CC Cardiol Croat Cardiologia Croatica Cardiol. Croat. 1848-543X 1848-5448 Croatian Cardiac Society CC 2019 14_11-12_320-2 10.15836/ccar2019.320 Other Coronary Care Unit - Zadar General Hospital Prikaz Koronarne jedinice Opće bolnice Zadar KasunMarija* Opća bolnica Zadar, Zadar, Hrvatska Zadar General Hospital, Zadar, Croatia ADDRESS FOR CORRESPONDENCE: Marija Kasun, Opća bolnica Zadar, Bože Peričića 5, HR-23000 Zadar, Croatia. / Phone: +385-91-721-77-45 / E-mail: marija.dunat@gmail.com 112019 14 11-12 320 322 16072019 17092019 2019 Croatian Cardiac Society SUMMARY

The Coronary Care Unit (CCU) at the Zadar General Hospital was founded in 1979. Today it has six hospital beds and is equipped with modern medical devices for intensive care. The CCU provides treatment for patients who require intensive cardiological treatment, percutaneous coronary interventions (PCIs), electrophysiology studies, radiofrequency ablation procedures, permanent pacemaker implantation, and implantation of cardioverter defibrillators and cardiac resynchronization devices. The CCU admits approximately 600 patients annually, and 208 primary PCIs were performed in 2018. Total patient mortality has been dropping every year and was 6.1% in 2018. The CCU employs 11 nurses with a head nurse in the morning shift and two medical nurses per shift.

 SAŽETAK

Koronarna jedinica Opće Bolnice Zadar osnovana je 1979. godine. Danas ima šest bolesničkih kreveta i opremljena je modernim medicinskim aparatima za intenzivno liječenje. U Koronarnoj jedinici liječe se bolesnici koji zahtijevaju intenzivno kardiološko liječenje, provode se perkutane koronarne intervencije (PCI), elektrofiziološke studije i postupci radiofrekventne ablacije, implantacije trajnih elektrostimulatora, implantabilnih kardioverterskih defibrilatora i resinkronizacijskih uređaja. Godišnje se u Koronarnu jedinicu primi oko 600 bolesnika, a u 2018. godini izvedeno je 208 primarnih PCI-ja. Ukupna se smrtnost bolesnika svake godine smanjuje, a za 2018. iznosila je 6,1%. U Koronarnoj jedinici radi 11 medicinskih sestara, odgovorna sestra u jutarnjoj smjeni te po dvije medicinske sestre u svakoj smjeni.

 KLJUČNE RIJEČI: opća bolnicaZadarkoronarna jedinica KEYWORDS: general hospitalZadarcoronary care unit

The Coronary Care Unit (CCU) at the Zadar General Hospital (GH) was founded in 1979 with three patient beds and four nurses working in shifts. The unit moved to a newly constructed building of the Internal Medicine Department in 1980, increasing its capacity to six patient beds. Further renovations organized the space into six separate rooms (boxes) with a central monitoring desk and a room for the nurses and the physicians. The space is practical and allows excellent supervision and access to patients for the purposes of treatment and care while also ensuring privacy for the patients. The unit is equipped with a Dräger telemetry system, Zoll defibrillators, an intra-aortic balloon pump, and infusion and perfusion pumps manufactured by the Braun company.

Since its founding, the CCU was completely focused on the treatment of patients who require intensive cardiological treatment. The development of interventional cardiology and the opening of the Angiography Hall at the Zadar GH in 2004 led to the introduction of percutaneous coronary interventions (PCIs), initially only during the morning shift on working days, but availability of on-call PCI procedures 24 hours a day, seven days a week was introduced in 2008. The Zadar GH has officially been part of the Croatian Network for Interventional Treatment for Acute Myocardial Infarction since the start of 2009.

The Coronary Care Unit admits approximately 600 patients annually (Figure 1). The number of primary PCI (PPCI) procedures administered tends to grow every year, and 208 PPCIs were performed in 2018. The growth tendency of PPCI procedures was especially noticeable in 2015, when PPCIs for patients with NSTEMI were introduced (Figure 2). In addition to PCI procedures, the CCU provides electrophysiology studies, radiofrequency ablation procedures, permanent pacemaker implantation, and implantation of cardioverter defibrillators (ICD) and cardiac resynchronization devices (CRT). Total patient mortality (Figure 3) has been dropping every year and was 6.1% in 2018.

Number of annual admissions to the Zadar General Hospital Coronary Care Unit.

The number of percutaneous coronary interventions at the Zadar General Hospital Coronary Care Unit.

Mortality at the Zadar General Hospital Coronary Care Unit.

The Zadar General Hospital CCU employs 11 nurses, including a head nurse in the morning shift and two nurses per shift. We responsibly and professionally conduct all healthcare procedures, procedures for infection prevention and prevention of other unwanted events, prevention of complications due to extended bed rest, education and motivation of patients in secondary prevention procedures for coronary heart disease, and educating patients in adapting to life with ICDs or CRTs. We are dedicated to maintaining proper nursing documentation and insist on continuous education for all our staff as well as participation on congresses and conferences of the Croatian Association of Cardiology Nurses and international congresses of the European Association of Cardiovascular Nursing as well as the implementation of continuous education at our Department.