Counties Manukau

ALISON PIRRET, NURSE PRACTTIONER (PRESCRIBING) INTENSIVE & HIGH DEPENDENCY CARE (ADULTS), COUNTIES MANAKAU DHB

Population: Patients in intensive care and acute care wards across Middlemore Hospital, who have evidence of, or potential for physiological instability.

Identified need: As Middlemore Hospital had 1.5 ICU beds per 100,000 population, the lowest in New Zealand, which on average has six ICU beds per 100,000 population, the hospital had ward patients, who in other hospitals in New Zealand would be in a HDU or ICU.

The NP role was implemented as an ICU outreach role to further support care of the physiologically unstable patient in the ward. The aims of the ICU outreach service are to avert ICU admission, enable timely ICU admission, enable ICU discharge by supporting continuity of recovery in the ward, and to share critical care skills with ward staff.

SERVICE DELIVERED

• Provides clinical assessment including clinical examination and ordering or performing of diagnostic tests, to identify diagnoses/problems, and implement an interdisciplinary plan of care.
• Provides direct links to the ICU medical consultant to enable timely admission to ICU if required.