One of the key recommendations of the Comprehensive Critical Care Review Report is the formation of ’Outreach Services’ to enable earlier detection and management of patients at risk of developing critical illness in a hospital ward environment.

Critical Care Outreach Service was first established in 2001. This 24 hour multidisciplinary team is lead by Dr Barry Sellick and Critical Care Specialist Nurse - Ingrid Johnson.

 

The main reasons and aims for introducing the service were:

  • to improve the care of patients at ward level who’s condition has deteriorated,
  • to share critical care skills with ward staff by provision of a 24 hour Critical Care Nurse Outreach Bleep Holder and, through the Bleep Holder, maintaining a link with the full range of specialist nursing and medical support existing within the Critical Care Directorate,
  • to promote continuity of care between critical care and ward areas,
  • to avert admissions to critical care beds by implementation of the Modified Early Warning Score - a scoring system, to assess all patients on wards thus enabling nursing staff to detect critically ill patients earlier.

The latter aim – “to avert admissions to critical care beds” - has been achieved by:

  • implementation of 24 hour Outreach Service,
  • development of acute skills and AIM study days,
  • introduction of a ward monitoring system to identify patients at risk .

The Outreach team will visit you on the ward, this tends to happen within the first 24 hours of your discharge. The service is available to help with the transition from a high dependency environment (ICU, HDU) back to a normal ward.

Any patient that has been on a ventilator in the ICU for 5 or more days will be seen twice weekly until they are discharged home or go for further rehabilitation. All other patients will receive subsequent visits according to their clinical state. Outreach staff work with the nursing and medical staff on the ward to aid a patient’s recovery. The Outreach Team ensures you continue to make progress and highlights any issues that occur with your parent Consultant. The Outreach team is also there to help answer your questions and hopefully relieve some of your anxieties.

 

The Outreach Team may be able to alleviate patient’s worries by spending time with, talking through and explaining what happened during the patient’s stay in ITU.

 

About one third of patients have no recollection of Intensive Care. This is due to a combination of severe illness, sedation and painkillers. If you are one of these people it can be very frightening to wake up in hospital and find out that you have lost days or weeks of your life and had no control over what happened to you. You may also feel very weak and feel your appearance has altered. The staff on the ward are able to tell you some of what has been happening to you and it often helps if a member of the ICU staff or Outreach team comes and talks with you about that time and discusses your progress and answers your questions. You may have some memory of ICU, which is hazy, and incomplete, again this is not unusual.

 

Family can also help by trying to be calm and reminding their recovering loved ones of things which are familiar to them.