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Showing results for tags 'HDU / ICU'.
Found 105 results
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Content ArticleThis video has been produced by the staff at Guy's and St Thomas' Hospital NHS Foundation Trust. It demonstrates how to prone an intensive care patient. If proning a patient with COVID-19, full personal protective equipment (PPE) will be required by all staff.
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Content Article
Intensive Care: a guide for patients and relatives
Claire Cox posted an article in Resources for patients
This guide contains advice and information about intensive care. It tells you how critical illness may be treated and what recovery may be like. Not every patient will experience all of these things, but they are more likely to if they have been in intensive care for more than a few days. Most of this guide is written for patients but there is a section specifically for relatives and visitors. By reading the guide, relatives will learn what a patient's recovery may involve and it will give them the answers to some of the questions they may have. -
News Article
Inside an ICU: how long can we stay calm in the face of the coronavirus crisis?
Patient Safety Learning posted a news article in News
Matt Morgan, an intensive care doctor, describes in this Guardian article how his ICU are preparing for the coronavirus crisis. "ICUs are as prepared as they can be. Locally business as usual has made way for preparations for caring for high numbers of patients. We are finding every ventilator we may have and identifying every suitably qualified member of staff. We will work together to fill gaps as best we can. There’s a sense of anticipation about what the next eight, 10, 12 weeks are going to bring in terms of work. Anyone who works in healthcare is also a mum, dad, daughter, brother, son. We want to give everything to saving lives and work and care, but equally we’re thinking about the logistics of personal lives and elderly relatives too." Matt says his worst nightmare is having insufficient workforce and equipment to meet patient needs. Whether or not that will come to fruition is tough to predict. He also says that his ICU has a psychologist who’s doing a huge amount of thinking about putting in place wellbeing resources for staff who might be in moral distress after having to prioritise one patient over another. "If there are 500 patients and only 200 ventilators then that’s when we need national guidance from the government and other bodies. It can’t be up to individual doctors. The age of playing God is long behind us. The question is who should we be making decisions with: the public, government or within the profession?" Read full story Source: The Guardian, 13 March 2020 -
News Article
Coronavirus: NHS bosses warn hospitals over intensive care demand surge
Patient Safety Learning posted a news article in News
NHS hospitals have been told to expect a “several-fold” increase in demand for intensive care beds during a serious coronavirus outbreak. Professor Keith Willett, NHS England’s incident director for the coronavirus outbreak, told a secret briefing of chief nurses from across the NHS that they needed to prepare now for the unprecedented demand which could overwhelm existing critical care services. Sources who were in the briefing told The Independent Prof Willett warned the demand was likely to be not just double but “several fold” the existing 4,000 intensive care beds in the NHS. Prof Willett said the NHS will also be holding large-scale simulations next week for an expected coronavirus surge in an effort to “stress test the system” ahead of rising cases of infection. If the predictions are right the NHS will likely be forced to cancel large numbers of operations and re-deploy nurses and doctors. Read full story Source: The Independent, 12 March 2020 -
Content Article
COVID-19: Information from the Intensive Care Society
Patient Safety Learning posted an article in Guidance
The Intensive Care Society has created a page to provide the critical care community with resources and information on COVID-19. The Society is collaborating with Government, FICM and other agencies to ensure they provide consistent, up to date and relevant messaging to support your understanding of and management of COVID-19. -
Content Article
Why I ‘walk on by’
Anonymous posted an article in Florence in the Machine
I recently read the blog on the hub ‘Walk on by...’ by a junior doctor. What a fantastic doctor, if only we had more of these people in our healthcare service. I wanted to respond to this blog by writing about my own experiences in ‘walking on by’. It’s been a difficult write as it has questioned my integrity, my motivation and my career.- Posted
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Content ArticleJones et al. hypothesised that antimicrobial stewardship (AMS) could be enhanced through positive feedback for the behaviors of healthcare professionals. This project aimed to reduce antimicrobial consumption in a Pediatric Intensive Care Unit (PICU) by >5%, with secondary aims to reduce broad-spectrum antimicrobial consumption, and processes related to AMS.
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Content ArticleChildren admitted to paediatric and neonatal intensive care units may be at high risk from medication errors (MEs) and preventable adverse drug events. In this systematic review published in Drug Safety, Alghamdi et al., reviewed empirical studies examining the prevalence and nature of MEs and preventable adverse drug events in paediatric and neonatal intensive care units. They found that medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions.
