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Showing results for tags 'HDU / ICU'.
Found 105 results
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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 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 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 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 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.
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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 ArticlePatients with delirium have changes in their thinking and are often confused and cannot pay attention. About half of patients in an intensive care unit (ICU) have delirium during their stay. Research has shown that patients with delirium are more likely to die or to have long-term brain problems, including posttraumatic stress disorder, depression and other mental health issues, than those without delirium. Although nurses and doctors have tools to measure delirium in the ICU, it can be hard to identify and, in some cases, may be missed. Family members may be the first to notice that their loved ones have changes in their thinking or cannot pay attention. There are tools called the Family Confusion Assessment Method (FAM-CAM) and Sour Seven questionnaire that can be used by family members to detect delirium. However, neither of these tools has been used in an ICU. This study from Krewulak et al., published in CmajOPEN, shows that these tools can be used by family members to measure delirium in the ICU. The results from this study could lead to a change in policy that would involve partnering with family members to improve the diagnosis of delirium in the ICU. In turn, this would improve patient and family care and outcomes in the ICU.
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Content Article
Invasive procedure safety checklist: ITU INTUBATION
Claire Cox posted an article in Process improvement
This checklist was devised by the Intensive Care Society and the Faculty of Intensive care Medicine and is ready for you to download and use. -
Content ArticleIn intensive care units (ICU) and operating theatres, arterial lines are used to accurately measure a patient’s blood pressure and take numerous and repetitive blood samples. In order to prevent bacterial contamination and blood spillage from the arterial line, red arterial connectors, which are closed cap coverings, are placed on the sampling port of the arterial line. Doctors from The Queen Elizabeth Hospital NHS Foundation Trust, Kings Lynn have collaborated with Eastern Academic Health Science Network and the Patient Safety Collaborative on this patient safety solution.
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Content ArticleThis decision tree, used at the Brighton and Sussex University Hospitals NHS Trust, was developed as a ‘quick reference’ aid for nurses setting up non-invasive ventilation (NIV). It highlights key settings and signposts users to the full trust policy for more detailed explanation. It is adapted from the British Thoracic Society guidelines for acute NIV.
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Content ArticleThe UK NHS has risen to the challenge posed by COVID-19 through Herculean efforts to expand capacity. This has included doubling or trebling intensive care (ICU) capacity within hospitals, augmenting this with Nightingale Hospitals, cancelling all non-emergency surgery and redeploying staff and equipment to focus on a single disease. At the same time, government and population efforts have – through social distancing then lockdown – successfully flattened the epidemic curve and so reduced demand. Together, these actions have enabled treatment of all those needing hospital care for COVID-19 and avoided the unfettered increase in mortality that would have accompanied an overwhelmed healthcare service. However, this has been achieved ‘by the skin of our teeth’ and until very recently, the threat of insufficient ICU beds ventilators, and the need for triage were all anticipated: a few hospitals were overcome by the surge of critically ill patents. Now, political and social thoughts and actions are turning to loosening lockdown and determining what ‘post-pandemic normality’ will look like. In this Editorial, William Harrop‑Griffiths and Tim Cook discuss the prospects and challenges of ‘planned surgery’ – both time-critical and wholly elective procedures.
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Content ArticleA medical student describes his experiences of working in the ICU of his local hospital during coronavirus in this Independent blog. "I was one of the first medical students at my university to be recruited to help out in local hospitals as fears grew about the NHS being overwhelmed by COVID-19."
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Content ArticleGoing through critical illness and recovery is difficult for both patients and their relatives and will be unlike anything we've experienced before. Not knowing what's normal and what might lie ahead in the journey makes coping with things that much harder, which is why honest, accurate, patient-centered information is fundamental to the work of ICUsteps. Only people who've been through it really know what matters to patients and relatives in the position we were in. This understanding is what drives ICUSteps to produce a range of information resources that can help patients and relatives make sense of what has happened and cope with the road ahead.
