Welcome to the ESHT Cross Site Critical Care Journal! These journal aims to be an informative sharing resource for all members of the Critical Care team. Happy Reading everyone!
Oracle April 2025 The
Cardiogenic Shock: A new Opportunity to learn from Data
Meet the Team: ESHT Blood Transfusion Team
Nurse Burnout: Five ways to prevent it
Denisse Ramos
Our April Cover is graced by no other than Denisse Ramos - our very young critical care sister over at Conquest. Thank you for allowing our journal to showcase your lovely smile!
The Oracle Team
Karl Pasamanero Joyce Pasamanero
Rosu Banzuela Chris Thwaites
Contents
1. Cardiogenic Shock: A New opportunity to learn from data 2. Nurse Burnout 3. ESHT Blood Transfusion Team 4. Announcement of new 8a Matron 5. Matron's Corner 6. CCOT and Practice Educartion Updates 7. Staff Section
Editor's Welcome
I hope this finds you well as spring breathes new life into our days. This month, we've assembled a collection of articles that I believe will resonate with many of you on the frontlines of critical care. Dr. Alex Warren shares fascinating insights in "Cardiogenic Shock: A New Opportunity to Learn from Data." The piece walks us through how smart data use is changing our understanding of this challenging condition—practical knowledge that could make a real difference in your daily practice. The best thing about this is ESHT Critical Care will take part in this study! Many of us have felt the weight of burnout, which is why I'm particularly grateful to nurse advocates Kim and Vera for their honest discussion of this issue. Their article offers practical strategies that have helped real teams rebuild resilience and rediscover purpose in their work. The ESHT Blood Transfusion Team has contributed an excellent update on transfusion practices that cuts through complexity with clear, actionable guidance. I've already picked up several tips I plan to implement in my own practice. We're also delighted to introduce our new 8a Critical Care Matron. Getting to know the person behind the title helps us understand the leadership vision that will support our collective work moving forward. Your experiences and perspectives matter tremendously to our community. Please continue sharing your thoughts and ideas— they're what make this journal a valuable resource for us all.
Happy Reading Everyone!
Karl and Joyce Pasamanero
C ardiogenic shock is a lethal condition in which reduced cardiac output causes inadequate oxygen supply to the body’s organs and tissues. It has several causes including heart attacks, worsening of pre-existing heart failure, acute heart failure such as myocarditis, first presentation of a cardiomyopathy, and overdoses of certain medications. The only recent study of patients with cardiogenic shock in the UK showed an in-hospital mortality of 55%, making it one of the most lethal conditions we treat in the ICU. Cardiogenic Shock: A New Opportunity to Learn from Data Dr Alex Warren, ICNARC
Despite this, there is relatively little data on the scale of the problem with cardiogenic shock in the UK. As it has several causes, it’s not particularly well coded within routine data. Both the Intensive Care Society and the British Cardiovascular Society have identified cardiogenic shock as a national research priority and called for data-driven research to improve these outcomes. Patients and the public understand this too — a relative of a patient who survived cardiogenic shock after being transferred for mechanical circulatory support with ECMO told us “it felt like she only had a good outcome because someone knew who to call and she was in the right place at the right time. We need to ensure as many patients as my daughter get the same chance of survival”.
That’s why ICNARC are undertaking a project to understand patients with cardiogenic shock via a new module within the Case Mix Programme, and I’m delighted that from the 21st April both Conquest Hospital and Eastbourne District General Hospital will be contributing data to it. The module uses an algorithm to identify patients with cardiogenic shock from the routinely collected data on ICU admissions that ICNARC already collect. We use both the diagnosis and measures of how sick patients are, including changes in their lactate and inotrope requirements over the first few days. We also collect data on specific management, such as the use of cardiac output monitors, and escalation to mechanical circulatory support.
We hope the data will help us understand which patients have the greatest risk of deterioration and mortality, and how we can best identify them. We think there is a lot of variation around the UK in how cardiogenic shock is treated — including the drugs people use, access to emergency echocardiography out-of-hours, and the way people monitor cardiac output and the response to therapies.
In other conditions with a high risk of mortality, such as major trauma and severe acute respiratory failure, many lives have been saved by the creation of regional networks to transfer the sickest patients to experienced centres with MDT expertise. No such pathway exists for cardiogenic shock patients at present, but the data provided by this module may help to build the case for them. As well as contributing to important national data collection, you’ll also receive a biannual report of your units’ case mix for cardiogenic shock and how management and outcomes relate to the national dataset.
