Staffing

There should be clear leadership in the unit.

Staff should be specifically trained to look after critically ill patients, with continuing education to maintain knowledge and skills.

Ideally, there should be one trained nurse for every two patients, plus a nurse in charge and nursing assistants. This is not always achievable.

Doctors or medical officers, surgeons and anaesthetists should review their patients daily, or more frequently if required.

Physiotherapists should visit the unit at least daily.

Pharmacists and dieticians should also visit the unit if available.

Ideally daily multidisciplinary ward rounds should include doctors, nurses, physiotherapist, pharmacist, dietician and microbiologist.

Patients also benefit from access to occupational therapists, speech and language therapists and psychologists.

Teaching student nurses in Malawi Reproduced with permission of Kate Stephens