Department of Health Studies, University of South Africa, Pretoria, South Africa.
J Nurs Manag. 2015 Oct;23(7):945-53. doi: 10.1111/jonm.12240. Epub 2014 Jun 16.
To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU).
The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise.
Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa.
Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses.
ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified.
This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs.
阐明加强大型重症监护病房（ICU）可持续管理的必要性，并提出相关策略。
南非重症监护护理所面临的挑战已得到充分记录。然而，似乎没有策略可以帮助护士管理大型 ICU，也没有 ICU 管理者在出现问题时的应对策略。
为说明策略的必要性，本文使用 ICU 管理者在管理大型 ICU 时所面临的挑战作为数据来源。在收集关于管理大型 ICU 所面临挑战的证据时，我们对管理者进行了个体访谈，并将其中有代表性的管理者纳入其中。这些挑战在 2012 年 8 月 28 日至 9 月 2 日于南非西北省太阳城举行的南非南部非洲危重病学会大会上进行了阐述。
针对所确定的挑战，提出了五项策略：将单位划分为多个部分；培养一支高技能、高效率的护理队伍，以确保提供优质的护理服务；营造文化，留住一支高效的 ICU 护理团队；资产管理；以及确定 ICU 护士的需求。
ICU 需要采取措施推动所需策略的实施，以持续改进单位的管理。未来的研究应致力于调查所确定策略的有效性。
本研究强调了与大型 ICU 相关的问题，这些策略将有助于 ICU 管理者应对与大型单位规模、缺乏经过培训的 ICU 护士、使用代理护士、设备和用品短缺以及 ICU 压力源相关的问题。本文将为 ICU 管理护理文献提供一定的贡献。
