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The Royal Marsden
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Advanced Critical Care Practitioner Introducing a new role at RMH
Alistair Ritchie
The Royal Marsden
The Royal Marsden Critical Care Unit What do we do?
We provide care for patients who require advanced monitoring or support for their condition
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16 Beds in Chelsea; 2 Treat & Transfer Beds Sutton
7 isolation rooms
Nearly 1500 admissions a year
75% post-surgery elective admissions
20% of admissions need advanced multiple organ support
Some of the best outcomes for cancer patients in Europe
The Royal Marsden Critical Care Unit (RMH CCU)
The Royal Marsden
The CCU Team
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Patient
Doctors
Nurses
Healthcare Assistants
Physiotherapists
Dieticians
Speech and Language Therapists
Occupational Therapists
Pharmacists
The Royal Marsden
What is an ACCP?
The Advanced Critical Care Practitioner is an
experienced critical care practitioner from a
nursing, physiotherapy or pharmacy background
who trains to fulfil roles traditionally performed
by medical staff
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The Royal Marsden
Role Overview Advanced Critical Care Nurse Practitioner
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Assess, Diagnose and Treat critically ill patients
Prescribe
Undertake invasive procedures
Contribute to leadership, service improvement and education
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Rationale for implementation at RMH CCU
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Workforce Planning
Enhanced MDT Working
Continuity of Care
Career progression
Collaborative Working
Enhanced Admission & Discharges
Professional Empowerment
Increased Safety
Presence
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Work Based Learning
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Experiential learning
Ward rounds
MDT
Managing case loads
Clinical Skills
Core Competencies
FICM competency Based Framework
System based consultant led teaching
2 weekly case based discussions
In-house & external courses/conferences.
Rotational placement to accommodate
different specialties
Reflective Practice
Monthly 1:1 Clinical competency evaluation
and planning.
DOPS
Case Based Discussions
Monthly Clinical Supervision
3 Monthly Written reflections
Self Directed Learning
Journal Club
E-Learning
Audit
Research
The Royal Marsden
Post Graduate Diploma in Advanced Practice provided by Kings College London
• Core Modules
• Evidence Based Decision Making in Health Care
• Measurement and Evaluation for Health Care in Practice
• Advanced Practice Clinical Portfolio
• FICM Appraisal Documentation
• ACCNP Specific Modules
• Advanced Assessment for Non-Medical Practitioners
• Prescribing for Nurses and Midwives
• MSC Advanced Practice
• Dissertation
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The Royal Marsden
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Challenges
Buy in
Funding
Governance
Indemnity
Acceptance
Definition of role
Boundaries
Skill Acquisition
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Impact
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“…sharing invaluable
knowledge and skills, which have been essential in helping us settle
in” CCU SHO
“Discharges have definitely improved.
Especially with regard to the rationalisation of
PCAs and IV access. This alone makes the
transition from CCU to the ward much
smoother” CCORT Sister
“You add an extra layer of support , especially if
the doctors are busy. You manage that link
between the doctors and us. I definitely notice
when you’re not here” B5 Staff Nurse
The Royal Marsden
ANY QUESTIONS?
Thank you!
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