Clinical Services

The Heart Institute is a leader in cardiac nursing, and education plays a central role in Clinical Services. We have extensive orientation programs to ensure nurses have sufficient training to allow them to make a smooth transition between services. Ongoing unit-based specialty training is provided year round.

Funding is available for staff to attend local, provincial and national conferences. As a major teaching facility, nurses have access to a myriad of Grand Rounds presented by internationally renowned clinicians and scientists. Our affiliation with the University of Ottawa provides us with a variety of nursing students, allowing mentorship and clinical teaching opportunities for experienced staff.

Education and Professional Practise

Working in a complex, highly technical environment requires excellence in nursing practise. We are committed to providing nurses with extensive educational opportunities. We offer:

• Advanced Academic Preparation
  Working with our academic partners, the University of Ottawa, Algonquin College and La Cite Collegiale, we offer access to Masters programs in Nursing, Health Administration and Education. A PhD program in Nursing is also available through the University of Ottawa. The Heart Institute has a number of educational programs on site to support ongoing education.
• Orientation
  All new staff receive a competency-based unit orientation. These programs are tailored to the needs of the RN and the nursing unit, and range from several weeks to months.
• On-unit Inservices
  Each unit has unit-based skills training and nursing practise discussions. Classes are available for specialized skills such as intra-aortic balloons, artificial hearts and CRRT.
• E-learning
  Staff have access to e-learning programs which allow nurses to advance their practise though disease-based education modules and self-assessment testing.
• Cardiac Nursing Series
  This program provides an eight module course on cardiac nursing care featuring cardiac surgery, interventional procedures, heart failure, ECG interpretation and device management.
• New Graduate Initiative
  This initiative provides 12 weeks of education and clinical practise to new graduates. The program is designed to provide a smooth transition for new graduates.
• Preceptor-Mentor Workshops
  Staff can attend workshops to develop preceptor-mentor skills to support students and new staff.
• Clinical Placements for Students
  The Heart Institute offers a variety of clinical placements for students including general wards, critical care, outpatients and nurse practitioner placements.
• Rounds
  The Heart Institute provides a comprehensive rounds program featuring internationally known speakers on cardiovascular care and science.
• Funding Support
  Funding support is available for CNA certification, local and national conferences and for specialty training.

For more information, please see Nursing Educational Programs.

Cardiac Catheterization and Electrophysiology Labs

The Heart Institute has four Cardiac Catheterization Labs and two Electrophysiology (EP) Labs. Procedures such as coronary angiograms, percutaneous cardiac interventions such deployment of stentsinto the coronary arteries, and adult congenital interventions are done in the catheterization labs. These labs are at the centre of the Heart Institute’s life saving CODE STEMI program, used across the Champlain region to provide quick intervention for individuals having a heart attacks.

Procedures that deal with the heart’s electrical system are performed in the EP labs. These include cardiac mapping, ablations and insertion of pacemakers, defibrillators, and loop recorders. EP studies allow physicians to diagnose the causes of abnormalities in heart rhythms ( arrhythmias) and determine the appropriate treatment.

Cardiac Operating Rooms 

The Surgical Suite includes five operating rooms (ORs) that perform booked and emergent cardiac surgery. Coronary artery bypass surgery,  heart valve replacement and repair, heart transplant, pulmonary thromboendarterectomy, and implantation of ventricular assist devices are performed in the ORs. The OR team is involved in developing cutting edge techniques such as MICS-CABG and other minimally invasive interventions.

Cardiac Surgery Intensive Care Unit 

The Cardiac Surgery Intensive Care Unit (CSICU) is a 19-bed unit providing care to patients immediately after heart surgery and to patients who require longer term complex care following surgical procedures. Complex care specific to CSICU includes ventilator support, specialized intravenous medications, renal support with continuous renal replacement therapy (CRRT) or cardiac assist devices. The CSICU clinical staff has had extensive training in the wide range of technology used in this setting. The medical team includes intensivists, cardiac surgeons and doctors in training.

Coronary Care Unit

The Coronary Care Unit (CCU) provides care to patients who are critically ill after a heart attack, life-threatening arrhythmias, heart failure, or to those in cardiogenic shock. Many patients in CCU will have undergone a life saving intervention called a percutaneous cardiac intervention (PCI) to open up narrowed coronary arteries that are preventing enough oxygen from reaching the heart muscle. Some patients are in the CCU because they require continual vital sign monitoring, while others may require ongoing specialized complex care such as ventilator support, specialized intravenous medications, renal support with continuous renal replacement therapy (CRRT) or cardiac assist devices. The 14-bed CCU is staffed by a multidisciplinary team that has had extensive training in the wide variety of technology used in this setting.

