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Showing results for tags 'ICU/ ITU/ HDU'.
Found 118 results
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Content ArticleThis is the first in a series of thematic reports which will be published by the Independent Maternity Services Oversight Panel in the coming year. The purpose of the report is to summarise the learning which is emerging from the ongoing programme of independent clinical reviews of the maternity and neonatal care previously provided by the former Cwm Taf University Health Board. This particular report summarises the key themes and issues which emerged from the clinical review of 28 individual episodes of care1 which were provided by the Health Board between 01 January 2016 and 30 September 20182. It focuses on the care of mothers who needed unplanned emergency treatment during childbirth, including some who required admission to an Intensive Care Unit.
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Content ArticleIn conditions of intensive therapy, where the patients treated are in a critical condition, alarms are omnipresent. Nurses, as they spend most of their time with patients, monitoring their condition 24 h, are particularly exposed to so-called alarm fatigue. The purpose of this study from Lewandowska et al. is to review the literature available on the perception of clinical alarms by nursing personnel and its impact on work in the ICU environment.
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Content ArticleThis case study looks at how implementing a daily emergency call safety huddle at Surrey and Sussex Healthcare NHS Trust has increased efficiency in team working and improved patient safety. A safety huddle is a short multidisciplinary briefing, held at a predictable time and place, and focused on the patients most at risk. By implementing the ten-minute daily safety huddle, the medical emergency and cardiac arrest teams improved patient outcomes and staff experience, and were able to make better use of resources.
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This learning resource has been designed for frontline clinical staff who are caring for critically ill patients during the COVID-19 pandemic. This includes a wide range of healthcare professionals in acute care, from many different clinical speciality backgrounds. You may have some previous critical care experience or none. The information in this resource will support those refreshing critical care knowledge and skills, newly qualified doctors, those who are upskilling, and those returning to acute clinical services during the COVID-19 pandemic. -
Content Article
Guidance for: Prone positioning in adult critical care (2019)
Sam posted an article in Respiratory conditions
Guidance from the Faculty of Intensive Care Medicine and Intensive Care Society on prone positioning in adult critical care. It is hoped that the adoption of the guidance set out within this document will help improve safety and reduce complications associated with the prone positioning of mechanically ventilated patients. This document also hopes to standardise the approach to manging a cardiac arrest in the prone position, and has some guidance on prone ventilation in ECMO patients as well as considerations for performing bronchoscopy in the prone position. Assuming adequate staffing and equipment is available, the intervention of prone positioning involves very low costs and provided additional patient complications and long-term injuries to staff do not occur, would almost certainly be a cost-effective intervention. -
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Intensive Care bed space orientation
Claire Cox posted an article in Other health and care software
This interactive orientation of an Intensive Care Unit (ICU) bed space, created by the London Transformation and Learning Collaborative, is ideal for healthcare professionals new to the ICU environment. It allows you to explore the risks and demonstrated the safety check required to keep patients safe in the ICU. This application is best used with a smart phone, but can be used on a computer. -
Content ArticleIn October the Faculty of Intensive Care Medicine surveyed their Fellows and Members about their experiences and feelings during the first wave of the COVID-19 pandemic. They have published Voices from the Frontline of Critical Care based on the results of this survey.
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Content ArticleThis study from Harris et al. estimated the effect of prompt admission to critical care on mortality for deteriorating ward patients. They found that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.
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News ArticleThe most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ. The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS. Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that: Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak. Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring. The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for. As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ. The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base). However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556). However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards. Read full story Source: HSJ, 23 October 2020
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Content ArticleIn March 2020 Philips Health Systems released an FSN concerning V60 ventilators. This FSN concerned a hardware fault in the device, which can result in an unexpected shutdown. There are two ways in which this shutdown can occur: The first will sound a warning to alert the user that the machine is shutting down. This will let the user know they need to switch to an alternative source of ventilation. There is a risk that the patient will be unventilated while this second source of ventilation is prepared. The second failure mode will cause the device to shut down with no warning to the user. If a device fails in use and does not alarm, the patient will not be adequately ventilated and there is a potential risk of brain damage or death, depending on how long it takes clinicians to become aware of the situation and respond. There has been a significant delay of replacement parts arriving in the United Kingdom, resulting in an increased risk of this failure occurring. The MHRA has decided to update the guidance issued in the Medical Device Alert published in June. The MHRA will continue to work with the manufacturer to improve the delivery time for replacement components.
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Community PostDuring the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas. We have different admission wards in terms of symptoms that the patient has, but also have a different type of flow, which i am getting my head around to be able to share I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed. So.... How is your department responding to the pandemic? Do you have any patient safety initiatives as a result of the response? Is there a long term plan? The reason why i am asking this, is so we can share practice and identify individual trust responses.
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Content ArticlePost-intensive care syndrome (PICS) is a nonspecific syndrome that results from physical, mental, and emotional stresses associated with critical illness and treatment in intensive care units (ICUs). Common features include neuromuscular weakness from immobility, cognitive impairment from sedation, and anxiety, depression, post-traumatic stress syndrome (PTSD), and, as we are learning, additional sequelae for COVID-19 survivors. Symptoms can manifest or persist weeks, months, or years after patient discharge. This eBook from ECRI provides an overview of PICS, the common danger signs health providers and family members should be able to identify, and its potential long term negative effects. Learn about strategies like creating an ICU diary to help mitigate risks, in addition to understanding other recommendations to consider to protect the safety and well-being of patients during their recovery.
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Content ArticleThis project, led by a team of researchers, aims to give a voice back to the critical care nurse so that there is a much greater understanding of the mental challenges of the profession and so that appropriate supportive measures can be developed that improve working conditions. In order to carry out the research, the team need volunteers to participate and share their own views and experiences of mental health and well-being in the profession. We are looking for any active critical care nurse who is open to discussing mental health and well-being to shed light on what is a too often ignored and overlooked subject. Find out more about the project and how to sign up via the link below.
