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Intensive care units (ICUs) almost always include nurses, intensivists, respiratory therapists, and pharmacists. However, staffing composition and team involvement in rounds show significant variation across U.S. adult ICUs, highlighting diverse interdisciplinary healthcare worker (HCW) team structures.

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Area of Science:

  • Critical Care Medicine
  • Healthcare Management
  • Health Services Research

Background:

  • There is limited data and no consensus on the composition of interdisciplinary healthcare worker (HCW) teams in intensive care units (ICUs).
  • Understanding pre-pandemic ICU staffing is crucial for establishing baseline models and identifying areas for improvement.

Purpose of the Study:

  • To define the composition and variability of HCW staffing in U.S. adult ICUs prior to the COVID-19 pandemic.
  • To analyze the presence and participation of various HCW types in daily ICU care and formal clinical rounds.

Main Methods:

  • A national survey of 574 adult ICUs assessed the availability and participation of 11 HCW types in care and rounds.
  • Data were analyzed descriptively to identify predominant and diverse staffing patterns.
  • HCW types were grouped into six categories for analysis, with bedside nurses included in both availability and rounds.

Main Results:

  • A core team of bedside nurses, intensivists, respiratory therapists, and pharmacists was available in most ICUs (88%).
  • Significant variability existed in the full team composition, with 28 different combinations of six HCW groupings identified.
  • Nearly all ICUs (96%) held interprofessional rounds at least five days a week, often including weekends, though participation varied by HCW type.

Conclusions:

  • Intensive care unit (ICU) care consistently involves a core team of bedside nurses, intensivists, respiratory therapists, and pharmacists.
  • Beyond this core, the presence of other healthcare worker (HCW) types demonstrates considerable variability in ICU staffing.
  • Interprofessional rounds are a common practice in ICUs, with most conducting them daily and many including weekend sessions.