Intensive care unit staffing
Intensive care staffing is a pure organizational issue in health care service. It will be important to understand the impact of ICU physician and nurse staffing on patients’ outcome. o Intensivists
Intensivists are board-certified physicians who are subspecialized in Critical Care Medicine. Staffing ICU by intensivists lowers the resources abuse since they reduce inappropriate admission and prevent complications that prolong the ICU stay. Sakr Y et al 2015
According to the ICU physician staffing, the ICU is classified into:
1. Closed ICU
The patient is admitted to the ICU and intensivist is responsible for the patient and his treatment.
2. Mandatory critical care consultation-Open icu
Every patient admitted
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Franzini L et al 2011
Providing specialized rehabilitative care to ICU patients during their recovery period.
Presenting an attentive care to the dying and their families and alleviate the patients’ suffering during their final hours.
All these includes the availability of services at the proper time, with well-trained operators using a well-designed ICU including portable X-rays ,laboratory, ultrasound, ECG, ABG analyzer, Echocardiography, bronchoscope at emergency situations, night time pharmacy and clinical pharmacists. Haerkens M et al 2012
ICU telemedicine [tele-ICU]
ICU staffing by intensivists has been associated with lower morbidity and mortality that’s why experts recommend that intensivists care for ICU patients. Tele ICU technology allows intensivists to remotely care for patients in several ICUs. Although remote monitoring is expensive but it is widely used to cover the shortage of intensivists. Reynolds H and Bander J (2015)
Tele-ICUs are networks of audio-visual communication and computer systems
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Kumar G et al 2013 http://avcx.net/website/wp-content/uploads/2012/10/prod5.jpg
Tele-ICU benefits:
It reduces ICU LOS which leads to fewer patient complications and lowers the resources consumption. Wilcox M and Adhikari N (2012)
The improved productivity of clinical staff is an important benefit. The electronic information systems reduce staff time spent in both charting and delivering care.
It compensates for the shortage of intensivists. Kahn J et al 2014
ICU design:
Healthcare providers have little experience designing an (ICU). Hospitals undertake ICU construction for many reasons: to adapt to changing patient demographics or disease patterns; to upgrade or add services; and to accommodate changes in the flow of information, materials, or patients. The Facility Guidelines