The online version of this article (doi:10.1186/1471-2253-14-76) contains supplementary material, which is available to authorized users.
The authors have declared that no competing interests exist.
Conceived and designed the study BCJS/CDD/GR, performed the study BCJS/CDD, analysed the data BCJS/CDD/FHMN/MP, wrote the paper BCJS/MP, all authors read and approved the final manuscript.
Improvement of appropriate bed use and access to intensive care (ICU) beds is essential in optimizing utilization of ICU capacity. The introduction of an intermediate care unit (IMC) integrated in the ICU care may improve this utilization.
In a before-after prospective intervention study in a university hospital mixed ICU, the impact of introducing a six-bed mixed IMC unit supervised and staffed by ICU physicians was investigated. Changes in ICU utilization (length of stay, frequency of mechanical ventilation use), nursing workload assessed byTISS-28 score, as well as inappropriate bed use, accessibility of the ICU (number of referrals), and clinical outcome indicators (readmission and mortality rates) were measured.
During 17 months, data of 1027 ICU patients were collected. ICU utilization improved significantly with an increased appropriate use of ICU beds. However, the number of referrals, readmissions to the ICU and mortality rates did not decrease after the IMC was opened.
The IMC contributed to a more appropriate use of ICU facilities and did result in a significant increase in mean nursing workload at the ICU.
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- Introducing an integrated intermediate care unit improves ICU utilization: a prospective intervention study
Barbara CJ Solberg
Carmen D Dirksen
Fred HM Nieman
Godefridus van Merode
- BioMed Central
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