I’d like to thank the team across East Sussex Critical Care for their enthusiasm to take part in this important project, particularly the ICNARC audit team who work so hard to ensure timely, high-quality data submission. Our initial number-crunching suggests that as many as 30 patients a year may be admitted to ICU with cardiogenic shock across the two sites in East Sussex, so it’s great to have you on board. We’ll be presenting some of our initial data both at the ICNARC Case Mix Programme annual meeting in May and at the ICS State of the Art meeting in July, so please keep an eye out!
The Oracle would like to thank Dr. Alex Warren for providing us a project abstract and taking time to write this wonderful resource. We do hope that both Critical Care units of EDGH and Conquest Hospitals can contribute to a better understanding and study of Cardiogenic Shock.
Cardiogenic Shock Module The Cardiogenic Shock Module is an optional additional dataset module for critical care units participating in the CMP. The aim of the module is to gain a better insight into the primary cause and treatment of patients with cardiogenic shock in critical care. For further information about the module please contact the team at csm@icnarc.org.
T he World Health Organization (WHO) defines burnout as a "syndrome resulting from chronic workplace stress that has not been successfully managed”. For WHO there are three dimensions of burnout: Nurse Bu Nurses are particularly vulnerable to burnout due to the intense physical, emotional, and mental demands of their profession. Heavy workloads, frequent understaffing, and long shifts create chronic stress, leaving little time for recovery. The emotional strain of caring for suffering patients, handling grief, and facing ethical dilemmas can lead to compassion fatigue and emotional exhaustion. Workplace stress is further intensified by a lack of control over decisions, exposure to difficult patient interactions, and sometimes even 1. Emotional Exhaustion: Feeling depleted, fatigued, and overwhelmed. 2. Depersonalization (Cynicism): Developing a detached or negative attitude toward patients and work. Kimberley Hysa Vera Quintas
workplace violence. Many nurses struggle with maintaining a work-life balance due to irregular schedules and long hours, which can disrupt sleep and personal well-being.
3. Reduced Personal Accomplishment: Feeling ineffective, unfulfilled, or lacking in professional achievement.
urnout Preventing burnout is crucial to
ensuring both nurse well-being and high-quality patient care and this requires nurses to proactively safeguard their well-being by practicing self-care, setting boundaries, and seeking peer or professional support.
"Preventing burnout is crucial"
Five tips to pre Keeping this in mind I have curated 5 tips to prevent burnout, I hope they are useful!
Prioritize Self-Care
Set Boundaries & Manage Workload Avoid excessive overtime and learn to say no when necessary. Take regular breaks during shifts to rest and recharge.
Seek Support & Connect with Others Talk to colleagues, friends, or family about your experiences. Speak to your PNAs and unit psychologist.
Get enough sleep, eat nutritious meals, and stay hydrated. Engage in activities that help you relax, such as exercise, meditation, or hobbies.
Burnout event
Develop Stress Management Strategies Practice mindfulness, deep breathing, or journaling to manage emotional stress. Focus on time management to prevent feeling overwhelmed.
Advocate for a Healthy Work Environment Encourage leadership to address staffing shortages and mental health resources. Be open about your feelings and encourage our colleagues to do the same.
Please approach your PNAs at any time , we are here to support you!
Kim and Vera
ESHT Blood Transfusion Team
This month, the Oracle has invited the ESHT Blood transfusion team for some resource guide and tips on blood transfusion. Let us meet the team and the awesome work that they do.
Blood Transfusion Team
Sally Richardson Lead transfusion Practitioner, based at Conquest. I qualified as a nurse in 1990 based at the then RESH (Royal East Sussex Hospital) and went to work in Theatres. From there I joined the Royal Navy for 5 years going from Theatre to Coronary Care and undertook the ENB 998 (trainer and assessor course). My interest in training continued ;leaving the Navy completing a Cert Ed & PG Cert to provide training for the Access to Nursing Course and BTEC at Bexhill & Hastings Colleges, maintaining my experience in setting up the BUPA wing attached to Conquest. I was fortunate to be given the opportunity for this post based here at CQ and the beginnings of ensuring ESHT was ‘Blood Transfusion Compliant’ to provide adequate training and the Integrated Care Pathway we now use. National Comparative audits are carried out by the team as well as compliances with MHRA and NICE guidance’s. We take part and facilitate Massive Haemorrhage Sims, offer Lab tours and support Harvey’s Gang to enable children to become a BMS (Biomedical Scientist) look around the lab follow their ’blood sample’ which has been so well received by parents and staff!
