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Success for critical care nursing initiative in Scotland

A group of intensive care nursing staff have seen their pioneering work result in some of the best improvements in patient care to be seen in Scotland.

The team of critical care outreach nurse specialists at Borders General Hospital are being credited with helping it achieve one of the lowest mortality rates in critical care, while also helping to deliver a reduction in cardiac arrest calls.

Analysis of the results has seen Borders General Hospital intensive care unit record some of the lowest patient figures for out-of-hours admissions, length of stay, need for ventilation and need for renal replacement therapy in the country.

In addition, the number of cardiac arrest calls at the hospital saw a reduction from 465 in 2000 to 48 in 2013. 

Specialist nurse Ronnie Dornan set up the Melrose-based hospital’s critical care outreach service to address the importance of early recognition management techniques when treating patients at risk of deterioration.

He said: “The service provides a team of dedicated specialist nurses who focus on the close monitoring of the medical conditions of both ward patients and patients recently discharged from intensive care.

“We believe that visibility and accessibility to a specialised team is of the utmost importance.”

Mr Dornan added: “We use an early warning chart to closely monitor blood pressure, heart rate, temperature, respiratory rate and blood results that highlight the early signs of deterioration

“This way we can act upon any decline in the patients’ condition at an early stage providing us with the optimal chance to prevent further deterioration and expedite treatment.”

The work of the critical care outreach service has been closely followed by two other Scottish hospitals who have now implemented similar models. The team have also received international recognition in the US and Denmark.

The initiative forms part of the work of the Scottish Patient Safety Programme, which has been running for more than five years, delivering a range of interventions to improve the safety and reliability of hospital care.

The programme, which is part of Healthcare Improvement Scotland, is now supporting the extension of initiatives to settings for adult mental healthcare, maternity and neonatal, paediatrics and primary care. 

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