Intensive Care Unit

Introduction
Located on the first floor of main hospital building, the Intensive Care Unit (ICU) is 11-bed adult and 3-bed Paediatric Intensive Care Unit (PICU) provides care to all adult and paediatric patients who have a variety of medical/surgical diagnoses requiring intensive care. The diagnoses include respiratory failure, sepsis, liver failure, renal failure, multi-system organ failure, GI bleeding, diabetic ketoacidosis, drug overdose, cancer, stroke, MI, arrhythmias, cardiopulmonary arrest. ICU accommodates patients of all services, who require mechanical Ventilator Support. The facility has state-of-the-art equipment including ventilators, invasive hemodynamic monitoring systems and hemodialysis.

Patients in ICU require 1:1 nursing care. They need continuous cardiac monitoring, frequent nursing and ancillary service intervention, and other specialised equipment and/or procedures such as intubation, mechanical ventilation, hemodynamic monitoring, and titration of vasoactive medications, Sedation and relaxant, transfusion of blood products, defibrillation, post operative care and pain management.

ICU uses a multidisciplinary approach to patient care. The ICU multidisciplinary team is responsible for assessing patient needs, planning and coordinating interventions to meet those needs. ICU is run by two teams of doctors under Department of Anaesthesia and Department of Medicine. Doctors from the two teams are responsible for assessing patient's needs, planning and coordinating interventions to meet patient needs. Doctors conduct their rounds with nurses and pharmacist. Physiotherapist will make assessment on patients and attend to their needs daily. They will liaise with the attending ward physician should there be a need to discuss on patient's line of treatment. Dieticians are also consulted on regular basis.

A full cadre of support services and specialty clinical services are available. These services are available through referrals from the multidisciplinary team, usually within 24 hours of request. These services and the multidisciplinary team assess appropriateness and clinical necessity of services on an ongoing basis.

The unit is open and staffed 24 hours a day, 7 days a week. The patients receive 1:1 nursing care depending on their acuity. The nursing staffs consist of Registered Nurse (Nurse Manager, Clinical Nurse specialist, Head Nurse, Clinical Nurse Instructor and Staff Nurse), Enrolled Nurse, Patient Care Assistant and Health Care Attendant. They work 8 hours rotational shifts. All registered nurses are Basic Cardiac and Life Support (BCLS) certified and they undergo re-certification every two years. All staff also completes an orientation to the ICU and under CBO for three months for credential purpose. All consultants and associate consultants are accredited.

Performance indicators are used to assess and improve important functions and processes of patient care. Inpatient feedback data i.e. patient satisfaction survey also provide information on meeting patient needs and expectations. Established treatment parameters (protocols) are initiated after the patient's needs are assessed. The department also monitors the following quality improvement indicators:

• Accidental extubation
  
• Skin breakdown (bedsores in ICU during hospital stay)
  
• Average length of stay
  
• Patient mortality
  
• Delay in transfer of patients to SCU​​​