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Content ArticleReflecting current best practice, the Oxford Handbook of Critical Care Nursing, Second Edition, is a practical, concise, easily accessible, and evidence-based guide for all levels of nursing staff working in critical care environments. It aims to provide a quick, easy-to-follow overview of critical care nursing, and is not intended as a specialist text. Rather it provides both the novice and the experienced nurse at the bedside with the answers to day-to-day problems experienced when caring for critically ill patients, and is also a guide to some of the less commonly encountered issues. The second edition has been updated to reflect recent significant changes in the management of the critically ill adult. Current guidance from organisations such as the National Institute for Health and Care Excellence (NICE), the British Association of Critical Care Nurses (BACCN), and the Intensive Care Society (ICS) has been included. In addition to the updating of clinical guidance, an emphasis has now been placed on nursing management, and the book is designed to help to facilitate systematic nursing assessment of the critically ill adult. New chapters focusing on changes in the delivery of critical care, systematic assessment, and end-of-life care have also been added. This is now a FREE ebook for anyone to download.
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Content ArticleA candid account from a healthcare professional on how it feels to have to tell a patient in intensive care that their treatment is to be delayed. Part of the Guardian newspaper's Blood, sweat and tears series.
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Content ArticleFor eligible patients, prompt admission to the Intensive Care Unit (ICU) can increase their chance of survival by up to 23%. Yet those that do survive may experience lasting physical and emotional effects, and it is the job of the clinician to carefully weigh up the potential gains and risks of admission in what is often a time-pressured environment. There are currently no national guidelines to help the decision-making process, and evidence suggests it is influenced by a range of factors, with considerable variation between clinicians. In addition, patients and their families are not always fully informed or consulted. This study, published by Health Services and Delivery Research, explored current practice in order to create a decision support tool that could be used to help take some of the uncertainty out of the process, thereby improving decisions and, when possible, also informing the discussions with the patient and their family.
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Content ArticleThe hospital environment is both unique and unusual in that electrical equipment is directly applied to the human body. From this contact either capacitive or resistive coupling may lead to current flow and harm. Surgical diathermy, patient monitoring and imaging, although universal, are often misunderstood, and many clinicians are ignorant of their principles and hazards. Electrical equipment in hospital therefore has the potential to lead to serious injury or death. This article published in Anaesthesia and Intensive Care Medicine outlines the basic physics of electricity, in particular the principles behind diathermy, the hazards posed by it and by other devices and the various measures available to reduce the risk of these.
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News Article
'Breaking point': fears over lack of intensive care beds for children
Patient Safety Learning posted a news article in News
Critically ill children are being rushed from one part of England to another because NHS hospitals are running short of intensive care beds in which to treat them, the Guardian has revealed. An increase in severe breathing problems in children driven by winter viruses and infections, including flu, means some are having to be transferred sometimes many miles from their home area because there are not enough paediatric intensive care (PICU) beds locally. Specialist doctors who staff the units say the situation is “dangerous and rotten for the families” involved and that staff are firefighting to handle the number of children needing sometimes life-saving care, many of whom are on a ventilator to help them breathe. In the past few weeks, young patients have been sent from the Midlands to Sheffield, from London to Cambridge, and from one side of the Pennines to the other in order to get them a place in a PICU. One doctor at a PICU in the Midlands said: “PICU beds are always in high demand. But since winter hit this year, around six weeks ago, the situation feels like we are simply firefighting. Many days I come on shift to find there are no beds in [our] region and the patients referred to us end up in Southampton, Sheffield, Oxford and other centres far away." “The PICU network is overstretched. There aren’t enough beds, nurses or skilled doctors.” Read full story Source: The Guardian, 29 December 2019 -
Content ArticleClinician burnout has been well-documented and is at record highs. The same issues that drive burnout also diminish joy in work for the healthcare workforce. Healthcare leaders need to understand what factors are diminishing joy in work, nurture their workforce, and address the issues that drive burnout and sap joy in work. The most joyful, productive, engaged staff feel both physically and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work, and perceive their work life to be fair and equitable. There are proven methods for creating a positive work environment that creates these conditions and ensures the commitment to deliver high-quality care to patients, even in stressful times.