What I enjoy about the role is every day is different to support and encourage good practice, occasionally thinking outside the box! The last few years with the release of the Blood Inquiry and the Pathology Network merger, EPMA and EPR have offered some head scratching, but the team has enjoyed being able to teach back in the classroom and not just via Teams. Being accessible is important and to ensure we can support staff during the whole transfusion process.
Claire Fox-Wilson
Transfusion Practitioner. I am based at Eastbourne and only work part time: Wednesdays, Fridays and alternate Mondays. I am a qualified Paramedic and have worked for the Trust for 8 years. Most people know me from my previous role a Resus Officer. I joined the Transfusion Team in 2022 and have enjoyed every aspect of the role since. Initially I had a steep learning curve, most Transfusion Practitioners come from either a nursing background, where they learn about transfusions during their work on the ward and have to learn the lab side, or as a Biomedical Scientist with knowledge about the lab work but need to learn about the ward practice. As I came from neither background, I not only had to learn about both sides but also teach it too, what a challenge!
I really enjoy the training aspect of the role, ensuring staff are confident and competent in the collection and administration of blood products. It’s not just in the classroom or on Teams, when I am out and about around the hospital staff often have a question for me and I am happy to help. The lab side is also fascinating, there is a whole other world behind the scenes where your samples are processed and blood products assigned to patients by a friendly team of Biomedical Scientists. If anyone wants to see what happens here please let us know and we can arrange a tour.
Tracy Levitt
Transfusion Admin Assistant and Trainer. I am based at Conquest and work part time Tuesday to Thurs, I have worked for the Trust for 23 years and joined the Transfusion Team in April 2022. Although employed as an admin assistant when I first joined there was no TP at Eastbourne, so, to assist Sally, I started to teach the HCA mandatory training sessions. When Claire joined, I enjoyed taking the sessions so much I continued to facilitate the Teams sessions and the classroom training at CQ. Part of our role involves training, both induction and mandatory, for all levels of practitioners. Induction is always face to face to ensure new staff are aware of transfusion practice, local protocols and create usernames and passwords for our electronic system for removing components from blood bank. Doctor’s training is via Teams which Sally facilitates approximately every three weeks at midday. Content includes sampling, documentation, administration of blood products, major haemorrhage protocol and Warfarin, DOACs and their antidotes. Registered practitioners and clinical support workers have the option of attending either classroom or Teams training.
Teams appears to be more popular choice as these sessions fill up quickly – though that may just be because we do fewer of them. As trainers the classroom sessions are preferable as it is easier to be interactive and read the body language of the staff. Content includes sampling, collection process, administration of blood products (for registered practitioners), documentation and Major Haemorrhage. We also emphasise that staff should be able to collect blood products from blood bank, all registered practitioners and clinical support workers have a username and password for logging onto Blood360 – do you know yours? Please contact one of the team if not. Mandatory training is an annual update, we do recommend attending one of the classroom or Teams sessions as we highlight any incidents that have occurred during the last year and measures taken to prevent any reoccurrence; however, on alternate years it is possible to do the e-learning on MYLearn instead.
In addition, we have run Major Haemorrhage simulation sessions in Endoscopy at Conquest and Urology at EDGH which were well received by staff. The Endoscopy simulation was filmed for learning purposes and made available as a YouTube video. We also presented the film at the South-East Region Transfusion Committee ‘Transfusion Bites’ event last November which impressed Transfusion Practitioners from multiple hospitals around the SE. If you would like to take part in simulation, please let one of us know, it is a useful learning tool which is underutilised for transfusion currently, something we wish to address. Need one of the team’s contact details or information regarding a transfusion policy? These are now available in one place on our resource page on the intranet. Insert link Our Blood and Blood Components Transfusion Policy, Clinical Guideline for the Management of Massive Blood Loss and Clinical Guideline for the Management of Patients who Decline Blood and Blood Components have recently been updated. One of the key changes is the addition of the TACO assessment following a National Patient Safety Alert last year. Transfusion Associated Circulatory Overload is one of the most common causes of transfusion-related deaths with incidents increasing annually. It is defined as an acute or worsening respiratory compromise or pulmonary oedema during or up to 12 hours after transfusion. TACO deaths are preventable, it is therefore essential to assess the risk prior to transfusion. The TACO checklist is embedded into ICCA for your convenience.