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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 ArticleThis teaching presentation, by Kings Hospital clinical fellows, is based on ‘Kings clinical summary guidelines’ when caring for a patient with diagnosed COVID 19 This presentation includes: Disease progression Diagnosis Bloods Imaging Radiology Guidelines Investigations Treatment Organ Support Prognosis Treatment escalation planning Palliative care PPE Resuscitation Intrahospital transfer.
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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
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
ICU Steps: Patient and relative experiences of critical illness
Claire Cox posted an article in Patient stories
For many people involvement with intensive care is a daunting experience. For some it's part of the care plan after major surgery but for many others it's a sudden and unexpected event.You find yourself in an alien environment unlike any you've known before where patients are connected to all kinds of machines and drips, where you might not be able to tell day from night and where there's constant noise and activity. The people that work in the Intensive Care Unit do an amazing job, but even when patients are on the road to recovery they still have a long way to go before they're fully better. Depending on how ill the patient has been, recovery can take a year or more. Knowing what might lie ahead and also that you're not alone in what you're going through can be a great help for both patients and relatives. This webpage set up by ICU Steps, include experiences from patients and relatives as they have spent time on the intensive care unit. -
Content ArticleTo extend the ICU Steps patient information guide, they have produced a series of information sheets on issues relevant to recovering intensive care patients. These documents are exclusively available online. They're free to download in PDF format for you to print, photocopy and distribute as needed. Topics include: Acquired brain injury and intensive care Breathing and critical illness Delirium and intensive care Looking after yourself after critical illness Medical tests in intensive care Planned treatment on the intensive care Tracheostomy in intensive care.
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Content ArticlePatient Safety Learning interviews a critical care outreach nurse from America to find out the challenges frontline teams are facing during the coronavirus pandemic.
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Content Article
The story behind CARDMEDIC (updated 28 May 2020)
Rachael Grimaldi posted an article in Blogs
Having read an article about a critically ill intensive care patient terrified when they couldn’t understand what the healthcare team were saying through their personal protective equipment (PPE), Rachael Grimaldi, an NHS anaesthetist, was inspired to create a simple communication tool: CARDMEDICTM. Update from Rachael: Since writing this blog, we have been accepted onto The Hill Accelerator Program, run by Oxford University, Oxford University Hospitals NHS Foundation Trust and Oxford Brookes University. We have also been selected to be a part of the Healthcare UK Digital Health Offer for Export for 2020. Healthcare UK is a joint initiative of The Department for International Trade (DIT), The Department of Health and Social Care (DHSC) and NHS England, which promotes the UK healthcare sector to overseas markets. We now have over 30,000 users in over 100 countries, alongside 11,500 app downloads. Version 2 of the app is out now, with a 'free notes' section so the patient and healthcare staff can communicate directly. Text can either be dictated or typed into the notes box, the language auto-detected and then translated into one of 10 languages available and read aloud to the patient if necessary. We are working on enhancing accessibility through the addition of sign language videos and images / illustrations / makaton signs. An independent academic evaluation by University of Brighton using simulated patients demonstrated 25% increased confidence in understanding a healthcare worker in PPE with CARDMEDIC than without. Overall, confidence improved by 28% to 95%. Results likely significantly higher for those unwell/communication needs. -
Content ArticlePhysiotherapy is critical for treating those worst affected by Covid19, including access to community rehabilitation after discharge from hospital. We face a huge increase in demand for high quality community rehab services. The Chartered Society of Physiotherapy (CSP) sets out what system leaders and policy makers will need to do to meet this challenge.
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Content ArticleAs the coronavirus pandemic focuses medical attention on treating affected patients and protecting others from infection, how do we best care for people with non–Covid-related disease? In her article in the New England Journal of Medicine, Lisa Rosenbaum discusses the impact the pandemic is having and how we help those people who are afraid to seek care.
