Professor Rory Dwyer, Clinical Lead for the Irish National ICU Audit presented the key findings from the Irish National ICU Audit Annual Report on 2022 data. The report, which looks at 96% of all ICU activity in 2022, including 10,423 patients in 26 Units across 22 hospitals, highlights the need for increased ICU bed availability and prioritised discharges.

KEY FINDINGS 2022:

• ICU Bed Availability: 5.6 ICU beds per 100,000 population (OECD avg: 12 beds per 100,000 population).

• Bed Occupancy: Average bed occupancy rate was 92%.

• Timeliness of Admissions: Only 30% of patients were admitted within 1 hour (target was 50%).

• Multi-Organ Failure: 9% of patients admitted from a ward developed multi-organ failure within 24 hours of ICU admission, which indicates delays in ICU admissions, likely due to bed shortages.

• Delays in Discharge: 27% of patients spent more than 24 hours in ICU after being cleared for ICU discharge.

• Organ Donation: The rate of assent by families when organ donation was requested was 73%. This is high by international standards.

__________________________________________________________________________________________________

Associate Professor Martina Healy, Clinical Lead for the Irish Paediatric Critical Care Audit presented the key findings from the Irish Paediatric Critical Care Audit National Report 2021-2022 report now. The report, which looks at 3,329 admissions to the two Paediatric Critical Care Units (PCCUs) in Ireland during 2021 and 2022, calls for more staff to open the National Children's Hospital critical care unit, which will see an expansion from 32 to 42 beds.

KEY FINDINGS 2021-2022:

• Neonatal Admissions: Neonates accounted for 28% of admissions at CHI Crumlin and 25% at CHI Temple Street.

• Respiratory Diagnoses: Respiratory issues made up 30% of admissions at CHI Crumlin and 39% at CHI Temple Street in 2022.

• Emergency Admissions: Unplanned emergency admissions comprised 67% at CHI Crumlin and 73% at CHI Temple Street in 2022.

• Workforce Shortages: Staffing levels at CHI Temple Street fell below the recommended 5.5 whole-time equivalent (WTE) nurses per bed each year from 2018-2022, averaging around 4.84 WTE in 2022.

• Mortality Rates: Crude mortality rates remained steady at 4% annually, with 75% of deaths at CHI Crumlin occurring in infants under 1 year.

• Organ Donation: 11 infants and children from 2 days old to 15 years of age donated organs and/or tissue.

__________________________________________________________________________________________________

There were also presentations from Dr Melanie Ryberg and Dr Neidin Eustace, who spoke about the role of psychology in patient and family care in ICU. Psychological care in ICU promotes optimal recovery outcomes.

There were local quality improvement initiatives presented from Zieta O'Hagan from St James's Hospital who's project looked at improving access times to ICU. Marie Lawlor presented the PICU Patient Diary, which is a record written by the patient’s family in everyday language to help the patient understand what has happened during their stay and to help the family cope with the situation during this difficult period.

Laura Curtis, who was admitted to the ICU with COVID, 20 weeks into her pregnancy, shared her personal experience. Ciara Swan, mother of a young patient who experienced the critical care unit first hand, shared her daughter Sophie's story to underscore the importance of adequate staffing and resources.

Copies of available presentations and the webinar recording are available below.