like EBUS/ Thoracoscopy, pleural service, busy sleep and domiciliary NIV service) and works in close collaboration with critical care. There is a 24/7 on-call GI bleed rota in place and 24/7 on-call service is also in place for cardiology and major surgical specialties (ENT, orthopaedics, vascular, urology).

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There is a well-established Post-ICU clinic with physiotherapists and a counsellor embedded within the team.

Image by Jair Lázaro
Welcome

About training in the Critical Care Unit

  • Faculty
    Faculty ensure that a safe learning environment is maintained for learners and encourages self-reflection on learning Faculty engage in continuing professional development with regular evaluation of performance by both learner and fellow faculty Faculty are competent in the process of debriefing
  • Activity
    Simulation-based education programmes are developed in alignment with formal curriculum Mapping or learning/training needs The patient perspective is considered and demonstrated within educational planning A faculty member with expertise in SBE oversees the simulation programme Design and ensures that it is regularly peer reviewed via feedback, kept up to date and relevant to the clinical needs and mapped curriculum Regular evaluation of programmes and faculty is undertaken to ensure that Content and relevance is maintained.
  • Assessment
    The assessment is based on the intended learning outcomes of the exercise, with clarity regarding the knowledge, skills and attitudes to be evaluated and is appropriately tailored to the professional Curricula to be evaluated. Psychological safety of the learner is considered and appropriately supported Faculty have a responsibility for patient safety and to raise concerns regarding learner Performance within educational settings.
  • In Situ Simulation (ISS)
    Every ISS exercise has clearly defined learning objectives that achieve individual, team, unit level and/or organisational competencies Local processes and procedures are carefully reviewed to deliver ISS activity authentically Faculty delivering the ISS activity are proficient in SBE and have the required expertise on a given Topic.
  • Resources
    A variety of simulation based modalities, including simulated patients, is incorporated into simulation based programmes to create appropriate realism of the learning environment and achieve the objectives of the session being taught The facility has a clear strategic plan which addresses wider organisational and stakeholders’ Needs A designated individual oversees the strategic delivery of SBE programmes and ensures that appropriate maintenance of simulation equipment is undertaken
  • Management, Leadership & Development"
    A designated lead (Dr Manisha Shah) with organisational influence and accountability manages the simulation activity There is a clear vision and mission statement to demonstrate aims and objectives of the facility There is a clear alignment to the wider organisational and stakeholders’ needs, Acting as a quality and risk management resource for organisations to help achieve the goals
About CCU

More information from the professional and statutory body for the specialty of intensive care medicine.

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