Technology and Disasters: The Evolution of the National Emergency Tele-Critical Care Network

Background Delirium is a common complication of critical illness with a significant impact on patient morbidity and mortality. The Greater Manchester Critical Care Network established the Delirium Reduction Working Group in 2015. This article describes a region-wide delirium improvement project launched by that group. Methods Multiple Plan-Do-Study-Act cycles were undertaken. Cycle 1: April 2015 demonstrated only 48% of patients had a formal delirium screen. Following this a network-wide event took place and the Delirium Standards for the Greater Manchester Critical Care Network were produced. Cycle 2: May 2016 quarterly audits across the network monitored compliance against the agreed standards. Group events involved implementation of a delirium care bundle, sharing best practice, educating staff and providing guidance on the management of delirium. Cycle 3: November 2016 quarterly audit continued and a regional delirium study day was rolled out across the region. Results We have 14 different units across our network, all of which have participated in the audit. The first audit showed a delirium point prevalence of 28%, subsequent point prevalence audits demonstrated rates as low as 13%. There has also been an improvement in the use of delirium screening tools. In the first audit 37% of patients had two delirium screens in 24 h, this has increased to 60% in the latest audit. Improvements were also made in availability of sensory aids and pain assessments. Conclusion The project has demonstrated the feasibility of delivering a coordinated delirium improvement project across multiple critical care units.

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Critical Care NETWORK

Dimensions of Critical Care Nursing ◽

10.1097/00003465-198609000-00002 ◽

1986 ◽

Vol 5 (5) ◽

pp. 260-262

Author(s):

&NA;

Keyword(s):

Critical Care ◽

Care Network

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Critical care transfer in an English critical care network: Analysis of 1124 transfers delivered by an ad-hoc system

Journal of the Intensive Care Society ◽

10.1177/1751143719832175 ◽

2019 ◽

Vol 21 (1) ◽

pp. 33-39 ◽

Cited By ~ 3

Author(s):

Scott Grier ◽

Graham Brant ◽

Timothy H Gould ◽

Johannes von Vopelius-Feldt ◽

Julian Thompson

Keyword(s):

Critical Care ◽

Ad Hoc ◽

Published Data ◽

National Guidelines ◽

Care Network ◽

National Conversation ◽

Hospital Transfer ◽

Specialist Treatment ◽

Transfer Services ◽

Time Critical

Background Critical care transfers between hospitals are time critical high-risk episodes for unstable patients who often require urgent lifesaving intervention. This study aimed to establish the scale, nature and safety of current transfer practice in the South West Critical Care Network (SWCCN) in England. Methods The SWCCN database contains prospectively collected data in accordance with national guidelines. It was interrogated for all adult (>15 years of age) patients from January 2012 to November 2017. Results A total of 1124 inter-hospital transfers were recorded, with the majority (935, 83.2%) made for specialist treatment. The transferring team included a doctor in 998 (88.8%) and nurse in 935 (93.7%) transfers. In 204 (18.1%) transfers, delays occurred, with the commonest cause being availability of transport. Critical incidents occurred in 77 (6.9%). Conclusions This is the first published data on the transfer activity of a UK adult critical care network. It demonstrates that current ad-hoc provision is not meeting the longstanding expectations of national guidelines in terms of training, clinical experience and timeliness. The authors hope that this study may inform national conversation regarding the development of National Health Service commissioned inter-hospital transfer services for adult patients in England.

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