H3 (Cardiology and Surgery) 

Located on the fourth floor of the Heart Institute, H3 is a combined general cardiology and cardiac surgery unit. It provides care to a varied group of patients including those who have medical heart conditions and those who have had cardiac surgery. Patients on H3 may be in hospital to have procedures such as cardiac catheterizationor a percutaneous cardiac intervention (PCI). Other patients may have had a pacemaker insertion, noninvasive testing, or, in the case of heart failure, to receive continual infusions of medications called inotropes. H3 also cares for patients recovering from open heart surgery. When required, patient’s heart rate and rhythm can be continually monitored using portable electrocardiogram (ECG) telemetry. The clinical team caring for the patients on H3 includes a wide range of staff, from registered nurses and doctors to dietitians and speech pathologists.

H4 (Cardiac Surgery) 

H4 is a cardiac surgery unit on the third floor of the Heart Institute. It provides care to patients who are recovering from surgical procedures. Patients on H4 may have had cardiac bypass surgery, heart valve repair or replacement, heart transplant, pulmonary thromboendarterectomy or implantation of a ventricular assist device. When required, patient’s heart rate and rhythm can be continually monitored on H4 using portable electrocardiogram (ECG) monitoring called telemetry.

H5 (Cardiology) 

H5 is a general cardiology unit on the fifth floor of the Heart Institute. It provides care to a diverse group of patients including those who have had a heart attack, or who have unstable angina, arrhythmias,  heart failure, or congenital heart problems. Patients on H5 may be in hospital to have procedures such as cardiac catheterizationor pacemakerinsertion, noninvasive testing, or, in the case of heart failure, to receive continual infusions of medications called inotropes. Other patients will be on H5 after having a life saving intervention called a percutaneous cardiac intervention (angioplasty) to open up narrowed coronary arteries that are preventing enough oxygen from reaching the heart muscle.

About half of the patients on H5 are on portable electrocardiogram (ECG) monitoring called telemetry which enables the clinical staff to continually monitor the patient’s heart rate and rhythm. Each patient is assigned to a medical team that will follow them during their hospitalization.

Pre-Admission Unit (PAU) 

The Pre-Admission Unit (PAU) ensures that all assessments, tests and educational information are available to patients and their families prior to their cardiac surgery or procedure. After being referred by their surgeon or cardiologist patients visit our clinic typically at least 48 hours in advance of their booked procedure. PAU services include nursing assessment; anesthesia assessment; additional referral if required to physiotherapy, social work, smoking cessation or other services as needed; pre-operative teaching and specific instructions for the day of admission and procedure.

Regional Referral Centre/Day Unit 

The Regional Referral Centre (RRC)/Day Unit is a combined unit that handles admitted inpatients and outpatients or day transfers from other hospitals. Located on the 1st floor of the Heart Institute, the Day Unit has is a 23-bed capacity. The RRC/Day Unit provide care to a diverse group of patients with cardiac issues, often requiring procedures such as cardiac catheterization, pacemaker or implantable cardioverter-defibrillator (ICD) insertion, or electrophysiology procedures.

Telehealth 

Telehealth employs telemedicine, telehome monitoring and interactive voice response technologies to improve access to specialized cardiac care for patients across the Champlain LHIN as well as throughout Ontario and Canada. Telehealth equipment platforms support videoconferencing for face to face interviews and remote physical examinations with a specialized stethoscope and camera.

Telehome monitoring and interactive voice response use regular phone lines to transmit clinical information from home to a central station at the Heart Institute. These systems promote self-care education, collaboration and coordination of care between primary care physicians, specialists and patients residing in urban or rural areas. Cardiac Telehealth has been successful in significantly reducing hospital readmissions.

Wait List Management 

The Wait List Management team provides a one number to call service for all patients requiring cardiac procedures, including cardiac catheterization, percutaneous coronary intervention, cardiac surgery and electrophysiology procedures. Patients are referred to the Wait List Management and then triaged based on a scoring system designed to ensure patients receive access to services based on their individual needs and acuity.

Triage coordinators provide information and support to patients and families while they wait for procedures. These coordinators work closely with physicians and Clinical Services staff to ensure the smooth transition of patients from admission to discharge or transfer back to their referring hospital. Triage coordinators are linked to the Cardiac Care Network of Ontario, a provincial system which coordinates access to cardiac services across the province.

Research is an important component of Clinical Services activities. Our staff are involved in research in a variety of ways, from identifying clinical problems amenable to research to leading studies as primary investigators. Staff are encouraged to present and publish the results of their academic and research activities at national and international meetings.