Dubrovnik General Hospital – Coronary Care Unit

    Authors

    Abstract

    The Cardiology Department of the Dubrovnik General Hospital (GH) has been independent from the Department for Internal Medicine since July 1, 2017, and it now represents one of the largest departments in the hospital. It consists of the following subunits: the Coronary Care Unit, the Cardiology Department, the Invasive Cardiology Laboratory, Cardiological Rehabilitation, and the Cardiological Polyclinic. This division is the result of many years of dedicated work and efforts by all our employees, which began with the pacemaker implantation program in 2007. This was followed by the formation of the Invasive Cardiology Laboratory in 2009 under the mentorship of Assist Prof Boris Starčević, MD, PhD and the University Hospital (UH) Dubrava. Cooperation was subsequently arranged with the Cardiac Surgery Clinic of the UH Dubrava, from which Prof Željko Sutlić, MD, PhD visited our institution once per month to perform pre-surgery consultations with potential candidates for cardiosurgical treatment, greatly contributing to the availability of treatment for cardiological patients, even those with the most severe conditions. Ten years after the establishment of invasive cardiology at the Dubrovnik GH, we perform approximately 500 coronarographies annually, of which 270 elective percutaneous coronary interventions and approximately 130 primary percutaneous coronary interventions in the course of acute coronary syndrome treatment. The Coronary Care Unit employs 11 nurses, with each shift having two nurses per 10 patients, including patients with mechanical respiratory support. Of these, 7 nurses simultaneously work at the Invasive Cardiology Laboratory and are on call between shifts. Considering the above, it can be concluded that significant advancements in the development of cardiology in the Dubrovnik GH have been achieved in the last decade, providing patients with timely and comprehensive cardiological care and largely due to the enthusiasm of our team of healthcare professionals

    Keywords

    coronary care unit, general hospital, cardiology

    DOI

    https://doi.org/10.15836/ccar2019.293

    Full Text

    The Coronary Care Unit (CCU) and the first monitoring system were founded in 1981, and the first implantations of temporary pacemakers were also performed. At the time, permanent pacemaker implantation and invasive interventions in our patients were possible only at cardiology clinics of other clinical hospital centers and clinical hospitals in the Republic of Croatia. The Cardiology Department was part of the Department of Internal Medicine until July 2017, after which it started functioning as an independent department with new organization and continuous efforts directed at improving our services. Today the “Cardiology Department with the Coronary Intensive Care Unit” is one of the largest departments in the hospital and consists of the following subunits: the CCU, the Cardiology Department, the Invasive Cardiology Laboratory, Cardiological Rehabilitation, and the Cardiological Polyclinic. All of the above contributes to proving high-quality and comprehensive cardiological care for our patients. We started a program for permanent pacemaker implantation in 2007. Today we implant approximately 100 permanent pacemakers, implantable cardioverter defibrillators, and biventricular pacemakers (cardiac resynchronization therapy – CRT). The “Invasive Cardiology Laboratory” was opened in 2009 under the mentorship of Assist Prof Boris Starčević, MD, PhD and the University Hospital (UH) Dubrava, where we carried out an education program for our staff. At the same time, we established successful cooperation with the Cardiac Surgery Clinic of the UH Dubrava, from which Prof Željko Sutlić, MD, PhD visited our institution once per month to perform pre-surgery consultations with potential candidates for cardiosurgical treatment as well as post-surgery monitoring and consultations and examinations after the surgery itself, which greatly contributed to the availability of treatment for cardiological patients with even the most severe conditions. Today, 10 years after the establishment of invasive cardiology at the Dubrovnik General Hospital (GH), we perform approximately 500 coronarographies annually, of which 270 elective percutaneous coronary interventions (PCI) and approximately 130 primary percutaneous coronary interventions (pPCI) in the course of acute coronary syndrome treatment. In 2016 we opened “Cardiorehabilitation” under the mentorship of Prof Viktor Peršić from the Opatija Thalassotherapy Hospital. Our patients are thus provided with inpatient rehabilitation after acute coronary syndrome or after any type of revascularization therapy or surgical treatment of valvular defects. The program is based on a team approach and consists of two physical therapists and a cardiologist, psychologist, and nutritionist. In 2018, 408 patients were hospitalized at the CCU through the Joint Emergency Hospital Admission system, in addition to 59 patients transferred from other hospital units; a total of 179 patients were hospitalized between January 1, 2019 and May 1, 2019. The Cardiology Department consists of 4 rooms with a total of 16 beds. Patients from the fields of cardiological pathology are treated at the department (arrhythmia, pacemakers, peripheral artery and venous disease, heart failure, valvular pathology). The CCU is equipped with a modern monitoring system and has 6 hospital beds with an additional 4 beds in Postcoronary Care. The unit also has a transesophageal ultrasound device available 24 hours a day. Eleven nurses work at the Coronary Unit, of which 5 with a bachelor’s degree in nursing and 2 with a master’s degree, and one physician – an interventional cardiologist. There are two nurses per 10 beds per shift. Patients on mechanical respiratory support are also housed at the CCU, with the same ratio of nurses per patient. Differences: 7 nurses simultaneously also work at the Invasive Cardiology Laboratory and are on call between shifts. Thanks to the devoted efforts and work of all employed personnel, significant advancements in the development of cardiology have been achieved over the last ten years at the Dubrovnik GH in line with all the relevant medical advancements and evidence-based guidelines, providing the patients with timely and comprehensive cardiological treatment. This is all largely based on the enthusiasm of our team of healthcare professionals.