To reduce the risk simple measures can be taken: use alternative treatments where possible, reassess Hb after each unit to determine if Hb target has been achieved, consider weight adjusted red cell dosing for patients of low body weight, avoid rapid transfusion, administer diuretic when appropriate and monitor obs closely. If any incidents of TACO occur please let us know and complete a Datix, it must be reported nationally.
While it is usual to state that blood is prescribed, in fact, as blood is not a medicine, it cannot be prescribed, instead it is authorised to be transfused with a written instruction. Currently in the Trust it is mostly medics that complete the authorisation, however, the haematology nurses are also able to authorise having completed the Non-medical authorisation of blood components course and are able to assist if necessary. Please note that any non-medic who has done the prescribing course is still not able to authorise blood components, the NMA course must be completed in addition. Places on the course are limited (it is fully booked for 2025/6) and permission to apply for the course should be sought from Sally. More information on the NMA course can be found at: Clinical courses - Hospitals and Science - NHSBT. We are a very approachable team, if you have any questions do feel free to contact us and we will get back to you as soon as possible.
Dear colleagues,
We have organised this session based on our network members feedback to support you with building your knowledge, skills, and confidence in QI as a key network priority for this year. The session with be facilitated by Zoe Lord, Deputy Director NHS Horizon along with a member of her team on: Please encourage your colleagues to join our network meetings which provides an opportunity to continue to grow their knowledge and skills in QI and apply this learning in practice along with connecting with other early career professionals, sharing achievements, and best practices in QI.
RE: National QI Network for Early Career and Newly Qualified Nurses & Midwives meeting - 7 May 2025 As part of our national QI networks commitment, to support early career nurses and midwives to develop and grow their knowledge, skills, and experience in Quality Improvement, enabling them with improving quality, safety, patients’ outcomes, and experiences of care. We are pleased to invite you to join our upcoming virtual Quality Improvement Network meeting with a focus on “Creating a culture of change and improvement: Inspiring nurses and midwives to lead” on 7th May 2025 14:00-15:30 This session will focus on: Your leadership development and growing your knowledge and skills in quality improvement, discuss practical strategies to inspire and support early-career professionals, empowering you to thrive in times of uncertainty and make a lasting impact in healthcare. explore how nurses and midwives can navigate challenges and lead meaningful change and improvement in their practice.
We kindly ask our new members to fill our registration form at https://forms.office.com/e/cGvYaTyqru Existing members are not required to do so.
We look forward to seeing you at the meeting.
Kind Regards
Milena Krasinska-Chavez RN |
Clinical Quality & Improvement Nurse Senior Manager Nursing Directorate NHS England https://www.england.nhs.uk/nursingmidwifery/deliveri ng-the-nhs-ltp/nursing-and-midwifery-quality-improve ment-networks/
Announcement of 8a Cross Site Critical Care Matron
April 7 2025
The Trust has announced the appointment of a new 8a Cross-Site Critical Care Matron - Marta Soares - Preece , marking a change in the organization's commitment to exceptional patient care across its two sites. The appointment comes as part of the trust's ongoing efforts to strengthen leadership in specialized care areas and promote consistency in clinical excellence throughout its network. The new matron will oversee critical care units across EDGH and Conquest Hospitals, working to standardize protocols, share best practices, and enhance patient outcomes. Sylvia Harris, Head of Nursing for Critical Care/Outreach, says -- "The band 8a post , in line with GPICS guidance will provide the units a leader who can work with the teams to develop a continuity cross site . Marta will join the team with a wealth of experience and motivation to continue to move the departments forward . She will work closely with both the clinical lead, HON , Gen Manager and Service manager to move the units forward in line with clinical research and best practice. In turn Marta will work closely with the critical care teams cross site, who are the fundamental drive in ensuring the standards remain excellent and the workforce feel supported . We wish Marta well and know you will make her welcome." Evette Davies, Assistant Director of Nursing DAS, remarked -- "Congratulations to Marta, we look forward to welcoming you to the team. Marta's start date is not yet confirmed and there will be a period of handover with both Caroline and Julie and further communication will be sent."
