Irish National ICU Audit Annual Report on 2024 data

This is the eighth national report from the Irish National ICU Audit. The Audit documented the care of 16,394 patients involving 17,307 admissions to 29 ICUs/HDUs in 25 adult public hospitals during 2024. These hospitals provided 99.9% of all complex (Level 3) ICU care delivered in adult public hospitals in Ireland.

Download Full Report Summary Report Appendices

Key Findings

In 2024, ICUs were very busy, with occupancy rates over 100% in some cases. This meant ICU beds were not always immediately available when needed and discharges to the wards commonly occurred at night. Reassuringly, mortality rates in all Units were within the expected range, indicating that a high quality of care was maintained across the national network of Units.

Key Recommendations

Recommendation 1

Continue the ongoing DoH/HSE programme to expand Critical Care capacity in line with the DoH, Strategic Plan for Critical Care (2020a).

Such capacity planning should include expansion of both Level 2 (HDU) and Level 3 (ICU) beds in order to enhance the efficiency and safety of both admissions to and discharges from appropriate levels of care; the exact configuration of both can be informed by hospital case mix, supported by INICUA annual reports.

Recommendation 2

Implement a national policy that each Unit should keep one staffed ICU bed empty for urgent admissions, whenever it is possible to achieve this by discharging a patient who is clinically ready for discharge.

Recommendation 3

Continue the implementation of measures to improve the care of critically ill patients outside ICU, including 24-hour provision of outreach services from ICU, uniform documentation of Irish INEWS scores, and compliance with protocols for the escalation of care for deteriorating patients.

Recommendation 4

Organ donation personnel in Organ Donation and Transplant Ireland (ODTI) and in each HSE Region, should use the data on organ donation from NOCA Irish National ICU Audit (INICUA) and Irish Potential Organ Donation Audit (IPODA) to identify the key issues limiting organ donation.

These include a falling rate of family consent to organ donation, low rates of diagnosis of brain death and of progression to organ donation after brain death in certain Units, and low rates of recognition of opportunities for donation after circulatory death nationally.