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Showing results for tags 'ICU/ ITU/ HDU'.
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News Article
Canada: 6 Saskatchewan ICU patients with COVID-19 being transferred to Ontario
Patient Safety Learning posted a news article in News
Saskatchewan will be transferring six COVID-19 patients to Ontario over the next 72 hours as the Prairie province struggles to deal with a record number of intensive care patients. One patient will be transferred Monday, with the other five expected by end of day Wednesday, according to the Saskatchewan Health Authority (SHA). Premier Scott Moe said planning for transferring patients has been going on for "a number of days" and that patients will be transferred to ensure they receive "the very best possible care that they can." Additional out-of-province support that may be required beyond Wednesday is being finalized, according to the SHA. "We recognize the stress this will cause the families affected," SHA CEO Scott Livingstone said in a news release Monday morning. "We continue to work every day to maximize capacity to provide care as close to home as possible, but this decision is necessary to maintain the quality of critical care services our patients need." Read full story Source: CBC News, 18 October 2021- Posted
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News Article
Hospitals consider ‘risky’ dilution of ICU nursing ratios
Patient Safety Learning posted a news article in News
NHS trusts in London are looking to dilute their intensive care nurse-to-patient ratios due to workforce shortages, according to a leading critical care nurse. Nicki Credland, chair of the British Association of Critical Care Nurses, told HSJ’s Patient Safety Congress that trust leaders in London have discussed relaxing the ratios from one nurse per patient, to one nurse per 1.75 patients. ICU staffing ratios have been intermittently diluted throughout the covid pandemic, but this has previously been used as a temporary measure. Ms Credland, a keynote speaker at the event on Tuesday, suggested some trusts are now looking at a permanent shift away from one-to-one care. She added: “What we are seeing now is that certain trusts in the country are doing exactly what we were worried about." “Starting to move away from those [guidelines for the provision of intensive care services] standards that we have, that protect both us as nurses but also protect the patient’s safety as well." Read full story (paywalled) Source: HSJ, 24 September 2021- Posted
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Intensive care units face ‘grim’ situation despite fall in Covid cases
Patient-Safety-Learning posted a news article in News
The president of the Intensive Care Society has warned despite the fall in Covid cases, intensive care units in hospitals remain under substantial pressure, with Stephen Webb, a consultant in intensive care and deputy medical director at the Royal Papworth Hospital Trust, describing the situation as "grim". “Cases of Covid infections are coming down but that’s not having much of an impact on hospitals and on intensive care units yet. The situation in ICUs is pretty grim at the moment and it’s grim for a completely different reasons from wave one and two of the pandemic.” Dr Webb told The Independent. Read full story. Source: The Independent, 5 August 2021- Posted
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Seven individuals face prosecution for alleged ill-treatment and wilful neglect of patients at a hospital for people with severe learning disabilities. The alleged offences took place at the psychiatric intensive care unit at Muckamore Abbey Hospital in County Antrim, Northern Ireland. Prosecution follows ongoing police inquiries A police investigation into claims of abuse at the hospital has been ongoing since 2018, following reports of inappropriate behaviour and alleged physical abuse of service users by staff. Read full story Source: Nursing Standard, 19 April 2021- Posted
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The 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- Posted
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Content Article
Guidance for: Prone positioning in adult critical care (2019)
Sam posted an article in Respiratory conditions
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By the end of the course, you‘ll be able to: Apply the current and evolving principles of personal protective equipment (PPE) in the care of COVID-19 patients. Apply evidence-based principles of advanced organ support and monitoring to the COVID-19 critically ill patient. Apply evidence-based daily practices to care of the critically ill patient. Develop a range of specialised self-caring practices Reflect critically on the complex elements required to achieve both self-awareness and self-compassion in a high-tension environment.- Posted
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Content Article
Intensive Care bed space orientation
Claire Cox posted an article in Other health and care software
