{"id":6428,"date":"2021-03-31T12:55:47","date_gmt":"2021-03-31T11:55:47","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6428"},"modified":"2021-06-30T15:30:08","modified_gmt":"2021-06-30T14:30:08","slug":"intensive-care-unit-icu-referrals-and-admissions-at-a-district-general-hospital-dgh-in-light-of-the-covid-19-pandemic-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2021\/03\/31\/intensive-care-unit-icu-referrals-and-admissions-at-a-district-general-hospital-dgh-in-light-of-the-covid-19-pandemic-2020\/","title":{"rendered":"Intensive care unit (ICU) referrals and admissions at a district general hospital (DGH) in light of the COVID-19 pandemic (2020)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\n*Blair J.; *Naughton E.; *Pradhan N.<\/p>\n

Citation:<\/strong>
\nIntensive Care Medicine Experimental; 2020; vol. 8<\/p>\n

Abstract:<\/strong>
\nIntroduction: The COVID-19 pandemic has led to an increase in ICU referrals and admissions across the UK during 2020 [1]. Intensive care beds are a limited and expensive resource and decisions on patient admission are often very challenging [2]. Proformas help to standardise documentation and decision logging during patient referrals [3]. They provide easily accessible evidence in case of a future referral and allow audit of decision-making processes. A preliminary survey of doctors working in a DGH ICU was undertaken to assess the current referral and admission process in expectation of an increased volume of work.
\nObjective(s): As a result of the survey, three main areas for improvement were identified: 1. To maintain a record of all ICU referrals and decision-making processes 2. To reduce the time taken for documentation of referrals and admissions 3. To improve the quality and appropriateness of referrals from parent specialities Methods: A proforma was designed for dual use as a referral and admission document. All referrals were recorded on paper and staff received training on how to apply the proforma. After assessment of each referral, irrespective of admission outcome, a completed copy of the proforma was placed in both the patient's notes and a dedicated referrals folder. After one month, a further survey was designed to assess the response postimplementation of the proforma. All referrals made over a threemonth period between April and June 2020 were audited.
\nResult(s): The initial survey received 12 responses. Prior to the COVID-19 pandemic, documentation of any referral or admission took on average 10-15 minutes. All survey participants felt that referring teams did not have a good understanding of the role of ICU care and estimated that up to 40% of all referrals received were inappropriate. The follow-up survey received 14 responses. Implementation of the proforma reduced the time taken to document a referral or admission on average by 5-10 minutes. Twelve participants found the proforma a useful aid, helping to provide clear documentation and ease communication between ICU team members. Less than 9% of the referrals made between April and June 2020 were admitted to ICU with over 32% of referrals deemed unsuitable for further escalation. Approximately 50% of referrals were made by registrars, with 13% discussed by consultants. The median age of patients referred was 67.5 and the most common reason was for respiratory deterioration.
\nConclusion(s): This quality improvement project successfully reduced the time taken to document ICU referrals and admissions. Use of a proforma has provided many benefits, including standardisation of documentation, decision logging and improvement of intra-and inter-team communication. Only a small proportion of patients referred to ICU have been suitable for admission. A teaching session is being designed so that referral information can be fed-back to parent specialties. Referrals will be reaudited after this. Data analysis of this project has been limited by incomplete proforma documentation from participating users.<\/p>\n

Link to full-text<\/a> [open access - no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): *Blair J.; *Naughton E.; *Pradhan N. Citation: Intensive Care Medicine Experimental; 2020; vol. 8 Abstract: Introduction: The COVID-19 pandemic has led to an increase in ICU referrals and admissions across the UK during 2020…<\/span><\/p>\n

Read more Intensive care unit (ICU) referrals and admissions at a district general hospital (DGH) in light of the COVID-19 pandemic (2020)<\/span> ›<\/span><\/a><\/div>\n

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