ICUs advised how to improve staffing ratios as covid pressure eases

Intensive care units (ICU) will be advised how to improve their staffing-to-patient ratios shortly as the number of patients admitted to hospital with COVID-19 falls across the country.

In expectation that the pandemic would put intense pressures on ICUs, staff ratios were relaxed. NHS England told trusts to base their staffing models on one critical care nurse for every six ICU patients, supported by two non-specialist nurses, and one senior ICU clinician for every 30 patients, supported by two middle-grade doctors.

Before the pandemic, guidance from the Faculty of Intensive Care Medicine recommended a ratio of one non-specialist nurse per patient. For senior clinicians the ratio was 1:10

New guidance, expected as early as next week, will encourage trusts to reduce the number of patients per ICU specialist nurses and senior clinicians on a localised basis as part of “transitional arrangements” aimed at moving staffing models back towards normal standards of care, HSJ has been told.

The new guidance, drawn up by NHS England, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses, will give trusts recommended staffing ratios based on the occupancy rates of their ICUs. It will tell trusts the existing ratios should be applied if their ICUs are running at four times their normal capacity. For ICUs running at double capacity, this ratio would be reduced to 1:2 for ICU nurses, and 1:15 for senior clinicians.

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Source: HSJ, 8 May 2020