Airedale NHS Foundation Trust is showcasing its Critical Care Outreach Team (CCOT) – a service which offers intensive care skills to patients with, or at risk of critical illness and done outside of the intensive care unit.
The 6-strong team of highly skilled intensive care nurses all have advanced life saving training skills to identify and respond to acutely unwell and deteriorating patients throughout the hospital.
The specialist team are on call 24/7 and respond to calls from any ward in the hospital, who may have patients who are becoming seriously unwell. The dedicated team are also able to monitor SystmOne, the patient online data system used in the hospital, to check all observations that have been recorded and receive automated alerts when a patient’s condition, or early warning scores, start to worsen.
The team can then give advice immediately to the ward or go and treat the patient themselves whilst at the same time providing expert support to clinical teams. They teach and support staff on the early signs of a deteriorating patient and provide prompt interventions.
The team see a range of patients including those with sepsis or renal complications, or those who have just had surgery and whose vital signs might be worsening.
Critical care nurse and team leader at Airedale NHS Foundation Trust, Paul Anderson explains:
“When we see the patient we do a comprehensive assessment, looking at why they’ve come in, right the way through checking their airway, breathing and circulation, mobility and any swellings, we also review all their blood results and see if there is anything of concern.
“We then make recommendations to the team and suggest some early actions that the nurses can do or we can step in and provide the care ourselves to support the ward. If we need to, and we think it’s more serious, we can contact the medical team and quickly get them into critical care. By expediting that we can get on top of the problem, give them the treatment in intensive care they need and shorten their stay, which has significant benefits for our patients’ recovery period.”
The team also review and follow up every patient who comes out of intensive care and are notified about every patient that leaves ICU or the HDU for the wards, within 12 hours. They ensure post intensive care plans are being followed and all their rehabilitation needs are in place. The team then continue to see patients until they know they are making their recovery from intensive care, sometimes just to give support and reassurance after having had 1:1 care.
In June 2022 the team assessed and treated almost 300 patients and as a result only 5 needed to be admitted to ICU. Catching any deterioration early has obvious benefits for the patient’s long term health and their length of stay in hospital. For every week too spent in critical care a patient can lose 10% muscle mass, which in itself equates to a month’s recovery.
Critical Care Matron Julie Brook says:
“It’s lifesaving really. If our patients don’t get that early intervention then their risks of deterioration increase. This service really helps reduce the need for critical care which is much better for our patients. It also improves their experience of being in hospital, as well as reducing pressure on services. We are very fortunate too to be able to provide this service 24/7 to staff and patients, as almost half of the patients we assess are seen during night hours.
The feedback from staff too has been excellent, they appreciate the expertise and support available 24 hours a day and the fact the team can start interventions early themselves.”