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When critically ill patients are held in the recovery area because of a lack of availability of appropriate facilities elsewhere, this should only occur if recovery staff are appropriately trained, and the recovery area is appropriately equipped to enable monitoring and treatment to the standard of a level 3 critical care unit. In some circumstances, such as a flu pandemic...
There should be equipment and facilities for blood tests and urine analysis.
The Mental Capacity Act 2005 must be complied with.88 Staff should have regular training in the application of the Mental Capacity Act 2005 and have defined access to patient advocates. This is a rapidly changing area, and clinicians should have access to expert advice.
All patients admitted to a critical care unitmust be included in a national clinical audit programme in which Levels of Care data are collected.
Level of Care classification must not be used in isolation to decide upon a patient’s staffing requirements.
The UK intensive care community should encourage and develop a validated methodology to review referralsto intensivecare and evaluate decisionmakingand subsequent outcomesrelating to intensivecare admission and refusal.
Units should develop a consistent approach to patient-centred decision making, evaluating burdens and benefitsof admission to intensivecare, and be able to demonstrate thisthrough the audit of pre-admission consultation, agreed ceilings oftherapy, and time-limited treatmenttrials.
Longer-termmortality should be collected on all patients admitted to critical care.
The UK intensive care community should encourage and develop validated measures of longerterm patient- and family-centred outcomes beyond mortality, including measures of functional ability,socioeconomic consequences, and carerburden.
Hospitals must have local policies in place for the identification, support and safeguarding of vulnerable adults.60
