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RCN warns of increasing risk to patient safety as hospital capacity reaches critical level
The RCN has said that it is seriously concerned about staff wellbeing and patient safety as intensive care units (ICU) across the UK experience extremely high levels of activity and operate considerably beyond their usual capacity.
It is recognised that there are not enough critical care nurses and ICUs are having to respond by reducing the critical care nurse to patient ratio from 1:1 to meet demand. NHS England and NHS Improvement with Health Education England issued guidance in December on workforce models for hospitals during COVID-19, which stated the staffing standards for intensive care units can be temporarily suspended. It said: l Nurse to patient ratios could be maintained at a minimum of one trained critical care nurse for two level 3 patients, compared with the normal 1:1 ratio, supported by one other registered nurse.
l And one trained critical care nurse for four level 2 patients, compared to the normal 1:2 ratio, supported by one registered healthcare professional.
The RCN understands from its members that nurse to patient ratios in ICU are being diluted more than this, and that ward areas
are also significantly short staffed. The RCN said that dilution of ICU nurse to patient ratios should only happen in exceptional circumstances where there is a need to expand capacity, despite escalation to regional and national critical care networks; and when all local and regional mutual aid options, including inter-regional assistance, have been exhausted. The UK Critical Care Nursing Alliance (UKCCNA), of which the RCN is a member, also requests that departments of health in the four nations provide further guidance on how increased workforce requirements are managed.
RCN chief executive, Dame Donna Kinnair,
said: “The safe ratio in intensive care units is one nurse to each patient. With every change to this ratio, the pressure on nursing staff increases and it becomes harder to provide care to patients. This is not safe practice, but it has become unavoidable in many hospitals. It is exacerbated by the severe shortage of nursing staff, which is not only affecting ICU but many wards packed with seriously ill patients where nurse to patient ratios are very high. We must see an urgent response from the Government that addresses the chronic underfunding of nursing over many years.”
AI to advance diagnosis and treatment for coronavirus patients
NHSX has brought together over 40,000 CT scans, MRIs and X-rays from more than 10,000 patients across the UK during the course of the pandemic. Access to this National COVID-19 Chest Imaging Database (NCCID) has now been extended to hospitals and universities across the country who are using the images to track patterns and markers
of illness. The database can speed up diagnosis of COVID-19, leading to a quick treatment plan and greater understanding of whether the patient may end up in a critical condition.
Clinicians at Addenbrooke’s Hospital in Cambridge are developing an algorithm based on the NCCID images to help inform a more accurate diagnosis of patients when
they present to hospital with potential COVID-19 symptoms and have not yet had a confirmed test.
Using visual signatures of the virus, as they appear in chest scans, they are able to compare the patterns in the patient’s imaging with those seen previously in the NCCID to get a more accurate diagnosis and prognosis.
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