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An early warning system at the London Clinic is reducing unplanned critical care admissions, reports Charlotte Alderman
SUMMARY
Picking up patient problems early has reduced the number of unplanned admissions to critical care. At The London Clinic this is achieved through a scoring system and a critical care outreach team.
* The outreach team is nurse-led.
* A scoring system alerts ward nurses to call the team.
* Under patient group directives, oxygen and intravenous fluid treatment can be modified.
* A patient group directive for the use of colloid is being developed.
Key words
Critical care * Outreach * Patient group directives * Modified early warning system * Patient observations
Preventing unplanned admissions to critical care is good for hospital resources and good for patients. Carmel Gordon-Dark sees helping nurses to identify patients at risk of deterioration and to intervene early as the core of her work at The London Clinic, a hospital in the independent sector.
In 2003 the hospital introduced a nurse-led critical care outreach service. It was backed by a large amount of research and development work carried out by Ms Gordon-Dark, then a sister in critical care, and her colleague Maxine Major, a critical care unit manager.
The work was prompted by the Department of Health (DH) report Comprehensive Critical Care, published in June 2000, and the requirements of the Independent Health Care Commission. The DH report encourages the development of critical care services and the...