The COVID-19 pandemic is a difficult time for all of us. The situation has changed rapidly and dramatically affecting all of our lives. Our focus at this time must be to prevent the spread of the disease and to protect our patients, families and loved ones as well as our staff. To allow us to do this, we have had to make the difficult decision to change our visitor policy. We have followed guidance from NHS England to develop a visiting policy for Neurocritical care. Find out more >
We are a highly specialised Neurosurgical and Neuromedical Critical Care Unit. Our neurocritical care service at NHNN consists principally of the Neurosurgical Intensive Care Unit (SITU) and Neuromedical Intensive Care Unit (MITU). We are located across 2 floor, 1st Floor Chandler Wing (SITU, HDU 1 and HDU 2) and the Ground Floor Chandler Wing (MITU and MHDU).
We are attached to the Emergency Stroke Unit.
Neurocritical care is led by the neurocritical care tam. This team works closely with the specialist teams e.g. neurosurgery or neurology.
Every morning there is a ward round led by the critical care consultant. A full review is made of each patient and a plan for the day made. This plan is later reviewed in the afternoon by the critical care consultant.
For longer term patients there is a weekly multi-disciplinary (MDT) meeting to discuss longer term plans, goals and strategies.
In neurocritical care, if a patient is requiring support from a ventilator they are classified as a Level 3 patient. If they are able to breath for themselves but still require critical care for other reasons then they are classified as a Level 2 patient.
Level 3 patients have a nursing ratio of 1:1. This means there is a nurse allocated to only them 24 hours a day.
Level 2 patients have a nursing ration of 2:1. This means a nurse will be allocated to two Level 2 patients.
There is a nurse in charge of each shift who is senior and oversees the care that is delivered.
ICNARC (Intensive Care national Audit and Research Centre)
Our critical care unit submits data to ICNARC which compares our performance with comparable critical care units across the UK.
For more information please visit www.ICNARC.org
North East and North Central London Adult Critical Care Network (NENCL)
We are part of the NENCL network.
Patient discharge from NCC may be to one of the wards at NHNN (before being either discharged home or back to their referring hospital if an extended period of care is required) or directly to the critical care unit at their referring hospital if appropriate care can be provided there.
Moving from NCC to a ward can be an anxious time for patients and their families and there may be concerns about the differences they find in the level of care. In the intensive care unit there is usually one trained nurse per patient, in the high dependency unit one trained nurse per two patients, and on the ward one trained nurse for six to eight patients.
Patients in intensive care may ‘step down’ to the high dependency unit prior to their planned discharge to the ward, but some patients may be receiving high dependency level care in the intensive care area in the days prior to discharge and go directly from intensive care to the ward.
Patients are only discharged to the ward once they have been assessed by the multidisciplinary team as no longer requiring the higher level of care provided on the high dependency or intensive care unit.
To provide continuity of care and support for patients and their families, the Critical Care Outreach Team will follow up all patients discharged from critical care to the ward.
The critical care outreach team (CCOT) includes a senior nurse, an anaesthetic registrar and a critical care consultant. The team cover the hospital day and night. All patients who are discharged from critical care to the ward are viewed by CCOT and kept under their review until they are satisfied the patient has safely settled on the ward. The ward will also refer any patients they have concerns about to CCOT who will review and support the ward teams.
If your relative has come to critical care as an urgent/unplanned journey you will receive a call from our critical care family liaison nurse (this will be within 72 hours of an admission) who will make sure you are happy with the information you are receiving. We may ask you a few questions about your relative, for example their likes and dislikes. This helps us to understand more about your relative as a person beyond their current situation as our patient. You can email us pictures of your relative for us to place at the bedside.
The critical care liaison nurse can help ensure you get updates as you need them and address any concerns you may be having in regards to your relatives stay. The best way is to contact via the email address with a number to call back on.
The email address is: firstname.lastname@example.org