Rehabilitation after critical illness: summary of NICE guidance

doi:10.1136/bmj.b822

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ education articles:

From

Limit by

The BMJ iPad app brings you the best of print and online, including live links to the latest news, blogs, video, and podcasts. Get the BMJ iPad app.
You can use bmj.com to help you with your continuing medical education. Find out about CME/CPD credits for BMJ articles
Keep up to date with cardiology: Access the latest cardiovascular medicine resources from across BMJ Group.
Countdown to London 2012: BMJ Group's Olympics portal highlights latest Olympics and sports medicine-themed research, comment and learning

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Toni Tan, technical analyst1,
Stephen J Brett, consultant in intensive care medicine2,
Tim Stokes, associate director1
on behalf of the Guideline Development Group

¹Centre for Clinical Practice, National Institute for Health and Clinical Excellence, Manchester M1 4BD
²Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS

Correspondence to: S Brett stephen.brett{at}imperial.ac.uk

Why read this summary?

More than 110 000 people are admitted to critical care units in England and Wales each year,1 of whom 75% survive to be discharged home. Many of these people experience considerable and persistent problems with physical, non-physical, and social functioning after discharge from critical care. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on rehabilitation after critical illness for adult general critical care patients.2

Recommendations

NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice and, in this guidance, also from lessons that can be derived from other clinically relevant fields of patient care. Evidence levels for the recommendations are given in italic in square brackets.

Key principles of care

To ensure continuity of care, healthcare professionals with the appropriate competencies should coordinate the patient’s rehabilitation care pathway. The healthcare professionals may be from intensive care or other services (including specialist rehabilitation medicine services) that have access to referral pathways and medical support (if not medically qualified). Key objectives of the coordination are:

To ensure that rehabilitation goals are reviewed, agreed, and updated throughout the patient’s rehabilitation care pathway
To ensure delivery and support of the structured and supported self directed rehabilitation manual (a specific type of rehabilitation programme),3 when applicable
To ensure that information, including documentation, is communicated to other relevant hospitals and to other rehabilitation services and primary care services
To ensure that patients have the contact details of the coordinating healthcare professional(s) on discharge from critical care and again on discharge from hospital.

[All the above recommendations are based on the experience and opinion of the Guideline Development Group (GDG)]