Published in:
Open Access
01-12-2014 | Research article
Introducing an integrated intermediate care unit improves ICU utilization: a prospective intervention study
Authors:
Barbara CJ Solberg, Carmen D Dirksen, Fred HM Nieman, Godefridus van Merode, Graham Ramsay, Paul Roekaerts, Martijn Poeze
Published in:
BMC Anesthesiology
|
Issue 1/2014
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Abstract
Background
Improvement of appropriate bed use and access to intensive care (ICU) beds is essential in optimizing utilization of ICU capacity. The introduction of an intermediate care unit (IMC) integrated in the ICU care may improve this utilization.
Method
In a before-after prospective intervention study in a university hospital mixed ICU, the impact of introducing a six-bed mixed IMC unit supervised and staffed by ICU physicians was investigated. Changes in ICU utilization (length of stay, frequency of mechanical ventilation use), nursing workload assessed byTISS-28 score, as well as inappropriate bed use, accessibility of the ICU (number of referrals), and clinical outcome indicators (readmission and mortality rates) were measured.
Results
During 17 months, data of 1027 ICU patients were collected. ICU utilization improved significantly with an increased appropriate use of ICU beds. However, the number of referrals, readmissions to the ICU and mortality rates did not decrease after the IMC was opened.
Conclusion
The IMC contributed to a more appropriate use of ICU facilities and did result in a significant increase in mean nursing workload at the ICU.