Table of Contents

Nurse

Doctor

Nurse Practitioner

Organ Donation Clinical Nurse Consultant

Research Team

Social Worker

Physiotherapist

Speech Pathologists

Dietitian

Pharmacist

Aboriginal Liaison Officer

Ward Clerk

Wardperson

At Nepean ICU our mission is to provide excellence in patient-centred care, teaching and research, guided by the best current knowledge and delivered with a compassionate approach. The ICU team consider patients and their families a central and vital part of our team. We value working together to deliver high quality care with compassion and respect to every patient. Our team are here to support and guide you and your loved one through this ICU journey.

The multidisciplinary team is defined as a group of health care staff who are members of different professions (doctor, social workers, nurses ect.) that work together to make decisions regarding the treatment of individual patients.

Nurse

Nepean ICU has a large team of nursing staff committed to delivering high quality care to critically unwell patients. The ICU nurse team is led by the Nurse Manager and supported by Clinical Nurse Unit Managers (CNUM). The CNUM is present in the unit 24 hours a day, 7 days a week collaborating with other managers, nursing staff, medical team, multidisciplinary team, patients, and families. The CNUM is responsible for the patient flow in and out of the unit in a timely manner. They coordinate and balance the roster with appropriate staff ratios and allocation based on clinical skills.

ICU patients often require a high level of care and observation. ICU nurses work a 7-day rotating roster . The nurse is present  24 hours a day providing high quality care to 1-2 patients at a time depending on the level of treatment the patient requires. Nurses collaborate with the multidisciplinary team to ensure optimal outcomes for the patient and carers of the serviceincluding the appropriate escalation of care and offer support to the patient and their families. All ICU nurses have a degree in nursing and many complete further courses and qualifications to care for and manage complex conditions and operate life-support equipment.

Doctor

Nepean ICU has a dedicated team of doctors coordinating the medical care of every patient in the unit, 24 hours a day, 7 days a week. The medical team is led by the ICU Medical Director and supported by a group of Intensivists with many years of training and experience caring for patients with critical illness.

The team includes a number of other doctors of different levels of seniority, some of whom are in their final year of specialty training while others are just beginning that journey. The team is divided into a day and night team, each doing a dedicated ward round during which every patient and their progress is thoroughly reviewed. These ward rounds occur in the morning and early evening. The medical team also review patients any time there is a change in their condition. The night and day teams handover the progress of patients at the end of their shifts. Some of these handovers occur at the bedside while others occur in one of our meeting rooms. A treatment plan is established in close collaboration with other members of the ICU multidisciplinary team as well as any medical or surgical specialties involved in the care of each patient.

The ICU medical team aim to communicate with families as often as we can. This might be a short update at the bedside or over the phone, or a longer conversation in one of our family rooms that often includes the nursing and social work teams.

Nurse Practitioner

The ICU Nurse Practitioner works closely with the multidisciplinary team to ensure all needs of the critical care patient are met. The ICU Nurse Practitioner role includes complex case management, vascular access, tracheostomy management and education, and assessment and training to ICU staff of all disciplines. The multidisciplinary team meet weekly to discuss and plan the healthcare needs of patients that have a protracted length of stay in ICU (greater than 14 days) where they establish goals for the patient and ensure that all care needs are being met. Patients  requiring central vascular access to facilitate the need for intravenous medications. can be expedited within the ICU where the NP or the Vascular Access Nurse can  provide timely central access for patients within the hospital and across our local health district. Patients that require a tracheostomy are also monitored closely by the ICU Nurse Practitioner including when the patients leave ICU. The Nurse Practitioner will follow up on a regular basis providing education to patients, families, and staff.

Organ Donation Clinical Nurse Consultant

Organ and tissue donation is rare and can change the lives of many people. One organ donor can potentially save and transform the lives of up to 7 people. If there is a possibility to consider donation at end of life, the role of the ICU Organ Donation Clinical Nurse Consultant is to provide information and to support families to make a decision that is right for the patient and the family.

Research Team

Nepean ICU have a dedicated research team committed to ensuring patients and their families, partners and friends have the opportunity to be involved and/or participate in clinical research. The ICU Research team includes a Research Clinical Nurse Consultant and two ICU Registered Research Nurses. Clinical research has led to major advances in the care of Intensive Care patients. The Research team may conduct studies comparing one treatment to another, known as clinical trials. This may include testing new drugs, machines or investigations as well as testing current known treatments in a new or different way. To help decide if the patient should be part of the study, the ICU Research Nurse will have a detailed discussion answering all questions or concerns the patient or family may have. The Research team work collaboratively with the multidisciplinary team throughout clinical research and/or trials and will keep the patient and families informed. A member of the research team will visit the patient while they are in the study, if you have any further questions or concerns, you will be able to speak to them. You can withdraw the patient from the study at any time without giving a reason. Not taking part in or withdrawing from the study will not affect the care of the patient.

