Standards for High Dependency Units
An HDU is a specially staffed and equipped section of an ICU complex that provides a care between that of ICU and general ward care. Patients in an HDU:
This covers the prescribed CICM standards for a HDU. Standards for an ICU are covered under Standards for Intensive Care Units - many HDU standards are shared with that of a level II ICU.
- Generally have single-organ failure
- Are at high risk of complications
- May be admitted as step-down from ICU or directly from another area of the hopsital
Requirements
Operational
- Geographically part of ICU
- Operationally linked to a level II or III ICU
- Have all patients under an ICU specialist
- Have defined policies for admission, discharge, management, and referral
- Have 24-hour access to ICU and the other requirements of a level II ICU
- A process for formal audit
- Infection control procedures
- Clerical support
Staffing
- FCICM as director
- ⩾1 other FCICM
- Adequate specialist cover
- ⩾50% of senior nurses having additional ICU or HDU qualification
- Nursing ratio of 1:2
- ⩾2 units in the unit when there is a patient present
Structure
- ⩾4 beds
- ⩾16m2/bedspace
- Adequate outlets
- 2 oxygen
- 1 air
- 2 suction
- 12 power points
- May share staff, education, and office space with the ICU
Equipment
Must include:
- Appropriate monitoring
- Hand ventilator
- Suction
- Airway equipment
- Vascular access equipment
- Defibrillator
- Temperature control equipment
- ICC equipment
- Infusion pumps
- Portable transport equipment
- Specialised beds
- Non-invasive ventilator
- Mechanical ventilator
1 available, access to a second.
Training
Trainees in a HDU:
- Can count training time when rostered to an HDU from accredited ICU
- Must work an appropriate amount of time in an ICU