Evaluating daily nursing use and needs in the intensive care unit: a method to assess the rate and appropriateness of ICU resource use.
Health Policy
; 73(2): 228-34, 2005 Aug.
Article
em En
| MEDLINE
| ID: mdl-15978965
ABSTRACT
BACKGROUND:
We designed a tool to measure the rate and appropriateness of intensive care unit (ICU) nursing coverage as a proxy for the use of resources.METHODS:
We tested the tool in 32 Italian ICUs during a cross-sectional study (4 days/week, October 2001 and April 2002). The level of care was classified as high or low. The appropriate patient-to-nurse ratio for both levels (2/1 and 3/1 in this ICU mix) was defined. The provided and theoretical nurse assistance was computed, the difference between the two quantifying the ICU use of personnel a positive difference means over-utilization, a negative one under-utilization. We calculated the maximum number of high-level and low-level care days available for ICU and the relative utilization rates. These two rates quantify the appropriateness of resource use in relation to the planned use.RESULTS:
Analysing 5783 treatment-days, the tool identified units using almost all available resources (five), overcrowded (14 too small units) or empty (16 too big). Units were overcrowded on account of the high-level of care required (five utilization rate >100%) or reallocated too much of their residual high-care nursing capacity to low-level care (six). In empty units both utilization rates were lower than expected.CONCLUSIONS:
The method quantifies the rate and appropriateness of resource usage and suggests the best management in units with fixed human resources or a fixed number of beds.
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Base de dados:
MEDLINE
Assunto principal:
Necessidades e Demandas de Serviços de Saúde
/
Unidades de Terapia Intensiva
/
Cuidados de Enfermagem
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Health Policy
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SAUDE PUBLICA
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Itália