Critical Care Outreach Team

The purpose of Critical Care Outreach is to support the care of critically ill patients on the ward. Critical illness may be defined as a condition that is both unstable and life threatening – a situation which can be distressing for patients and relatives alike.

At Maidstone and Tunbridge Wells NHS Trust, we recognise that critically ill patients require high levels of nursing and medical care. The Outreach Team provides a supportive service, which is founded on a philosophy of respect and empowerment.  Individual team members work as part of the ward team, with the needs of patients and staff being central to all they do.

The team consists of critical care nurses who work closely with anaesthetists, physiotherapists, dieticians and nurse specialists.

• Aims of the service
• Which patients benefit from Outreach?
• How does Outreach help?
• Who refers patients?

Our aim is to promote optimum care for the critically ill by offering a service to assist ward staff in:

• supporting patients and families at this difficult time;
• developing their critical care skills and knowledge;
• identifying patients who have become, or who are at risk of becoming critically ill;
• monitoring a patient’s condition both closely and accurately;
• securing early medical intervention in the event of any observed deterioration of the patient’s condition;
• obtaining rapid access to experienced medical practitioners if necessary; and
• co-ordinating the transfer of patients to or from intensive care to ensure that critically ill patients are cared for in the safest environment.

We are also committed to the teaching of critical care skills at the bedside and offer formal teaching sessions to all staff within the Trust.

Any patient whose condition is causing concern to nursing, medical or physiotherapy staff such as:

• a pre-operative patient whose condition is unstable;
• post operative patients following major surgery;
• medical patients with multiple illnesses;
• patients receiving help with their breathing;
• trauma patients who have multiple injuries;
• patients who have been discharged from intensive care;
• patients with specific conditions such as pancreatitis which make them very unwell; and
• patients with tracheostomies (neck breathers) who are not being nursed in intensive care or the ENT ward;

Following ward referral, we will discuss the patient’s condition, situation and other relevant factors with the nurses and doctors looking after the patient.  We will also discuss concerns about the patient and offer advice. The Outreach team supports the critically ill patient on the ward by:

• ensuring that the necessary monitoring equipment is obtained;
• facilitating further investigations or nursing actions as directed by the attending doctor;
• ensuring rapid response by senior medical staff if necessary;
• facilitating transfer of patient to intensive care/ theatres / other hospitals as appropriate;
• offering advice or teaching for nursing staff as requested;

The Outreach team also visits the ward daily to offer their support and register those patients that the ward nurses or doctors wish to designate as Outreach patients. In addition, we ensure that the site practitioners and the anaesthetic teams on call at night are aware of the condition and location of designated Outreach patients.

Any nurse, health care assistant, doctor, physiotherapist, dietician or clinical nurse specialist who has assessed the patient can refer them for Outreach support.

The professional judgement of the person at the bedside is the most important factor in assessing and identifying critical illness. The nurses and doctors call us to assist them in making that judgement.

Visitors and patients can also request an outreach nurse to see them should they feel that the patient fulfils the relevant criteria.