Pioneering Work in Intensive Care short listed for Award

5 April 2005

A nurse working in the intensive care unit at West Suffolk Hospital has introduced a pioneering initiative for critically ill patients to aid them in their recovery. It has been so successful that it has been shortlisted in an innovation competition run by Health Enterprise East.

Patients are usually sedated in the Intensive Care Unit (ICU) so have no recollection of their time there.  Sometimes this can cause psychological difficulties such as post-traumatic stress disorder as patients who can be in ICU for weeks struggle to fill the time gap.

Patient diaries were introduced to aid patients’ recovery. Nurses and relatives can write in a daily diary for the patient and it is offered to them when they awake to help them with the missing period.

Follow-Up Sister Denise Combe set up the diaries initiative after patients attending follow up clinics at the hospital said that the biggest difficulty they had was having no memory of their time in ICU. Denise got the idea after attending a medical conference where a doctor from Sweden described a similar initiative.

The daily diaries initiative is thought to be the first in the UK and Denise's paper appears in the current edition of the British Association of Critical Care Nurses journal.

Denise said: "Patients and relatives have said that it really helps them and it certainly helps the patient to appreciate just how seriously ill they were and to set realistic goals in their recovery.

"Everyone in the medical team writes in the diaries including nurses, doctors and physiotherapists. Relatives write about how they are feeling, when they visited, the latest football results or news from the patient's family. Sometimes the patient's children or grandchildren want to do something to help and they can draw photos or write letters to put in the diary. If the family agree we sometimes take photos of the patient in ICU to put into the diary. It really does help the patient put together a mental image of their time here."

Denise has now helped other nurses from other Trusts set up similar schemes.

This week Health Enterprise East announced that the initiative had been short listed in the "Service Delivery Category" of its annual innovation competition.

Elizabeth Godfrey, 71, who lives in Bury with her husband Robert, has found the diary "invaluable". A year ago, Elizabeth was rushed into intensive care following complications after an operation to treat septicaemia

For eight days Elizabeth was critically ill and her family worried whether she would pull through. Each day her husband, her daughters and sons, and her grandchildren wrote in the patient diary along with medical staff that cared for her.

She said: "I lost eight days of my life. But being able to look back through my diary has been of tremendous help.

"The medical staff wrote how they turned me and washed me and looked after me. My family wrote messages like 'keep up the fight mum'. Even my older grandchildren wrote in the diary.

"The first thing I remember when I came round was my daughter saying mummy you have been very ill. I spent a further three days in intensive care and was then transferred to a ward. The staff were marvelous and I cannot praise West Suffolk Hospital enough.

"A year on I feel fantastic and very very lucky to be alive. I am able to look back through my diary and see who visited me in intensive care and how the staff looked after me."

The winners of the Health Enterprise East innovation competition will be announced at an Awards Dinner in Cambridge on Wednesday (April 6).

West Suffolk Hospital will be competing against Epping Forest Primary Care Trust/North Essex Mental Health Partnership, Norfolk and Norwich University Hospital NHS Trust, and Thurrock Primary Care Trust. There were 163 entries in the competition.

The patient diaries initiative follows several other pioneering initiatives run by West Suffolk Hospital’s intensive care unit. The hospital was one of the first in the country to hold open evenings where former ICU patients and their families can meet and talk about their experiences.  West Suffolk is also one of the few hospitals to run follow up clinics where patients return to the hospital after two, six and 12 months after being in ICU so that a doctor, nurse and physiotherapist can assess their physical, psychological and social status.