Irish National ICU Audit Annual Report 2018

The Irish National ICU Audit (INICUA) was established by NOCA in 2013 and focuses on the care of patients in adult and paediatric Intensive Care Units, the very sickest patients in the hospital.

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Key Highlights 2018

Bed occupancy was very high in Irish Units; 88% overall and up to 96% in some Units. The European Society of Intensive Care Medicine recommends an occupancy rate of 75%, if bed occupancy is calculated using the fraction of a day a patient occupies a bed, as our audit did. The high bed occupancy rate is not surprising, as the provision of critical care beds in Ireland (including beds in private hospitals) is only 6.0 beds per 100,000 population compared with the European average of 11.5 per 100,000.

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Key Recommendations

  • Increase bed capacity in adult Critical Care Units (ICU and HDU) towards the 430 beds recommended in the Department of Health’s Health Service Capacity Review 2018.
  • Review the appropriateness of providing care for critically ill patients in Units with small numbers of patients with multiorgan failure, in line with the recommendations of the HSE Critical Care Programme Model of Care, the Joint Faculty of Intensive Care Medicine of Ireland, and the European Society of Intensive Care Medicine.
  • Prioritise the discharge of patients from ICU to the ward once they have been declared fit for discharge
  • Explore best practice in providing optimal care for high-risk patients outside critical care, including the potential benefits of critical care outreach teams.
  • Improve the rates of organ donation after brain death in the larger Units
  • Improve the rates of organ donation after circulatory death (DCD).
  • Improve psychological care for relatives whose family member is in critical care.
  • Expand the range of reports produced by the NOCA ICU Audit on data already collected for ICU Audit.
  • Regrade ICU Audit Coordinator posts to clinical nurse manager (CNM) level.