RT Book, Section
A1 Garland, Allan
A1 Gershengorn, Hayley Beth
A1 Manthous, Constantine A.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Kress, John P.
SR Print(0)
ID 1107710753
T1 Intensive Care Unit Staffing
T2 Principles of Critical Care, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738811
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107710753
RD 2024/04/23
AB Most  studies  addressing  staffing  of  ICUs  have  had  significant  limitations,  and  this  literature  does  not  yet  provide  a  consistent  view  of  the  best  model  to  use.  This  subject  is  complicated  by  the  fact  that  optimal  ICU  staffing  may  depend  on  ICU  characteristics.Despite  calls  for  all  ICUs  to  function  as  closed-model  units  with  intensivists  as  the  primary  physician  of  record,  evidence  supporting  this  view  is  contradictory.  Likewise,  studies  of  around-the-clock  intensivist  presence  have  not  consistently  shown  that  it  is  associated  with  superior  outcomes.The  data  do  not  supply  a  consistent  answer  to  the  question  of  whether  ICUs  would  obtain  better  outcomes  if  they  added  nurses  to  reduce  their  patient:nurse  ratios.Increasingly,  nonphysician  providers  are  playing  innovative  roles  in  the  ICU,  and  care  provided  by  teams  including  nurse  practitioners  or  physician  assistants  appears  to  be  safe  and  comparable  to  that  provided  by  other  staffing  models.The  conditions  of  ICU  staffing  will  continue  to  change  under  the  stresses  of  shortages  of  a  variety  of  health  care  workers  relevant  to  ICU  care,  and  increasing  duty  hour  limitations  for  physician  trainees.  Nonphysician  providers,  innovative  staffing  models,  telemedicine,  and  other  technologies  will  be  increasingly  used  to  cope  with  these  realities.Since  only  quantitative  evaluation  can  tell  us  whether  one  staffing  model  is  better  than  another,  we  need  more  research  from  multiple  sites  to  develop  a  consistent  and  integrated  understanding  of  this  complex  topic.