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A prospective two‐month audit of the lack of provision of a high‐dependency unit and its impact on intensive care
Author(s) -
Ryan D. W.,
Bayly P. J. M.,
Weldon O. G. W.,
Jingree M.
Publication year - 1997
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1997.068-az0055.x
Subject(s) - medicine , intensive care unit , emergency medicine , audit , psychological intervention , intensive care , elective surgery , intensive care medicine , surgery , nursing , management , economics
All admissions into a six‐bedded intensive care unit were audited prospectively over a 2‐month period. Data were collected daily and classified according to criteria for intensive care or high‐dependency admission. There were 30 planned admissions (72 bed days) following elective major surgery, seven admissions following semi‐elective surgery (41 bed days) and 47 emergency admissions (185 bed days). Overall bed occupancy was 89%. Of 366 possible intensive care days, 66 (23%) were occupied by high‐dependency patients. Of the planned admissions all but five were discharged within 2 days. There were 39 major complications during the study period requiring life‐saving interventions and 16 lesser but significant complications. In 12% of patients discharge was delayed because of the absence of a high‐dependency unit. Four patients were transferred to an intensive care unit in another hospital and four patients were discharged prematurely because other patients required urgent admission. Seven patients were refused admission and three patients scheduled for elective operations had their surgery deferred. We estimate that over the study period 22 additional patients could have been cared for if a high‐dependency unit existed.