Social Worker

Social workers provide assistance to patients in the ICU as well as their families, carers and friends by offering practical and emotional support. Having a loved one in ICU can be a very difficult and challenging time and speaking with a social worker for emotional support may help. This can include speaking about anxiety, adjustment to illness, family or relationship issues, carer stress. Social workers also provide crisis and bereavement support. If you have any concerns about Mental Health, Domestic Violence or Child Protection you can request to speak to a social worker. A social worker can also provide practical assistance or referrals to other support services. This can include assistance with support letters, housing concerns, legal matters, financial issues. You may also wish to discuss some community services such as aged care or the NDIS with a social worker. Social workers are available Monday to Friday during business hours and there is an on-call service for urgent issues. If you would like to speak to a social worker, you can ask the ICU team to refer to social work.

Physiotherapist

ICU Physiotherapists work with the multidisciplinary team to reduce the patients ICU stay and overall hospital stay, prevent ICU related complications and improve function and quality of life. Physiotherapy is an important intervention that assists with adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Physiotherapists perform an assessment that includes the respiratory, cardiovascular, neurological and musculoskeletal systems to create a treatment plan aimed at achieving individual patient goals. For long term patients (greater than 14 days) the treatment plan is created in consultation with the multidisciplinary team. Patient goals are set in communication with the patient, patient's family and the multidisciplinary team and are divided into short- and long-term goals. The set goals can change at any time throughout the patient's ICU stay. Physiotherapists assist with management of airway secretions, perform chest physiotherapy (manual techniques such as shaking and vibrations applied to the ribs), mobilisation, breathing exercises and weaning from mechanical ventilation. As part of the treatment plan physiotherapists may prescribe exercises and tasks to be performed throughout the day.

Speech Pathologists

ICU speech pathologists are responsible for managing a range of speech, swallowing and communication difficulties that patients may experience following critical illness, trauma, major surgery or long-term decline. Speech pathologists have specific skills and knowledge around the nature of these issues and how to best facilitate their care while in ICU. Speech pathologists also play an important role in tracheostomy weaning along with the multidisciplinary team. Positive impacts include assisting patients with beginning to communicate earlier and more effectively as well as safe commencement of food and drink. This can help to improve quality of life and mood, prevent complications and support reduced length of stay in ICU.

Dietitian

The role of a dietitian in ICU is to provide nutrition support safely to patients who are malnourished or at high nutritional risk of malnutrition, to help with their recovery. Nutritional support can include tube feeding, feeding intravenously (IV) and oral intake (normal food). The dietitian takes into consideration multiple aspect of the patient’s life including current and past medical conditions, medications, blood results, previous weight history, any nutrition impact symptoms (such as nausea, vomiting, poor appetite, diarrhoea) and previous mobility status to complete a detailed nutritional assessment to determine the best nutritional care for the patient.

Pharmacist

ICU pharmacists are an integral part of ICU patient care. Pharmacists offer specialised pharmaceutical knowledge and skills to optimise medication management and medication safety for critically ill patients, by working collaboratively with doctors, nurses and allied health professionals.

Pharmacists co-ordinate medication supply with hospital pharmacy dispensary and pharmaceutical suppliers to ensure continuity of patient care. We vigilantly monitor patients' response to their medications and ensure the correct medications and appropriate dosages are prescribed for and administered to ICU patients. Pharmacists also offer education and support to hospital patients on the use of their prescription medications, on an as needed basis.

Aboriginal Liaison Officer

Aboriginal patients and carers have the option to access Aboriginal Liaison Officers. Aboriginal Liaison Officers can help bridge communication barriers and act as a support and advocate for patients and families on health and Aboriginal cultural concerns. An Aboriginal Liaison Officer can provide patients and families with support and information on navigating the health care system and services available at Nepean Hospital. If you have concerns about Child Protection, Mental Health, Domestic Violence, Loss, Trauma or Grief you can request to speak with the Aboriginal Liaison Offer.

Ward Clerk

The ICU Ward Clerk provides a comprehensive range of administration support and customer service within ICU. Their duties include, answering phones, Intercom, filing patient documents, computer data entry andanswering patient enquiries. Ward clerks also manage and perform all patient transfers and discharges via the relevant databases while ensuring all patient information is accurate, both independently and as part of a team. The ICU Ward Clerk is the first contact for patients, families and health professionals visiting and telephoning the ward. They work a 7-day rotating roster covering each shift between 0700 to 2200. It is essential to press the intercom and speak with the ward clerk before entering the ICU. The ward clerk checks with the bedside nurse that no procedure, cares or examinations are taking place prior to allowing entry into the ICU. The ward clerk will also assist in explaining and guiding you to the bedside of your loved one to maintain the privacy of other patients in the ICU.

Wardperson

The Wardperson is an important part of the ICU service that provides high quality care to patients in the ICU. ICU patients require safe transportation, mobilisation, pressure injury care and personal hygiene. These cares are to be performed by ICU nursing staff with the help of  the wardperson. The wardperson provide support to assist in the delivery of safe, effective and quality patient care.