Outcomes from paediatric intensive care remain good despite poor staffing ratios

Posted by ap507 at Nov 02, 2015 03:55 PM |
New report by the universities of Leicester and Leeds

Issued by the University of Leicester Press Office on 3 November 2015

Mortality rates in children’s intensive care units across the country remain very low, despite only 15% of them meeting recommended nurse staffing levels, a new report by the universities of Leicester and Leeds has said.

Of 19,760 admissions of children to paediatric intensive care units (PICUs) in 2014, less than 4% died after being admitted, according to the latest report from the Paediatric Intensive Care Audit Network (PICANet). The audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England.*

The mortality rate remains low despite only five out of 34 PICUs meeting the current nurse staffing levels as set out in Paediatric Intensive Care Society (PICS) standards, and a high percentage of agency and bank nursing staff working in PICUs in some regions.

Professor Liz Draper, from the College of Medicine, Biological Sciences and Psychology at the University of Leicester, said: “Paediatric intensive care units continue to have difficulty achieving the PICS nursing standards and a more detailed analysis of this problem has shown a particular issue for NHS PICUs in London, where the use of agency and bank nursing staff was as high as 25% from our snapshot survey at midnight on a Sunday. 

“It is difficult to achieve continuity of care and the use of a designated nurse when staffing is so stretched and the complexity of care required by the children admitted to intensive care continues to rise. Problems with the recruitment and retention of nursing staff in this stressful environment are growing and innovative solutions are required to maintain a high quality work force, such as self-rostering and more flexible working for staff with families and other dependents.”

Although there has been no significant increase in the number of children admitted to PICUs over the last three years, children are spending longer in them. Beds were occupied for 131,268 days in 2014 – an increase of 2,748 bed days compared with 2013.

Dr Roger Parslow, of the School of Medicine at the University of Leeds, added: “It is gratifying to know that despite continuing problems with staffing we have not observed a measurable reduction in the quality of paediatric intensive care delivered by the 34 PICUs covered in the report.

“Continued pressure on the service caused by more admissions, longer stays and inadequate staffing levels may, at some stage, result in changes to the quality of service delivered. PICANet will closely monitor outcomes and processes in UK and Ireland PICUs over the next 12 months to detect any such change.”

The 12th annual report from PICANet, on activity and outcomes in paediatric intensive care services in the UK and Ireland, includes a series of special articles on the uses of PICANet data for driving quality improvement through research and clinical trials as well as providing information for commissioning and service development. The report is available to download free here: www.picanet.org.uk.

Ends

Further information:

For further information, contact Ben Jones in the University of Leeds Press Office email B.P.Jones@leeds.ac.uk or University of Leicester Press Office at email: pressoffice@le.ac.uk

Copies of the report are available from University of Leeds Press Office.

Notes to Editors:

  1. PICANet has been collecting data on all admissions to paediatric intensive care in England and Wales since 2002 and has expanded to include Scotland, Northern Ireland and the Republic of Ireland. It currently holds data on over 197,000 admissions.  The information held on the PICANet database has been used by the Department of Health, strategic health authorities, commissioners, clinical audit teams, researchers and individual institutions to improve the delivery of paediatric intensive care.
  2. *PICANet is commissioned through the HQIP and the National Clinical Audit Programme* and also administered by the Welsh Health Specialised Services Committee; NHS Lothian/National Service Division NHS Scotland; the Royal Belfast Hospital for Sick Children; National Office of Clinical Audit Ireland (NOCA) and HCA International.
  3. About HQIP, the National Clinical Audit Programme and how it is funded

The PICANet Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme (NCA). HQIP is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP holds the contract to manage and develop the NCA Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The PICANet Audit is funded by NHS England, the Welsh Government, NHS Lothian/National Service Division NHS Scotland, the Royal Belfast Hospital for Sick Children, The National Office of Clinical Audit (NOCA), Republic of Ireland and HCA Healthcare.

  1. The University of Leeds is one of the largest higher education institutions in the UK, with more than 31,000 students from 147 different countries, and a member of the Russell Group research-intensive universities. We are a top 10 university for research and impact power in the UK, according to the 2014 Research Excellence Framework, and positioned as one of the top 100 best universities in the world in the 2015 QS World University Rankings. www.leeds.ac.uk
  2. The University of Leicester is a leading UK University committed to international excellence through the creation of world changing research and high quality, inspirational teaching. Leicester is consistently one of the most socially inclusive of the UK’s top 20 universities with a long-standing commitment to providing fairer and equal access to higher education. Leicester is a three-time winner of the Queen’s Anniversary Prize for Higher and Further Education and is the only University to win seven consecutive awards from the Times Higher. Leicester is ranked as a top 20 UK university and among the top two-per cent in the world.

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