HSE staff cuts see one in 10 critical care beds unused
Figures published by the HSE show that 22 out of 259 beds meant for treatment of the most seriously ill patients were not operational last year because of a shortage of nursing staff, despite funding being in place.
The HSE’s annual critical care bed capacity census for 2016 also reveals that a further 72 bed spaces were available but not resourced across the 26 hospitals with intensive care units (ICUs) and high dependency units (HDUs).
The census which was carried out on September 30 last records that 7,320 patients required invasive ventilator supports during the previous 12 months.
It is estimated that between 10,000 and 15,000 critically ill adults require care in ICUs and HDUs annually in Ireland.
ICUs in 10 hospitals provide 77% of all intensive care to patients with Cork University Hospital and St James’ Hospital the busiest in the country with each looking after around 1,100 critically ill patients each year.
The HSE figures show the problem of non-operational but funded beds in ICUs and HDUs is most pronounced in Beaumont Hospital where 5 out of 20 beds are affected by the problem of staff shortages and University Hospital Galway where 4 out of 25 beds could not be used.
Two critical care beds were also not in use in St James’ Hospital and the Mater Hospital.
Under national standards for adult critical care services introduced in 2011, the HSE requires a minimum whole-time working staff equivalent of 5.6 nurses to operate each level 3 ICU bed.
Commenting on the figures, a HSE spokesperson said the census helped to measure capacity within the hospital network as well as identify deficits and plan improvements.
The spokesperson said a working group in each hospital group was implementing a national “career pathway” programme to solve the problem.
It will see nursing graduates starting standardised and accredited critical care education and training in permanent, pensionable full-time staff nurse posts.
The HSE spokesperson said 22 graduate nurses had commenced such training at Beaumont last October.
“Each hospital group in Ireland is now operating its own Critical Care Nursing Workforce Planning Group under the direction of the clinical directors and nursing directors to continue to strengthen the critical care nursing staff,” he added.
Overall a total of 35 beds in ICUs in Irish hospitals have been decommissioned since 2008 following a move towards the centralisation of care for critically ill patients.
Hospitals where ICUs were removed include Dundalk, Monaghan, Roscommon, Merlin Park Galway, St John’s Limerick, Ennis, Nenagh, Bantry, Mallow, the South Infirmary in Cork and St Columcille’s in Loughlinstown.
The census also highlighted inefficiencies between ICUs in the smaller hospitals and the country’s 10 largest medical centres.
“The lower volume ICUs deliver 23% activity with 29% of resources while the higher volume ICUs deliver 77% activity with 71% of resources,” it stated.
The report suggested such figures indicated better use could be made of up to 81 critical care staff nurse posts.
Over the 12-month period covered by the census, 127 critically ill adults were admitted to ICUs with influenza, of which 47 died.