Meet Marta Soares - Preece
"I qualified in Portugal in 2010 and started working in the NHS in 2011, in the Surgical Assessment Unit in Eastbourne. I loved my time on SAU where I gained so much knowledge and skills but from early on, I always had a passion for Critical Care". When I was in my first year of university, my dad was unwell and had to spend time in ICU, the care and compassion that he received, inspired me to pursue critical care, I remember thinking, what an amazing job. T he Oracle Team has invited Marta for a short bio and a few interview questions so that the whole Critical Care Team can get to know her better before she formally starts her role as the 8a Critical Care Matron.
I started my career in Critical Care, in 2013, in the Royal Sussex County Hospital. I completed the ICU Foundation programme, the mentorship course and the ICU course. I presented my ICU course poster, an audit of critical care discharges, at the BACCN conference. I also had the opportunity to work alongside the neurosurgical nursing team when Hurstwood Park ICU merged with Brighton ICU, this allowed me to gain an insight of the complexity of neurosurgical critical care. I also worked as agency nurse in different critical care units across the south and as community complex nurse.
In 2021, I moved to the Outreach Team at Eastbourne. It was a hard period for the Trust with so much change. I worked on improving the NIV teaching in the respiratory services across site and worked with the Simulation team and AMU in quality improvement projects. I brought back AKI teaching to Eastbourne and alongside this, I started a leadership course with Henley Business School. Throughout the course, I acquired so much knowledge and skills that allowed me to influence and contribute to improvements across nursing and patients. Henley Business School has shaped my approach to leadership, given me space to reflect about myself but to think strategically which ultimately motivated me to apply for the band 8a Matron. In 2017, I joined the Critical Care Outreach Team working both at Royal Sussex County and Princess Royal Hospitals. I enjoyed the busyness of the outreach role and embraced some projects such as medical student teaching and being an advocate for safe sedation on the wards, whilst actively contributing for the development of the outreach service. I also completed the advanced physical assessment module.
I truly enjoy learning and I’m also undertaking a coaching certificate, although I’m almost at the last steps! Outside work, I enjoy spending time with my husband, two children and my dog. I enjoy spending time outdoors – whether it’s walking, gardening or just getting some fresh air. I also engage in community events and enjoy listening to others’ stories and experiences. DIY, crafts and cooking are how I like to spend my spare time. I have worked and learned from so many people in my career which helped shape me into the nurse who I am today, and I feel privileged to be embracing this new opportunity!
"I enjoy spending time with my husband, two children and my dog"
What inspired you to pursue a career in critical care nursing, and what keeps you passionate about this specialty? I was inspired from early on to pursue a career in critical care nursing due to the holistic care that we deliver in intensive care, the complexity of patients and the learning opportunities. What keeps me passionate about critical care is the relationship building between patients and their families, at one of their most crucial moments of their life. I enjoy the complexity, the learning, the multidisciplinary work and the difference that we make to our patients and families. Every day is different and there is always an opportunity to learn something new!
As someone who would be overseeing critical care across two sites, what do you see as the biggest challenge facing these two units, and how do you plan to address it? One of the biggest challenges in managing critical care across two sites is ensuring consistency in care standards and communication, while supporting the strengths and needs of each team. It is essential to me that both sites feel equally supported, heard and connected, despite working in different locations. It is equally important to me to create a culture where everyone feels part of the same team. I want everyone to feel supported, valued and connected. I plan to address it by prioritising strong, transparent communication and creating opportunities for shared learning and collaboration between sites. I believe in being a visible and approachable leader by spending time on both sites, listening to staff and responding to concerns. Ultimately, it’s about building trust and empowering others to deliver the best possible care together.
Marta during her toddler years
How do you plan to foster collaboration and knowledge-sharing between the two critical care units under your supervision? My plan is to spend time on both sites regularly – not just in meetings but on the unit with the teams. My first priority is getting to know everyone, understanding their daily challenges, and seeing first-hand how each unit works. By listening, learning and working alongside the teams, I hope to create open and reliable channels of communication between the two sites. This includes regular cross-site meetings, shared learning events and cross-site working groups where we can come together to discuss challenges, celebrate successes and exchange best practice.
Could you share a memorable moment from your career that shaped your leadership approach or philosophy? I was called to review a deteriorating patient on a busy ward, and when I arrived, it was clear the ward team were anxious and unsure. What struck me the most wasn’t just the patient’s condition, it was how my ward colleagues were looking for guidance, reassurance and someone to support them. Rather than jumping to conclusions, I paused to listen to the nurse and what actions had already taken place, and to the resident doctor. By doing that, I was able to create a calm environment, encourage teamwork, empower others to trust their judgment and prioritise actions to stabilise the patient. Critical Care Outreach and my recent leadership course has shaped my leadership philosophy. In outreach, you are a guest in someone else’s space, so I carry a deep level of respect towards others.