    Cardiologia Croatica
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    Dubrovnik General Hospital – Coronary Care Unit

    Other
    Issue11-12
    Published
    Pages293-295
    PDF via DOIhttps://doi.org/10.15836/ccar2019.293
    coronary care unit
    general hospital
    cardiology

    Authors

    Anita Miljas*ORCIDDubrovnik General Hospital, Dubrovnik, Croatia

    Abstract

    The Cardiology Department of the Dubrovnik General Hospital (GH) has been independent from the Department for Internal Medicine since July 1, 2017, and it now represents one of the largest departments in the hospital. It consists of the following subunits: the Coronary Care Unit, the Cardiology Department, the Invasive Cardiology Laboratory, Cardiological Rehabilitation, and the Cardiological Polyclinic. This division is the result of many years of dedicated work and efforts by all our employees, which began with the pacemaker implantation program in 2007. This was followed by the formation of the Invasive Cardiology Laboratory in 2009 under the mentorship of Assist Prof Boris Starčević, MD, PhD and the University Hospital (UH) Dubrava. Cooperation was subsequently arranged with the Cardiac Surgery Clinic of the UH Dubrava, from which Prof Željko Sutlić, MD, PhD visited our institution once per month to perform pre-surgery consultations with potential candidates for cardiosurgical treatment, greatly contributing to the availability of treatment for cardiological patients, even those with the most severe conditions. Ten years after the establishment of invasive cardiology at the Dubrovnik GH, we perform approximately 500 coronarographies annually, of which 270 elective percutaneous coronary interventions and approximately 130 primary percutaneous coronary interventions in the course of acute coronary syndrome treatment. The Coronary Care Unit employs 11 nurses, with each shift having two nurses per 10 patients, including patients with mechanical respiratory support. Of these, 7 nurses simultaneously work at the Invasive Cardiology Laboratory and are on call between shifts. Considering the above, it can be concluded that significant advancements in the development of cardiology in the Dubrovnik GH have been achieved in the last decade, providing patients with timely and comprehensive cardiological care and largely due to the enthusiasm of our team of healthcare professionals

    Full Text

    The Coronary Care Unit (CCU) and the first monitoring system were founded in 1981, and the first implantations of temporary pacemakers were also performed. At the time, permanent pacemaker implantation and invasive interventions in our patients were possible only at cardiology clinics of other clinical hospital centers and clinical hospitals in the Republic of Croatia. The Cardiology Department was part of the Department of Internal Medicine until July 2017, after which it started functioning as an independent department with new organization and continuous efforts directed at improving our services. Today the “Cardiology Department with the Coronary Intensive Care Unit” is one of the largest departments in the hospital and consists of the following subunits: the CCU, the Cardiology Department, the Invasive Cardiology Laboratory, Cardiological Rehabilitation, and the Cardiological Polyclinic. All of the above contributes to proving high-quality and comprehensive cardiological care for our patients. We started a program for permanent pacemaker implantation in 2007. Today we implant approximately 100 permanent pacemakers, implantable cardioverter defibrillators, and biventricular pacemakers (cardiac resynchronization therapy – CRT). The “Invasive Cardiology Laboratory” was opened in 2009 under the mentorship of Assist Prof Boris Starčević, MD, PhD and the University Hospital (UH) Dubrava, where we carried out an education program for our staff. At the same time, we established successful cooperation with the Cardiac Surgery Clinic of the UH Dubrava, from which Prof Željko Sutlić, MD, PhD visited our institution once per month to perform pre-surgery consultations with potential candidates for cardiosurgical treatment as well as post-surgery monitoring and consultations and examinations after the surgery itself, which greatly contributed to the availability of treatment for cardiological patients with even the most severe conditions. Today, 10 years after the establishment of invasive cardiology at the Dubrovnik General Hospital (GH), we perform approximately 500 coronarographies annually, of which 270 elective percutaneous coronary interventions (PCI) and approximately 130 primary percutaneous coronary interventions (pPCI) in the course of acute coronary syndrome treatment. In 2016 we opened “Cardiorehabilitation” under the mentorship of Prof Viktor Peršić from the Opatija Thalassotherapy Hospital. Our patients are thus provided with inpatient rehabilitation after acute coronary syndrome or after any type of revascularization therapy or surgical treatment of valvular defects. The program is based on a team approach and consists of two physical therapists and a cardiologist, psychologist, and nutritionist. In 2018, 408 patients were hospitalized at the CCU through the Joint Emergency Hospital Admission system, in addition to 59 patients transferred from other hospital units; a total of 179 patients were hospitalized between January 1, 2019 and May 1, 2019. The Cardiology Department consists of 4 rooms with a total of 16 beds. Patients from the fields of cardiological pathology are treated at the department (arrhythmia, pacemakers, peripheral artery and venous disease, heart failure, valvular pathology). The CCU is equipped with a modern monitoring system and has 6 hospital beds with an additional 4 beds in Postcoronary Care. The unit also has a transesophageal ultrasound device available 24 hours a day. Eleven nurses work at the Coronary Unit, of which 5 with a bachelor’s degree in nursing and 2 with a master’s degree, and one physician – an interventional cardiologist. There are two nurses per 10 beds per shift. Patients on mechanical respiratory support are also housed at the CCU, with the same ratio of nurses per patient. Differences: 7 nurses simultaneously also work at the Invasive Cardiology Laboratory and are on call between shifts. Thanks to the devoted efforts and work of all employed personnel, significant advancements in the development of cardiology have been achieved over the last ten years at the Dubrovnik GH in line with all the relevant medical advancements and evidence-based guidelines, providing the patients with timely and comprehensive cardiological treatment. This is all largely based on the enthusiasm of our team of healthcare professionals.