Common issues give us an uncommon opportunity to make our voices heard loud and clear

RACHEL BINKS, Chair of the RCN Critical Care Forum, provides the IFNA with an update of where our merged forums are headed.

The RCN Critical Care Steering Committee has been representing the voice of critical care nursing for many years in a wide range of national projects, including the Intensive Care Society's Standards Committee, UK Transplant, NCEPOD (National Confidential Enquiry into Patient Outcome and Death), Workforce Reference Group, and Equality and Diversity. We attend Congress every year and with our four votes help to shape and influence nursing policy and practice.

We very much look forward to merging with the In-Flight Nurses Association to expand our influence.

As we continue through 2009 I believe we can make the voice of critical care and in-flight nurses even louder. How can we do that? By involving as many people as possible in our forum activities. Make this the year you get involved - and indeed, how can you not when there are a host of issues still to be resolved!

Acute and Critical Care Quality Indicators

The Quality Indicators Group aims to produce guidance for commissioners for the quality standards and discussions that are taking place with the NPSA regarding the inclusion of indicators for medicine errors and infection control. The latter is likely to be informed by the NPSA's "'Matching Michigan" project, currently being piloted in the north east of England.

Resuscitation Council

Jerry Nolan is working on developing training materials and courses, and also participating with the Intensive Care National Audit and Research Centre (ICNARC) in the National Cardiac Arrest Audit. We hope there will be high uptake of the resuscitation data collection tool, but there is a cost attached to this. The aim of the audit is to identify the number of cardiac arrests, reduce the number of unexpected arrests and improve outcomes through monitoring and benchmarking the performance of trusts.

The Organ Donation Task Force

This work has now been separated from UK Transplant. Transplant co-ordinators are being appointed for each trust and donation committees are being established along with donation champions in all trusts. Early indications are that donation and referral rates are improving. Overall refusal rates remain at around 40 per cent, but where a patient is on the Organ Donation Register, the rate falls to around five per cent.

Neuroscience Stakeholder Group

Work on good practice guidance describing "what a good service looks like" is continuing. A draft workflow chart has been developed and is out for discussion.

Admission and discharge from critical care

The 1996 document on admission and discharge from critical care is being updated and it is suggested that this will fall into three areas:

Admission including the interface with other services, wards and so on.
Care within the critical care area - the Intensive Care Society (ICS) document on critical care quality indicators will almost certainly help with this.
Discharge interface and ongoing care on the ward. The recent NICE guideline on Rehabilitation of the critically ill (NICE CG83) will cover much of this.

Payment by Results

A PbR meeting took place in March, and reference costs have been received and are being analysed. It is proposed that there should not be a zero organ support HRG (healthcare resource group), the cost of this care being met at normal ward stay rates. Work is continuing on high cost drugs and blood products.

Levels of care

The ICS published the revised Levels of care document in March 2009. It was agreed that this was an improvement on the earlier document.

Critical care technologists

A staff training/competency accreditation document has been developed at St Mary's Hospital and is being taken away and widely adopted elsewhere.

ICNARC

The Annual Case Mix Programme meeting took place in April and was a great success. ICNARC is involved in a swine flu research project.

Independent sector

The transfer document is now completed and will be published and made available shortly. Guidance on bariatric care has been developed and will be out for consultation soon.

NOrF (National Outreach Forum)

The website is being revised. The AGM/annual meeting was on 1-2 October 2009.

Network Nurses

This group met in April and looked at organ donation, nurse training and single-sex accommodation.

Workforce

There remains a lot of interest in the critical care practitioner role, especially at advanced level, and Carole Boulanger (Royal Devon and Exeter) is supporting a number of hospitals with the development of this role.