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Accp training
This document summarizes Lee Berry's training and experience as an Acute Care Practitioner (ACP). It outlines their educational background and clinical rotations in intensive care, anesthesia, and outreach. It also describes the practical procedures Lee performed such as intubation, vascular access, and prescribing. Feedback was generally positive but some misunderstanding of the ACP role was encountered. Long term goals include increased responsibility and competency in the intensive care unit.
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Accp training
- 1. ACCP training A personal perspec,ve
- 2. Lee Berry • RN qualified 1998 • Cri,cal care experience 2000-‐2011 (university teaching hospital SGH) • ICU • Medical HDU • Cri,cal Care Outreach • Lead for resuscita,on 2011-‐2013
- 3. Education • Formal -‐ University of Southampton MSc pathway • Key components-‐ • History taking and physical assessment • Pharmacology and Independent prescribing • Modules generic not tailored to ACCP programme
- 4. Education • Tutorial programme – • List of core topics selected by ACCPs • Formal teaching delivered by intensivits and anaesthe,c consultants • High fidelity simula,on sessions-‐ • Core clinical decision making and airway skill prac,ce • Non ,metabled opportuni,es (Theatre, ICU, Outreach)
- 5. Clinical rotations • Rota,ons at RHCH & BNHH • Intensive care unit • Theatre • Cri,cal care outreach ICU 30 50% Anaesthe,cs 13 22% Outreach 17 28% Clinical Alloca*on ICU Anaesthe,cs Outreach
- 6. Practical procedures • Facilitated by ST3 and above during clinical alloca,on • Intuba,on & Airway skills • Vascular access, CVC, ‘vas cath’ • Arterial line
- 7. Airway Grade 1 Grade 2a Grade 2b Grade 3 Total 26 9 6 2 LMA 56 ETT 43 Total 99 60% 21% 14% 5% Laryngoscopy Grade 1 Grade 2a Grade 2b Grade 3 Airway procedures LMA 56 ETT 43 Total 99
- 8. Vascular access catheters • Supervised in theatre and ICU • No Immediate complica,ons • Reduced opportuni,es in ICU for line placement • Pseudomyxoma surgery 3-‐5 cases a week and line changes. 10 3 11 Vascular Access CVC Vas Cath Arterial lines
- 9. Clinical role notjust procedures • Working within ICU medical team • Responsible for pa,ent daily review and presenta,on on consultant ward round • Undertaking physical assessment and interpreta,on of diagnos,c informa,on • Ordering of diagnos,c tests • Liaising with other clinical teams. • Independent prescribing
- 10. Feedback • Regular 360 feedback from-‐ • Anaesthe,c trainees • Anaesthe,c consultants • ICU Nursing staff • Cross boundary working nature of role has led to misunderstanding of role and role apprehension among a small number of medical and nursing staff. “Nurse pretending to be a doctor?”
- 11. Second year goalsand beyond • To become involved with ICU audit • M & M mee,ngs & case presenta,ons • Out of Hours working (weekends / nights) Increased learning opportuni,es but maintaining supervision with ICU consultant • Complete competency document and final assessment.
- 12. FICM exit exam& National syllabus • FICM exit exam not yet in place. In hospital exam and competency document equivalent? • Na,onal syllabus required for valida,on and role consistency.