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Found 118 results
  1. News Article
    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
  2. News Article
    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
  3. News Article
    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
  4. News Article
    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
  5. News Article
    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
  6. Event
    until
    This Webinar hosted by Hamilton Medical, will focus on the clinical use of intelligent ventilation software. Agenda Intro from Chair Luigi Camporata Presentation from Prof. Giorgio A. Iotti : “ The birth and growth of the visionary idea” Presentation from Laura Buiteman-Kruizinga: “Lung protective ventilation in the time of COVID-19” Followed by a Q&A Register for the webinar
  7. Content Article
    In the first in a two-part series looking at the work of the coroner, James Sira talks to Derek Winter about the role of the coroner, medical examiner, and the coroner’s inquest.   Derek is HM Senior Coroner for the City of Sunderland and was appointed as one of the two Deputy Chief Coroners of England and Wales in 2019. He has conducted a wide range of cases in the 15 years he has spent as a coroner and has modernised the Sunderland coroner service.  Most intensive care doctors will at some point in their career be required to provide a statement for or give evidence at a coroner’s inquest, and this can be a daunting experience.
  8. Content Article
    This video is based on research interviews with acute medical patients and examines how staff and patients in hospital can create safe care together. It includes quotes from real-life patient experiences and highlights the importance of listening to and reassuring patients, and involving them in their care.
  9. Content Article
    This National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report highlights the results of a study into quality of care received by people aged 0-24 receiving long-term ventilation (LTV). It aimed to identify remediable factors in the care provided to children and young people who were receiving, or had received, LTV.
  10. Content Article
    Call 4 Concern enables patients, relatives and carers to call for help/advice from the Acute Intervention Team when they are concerned about a patient’s condition, and/or they feel that their concern is not being addressed by the ward team. County Durham and Darlington share their Call 4 Concern leaflet.
  11. Content Article
    The 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.’
  12. Content Article
    During the Covid-19 pandemic, intensive Care Units (ICUs) all came under severe pressure, resulting in higher than usual mortality and complications rates, and longer stays. However, there was variation in outcomes among ICUs and this editorial in the journal Annals of Intensive Care discusses the concept of a resilient ICU. It looks at which metrics can be used to address the capacity to respond, sustain results and incorporate new practices that lead to improvement.
  13. Content Article
    This case study summarises the story of Evadney Dawkins, a 77 year-old living in East London who died on 23 August 2018 as a result of treatment errors and poor care received at Newham University Hospital. Following a fall at home, Evadney was taken to the hospital on 22nd July 2018, where she was initially treated for a chest infection and fast atrial fibrillation (an irregular and abnormally fast heart rate). As she had other co-morbidities that included chronic renal failure, a treatment plan including renal monitoring was agreed, but the hospital failed to monitor her renal function and she sustained a profound acute kidney injury. Following intensive treatment, the acute kidney injury resolved but she sustained a cardiac arrest on 23rd August 2018 and died later that day. This case study outlines how Action Against Medical Accidents (AvMA) helped Evadney's family convince the Coroner to open an inquest. The inquest found that there were ‘gross failures’ in the care provided to Evadney which led to her renal deterioration, including a failure in the frequency of blood tests, a failure in fluid monitoring and a failure to carry out renal ultrasound. The Coroner also criticised Bart's Health NHS Trust's systems of governance for not identifying for two years that Evadney’s case was a serious incident which required investigation.
  14. Content Article
    The call for meaningful patient and family engagement in healthcare and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, Burns et al. review the rationale and the current state of patient and family engagement in patient care and research in the ICU. The authors identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. They also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, the authors provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
  15. Content Article
    Studies comprehensively assessing interventions to improve team communication and to engage patients and care partners in intensive care units are lacking. This study from Dykes et al. examines the effectiveness of a patient-centered care and engagement program in the medical ICU. They found implementation of a structured team communication and patient engagement program in the ICU was associated with a reduction in adverse events and improved patient and care partner satisfaction.
  16. Content Article
    Post-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.
  17. Content Article
    In 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.
  18. Content Article
    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.
  19. Content Article
    Newborn babies may need extra care in a neonatal intensive care unit or special care baby unit if they were born prematurely or if they need care for a particular health condition. Babies and infants that need long-term care can be transferred to a local unit or discharged to receive care at home. A baby with complex health needs may move between distinct areas of care or 'pathways'. This Care Quality Commission (CQC) review looked at how risks for newborn babies are identified and managed and at the care for infants in the community who need respiratory support. This review draws on one particular case that had a tragic outcome for a baby and her parents. Elizabeth Dixon was born prematurely but suffered brain damage as a result of missed high blood pressure. She died shortly before her first birthday in 2001, when there was a failure to correctly maintain her tracheostomy tube. While this review was not an investigation of the specific circumstances of Elizabeth's case, it drew on this to examine current practice, systems and guidance.
  20. Content Article
    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.
  21. Content Article
    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.
  22. Content Article
    In 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.
  23. Content Article
    A culture of teamwork and learning from mistakes are universally acknowledged as essential factors to improve patient safety. Both are part of the Comprehensive Unit-based Safety Program (CUSP), which improved safety in intensive care units but had not been evaluated in other inpatient settings.
  24. Content Article
    This 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.
  25. Content Article
    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. 
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