Irish National ICU Audit Annual Report 2021

This is the fifth national report from the Irish National ICU Audit. It includes activity from 22 adult public hospitals, which collectively provided 96% of Level 3 ICU care in adult HSE-funded hospitals in 2021. The ICU audit documented 12,151 admissions of 11,420 patients to 26 Units in 22 hospitals.

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Key Findings

On average, 303 ICU/HDU beds were open daily in publicly funded hospitals in 2021, which corresponds to 6.0 critical care beds per 100,000 population, compared to the OECD average of 14.1/100,000. Fifteen hospitals met the target of 80% of patients admitted to ICU within 4 hours of a decision to admit. The report includes areas for improvement such as addressing high bed occupancy rates ensuring timely admission to ICU, optimising the inter-hospital patient transfer process, enhancing the quality of patient care, and optimising the use of scarce resources.

Recommendation 1

Continue the ongoing HSE programme to expand ICU capacity in line with the Critical Care Strategic Plan.

Recommendation 2

Develop and implement a national policy that each Unit should keep one staffed ICU bed empty to be available for immediate admission of critically ill patients, if this can be achieved by discharge of a patient who has been declared clinically ready for discharge.

Recommendation 3

Develop the Critical Care Retrieval Service of the National Ambulance Service to provide a 24-hour, 7-day transport service for inter-hospital transfers of critically ill patients.

Recommendation 4

Adequately staff ICU audit by providing one whole-time equivalent (WTE) ICU audit coordinator for every 10 Unit beds audited.

Recommendation 5

Continue the development of the National ICU Audit database at NOCA to allow wider reporting of data nationally.