Critical Care's - Small Change Challenge
This month we carry on with our small change challenge and try to save as little as we can. On your left hand side is our Top 20 medication consumption for last month. Below we share some quick tips to prevent medication wastage 5 Top Tips to Prevent Intravenous Medication Wastage for ICU Nurses During Preparation 1. Verify Orders Before Preparation Double-check active orders in the electronic prescribing system immediately before preparation Confirm administration times to prevent preparing medications too early Communicate with the medical team about any planned medication changes or potential discharge Review the patient's clinical status to ensure IV route is still appropriate 2. Use the Right Vial Size Select appropriate vial sizes that match ordered doses to minimize leftover medication Consider using 500mg paracetamol vials instead of 1000mg when smaller doses are prescribed Check for availability of multiple vial sizes in your medication storage area Report commonly wasted medications to pharmacy for potential stocking adjustments 3. Batch Similar Preparations When Appropriate Coordinate preparation times for patients receiving the same medication Use appropriate batch preparation techniques while maintaining aseptic standards Share resources with neighbouring bed spaces when safe and permitted by policy 4. Know Your Stability Times Be aware of stability data for commonly used IV medications after reconstitution Label all preparations clearly with preparation time, expiry time and your initials Store prepared medications appropriately according to temperature requirements Use medications with shorter stability times first when multiple IVs are due 5. Implement Early IV-to-Oral Conversion Assess swallowing capability daily for all patients on IV medications Initiate IV-to-oral switch discussions during ward rounds Know which medications have excellent oral bioavailability (e.g., paracetamol, fluconazole) Document rationale if IV route needs to be continued despite oral route being available Remember: Every pound saved through reduced medication wastage can be reinvested in patient care. A single 1g IV paracetamol dose costs the NHS approximately £48.30, compared to less than £1 for tablets!
Critical Care Rehab updates: PICUPS Sadie Williams Holly Makin
As an MDT we have been working on this a QI project which has been approved, so now we can start using this for our long stay rehab patients. This article outlines its use and importance. As per the diagram there are three stages to this screening tool. It is used initially in critical care, on the ward and then home (critical care follow up). It is used to create a
rehab prescription and track patients progress. This gives the follow up team an idea of patients progression and what additional support is required within the follow up service. The tool will be used by the MDT and can be found on ICCA under the follow up records tab.
Abstract Background
Results Initial PICUPS design yielded a 24-item tool. In piloting, a total of 552 records were collated from 314 patients, of which 121 (38.5%) had COVID-19. No obvious floor or ceiling effects were apparent. Exploratory factor analysis provided evidence of uni-dimensionality with strong loading on the first principal component accounting for 51% of the variance and Cronbach’s alpha for the full-scale score 0.95 – although a 3-factor solution accounted for a further 21%. The PICUPS was responsive to change both at full scale- and item-level. In general, positive responses were seen regarding the tool’s ability to describe the patients during their clinical course, engage and flag the relevant professionals needed, and to inform what should be included in an RP. Conclusions The PICUPS tool has robust scaling properties as a clinical measure and is potentially useful as a tool for identifying rehabilitation needs as patients step down from ICU and acute hospital care.
Patients who have had prolonged stays in intensive care have ongoing rehabilitation needs. This is especially true of COVID-19 ICU patients, who can suffer diverse long-term ill effects. Currently there is no systematic data collection to guide the needs for therapy input for either of these groups nor to inform planning and development of rehabilitation services. These issues could be resolved in part by the systematic use of a clinical tool to support decision-making as patients progress from the Intensive Care Unit (ICU), through acute hospital care and onwards into rehabilitation. We describe (i) the development of such a tool (the Post-ICU Presentation Screen (PICUPS)) and (ii) the subsequent preparation of a person-centred Rehabilitation Prescription (RP) to travel with the patient as they continue down the care pathway. Methods PICUPS development was led by a core group of experienced clinicians representing the various disciplines involved in post-ICU rehabilitation. Key constructs and item-level descriptors were identified by group consensus. Piloting was performed as part of wider clinical engagement in 26 acute hospitals across England. Development and validation of such a tool requires clinimetric analysis, and this was based on classical test theory. Teams also provided feedback about the feasibility and utility of the tool.