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Key findings 45% of respondents have seen a permanent increase in the critical care capacity of their directorates. However, when asked if they consider any increase in capacity to be adequately staffed only 18% of respondents agreed. 60% of respondents reported that their units are still attempting to follow the Guidelines for the Provision of Intensive Care Services (GPICS) but 54% of respondents have seen some relaxation of those standards including to their medical staffing. 80% of respondents increased their working hours, and 71% report covering sick consultant colleagues. Future uncertainties affect the wellbeing of the Faculty’s fellows and members. How hospital structures support those working in critical care is vitally important for both recruitment and retention. 88% of respondents had leave cancelled. Work/life balance is extremely important. Whilst the vast majority of respondents were happy to deliver the needed increase in work in the first wave, to do this over subsequent waves of the pandemic becomes increasingly difficult for individuals and their family. Supporting professional activities and agreed job plans will be even more important in subsequent COVID-19 waves. Faculty fellows and members understood the impact the first wave of COVID-19 had on non-critical care staff, and hugely appreciated their response to the crisis. The flexible increase in staffing was so important for care, although the drop in GPICS standards underlines the need to increase the underlying critical care capacity, and the multi-disciplinary workforce. Key recommendations GPICS standards exist for reasons of best care, safety and governance. Units should be attempting to adhere to them or working towards achieving them. Inability to meet GPICS standards needs to be brought to the attention of management structures within hospitals and plans for addressing deficiencies identified and implemented. Supporting and maintaining the wellbeing of critical care staff is vitally important. Not only for recruitment by attracting multi-disciplinary team members in, but also for their retention in the specialty. Staff must not be taken for granted and listening to the voices from the frontline is only the start of this process. Enhanced Care recommendations, written and promoted by the Faculty, will allow for greater flexibility in future responses to surges in demand as well as safer care for those needing a higher level of care. Critical Care Directorates should make the case widely within their hospitals for enhanced surgical and medical care. -
Content Article
In this study from Timmel et al., CUSP was implemented beginning in February 2008 on an 18-bed surgical floor at an academic medical center to improve patient safety, nurse/physician collaboration, and safety on the unit. This unit admits three to six patients per day from up to eight clinical services. Improvements were observed in safety climate, teamwork climate, and nurse turnover rates on a surgical inpatient unit after implementing a safety programme. As part of the CUSP process, staff described safety hazards and then as a team designed and implemented several interventions. CUSP is sufficiently structured to provide a strategy for health care organizations to improve culture and learn from mistakes, yet is flexible enough for units to focus on risks that they perceive as most important, given their context. Broad use of this program throughout health systems could arguably produce substantial improvements in patient safety.- Posted
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News Article
New data has shown the number of coronavirus patients being admitted to hospital and intensive care units across the country has risen as lockdown rules are set to be eased further on Monday. The Public Health England (PHE) data, published on Friday, covers 134 NHS trusts across the country and shows the daily rate of new patients admitted to hospital and critical care with COVID-19 has risen compared to recent weeks, with London experiencing a sharp spike in new admissions in the past week. The south east region also saw an increase. The surveillance data on the spread of COVID-19 throughout England has also revealed an increase in the number of people testing positive at their GP. Read full story Source: Independent, 31 May 2020- Posted
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Coronavirus: Delirium 'may be common' in Covid seriously ill
Patient Safety Learning posted a news article in News
Delirium and confusion may be common among some seriously-ill hospital patients with COVID-19, a study in The Lancet suggests. Long stays in intensive care and being ventilated are thought to increase the risk, the researchers say. Doctors should look out for depression, anxiety and post-traumatic stress disorder (PTSD) after recovery, although most patients, particularly those with mild symptoms, will not be affected by mental health problems. The evidence is based on studies of patients with severe acute respiratory syndrome (Sars) and Middle-East respiratory syndrome (Mers), as well early data on COVID-19 patients. Read full story Source: BBC News, 19 May 2020- Posted
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Coronavirus: Restarting NHS services will be a major challenge, warn experts
Patient Safety Learning posted a news article in News