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Content Article
Critical Care Recovery: COVID-19
PatientSafetyLearning Team posted an article in Resources for patients
Critical Care Recovery and Life Lines have teamed up to develop this web resource, designed to help patients and families recover from COVID-19. Informed by published expert guidance, they have also worked very closely with front line health care professionals, patients and families. This website will be updated regularly, as more information becomes available. -
Content ArticleThis webinar recording from ICU Steps is a session with trustees about recovery from critical illness and what can be done to help.
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Content ArticleThe aim of the project was to introduce and evaluate a Call for Concern (C4C) service that provides patients and relatives with direct access to the Critical Care Outreach (CCO) team, to give patients and relatives more choice about who they can consult with about their care, and facilitate the early recognition of the deteriorating ward patient. The project involved two phases: a six month pilot phase to evaluate the C4C service for feasibility, and its effects on patients, relatives and the health care teams. a three month phase implementing the C4C service onto two surgical wards to test and evaluate the findings of the feasibility phase in preparation for expansion to all hospital wards. Between 1st Sept 2009 and 23rd Sept 2010, the CCO team received 37 C4C referrals representing 0.5% of total CCO activity. Critical deterioration of a patient was prevented in at least two cases, and the service received positive feedback from patients and relatives. In the words of a relative, C4C provided: ‘…a better quality of care…and…reduces the risk of death.’
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Content ArticleThe Imperial Simulation Team, led by Dr Malik, filmed this Immersive Simulation of a SARS-CoV2 patient with COVID-19 disease who had a cardiac arrest. Filmed at Imperial College Healthcare NHS Trust/Imperial College London.
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Content ArticleHospital-acquired pneumonia, whether device associated or not, is the number one hospital-acquired infection in the United States and a major threat to the safety of patients. This blog by Patient Safety Movement discusses how engaging nurses in quality improvement around mouth care reduces ventilator acquired pneumonias.
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Content Article
COVID-19: voices from the front line
Claire Cox posted an article in Stories from the front line
The COVID-19 pandemic has changed most lives internationally. Households have shifted, balancing financial concerns and anxieties about the health of family and friends with the trials and responsibilities of childcare. During this pandemic it became clear that while many were struggling with the same issues, a series of shared stories could help the wellbeing of frontline NHS staff who might feel isolated and alone. The following voices are not unique to Guy’s and St Thomas’ NHS Foundation Trust, anaesthesia or healthcare in the UK, but they were selected from the department to represent some of many healthcare workers who have taken on new professional roles as well as radically different ways of working and living. -
Content ArticleThis report, from the Healthcare Safety Investigation Branch (HSIB), provides insight into a current safety risk that was identified on a referral. The referral was about difficulties in identifying clinical deterioration in patients with COVID-19 on general wards. The Royal College of Physicians (RCP) highlighted the issue of rapid deterioration in oxygenation in patients with COVID-19 and how this might relate to the use of early warning scores.
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Content ArticleThis film, produced by Hearts in Healthcare, shows Kathy talking about her experience of being in an Intensive Care Unit following a serious accident. Kathy talks about the importance of communicating to patients, even when they are unable to respond, and recalls one particular nurse who made a huge difference to her recovery. An incredibly powerful account that beautifully illustrates human-centred healthcare.
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Content ArticleThis bedside guide, from the Chartered Institute of Ergonomics and Human Factors, is intended for the use of all healthcare staff who are looking after adult patients with tracheostomies. The tasks described should not be attempted by those who have not received training or been deemed as competent in tracheostomy care and management. This guide includes posters, checklists and practical resources to aid the safe care of patients with tracheostomies.
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Content ArticleThe COVID-19 pandemic has resulted in an overall surge in new cases of depression and anxiety and an exacerbation of existing mental health issues, with a particular emotional and physical toll on health care workers. Limited resources, longer shifts, disruptions to sleep and to work-life balance and occupational hazards associated with exposure to COVID-19 have contributed to physical and mental fatigue, stress and anxiety and burnout. In this article, published by Wolters Kluwer, the Houston Methodist Hospital share the lessons learned collectively by an interdisciplinary team of Intensive Care Unit (ICU) leadership and collaborating scientists about the experience of occupational fatigue and burnout of intensive care personnel as a result of responding to the COVID-19 pandemic. They propose specific policy recommendations and guidelines for organisational readiness, resilience and disaster mitigation.
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Content ArticleIf a nasogastric tube (NGT) has been misplaced into the respiratory tract and this is not detected before fluids, feed or medication are given, death or severe harm can be caused. The consequences are even more likely to be fatal for patients who are already critically ill. Most nasogastric ‘Never Events’ of feeding into the respiratory tract through a misplaced tube continue to arise from misinterpretation of x-rays by staff who had not been given training in the ‘four criteria’ technique and were unaware that relying on the position of the tube tip alone on a radiograph can be a fatal error.
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Content ArticleThe prone position is defined as lying in a horizontal position with the front of the body facing downwards. Its use with critically ill patients with respiratory compromise is known to improve short-term oxygenation and lung compliance. The desired outcome of prone positioning is to improve lung perfusion and oxygenation in patients who are in the early stages of pneumonia or who have an acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) which is common in COVID–19 patients. One of the most common complications of nursing patients in the prone position is the occurrence of pressure ulcers. Pressure ulcers are likely to occur as patients are repositioned far less frequently once in prone (generally only after 16 hours) and also the patient may develop significant facial oedema. It is important therefore to take precautions to reduce the risk of pressure ulcers when preparing for and caring for the patient in the prone position. This NHS guidance promotes good skin care during prone positioning.
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