Strengthening critical care skills for COVID-19 patients

Case study: Cheryl-Ann Carr, Clinical Practice Educator, Imperial College Healthcare NHS Foundation Trust.

Background to learning

The COVID-19 pandemic has highlighted the need to respond appropriately to the increase in demand for critical care services across NHS trusts. Whether this has been caring for patients within intensive care units, or those on general medical or surgical wards, the nursing profession is recognised as fundamental to maintaining high standards of care, compassion and safety throughout this challenging time.

Nursing colleagues at Imperial College Healthcare NHS Foundation Trust led the introduction of a support, education and training approach for deployed staff to ensure critical care capacity was increased effectively across the organisation.

Learning and advice to be shared

The trust recognised the importance of strengthening critical care skills outside of the intensive care unit, offering rapid high-quality inductions for both redeployed, agency employed and returning colleagues. Nursing teams used a holistic approach to assess the support needs of new colleagues and they also involved medical and clinical specialist colleagues to broaden knowledge and skills offered during education sessions. Sessions have been delivered virtually, recognising the need to be socially distanced and flexible, with online elements included in packages such as introductions to ward processes, electronic patient record systems and other general documentation.

Joint working with clinical practice educators within ward teams also facilitated the rapid implementation of training for new starters for IV drug calculation competencies – an essential skill for caring for COVID-19 positive patients.

Following discussion at the Chief Nursing Officer’s national Shared Decision-Making Council on the 10 June 2020, other council members identified approaches and opportunities within their trusts for strengthening support to colleagues.

These included the use of specialist and senior nursing teams working ‘across floors’, deployed to support staff caring for patients with the respiratory symptoms that COVID-19 presented, as this was a particular challenge for those unfamiliar with them. Other council members identified approaches to supporting non-clinical colleagues, some of whom had been designated for family support and were working very differently and requiring different skill sets

The council felt that the use of methodical approaches to redeployment based upon skillsets and operational tools such as daily briefing were positive approaches.

Would it be beneficial to retain these changes?

Council members agreed that there were common challenges and some obvious benefits when working to support workforce changes such as these, and when delivered in a consistent and methodical way would offer rewards both to staff and patients across an organisation.

They suggested that beyond COVID-19, the approaches developed to support strengthening of critical care skills outside of intensive care might be:

  • Supporting a methodical and coordinated approach to redeployment, including a single point of access for education, training and support offers where available.
  • Utilising the wider multidisciplinary team to offer support to new staff, especially where specialist skills are required.
  • Use of documentation, such as nursing pandemic care plans, which include all aspects of care for patients with COVID-19. This may support with ensuring high quality documentation on general wards.

For further details on this case study or to connect with Cheryl-Ann, please email