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Content ArticleIn 2008, the UK National Patient Safety Agency (NPSA) made recommendations for safe arterial line management. Following a patient safety incident in their intensive care unit (ICU), Leslie et al. surveyed current practice in arterial line management and determined whether these recommendations had been adopted. They contacted all 241 adult ICUs in the UK; 228 (94.6%) completed the survey. Some NPSA recommendations have been widely implemented – use of sodium chloride 0.9% as flush fluid, two‐person checking of fluids before use – and their practice was consistent. Others have been incompletely implemented and many areas of practice (prescription of fluids, two‐person checking at shift changes, use of opaque pressure bags, arterial sampling technique) were highly variable. More importantly, the use of the wrong fluid as an arterial flush was reported by 30% of respondents for ICU practice, and a further 30% for practice elsewhere in the hospital. This survey provides evidence of continuing risk to patients.
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Content ArticleHealthcare is in the midst of significant change, with substantial shifts in emphasis and priorities. Patient-centered care has become central to the core goals of better health, better quality, and lower costs while highlighting the necessity of incorporating patients’ efforts, needs, and perspectives into healthcare at all levels. Patient and family engagement (PFE) is critical to patient-centered care, and important theoretical and empirical work has identified key elements and implications of PFE, especially for management of chronic illnesses and preference-sensitive clinical decision making. Brown et al. believe that the ultimate goal of active, mutually respectful partnership among clinicians and patients/families is urgent and important. However, consistent terminology and definitions of PFE are still lacking. This deficit is particularly striking in intensive care units (ICUs), which pose special challenges to outpatient models of PFE: the emotional stakes are high, time is greatly compressed, surrogates play a central role, and the specter of death often dominates decision making.
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Content ArticleTo address increasing patient demands and acuity, the Calgary Health Region is renovating the intensive care units (ICU) at three of their adult acute care sites. Before finalising the design plans, mock-up rooms were created at two of the sites according to several proposed room designs in order to identify potential issues during the design phase of the project. All necessary equipment was included within each of the two mock-up rooms so as to nearly replicate a functioning ICU. Evaluations of equipment, room layout and conflicts were accomplished using patient simulation of a cardiac arrest, an acutely ill patient, a palliative care patient and the admission of a new patient. Digital videos, think aloud audio tracks and extensive debriefing sessions were combined and analyzed. Specific category issues were identified including the articulating arms, visibility of the patient monitors, equipment usability, collisions with equipment, and communication issues. Elaboration of each issue and presentation of design recommendations is given.
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Content ArticlePatient diaries have often been used in the adult intensive care setting. This paper explores the use of diaries with the paediatric population and how this can enhance care and rehabilitation post critical care stay.
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Content ArticleA free eBook for everyone who responds to deteriorating hospital in-patients. This book has been written for team members and leaders of hospital rapid response teams who attend deteriorating patients. It provides pragmatic advice on a number of topics. These include: How to design then run effective rapid response systems. Principles of team management. An A to E approach to clinical deterioration. An approach to managing acute dying. Approaches to common acute clinical conditions including hypoxia, altered consciousness, hypotension, oliguria and sepsis. Its authors are all intensive care specialists and experts in the field. They have been involved in the design, implementation and governance of rapid response systems across Australia and New Zealand at both local and national levels as well as teaching and researching in this area. Evidence for the recommendations made are provided as a comprehensive reading list at the end of each chapter.
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Content ArticleEach quarter, the Patient Safety Movement Foundation hosts a free webinar on a variety of central patient safety topics aligned with their Actionable Patient Safety Solutions (APSS). This session addressed airway safety. It's focus was on how existing, high-impact solutions can be planned to reduce unplanned extubation. The presentation was given by Dr. Art Kanowitz.
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Content ArticleThis case story highlights the missed opportunities that could have prevented a cardiac arrest and subsequent severe hypoxic brain injury in an intensive care patient.
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Content Article"It’s time to halt, take a break, and redraw the relationship between patient care and self-care. Self-care isn’t an optional luxury. It must sit at the heart of what we do, to ensure our teams can continue to rise to the challenges of working in the 21st century NHS, to give our patients the best of both ourselves, and the organisation so many of us are proud to be a part of."
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Content ArticleSalford Care Organisation uses this great infographic on their wall to show patients and relatives what they may experience when on the intensive care unit.
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Content ArticleThis action plan was produced by the Ipswich & East Suffolk Clinical Commissioning Group and West Suffolk Clinical Commissioning Group following a treatment delay for a patient in intensive care.
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Content ArticlePolicy to date has mostly focused on the role of 'whistleblowers' in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 hours of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), Tarrant et al., in a paper published in Social Science & Medicine, studied how personnel gave voice to concerns about patient safety or poor practice.
