Critical care
These pages have been developed for you, the family and friends of patients who are being cared for by our Critical Care teams. We know that this will be a worrying and stressful time for you, but hope that this information will answer many of your questions you may have about our service.
Please do not hesitate to ask a member of staff for any additional information.
About Us
Medway NHS Foundation Trust is home to a 19 bedded Critical Care department: our Intensive Care Unit has a total of nine beds, whilst our General High Dependency Unit has a total of 10 beds. Although these units are slightly different in terms of the care that they provide, they are run by one team whose top priority is caring for your loved one.
What is Critical Care?
Critical Care is a term that covers the care that is provided by both ‘Intensive Care’ and ‘High Dependency’ Units. Critical care is the treatment and monitoring of people who are in a critically ill or unstable condition.
A patient may require admission to Intensive Care because they require advanced respiratory support (ventilation), advanced renal support (haemofiltration) and other complex therapies. This could be following an acute episode of illness or after receiving a complex operation.
Admission to the High Dependency Unit is required for a variety of reasons. This may include the complex nature of their surgical procedure, their existing medical conditions, or they may be stepping down from the intensive care unit and will need more complex monitoring and intervention prior to going back to the general wards.
Levels of care
| Level 0 | Patients whose needs can be met through normal ward care in an acute hospital. |
| Level 1 | Patients at risk of their condition deteriorating, or those recently relocated from higher levels of care whose needs can be met on an acute ward with additional advice and support from the critical care team. |
| Level 2 | Patients requiring more detailed observation or intervention including support for a single failing organ system or postoperative care, and those stepping down from higher levels of care. |
| Level 3 | Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi-organ failure. |
Delivering care
The nature of the care that we provide to patients in our Critical Care units means that you will likely see a lot of staff around when you visit, particularly nursing staff.
The Intensive Care Society guidelines suggest that Level 3 patients should have a ratio of registered nurses to patients of at least 1:1 (i.e. one nurse per patient) to deliver direct care. The ratio of registered nurses to Level 2 patients is suggested as 1:2 (i.e. one nurse per two patients) to deliver direct care.
We routinely operate our Critical Care units to these suggested staffing levels. On the rare occasions that we are unable to do so - such as unexpected staff illness when no other staff are available to cover their shift, we will use our workforce as flexibly as possible to ensure we continue to provide a high standard of care. Patient safety remains a priority for this our Critical Care team.
Visiting
We encourage visitors to come and spend time with their loved one in our Critical Care units. However, we do have certain policies in place to ensure that our staff can get to our patients to deliver care quickly when needed.
To ensure that staff can get to patients quickly and without obstruction, a maximum of two visitors can visit each patient at any one time. Because some of our patients on Critical Care may require more complex and rapid support, visiting is always at the discretion of the Nurse in Charge. However if you do have any special requirements, please do discuss these with the team - we will always try and support these requests where possible.
There are some occasions in which you may be asked to leave your loved ones bed space and step outside of the main unit. These occasions include: during the ward round where confidential information is discussed regarding your loved one or another patient or during certain patient care/treatment. If there is an emergency on the unit, it may be that you are asked to leave until it is suitable for you to return.
For patients who are positive for Coronavirus, visiting is suspended except in compassionate circumstances (such as patients receiving end of life care) in order to protect you and our community. In these particular circumstances, the Critical Care team will be in contact with the designated Next of Kin for your loved one to arrange a visit.
If visiting is temporarily suspended or you are unable to visit, please discuss with the Nurse in Charge/bedside nurse looking after your loved one about arranging a Skype call.
Please do not visit if you are unwell of have any signs of infection. Our patients are very susceptible to infection, please do not put them at risk.
Parking
Visitors of Critical Care are able to claim a concessionary rate of £10.50 per seven days. Forms are available from ICU/HDU – please ask the Nurse in Charge. Completed forms should then be taken to the security and car parking reception desk in the hospital’s main entrance. Please note that only one concessionary ticket will be issued per patient.
Intensive Care Unit: Purple zone, level 3
01634 833967
General High Dependency Unit: Green zone, level 3
01634 835045