Restarting NHS services will be an even greater challenge than coping with the first coronavirus infections, health think tanks and hospital chiefs have warned. Since March, the NHS has freed up more than 33,000 beds to prepare for an influx of COVID-19 patients needing intensive care, but since the peak of infection health chiefs have worried that delays to care were harming patients. Around 46,000 so-called excess deaths have been recorded during the pandemic, as compared against a five-year average. Around a quarter of these are believed to be unrelated to COVID-19. In a joint statement, the Health Foundation, Nuffield Trust and King’s Fund think tanks have said it could take months before the NHS and social care are able to fully restart. All three bodies will be giving evidence to the Commons health committee on Thursday, where they will warn about the impact on the health service’s “exhausted staff” and demand action to help care homes – which are now at the frontline in the fight against coronavirus. The experts will stress the need for the NHS to begin planning for a second peak of infections, especially if it comes in winter – when the service is usually overwhelmed by seasonal flu. They will warn about concerns over how the NHS manages the risk of infection, with the need for more protective equipment, social distancing and increased testing. This will “severely limit capacity for many months”, they said. Read full story Soruce: The Independent, 14 May 2020 -
News Article
NHS staff given conflicting advice over resuscitation of coronavirus patients
Patient Safety Learning posted a news article in News
Doctors, nurses and paramedics have been given conflicting advice about when to start resuscitation for coronavirus patients, amid fears the procedure could put them at risk of infection. While Public Health England has said it does not believe CPR creates a risk, the UK’s Resuscitation Council – which is responsible for setting standards for resuscitation in the NHS – has said it believes there is a risk and staff should wear full equipment. The Independent has seen several examples of different messages being sent out to hospital staff and ambulance workers, and some NHS trusts were forced to change their guidance within a matter of days after PHE changed its stance. One set of guidance could mean a delay in starting CPR for patients while staff put on protective equipment, while the other means staff could be at risk of being infected with coronavirus. Ken Spearpoint, a former consultant nurse and resuscitation officer at Imperial College Healthcare Trust, said the situation had led to confusion and created an “ethical dilemma” for some staff who were being forced to choose between the Resus UK’s position and their trust’s guidance. Read full story Source: The Independent, 6 April 2020- Posted
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Frantic action to stop London ‘running out of beds in four days’
Patient Safety Learning posted a news article in News
Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity. In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak. According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said. The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. Read full story Source: HSJ, 24 March 2020- Posted
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News Article
New guidelines have been published to help doctors and nurses decide how to prioritise patients during the coronavirus pandemic. The advice from the National Institute for Health and Care Excellence (NICE) was produced amid concerns that the NHS would be overwhelmed by the demand for intensive care beds and ventilators. The three new NICE guidelines, which have been drawn up within a week rather than the usual timescale of up to two years, cover patients needing critical care, kidney dialysis and cancer treatment. They say all patients admitted to hospital should still be assessed as usual for frailty “irrespective of Covid-19 status”. Decisions about admitting patients to critical care should consider how likely they are to recover, taking into account the likelihood of recovery “to an outcome that is acceptable to them”. Doctors are advised to discuss possible “do not resuscitate” decisions with adults who are assessed as having increased frailty, such as those who need help with outside activities or are dependent for personal care. Read full story Source: Independent, 22 March 2020- Posted
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Content Article
Key takeaways Presentation weeks and/or months after ICU discharge Physical and mental tolls of critical illness and care Beware of the possible warning signs, which may include: muscle weakness or problems with balance, problems with thinking and memory, severe anxiety, depression and nightmares The medical community expects to see a high number of PICS cases among COVID-19 survivors due to the increasing number of patients receiving critical care.- Posted
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Actions required Primary actions to be completed by 7 October 2020: Identify and locate affected devices in your organisation. Identify alternative ventilators available on site. If no suitable alternative available, and capacity is an issue currently or expected imminently, follow protocol for resource shortage escalation set out by your local governance. Train all relevant staff on alternative ventilators and ensure training records are up to date. When actions 1–4 are complete, remove affected V60s from use and quarantine until repaired by the manufacturer. Place the alternative devices into service in place of the affected V60s. You may continue to use affected V60s if there is a risk of severe patient harm due to lack of ventilator availability. A thorough risk assessment must be completed, and additional monitoring must be used. A backup form of ventilation must be available at all times. Secondary action to be completed by 23 December 2020: 8. Review procurement and stock policies to ensure you are not reliant on one manufacturer or model of ventilator.- Posted
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