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Background Critical care survivors face physical, psychological and socio-economic burdens. Peer support is acknowledged as a way individuals can face, accept and overcome the challenges arising from a stressful event. We sought to examine the provision and benefits of peer support to critical care survivors in the UK. Method We distributed a survey, devised by the patients and relatives committee of the Intensive Care Society and ICUsteps, to contacts in 163 UK Trusts/hospitals with critical care departments. The benefit to individuals was assessed by seeking the views of attendees of two support groups. Results A response was received from 91 (56%) of the critical care departments. Of these, 46 (48% of respondents) have patient support groups. Our analysis of comments from 30 people is that support groups greatly benefit service users and staff. Conclusions Attendees of patient support groups gave highly positive comments about the service yet provision of patient support groups in the UK is not universal. Recommendations We make a series of recommendations for consideration by UK health care providers.

The car parks at the study hospital are accessed using re-usable, machine-read tickets. In the initial phase of this study, 598 staff members were observed entering the car park, and 21.6% of them put their parking ticket in their mouth. Ultraviolet dye was used to demonstrate card-to-card cross-contamination. Swabs of the ticket machine yielded commensal bacteria: coagulase-negative staphylococci and a Bacillus sp. After placing a poster on the ticket-reading machine highlighting the potential risk of infection, a further 1366 observations demonstrated a significant and persistent decline in the proportion of staff who put their ticket in their mouth (P

Payment by Results (PbR) is a system of paying for health care. It is linked to activity and adjusted for case-mix. This article explores the background to PbR for critical care, explains some of the terminology and looks at the implications of its planned introduction in 2011/12.

Patients undergoing major orthopaedic surgery are at risk of developing postoperative hypotension. In the majority of cases this is secondary to hypovolaemia. In an attempt to ensure prompt treatment of such hypotension, a multidisciplinary group from the Chesterfield Royal Hospital worked together to produce a patient group direction (PGD), that would allow nurses to administer fluid boluses. This was piloted for 3 months on three orthopaedic wards. During the pilot period, the PGD was used 14 times. The average increase in systolic blood pressure following a fluid bolus was 18.7 mm Hg. Only one patient did not respond. None of the patients suffered complications as a result of the fluid bolus(es). Early indications are that this initiative appears to be a safe and effective way of empowering nurses to treat early signs of physiological deterioration. This PGD could be easily adapted for use in other surgical specialities.