Strosberg M A, Teres D, Fein I A, Linsider R
Union College, Schenectady, NY 12308-2311.
Heart Lung. 1990 Sep;19(5 Pt 1):452-5.
The Joint Commission on the Accreditation of Healthcare Organizations and the Society of Critical Care Medicine call on the physician medical director of the intensive care unit (ICU) to play an important role in admission and discharge decision-making. To assess nursing perception of the medical director's involvement in this decision-making, we analyzed data from a questionnaire administered at an annual ICU management conference to ICU nursing supervisors representing 101 hospitals and 137 ICUs. We asked nurses if the medical director or his or her designee (excluding residents) was available at night for triage, admission decision-making, and conflict resolution. In 21% (29) of the ICUs, nurses perceived no medical director at all. In the 54 ICUs with full-time medical directors, nurses in approximately 30% of the units said that there was no nighttime availability of the medical director or designee. The data suggest that many ICUs lack physician leadership in ICU management and resource allocation.
医疗保健组织认证联合委员会和危重病医学会呼吁重症监护病房（ICU）的内科医疗主任在入院和出院决策中发挥重要作用。为了评估护士对医疗主任参与这一决策过程的看法，我们分析了在一次年度ICU管理会议上向代表101家医院和137个ICU的ICU护理主管发放的调查问卷数据。我们询问护士，医疗主任或其指定人员（不包括住院医师）在夜间是否可进行分诊、入院决策和解决冲突。在21%（29个）的ICU中，护士根本感觉不到有医疗主任。在设有全职医疗主任的54个ICU中，约30%的科室护士表示，医疗主任或其指定人员在夜间无法提供服务。数据表明，许多ICU在ICU管理和资源分配方面缺乏医师领导。
