Literature DB >> 8874297

Planning patient services for intermediate care units: insights based on care for intensive care unit low-risk monitor admissions.

J E Zimmerman1, D P Wagner, X Sun, W A Knaus, E A Draper.   

Abstract

OBJECTIVE: To describe the technology and nursing services that would be required to care for intensive care unit (ICU) low-risk monitor admissions in an intermediate unit.
DESIGN: Prospective, multicenter, inception cohort analysis.
SETTING: Forty U.S. hospitals with > 200 beds, including 26 hospitals that were randomly selected and 14 that volunteered for the study. PATIENTS: A sample of 8,040 ICU patients admitted to the ICU for monitoring, who received no active life-support treatment on ICU day 1.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Demographic, physiologic, and treatment information were obtained during ICU days 1 to 7. A previously validated multivariate equation was used to identify 6,180 monitor admissions at low (< 10%) risk for receiving active treatment during their entire ICU stay. We used daily Therapeutic intervention Scoring System (TISS) data to identify the equipment, type and amount of nursing care, and the types of active treatment that would have been used had these ICU patients been admitted to an intermediate care unit. Mean day-1 ICU TISS scores were as follows: 16.4 for all patients; 18.3 for surgical patients; and 13.5 for medical admissions. Concentrated nursing care accounted for 89% and technologic monitoring for 11% of day-1 TISS points. Surgical admissions had a 2.8-day mean ICU length of stay and received an average of 16.5 TISS points per patient per day. Medical admissions had a 2.7-day mean ICU length of stay and received an average of 12.3 TISS points per patient per day. Subsequent active life-support therapy was received by 4.4% of these ICU low-risk monitor admissions.
CONCLUSIONS: The services received by ICU low-risk monitor admissions provide insight regarding the equipment and nursing care that might be required, and the kinds of emergencies that might occur, if these patients were cared for in medical and surgical intermediate care units. Our data suggest that if ICU low-risk monitor patients were admitted to an intermediate care unit, they would mainly require concentrated nursing care (nurse/patient ratio of 1:3 to 1:4) and limited technologic monitoring.

Entities:  

Mesh:

Year:  1996        PMID: 8874297     DOI: 10.1097/00003246-199610000-00005

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  6 in total

1.  ["Surgical intermediate care unit" outcomes, facts and experiences after 5 years].

Authors:  Mohammad Tezval; Klaus Dresing; Karl Heinz Frosch; Dirk Hammel; Norbert Erichsen; Klaus Michael Stürmer
Journal:  Wien Med Wochenschr       Date:  2010-02

2.  Effects of intensivist coverage in a post-anaesthesia care unit on surgical patients' case mix and characteristics of the intensive care unit.

Authors:  Marc Kastrup; Matthes Seeling; Stefan Barthel; Andy Bloch; Marie le Claire; Claudia Spies; Matthias Scheller; Jan Braun
Journal:  Crit Care       Date:  2012-07-18       Impact factor: 9.097

3.  Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial: study protocol, rationale and feasibility of a randomised multicentre trial.

Authors:  Morten Vester-Andersen; Tina Waldau; Jørn Wetterslev; Morten Hylander Møller; Jacob Rosenberg; Lars Nannestad Jørgensen; Inger Gillesberg; Henrik Loft Jakobsen; Egon Godthåb Hansen; Lone Musaeus Poulsen; Jan Skovdal; Ellen Kristine Søgaard; Morten Bestle; Jesper Vilandt; Iben Rosenberg; Rasmus Ehrenfried Berthelsen; Jens Pedersen; Mogens Rørbæk Madsen; Thomas Feurstein; Malene Just Busse; Johnny D H Andersen; Christian Maschmann; Morten Rasmussen; Christian Jessen; Lasse Bugge; Helle Ørding; Ann Merete Møller
Journal:  Trials       Date:  2013-02-02       Impact factor: 2.279

4.  Do All Acute Stroke Patients Receiving tPA Require ICU Admission?

Authors:  Farid Sadaka; Amar Jadhav; Jacklyn O'Brien; Steven Trottier
Journal:  J Clin Med Res       Date:  2018-01-26

5.  Low Risk Monitoring in Neurocritical Care.

Authors:  Christian D Becker; Christian Bowers; Dipak Chandy; Chad Cole; Meic H Schmidt; Corey Scurlock
Journal:  Front Neurol       Date:  2018-11-06       Impact factor: 4.003

6.  Predictors and Direct Cost Estimation of Long Stays in Pediatric Intensive Care Units in Saudi Arabia: A Mixed Methods Study.

Authors:  Mohamad-Hani Temsah; Noura Abouammoh; Ayman Al-Eyadhy; Yazed AlRuthia; Marwah Hassounah; Fahad Alsohime; Ali Alhaboob; Mohammed Almazyad; Majed Alabdulhafid; Fadi Aljamaan; Khalid Alhasan; Amr Jamal
Journal:  Risk Manag Healthc Policy       Date:  2021-06-22
  6 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.