Nutrition support in intensive care units in England: a snapshot of present practice

Nutrition support is an important part of care management in critically ill patients, not only to prevent and treat malnutrition but also it has a significant impact on recovery from illness and overall outcome. There is little information available about present nutritional support practice for patients in intensive care units (ICU) in the UK. This survey was designed to evaluate the present nutrition support practice in ICU and high dependency units (HDU) in England. Data were gathered by a 72 h phone survey from 245 ICU and HDU in 196 hospitals in England. A questionnaire was completed over the telephone, including general information, nutrition support and teams involved in the nutrition management in the ICU. Of 1286 total patients in the ICU, 703 (54·6 %) were receiving nasogastric feeding, two (1·5 %) were receiving feeding via a percutaneous endoscopically placed gastrostomy tube and two (1·5 %) were receiving nasojejunal feeding. One hundred and forty-seven (11·4 %) patients were on parenteral feeding during the study period. A nutrition support team was not available in 158 (83·1 %) ICU and there was no dietitian or specialist nutrition nurse to cover ICU in nine (4·7 %) hospitals. In conclusion, the present survey reported an increased trend in usage of enteral feeding in ICU in England, and a reduction in the use of parenteral nutrition compared with previous surveys. However, we are still far from integrating nutrition into care management in the ICU.

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ICU admissions: Consequences after discharge

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738020932613 ◽

2020 ◽

Vol 13 (9) ◽

pp. 550-556

Author(s):

Minal Karavadra ◽

Ricky Bell

Keyword(s):

Intensive Care ◽

Cognitive Decline ◽

Intensive Care Units ◽

Critically Ill ◽

Critically Ill Patients ◽

Psychiatric Disturbance ◽

Intensive Care Department ◽

Previous Level ◽

The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

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The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

Advances in Dual Diagnosis ◽

10.1108/add-06-2021-0008 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Hattie Catherine Ann Moyes ◽

Lana MacNaboe ◽

Kate Townsend

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Substance Misuse ◽

Well Being ◽

Training Programme ◽

Content Type ◽

National Quality ◽

Improvement Programme ◽

The Uk ◽

The Impact

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

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High Dependency or Intensive Care Units

Encyclopedia of Pain ◽

10.1007/978-3-540-29805-2_1752 ◽

2006 ◽

pp. 894-894

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

High Dependency

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Oxygenation of the critically ill in selected intensive care units in the UK: are we usual?

British Journal of Anaesthesia ◽

10.1016/j.bja.2020.06.033 ◽

2020 ◽

Vol 125 (3) ◽

pp. e277-e279

Author(s):

Benjamin Post ◽

Edward Palmer ◽

Steve Harris ◽

Mervyn Singer ◽

Daniel Martin

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Critically Ill ◽

The Uk

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Nutrition support team activities can improve enteral nutrition administration in intensive care units

Nutrition ◽

10.1016/j.nut.2018.04.017 ◽

2019 ◽

Vol 57 ◽

pp. 275-281 ◽

Cited By ~ 3

Author(s):

Martina Celi Bandeira Rufino Lopes ◽

Guilherme Duprat Ceniccola ◽

Wilma Maria Coelho Araújo ◽

Rita Akutsu

Keyword(s):

Intensive Care ◽

Enteral Nutrition ◽

Intensive Care Units ◽

Nutrition Support ◽

Support Team

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Role of the intensive care unit

10.1093/med/9780199568741.003.0148 ◽

2018 ◽

Author(s):

Matt Wise ◽

Paul Frost

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Organ Failure ◽

Radiology Department ◽

Organ Support ◽

Specific Patient ◽

High Dependency ◽

Operating Theatres ◽

The Uk ◽

General Wards

The intensive care unit (ICU) can be defined as an area reserved for patients with potential or established organ failure and has the facilities for the diagnosis, prevention, and treatment of multi-organ failure. Usually, the ICU is located in close proximity to A & E, the radiology department, and the operating theatres, as it is between these areas that patient flows are greatest. In large urban hospitals, there may be more than one ICU, some of which serve specific patient populations, such as paediatrics, neurosurgery, cardiothoracic surgery, liver failure, and burns. Many hospitals also have high-dependency units (HDUs) that offer higher nurse-to-patient ratios and more advanced monitoring than a general wards does, as well as limited organ support. In the UK, the distinctions between ICU, HDU, and general ward have been abandoned in favour of a classification based on the patient’s needs rather than their location.

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Characteristics of patients admitted to psychiatric intensive care units

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700010284 ◽

2007 ◽

Vol 24 (2) ◽

pp. 75-78 ◽

Cited By ~ 5

Author(s):

Yasir Kasmi

Keyword(s):

Intensive Care ◽

Literature Review ◽

Ethnic Minority ◽

Intensive Care Units ◽

Ethnic Minorities ◽

Service Provision ◽

National Guidelines ◽

Minority Overrepresentation ◽

The Uk ◽

Study Designs

AbstractObjective: A paucity of research exists on the types of patients admitted to psychiatric intensive care units (PICUs), which is important in terms of identifying patient needs, training and service provision. Questions have also been raised as to whether or not ethnic minorities are overrepresented in these units.Method: A literature review using MeSH headings from a wealth of databases was performed to identify such studies. In addition studies on ethnic minority overrepresentation in psychiatric care were also identified.Results: Under a dozen studies were identified, mainly from the UK and Australia. Study designs tended to be basic and heterogeneous, but this was reflected in the nature of the study and the data gained. A typical PICU patient emerged, namely a young schizophrenic detained male, belonging to an ethnic minority (if in an inner city), known to mental health services with previous informal, detained and PICU admissions, admitted due to violence and often possessing a forensic history. If a complex need existed, it was usually substance misuse. The inpatient stay tended to be for less than two months and discharge was usually to an acute ward. Ethnic minorities were overrepresented in PICU care.Conclusions: The literature review highlighted a paucity of good-quality studies in this field. The establishment of a national association of intensive care units as well as national guidelines can only improve services. The reason for ethnic minority over-representation on these units is still far from clear.

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