The post-ICU presentation screen (PICUPS) and rehabilitation prescription (RP) for intensive care survivors part I: Development and preliminary clinimetric evaluation - PMC
Matron's Corner
Thank you to everyone for working above and beyond, we have been so busy recently, it does not go unnoticed how the team support each other Again thank you to EDGH staff for supporting us when we have been short staffed, your help is always appreciated The escalation unit is currently being used by the wards due to bed shortage in the trust , please do be mindful when you need to pop in there for any of our equipment. I am unsure when it will be handed back again Special thanks to our PNA’s Kim and Vera, they do an amazing job supporting the teams wellbeing, don’t forget to book in with them if you need support or advise Good Luck to our pharmacist Nicole who is leaving ESHT on the 11th May to pursue new opportunities We will be supported by George Pooke until they appoint The weather is looking up, the sun is out and with the new appointment of our 8a leader, I'm sure more settled times are now ahead of us - Congratulations to Marta! Thank you everyone for your continued hard work and my apologies that you have found yourselves being moved so much either to Conquest or the wards, I fully appreciate how hard and unsettling this is but, I can assure you that your assistance is very much appreciated. Well done everyone for our 100% Excellence in Care audit for the second month in a row - fantastic! I want to say another big thank you to the whole team for welcoming and supporting our new starters, Claire and Anna C, and continuing to support students from the University - I know that this puts an extra strain on everyone, but, as always, you are all wonderful professionals and you take it in your stride. Shout out to Chris, who raised a huge amount of money for the Kent, Surrey and Sussex Air Ambulance in a charity boxing match recently, he was the top fundraiser on the night - well done Chris, you did us all proud X.'
Caroline Ellis Critical Care Matron
Julie Boydell Interim Critical Care Matron
Critical Care Outreach Updates
March Data CCOT
Number of referrals: 242 ICU Admissions: 37 (15% of those referred to service admitted to critical care) Total amount of assessments: 439 2222 calls: 117 ICU step downs: 37
Advice only: 115 Call4Concern: 1
There is an upcoming secondment opportunity into the team at Conquest - advert imminent. Please contact Cheryl Sparkes directly for further information if interested. A further post at EDGH will advertised in due course. Congratulations to Marta on her appointment to 8a matron - we wish her every success! John has conducted a review of the trust tracheostomy policy and changes have been made. This is currently awaiting ratification, please update yourselves with these changes once available.
Tori Privett Critical Care Outreach Sister
Critical Care Practice Education Updates
We will soon be commencing a cross site trial of a new infusion giving set with a built in flush. First of all I would ask you all to remember to label all lines with the date as these sets can be used for 72 hours, flushed insitu whilst maintaining connection, then used again with a different medication. So, reminding each other to label our lines with the date will help in our transition towards the trial and our compliance with the new sets. I will be carrying out an audit over the next couple of weeks to try and see how many sets we use currently. I am hoping that these new sets will improve our medication compliance as we will be giving the full dose whilst improving our sustainability. Full training will obviously be given by moi! I will also pop over to Eastbourne and assist there. Jess is off supernumery from week beginning 5th May and I know you guys will continue to support and guide her. We are currently being trained in the use of some new PCA pumps. We will have support from the reps 12-2pm Mon-Thurs and they will catch as many people as possible on shift - with Bob and Sam covering. There will also be a pump set up for us to cascade to trained staff with a view to us all having some training over the next 3 weeks. Protect trial we still waiting for the green light to go ahead with recruiting participants We have not had any candidates yet for the release trial - so we still need to keep informed with regards to APRV.
Sam Bull Clinical Skills Facilitator
New Starters
Claire Barrett
Anna Chaplin
Critical Care Doctor of the Month Dr. Elliot Carter Dr. Andrew Li
Congratulations!
A huge Congratulations to both Faye and Chelsea for their long service certificates! well done ladies!
The Oracle would like to congratulate Kim and Noreen for their Band 7 secondment appointments. Well done to you both!
Happy Mother's Day!
Best Moms Ever!
Critical Care Employee of the Month Saziso Ncube Jennifer Fabian
Happiest Birthday to you Noreen! and to all our April celebrants!
Lilac Group's QIG Day
April's Gender Reveal Party
Congratulations to April and her husband Evaldas for the coming baby boy! The whole crew wishes you both all the best!
See you on the next Edition - The Oracle Team
Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40Made with FlippingBook. PDF to flipbook with ease