We are a level 3 tertiary referral centre for adult patients requiring intensive care within the state. Our Department comprises cardiothoracic intensive care, general intensive care and a high dependency area. As the tertiary referral centre for the state, the DCCM admits all type of patients, with the exception of Spinal Rehab or Organ Transplant
A redevelopment has commenced to increase our bed numbers to 25, including 11 beds in a new building that will be linked to our current unit. With this redevelopment the entire DCCM will be furnished with a new monitoring system, complete with clinical Information System (CIS), that will progress DCCM to being a ‘paperless’ unit.
Staff within the department have opportunities to rotate between the three clinical areas thereby increasing the scope of practice. Nurses within the unit become multi-skilled through exposure to the broad age spectrums and critical illness presentations.
Patients are placed in individual bed spaces with ready access to all the equipment that should be required to care safely for the patient. Reverse pressure, individually heated isolation rooms are available for infection control purposes. Monitoring units are included in each patient care area.
An outreach nursing and medical service is provided through the provision of a code blue response and medical emergency team (MET). Informal education support is provided to ward areas on an as needs basis by clinical staff.
At the RHH we are privileged to work as a closely knit unit despite a fairly large part- time establishment. Five full time intensive care consultants make up the team.
With over 130 nursing staff on the establishment the majority have completed specialised critical care courses. Most staff work on a part time basis. Rotation positions are offered to nurses from their 1st year of postgraduate experience. Career structure is slightly different in Tasmania.
A Clinical Nurse Consultant is responsible for the day to day running of the department. The role supports clinical staff, and patient care delivery. This role is integral to quality patient services.
There is a Level 3 Nurse Manager and 3 Clinical Educators for the DCCM.
There is also a rostered ACCESS Nurses for all shifts in line with ACCCN guidelines.
Clinical nurses (Level 2’s) have a daily patient load, with their role also encompassing clinical support for staff, quality initiatives and shift coordination after hours. A clinical education facilitator provides support to rotation staff, nursing staff and students undertaking postgraduate studies in critical care nursing.
Professional development and education
In-service is held a minimum of 4 times per week, with study days related to focussed critical care issues held 5-6 times per year. The RHH supports students of the University of Tasmania in a collaborative partnership model. This results in clinical staff providing lectures, tutorials and clinical support to students on a regular basis. A part time lecturer/facilitator also provides clinical and academic support. Preceptorship for students and new staff to the area is also undertaken. A structured orientation program is encouraged which aims to meet the developmental needs of the nurse.
Gaining critical care experience
Nurses with minimal or no experience are encouraged to gain critical care experience through a structured, supported Introduction to Critical Care Programme, for 6 months. This has provided nurses with a taste of critical care and often leads to recruitment into the postgraduate certificate course.
The Department of Critical Care Medicine (DCCM) is located within the Royal Hobart Hospital which is the major teaching hospital for the University of Tasmania (Faculty of Health Sciences), and is the State referral centre for cardiothoracic surgery, neurosurgery, burns, hyperbaric and diving medicine, neonatal intensive care and high risk obstetrics.
The Hospital provides all general and specialty medical and surgical services, excluding organ transplant, spinal and paediatric cardiac surgery. The Hospital services a population of approximately 240,000 people, and has 490 beds including 86 day beds.
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