Most units have a lead nurse and a lead consultant who work with the hospital and health board to ensure a safe, effective and person centred service.
Provision of high quality care is the priority of every unit. In Scotland, every intensive care unit, and most high dependency units, contribute to a national audit, led by SICSAG – the Scottish Intensive Care Society Audit Group – which monitors activity and outcomes. The audit also records adherence to ten quality indicators, devised by the SICS Quality Improvement Group. SICSAG releases an annual report of comparative data.
Click to find out more about SICSAG and quality indicators
The fundamental aim of this programme is to reduce avoidable harm to patients by improving the safety of patient care at all points of care delivery in Scottish healthcare. The project is co-ordinated by Health Protection Scotland. Critical care units record a number of processes and outcomes as part of the programme, and you may see these displayed on the unit noticeboards. Ask a member of staff if you want to know more.
Click to find out more about SPSP
Reducing rates of hospital acquired infection is a cornerstone of improving patient safety. This is particularly important in the critical care areas where unwell patients are more susceptible to infection, and fight them off less easily. All ICUs contributing to the SICSAG database also submit data on certain infection rates – these are infections related to central intravenous lines, pneumonias developing in patients on ventilators, and bloodstream infections. You might see the recent rates displayed on the unit noticeboards. Ask a member of staff if you want to know more.
Click to find out more about infection surveillance at the Health Protection Scotland website
The Healthcare Environment Inspectorate (HEI) undertakes at least one announced and one unannounced inspection to all acute hospitals across NHSScotland every 3 years, these visits include critical care areas. Inspectors check that hospitals are meeting national standards, guidance and best practice. Reports are accessible to the public, and form the basis of ongoing improvement.
Click to find out more about inspections at the Healthcare Improvement Scotland website
Advances in critical care rely on research to prove that they are effective, safe and cost-efficient. Taking part in research is entirely voluntary, and the processes regulating it are extremely rigorous and designed to protect the participant from any new harm. It is always ok to say no, or to stop taking part at any time.
Unlike other settings it can be hard to consent a severely ill patient to take part in a research project, although this is always done if possible. It is good practice to get the agreement of the next-of-kin; this may be called “assent” rather than “consent”. If the patient can consent at a later time they will be asked to do so, if they refuse any collected data or samples are destroyed.
Research which must be performed without prior consent because of an emergency situation is deemed acceptable if the local Ethical Committee have accepted the protocol, and will usually (but not invariably) request consent or assent to be obtained at the earliest opportunity afterwards.
To find out more about research in critical care in Scotland:
The Scottish Critical Care Trials Group – click here
The Edinburgh Critical Care Research Group – click here