Beaumont Hospital

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ICU Team

Beaumont's Intensive Care Unit is run by a highly specialised team which includes consultants and other senior doctors, nursing staff, physiotherapists, dieticians, pharmacists and many more.

The Role of the Physiotherapist in ICU

The units have 7 days per week physiotherapy cover in addition to on-call cover 24 hours per day. Main aims of physiotherapy input are respiratory assessment/management and initiation/progression of functional rehabilitation.

Specialist assistance is also provided for:

  • Weaning of artificial ventilation
  • Tracheostomy weaning
  • Microbial sampling of respiratory secretions
  • Spirometry and respiratory muscle capacity
  • In-depth neurological assessments
  • Musculo-skeletal assessments and treatments
  • Brace fitting
  • Contracture preventative measures
  • Positioning protocols

Speech and Language Therapy in ICU

Speech & Language Therapists (SLTs) work with a wide variety of people who experience difficulties in communication, voice and swallowing. The main people who avail of the service in Beaumont Hospital are those who have these difficulties due to conditions such as stroke, traumatic brain injury, brain tumour, neurological conditions, head & neck cancer and voice disorders.

The main role of the SLT in ICU are:

  • To establish a basic communication system for patients who are awake but cannot currently use their voice because of a breathing tube (endotracheal tube – in the mouth, or tracheostomy tube). The immediate aim is to help patients to answer and ask questions and to make their care needs known. The SLT considers the patient’s ability to concentrate, understanding of instructions, range of physical movement and vision when recommending a communication system.
  • Begin the weaning process alongside physiotherapy for patients with tracheostomy tubes. This means making steps to using speaking valves which allow for voice and to possibly removing the tube eventually.
  • Assess the swallow function and make recommendations for the most suitable food and drink consistencies. Sometimes a patient is not ready to start eating while they are in ICU. People in ICU can have swallowing difficulties from some internal swelling after being intubated, due to the nature of their underlying medical condition or because they are drowsy because of their treatment or medical condition.

Currently there is no resourcing for speciality SLT staff for the General ICU. Patients are therefore seen by SLT on a referral basis only. 

Patients can be referred by consultant, nurse or multidisciplinary team member for patients who experience difficulties in swallow, speech, language and voice associated with their medical condition.

Occupational Therapy in ICU

The main roles of the OT in ICU include:

  • Assessing the positioning and seating needs of patients. Do they need a chair with extra support?
  • To assess the appropriateness of early mobilisation of the critically ill patient i.e. are they safe for seating/are the safe to get out of bed.
  • To assess transfers and advise on safe transfer methods.
  • To provide intervention and guidance around limb positioning and contracture management as required.
  • To encourage independence with everyday tasks and link with the nursing staff with the patients plan.

The role of Chaplaincy in ICU

The Chaplaincy Department provide an invaluable multi-denominational pastoral service to our patients, relatives and staff. Please let us know if you would like to arrange a visit from a member of the Chaplaincy Department.

Further details on their service can be found HERE

Details of Religious Services can be found HERE

Research and Audit in the ICU

Research

Clinical research is fundamental to our department. We are participating in a number of multi-centre, randomised controlled trials in the area of critical care and anaesthesia. The research we conduct at Beaumont Hospital in conjunction with other key institutions and trial groups provides us with knowledge and expertise to deliver high standards of evidence based care for critically ill patients. Our research team are currently conducting research in the areas of Acute Respiratory Distress Syndrome (ARDS), sepsis, neuro critical care, Acute Kidney Injury (AKI), and post resuscitation care.

ICU Audit

GICU takes part in The National ICU Audit under the governance of NOCA- National Office of Clinical Audit.  The primary purpose of NOCA which is HSE funded is to establish sustainable clinical audit programmes at National level which will ultimately improve outcomes for Irish patients. Its aims include measuring the quality of care in Intensive care and benchmark this against other units in Ireland and the UK. It measures activity in GICU to aid the planning of Critical Care services locally and nationally.

Microbiology team in the ICU

Clinical microbiologists are doctors that specialise in diagnosing, preventing and treating infections.  The best way to improve conditions like sepsis is to manage patients with infection as quickly as possible. The ICU can contact a clinical microbiologist at any time, 24/7. This allows the critical care team to quickly access all urgent test results, and means that all ICU patients with infections get the correct antibiotics as soon as they are needed. 

Every day, a team of clinical microbiologists, doctors, nurses, and pharmacists review every patient in the ICU. This special review team monitors infections, and makes a treatment plan for each individual patient. 

When reviewing a patient, the microbiology team look at:

  • Results from any samples sent to the microbiology laboratory (such as blood, urine, and swabs from wounds)
  • Scans (such as x-ray and CT images)
  • Specific signs which show the body’s response to infection (such as an increased temperature, or an increase in certain cells or chemicals in the blood)

After reviewing the patient, the team decides on a management plan for each patient. Treatments may include antibiotics and more tests to monitor the infection and guide further decisions. 

The clinical microbiologists also provide advice on controlling infection. For example, during 'flu' season, they give advice on how to prevent the spread of ‘flu’. This might mean moving a patient to a single room, or that staff wear extra protective clothing like a face mask. This helps prevent the spread of infections to other patients.

Clinical microbiologists have an important role in patient safety and infection prevention and control in critical care. This includes:

  • Monitoring and preventing infections which develop in the ICU. Such as bloodstream infection, central line infection and ventilator-associated pneumonia
  • Promotion of hand hygiene
  • Appropriate use of antibiotics

Who are the clinical microbiologists?

  • Prof. Edmond Smyth
  • Prof. Hilary Humphreys
  • Dr. Fidelma Fitzpatrick
  • Dr. Karen Burns
  • Dr. Binu Dinesh
  • Dr. Karina O Connell

Student Nurses in the ICU

From time to time student nurses from Dublin City University are mentored in the ICU. The following is the experience of a student nurse during her time in the ICU:

“As a student nurse I get the opportunity to shadow the nurses of ICU for a two-week placement. The aim of an ICU nurse is to provide care to a patient until they are well enough to be transferred to the ward where they will continue to be cared for. There are many people involved in the care of each patients, there are the nurses, the anaesthetist, the doctors and the surgeons when necessary. The ICU provides so many learning opportunities for students and the nurses are excellent and eager to provide us with opportunities to learn. The ICU nurses are brilliant and work hard throughout the day providing the best care possible for their patients. I am so grateful for the opportunity I was given to shadow the nurses as I have gained so much knowledge from them.” Amy Sheehan, Student Nurse