Intensive Care Week - 'Hub' of the Hospital - what makes Critical Care tick
This Intensive Care Week (ICU Week) we are celebrating our outstanding Critical Care professionals. At LHCH, we have over 220 staff working in our Critical Care Unit. We would like to thank them for their hard work and dedication in providing outstanding care for our patients and families every single day.
You can read more about the Critical Care Unit from the unit leadership team below:
The ‘Hub’ of the Hospital
Critical Care is the hub of the hospital with a lot of our patients visiting us during their patient journey. It’s amazing and efficient unit in the way it runs like a well-oiled machine. In relation to the high level of activity and at times acuity of the unit, we don’t really have many delayed discharges to the ward or a significant number of cancellations.
The unit incorporates Intensive Care Unit (ITU), Post Operative Critical Care Unit (POCCU), Critical Care Outreach and Critical Care Psychology.
Outstanding team doing special things
There is a wide group of staff that play an important part in Critical Care. We have sixteen intensivist consultants who often take on leadership for a specific area e.g. sepsis, palliative care, patient safety and more. We have two on the unit at any one time – one in POCCU and one on ITU. We have a cohort of medical trainees who also provide care including anaesthetic and critical care trainees.
The main service provision is provided by the Critical Care Advanced Nurse Practitioners (ANPs). This team has grown over the last decade from two to twelve members with five trainees. They provide continuity and are crucial to the flow of patients throughout the unit.
We have support from a wide range of Allied Health Professionals. For example, the Speech and Language, Therapists, Dietitians, Pharmacy and Psychology teams. Developments over the last ten years enables different specialist and valuable inputs into a patient’s care.
We created a unique role for a Microbiology Specialist Nurse to ensure we had this input too and this is something that was praised by the regional Critical Care Network. We have a dedicated education team who provide opportunity for staff development, and we offer shadowing to support career progression. The team has faced challenges, such as the covid 19 pandemic, but we have continued to develop and that’s what makes it outstanding.
Our Critical Care Outreach team is small and is now providing a 24-hour, 7 day a week service by working closely with the wards, and monitoring patients, and they help to prevent readmissions to Critical Care. The team introduced a Call for Concern service last year for relatives concerned about their loved one’s health condition.
Every single colleague from a wide range of professions including the nursing, admin team and stores all have a purpose and do a fantastic job.
One of the biggest single-site Critical Care Units in the country
When compared with the units at other hospitals we have one of the largest single-site Critical Care Units in the region. Other hospitals may have more beds but across different locations.
Advances in practice and ways of working
The Covid pandemic brought a team spirit and support for one another which has a big impact on staff morale. Many staff stay long-term and continue to work here. We have colleagues training to become a Professional Nurse Advocate, which has a positive impact on patient safety and experience.
There is a staff wellbeing group, where plans are put in place for the benefit of staff health and wellbeing.
We see more patients undertaking bigger operations such as aortic surgery or triple valve replacements who have more complex health
conditions, and are more poorly post operatively. We have had to adapt to this to provide more complex specialist care. Despite this, the average length of stay doesn’t seem to have significantly increased which is very positive.
The main change over the years has been the efficiency and flow through the unit and the way the ANPs are able to get patients through so effectively.
We are always looking at preventing patient falls, improving safety and conducting research to improve care for the future.
Improvements made
We introduced sky tiles for side rooms in Intensive Care, funded by LHCH Charity, which have an impact on reducing the risk of delirium in our patients.
We upgraded the dedicated garden area for our patients, families and staff which has improved their experience hugely.
A new family room with kitchen facilities has been introduced so in the event of an emergency in the middle of the night families have somewhere they can go.
We implemented a quiet hour a couple of years ago which ensures patients get rest and prevents them being overwhelmed.
We often receive visits from patients,after their discharge, if they had stayed with us a long time. There is a follow up clinic to chat with one of the leadership team and to see if they need any
psychological support.
We pride ourselves with good team communication. We have a staff huddle twice a day, our own newsletter and listen to new ideas the team may have.
Improvements have been made to support sustainability. As a unit we reduced our use of plastic gloves which had a positive impact on the environment, patient experience and
cost reductions.
Plans for the future
As a unit we are keen to work on new research studies with the overall aim of improving patient care.
We have plans to pilot a project called ‘Silent ITU’. Alarms can be a problem for our patients, particularly during the night, so we are looking at a system which will just alert the nurses, so it doesn’t disturb the patients. More to follow on this, which will be a big project, and is very exciting.
We are moving to digitalised charts and will be introducing an Allied Health Professional lead on ITU.
We currently support Broadgreen Hospital high risk orthopaedic patients and there is always potential to collaborate further for the overall benefit of patients.
Critical Care in Numbers
- Circa 220 staff working in the unit
- 30 beds commissioned including:
- 18 Level 3 beds
The highest level of intensive care required where patients require advanced respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi organ failure. - 12 Level 2 beds
For patients requiring more detailed observation or intervention including support for a single failing organ system or post-operative care and those ‘stepping down’ from higher levels
of care. - 2,146 patients cared for per year