'Critical need' for staffing plan for children's hospital intensive care units
A year before the children's hospital opens, there is a hike in numbers of sick children. Picture: NCH
A staffing plan for intensive care units at the new children’s hospital is urgently needed, with only a year to the expected opening and a steep increase in the number of sick children, a new audit advises.
The Irish Paediatric Critical Care Audit National Report also says the HSE should open more children’s high-dependency care units outside of Dublin.
There is currently only one, at University Hospital Limerick.
The audit looked at Ireland’s only paediatric critical-care units (PCCU) in CHI at Temple St and Crumlin hospitals and found the number of critical-care admissions rose by 14% in 2021 and 2022.
Bed occupancy rates were “consistently” above 95%, when 85% is the recommended maximum.
The National Children’s Hospital is expected to open by next summer, with a 42-bed critical-care unit which accepts children from Dublin and hospitals around the country.
This is 10 more beds than are now available.
Associate Professor Martina Healy, clinical lead of the Irish Paediatric Critical Care Audit, said there is a “critical need” for planning to have staff hired before the move to the new hospital.
“We are going to move to 42 beds from 32 beds, and the design is also different so we are going to have to look at a new way of staffing this safely," she said.
“In moving to a new hospital our most important concern is risk, and to reassure families that we are not moving from something that is safe to something that is less safe.”
A workforce plan should also cover paediatric critical-care consultants and trainees, she said.
“The data clearly indicate an urgent need for a detailed workforce plan to facilitate the opening of the National Children’s Hospital PCCU,” she added.
Prof Healy, consultant in paediatric critical care at Crumlin, said the audit found that “over half” the PCCU patients were transferred from other hospitals.
Among the recommendations are for the HSE to develop more regional paediatric high-dependency units which would allow children to have care, after surgery for example, near home.
“Limerick already has a high-dependency unit set up for the last number of years and it works really well,” she said.
She described this as “a model which is up and running“ for other hospitals.
The HSE already plans to expand regional surgical units for children, and the audit stresses critical care supports will be needed.
