We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving crit...

Goals of health care are patient safety and quality patient outcomes. Evidence based practice (EBP) is viewed as a tool to achieve these goals. Health care providers strive to base practice on evidence, but the literature identifies numerous challenges to implementing and sustaining EBP in nursing. An initial focus is developing an organizational culture that supports the process for nursing an...

To the Editor: Critical care is an expensive and labour-intensive undertaking, and it is well recognised that there is a global shortage of intensive care unit (ICU) beds.1 Although there are no recent published data regarding the cost of ICU care, total costs were estimated to exceed R2 000 per patient per day in 1991.2 Despite the cost, it is widely accepted that patients refused ICU admissio...

Bacteremia due to multiply-antibiotic-resistant Serratia marcescens occurred within 1 week in four patients who were in adjacent beds in an intensive care unit. The strains were serotyped as O14:H12 and were nitrate negative. This unusual biochemical marker was useful in the investigation of the outbreak.

We investigated the incidence of cases of nosocomial pathogens and risk factors in an intensive treatment unit ward to determine if the number of cases is dependent on location of patients and the colonization/infection history of the ward. A clustering approach method was developed to investigate the patterns of spread of cases through time for five microorganisms [methicillin-resistant Staphy...

INTRODUCTION Prior reports suggest that restrictive ICU visitation policies can negatively impact patients and their loved ones. However, visitation practices in US ICUs, and the hospital factors associated with them, are not well described. METHODS A telephone survey was made of ICUs, stratified by US region and hospital type (community, federal, or university), between 2008 and 2009. Hospit...

OBJECTIVES To determine the effect of the critical care outreach team on patient survival to discharge from hospital after discharge from critical care and readmission to critical care. DESIGN Non-randomised population based study. SETTING Tertiary referral teaching hospital with 1200 beds. PARTICIPANTS Patients discharged from the critical care unit after their first or only admission fo...

A long-term care hospital (LTCH) is a specialized facility for patients with serious health problems who require continuous and intensive care but not comprehensive diagnostic methods. LTCHs provide prolonged complex care and wound care in the period following the acute stage of disease. When intensive care unit (ICU) stay is prolonged in the United States of America, the patients may be transf...

BACKGROUND Intensive care unit (ICU) beds are scarce resources in low- and middle-income countries. Currently there is little literature that quantifies the extent of the demand placed on these resources or examines their allocation. OBJECTIVES To analyse the number and nature of referrals to ICUs in the Pietermaritzburg metropolitan area, South Africa, over a 1-year period, to observe the tr...

OBJECTIVE To quantify midlevel practitioner (MLP) staffing requirements based on the volume and complexity of patient care and the duty-hour constraints of the Accreditation Council for Graduate Medical Education 80-hour workweek. DESIGN Data extracted from Eclipsys Sunrise Decision Support Manager, the hospital financial budget, and census reports; and MLP, resident, and subspecialty fellow ...