创建和扩大混合患者中期护理单位,以提高ICU容量
Emmett A Kistler1,2, Elaine Klatt1, Jesse D Raffa3
1Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Critical care explorations
|October 23, 2023
概括
一个中间护理单位 (IMC) 显著增加了重症监护室 (ICU) 病床容量,释放了1023个病床. 这一举措在高需求时期提供了至关重要的支持,证明IMC是管理重症监护资源的有价值策略.
科学领域:
- 关键护理医学 关键护理医学
- 医院运营管理 医院运营管理
- 医疗保健系统工程 系统工程
背景情况:
- 重症监护室 (ICU) 的容量压力与患者的治疗结果较差有关.
- 中级护理单位 (IMC) 通过管理中级敏度的患者,为卸载ICU提供了潜在的解决方案.
- IMCs对ICU容量的具体影响还没有得到很好的描述.
研究的目的:
- 描述建立一个医疗外科中间护理单位 (IMC) 的情况.
- 评估IMC对重症监护室 (ICU) 容量的影响.
- 评估IMC中的患者结果和资源利用情况.
主要方法:
- 一份描述性报告,使用回顾性队列审查.
- 这项研究是在一个拥有673张床位的三级医疗学术医疗中心进行的,该中心有77张ICU床位.
- 一个跨学科的团队在一个普通病房建立了IMC,由医院医生和外科医生组成,在重症监护顾问的支持下. 招生标准演变为包括先进的非侵入性呼吸辅助.
主要成果:
- 在2021年8月至2022年7月期间,产生了超过1023个ICU病床日,其中230名患者入院IMC.
- 在IMC入院的首要指示是医疗患者的呼吸支持和手术患者的术后护理.
- 只有8%的患者需要在48小时内转移到重症监护室;输管 (2%) 和死亡 (1%) 不常见.
结论:
- 一个中期护理单位 (IMC) 可以大大增加重症监护室 (ICU) 的病床容量,即使每天进行了适度的普查.
- 在需求高峰时期,IMC在增加重症监护资源的可用性方面被证明是有效的.
- 医院医疗中心是优化医院资源配置和管理ICU容量的可行战略.
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