Recommendations on Basic Requirements for Intensive Care Units: Structural and Organizational Aspects

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 2011 Sep 16

PMID 21918847

Citations 85

Authors

Andreas Valentin

Patrick Ferdinande

Affiliations

Soon will be listed here.

Abstract

Objective: To provide guidance and recommendations for the planning or renovation of intensive care units (ICUs) with respect to the specific characteristics relevant to organizational and structural aspects of intensive care medicine.

Methodology: The Working Group on Quality Improvement (WGQI) of the European Society of Intensive Care Medicine (ESICM) identified the basic requirements for ICUs by a comprehensive literature search and an iterative process with several rounds of consensus finding with the participation of 47 intensive care physicians from 23 countries. The starting point of this process was an ESICM recommendation published in 1997 with the need for an updated version.

Results: The document consists of operational guidelines and design recommendations for ICUs. In the first part it covers the definition and objectives of an ICU, functional criteria, activity criteria, and the management of equipment. The second part deals with recommendations with respect to the planning process, floorplan and connections, accommodation, fire safety, central services, and the necessary communication systems.

Conclusion: This document provides a detailed framework for the planning or renovation of ICUs based on a multinational consensus within the ESICM.

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References

. Guidelines for intensive care unit design. Guidelines/Practice Parameters Committee of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med. 1995; 23(3):582-8. View

Lecuyer L, Chevret S, Guidet B, Aegerter P, Martel P, Schlemmer B . Case volume and mortality in haematological patients with acute respiratory failure. Eur Respir J. 2008; 32(3):748-54. DOI: 10.1183/09031936.00142907. View

Pronovost P, Dang D, Dorman T, Lipsett P, Garrett E, Jenckes M . Intensive care unit nurse staffing and the risk for complications after abdominal aortic surgery. Eff Clin Pract. 2001; 4(5):199-206. View

Gurses A, Carayon P . Performance obstacles of intensive care nurses. Nurs Res. 2007; 56(3):185-94. DOI: 10.1097/01.NNR.0000270028.75112.00. View

Barry W, Rosenthal G . Is there a July phenomenon? The effect of July admission on intensive care mortality and length of stay in teaching hospitals. J Gen Intern Med. 2003; 18(8):639-45. PMC: 1494902. DOI: 10.1046/j.1525-1497.2003.20605.x. View

Landrigan C, Rothschild J, Cronin J, Kaushal R, Burdick E, Katz J . Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med. 2004; 351(18):1838-48. DOI: 10.1056/NEJMoa041406. View

Moreno R, Miranda D . Nursing staff in intensive care in Europe: the mismatch between planning and practice. Chest. 1998; 113(3):752-8. DOI: 10.1378/chest.113.3.752. View

. Fair allocation of intensive care unit resources. American Thoracic Society. Am J Respir Crit Care Med. 1997; 156(4 Pt 1):1282-301. DOI: 10.1164/ajrccm.156.4.ats7-97. View

Wunsch H, Angus D, Harrison D, Collange O, Fowler R, Hoste E . Variation in critical care services across North America and Western Europe. Crit Care Med. 2008; 36(10):2787-93, e1-9. DOI: 10.1097/CCM.0b013e318186aec8. View

10.

Duke G, Green J . Outcome of critically ill patients undergoing interhospital transfer. Med J Aust. 2001; 174(3):122-5. DOI: 10.5694/j.1326-5377.2001.tb143182.x. View

11.

Dimick J, Pronovost P, Heitmiller R, Lipsett P . Intensive care unit physician staffing is associated with decreased length of stay, hospital cost, and complications after esophageal resection. Crit Care Med. 2001; 29(4):753-8. DOI: 10.1097/00003246-200104000-00012. View

12.

Ramnarayan P, Thiru K, Parslow R, Harrison D, Draper E, Rowan K . Effect of specialist retrieval teams on outcomes in children admitted to paediatric intensive care units in England and Wales: a retrospective cohort study. Lancet. 2010; 376(9742):698-704. DOI: 10.1016/S0140-6736(10)61113-0. View

13.

Miranda D, Moreno R, Iapichino G . Nine equivalents of nursing manpower use score (NEMS). Intensive Care Med. 1997; 23(7):760-5. DOI: 10.1007/s001340050406. View

14.

Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P . Errors in administration of parenteral drugs in intensive care units: multinational prospective study. BMJ. 2009; 338:b814. PMC: 2659290. DOI: 10.1136/bmj.b814. View

15.

. Guidelines for training in intensive care medicine. European Society of Intensive Care Medicine. Intensive Care Med. 1994; 20(1):80-1. DOI: 10.1007/BF02425062. View

16.

Dang D, Johantgen M, Pronovost P, Jenckes M, Bass E . Postoperative complications: does intensive care unit staff nursing make a difference?. Heart Lung. 2002; 31(3):219-28. DOI: 10.1067/mhl.2002.122838. View

17.

Garland A . Improving the ICU: part 1. Chest. 2005; 127(6):2151-64. DOI: 10.1378/chest.127.6.2151. View

18.

Iapichino G, Radrizzani D, Bertolini G, Ferla L, Pasetti G, Pezzi A . Daily classification of the level of care. A method to describe clinical course of illness, use of resources and quality of intensive care assistance. Intensive Care Med. 2001; 27(1):131-6. DOI: 10.1007/s001340000776. View

19.

Minvielle E, Dervaux B, Retbi A, Aegerter P, Boumendil A, Jars-Guincestre M . Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire. J Crit Care. 2005; 20(2):126-38. DOI: 10.1016/j.jcrc.2004.12.003. View

20.

Hasin Y, Danchin N, Filippatos G, Heras M, Janssens U, Leor J . Recommendations for the structure, organization, and operation of intensive cardiac care units. Eur Heart J. 2005; 26(16):1676-82. DOI: 10.1093/eurheartj/ehi202. View