Irish Paediatric Critical Care Audit National Report 2024

Irish Paediatric Critical Care Audit National Report 2024 Image

This is the fifth national report published from the Irish Paediatric Critical Care Audit. It provides detailed information on the care and outcomes of children admitted to the two Paediatric Critical Care Units at Children’s Health Ireland (CHI) at Crumlin and Temple Street, including admissions, specialist transports and key quality indicators.

In 2024, there were 1,715 admissions to the two units, which delivered a total of 10,274 bed days. Almost three-quarters (73%) of these bed days were provided at CHI at Crumlin. Overall, 97% of children survived to discharge from paediatric critical care. The report also highlights improvements in specialist transport times and a reduction in respiratory admissions among newborn babies, alongside ongoing challenges relating to capacity, staffing and access to specialist services.

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Key Findings

The report highlights key findings from 2024, providing insights into paediatric critical care activity and outcomes in Ireland. Unplanned admissions accounted for 68% of all admissions, while 128 children were admitted to adult Intensive Care Units (ICUs), compared with 148 in 2023. Respiratory conditions remained the most common reason for admission to Paediatric Critical Care Units (PCCUs), accounting for 31% of cases. Notably, respiratory admissions among newborn babies decreased by 45%, a reduction likely associated with the introduction of the national RSV immunisation programme. Overall survival to discharge from PCCUs remained high at 97%. The report also records that four children donated organs or tissues, representing 7% of PCCU deaths.

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Key Recommendations

Recommendation 1

The RSV immunisation programme should be continued and supported nationally as a preventative measure to reduce severe respiratory illness with potential to alleviate demand on paediatric critical care services. NOCA will continue to monitor reasons for admission to PCCU and assess the impact of changes to the RSV immunisation programme on paediatric critical care services, with findings informing service planning and policy decision-making.

​Recommendation 2

Strengthen data systems and audit infrastructure supported by dedicated local data management resources, to enable comprehensive paediatric critical care reporting, service planning and quality improvement.

OUTSTANDING RECOMMENDATIONS FROM PREVIOUS REPORTS

  1. Children’s Health Ireland (CHI) should continue planning for the required increase in the workforce of paediatric critical care medicine consultants, trainees, nurses, and allied health professionals for the safe opening and operation of the National Children’s Hospital (NCH) Critical Care Unit with 32–42 beds. This should be part of a comprehensive published CHI workforce document that is in line with medical, nursing, and health and social care professional (HSCP) national standards.

  2. A national paediatric respiratory extracorporeal life support (ECLS) programme should be progressed in CHI.

  3. The Health Service Executive (HSE) should support the development of regional Paediatric High Dependency Units (PHDUs) in hospitals providing regional paediatric surgical facilities. It is essential that future planning includes regional investment in the development of regional PHDUs.

  4. Continue the extension of specialist paediatric transport services to operate 24 hours per day, 7 days per week by resourcing the Irish Paediatric Acute Transport Service (IPATS).

  5. Organ Donation Transplant Ireland (ODTI) and CHI should progress the appointment of organ donation personnel.