Nawaz Faisal A, Deo Neha, Surani Salim, Maynard William, Gibbs Martin L, Kashyap Rahul
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates.
Department of Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN 55905, United States.
World J Crit Care Med. 2022 May 9;11(3):169-177. doi: 10.5492/wjccm.v11.i3.169.
There is variability in intensive care unit (ICU) resources and staffing worldwide. This may reflect variation in practice and outcomes across all health systems.
To improve research and quality improvement measures administrative leaders can create long-term strategies by understanding the nature of ICU practices on a global scale.
The Global ICU Needs Assessment Research Group was formed on the basis of diversified skill sets. We aimed to survey sites regarding ICU type, availability of staffing, and adherence to critical care protocols. An international survey 'Global ICU Needs Assessment' was created using Google Forms, and this was distributed from February 17, 2020 till September 23, 2020. The survey was shared with ICU providers in 34 countries. Various approaches to motivating healthcare providers were implemented in securing submissions, including use of emails, phone calls, social media applications, and WhatsApp™. By completing this survey, providers gave their consent for research purposes. This study was deemed eligible for category-2 Institutional Review Board exempt status.
There were a total 121 adult/adult-pediatrics ICU responses from 34 countries in 76 cities. A majority of the ICUs were mixed medical-surgical [92 (76%)]. 108 (89%) were adult-only ICUs. Total 36 respondents (29.8%) were 31-40 years of age, with 79 (65%) male and 41 (35%) female participants. 89 were consultants (74%). A total of 71 (59%) respondents reported having a 24-h in-house intensivist. A total of 87 (72%) ICUs were reported to have either a 2:1 or ≥ 2:1 patient/nurse ratio. About 44% of the ICUs were open and 76% were mixed type (medical-surgical). Protocols followed regularly by the ICUs included sepsis care (82%), ventilator-associated pneumonia (79%); nutrition (76%), deep vein thrombosis prophylaxis (84%), stress ulcer prophylaxis (84%), and glycemic control (89%).
Based on the findings of this international, multi-dimensional, needs-assessment survey, there is a need for increased recruitment and staffing in critical care facilities, along with improved patient-to-nurse ratios. Future research is warranted in this field with focus on implementing appropriate health standards, protocols and resources for optimal efficiency in critical care worldwide.
全球重症监护病房（ICU）的资源和人员配备存在差异。这可能反映了所有卫生系统在实践和结果方面的差异。
为了改进研究和质量改进措施，行政领导可以通过在全球范围内了解ICU实践的性质来制定长期战略。
全球ICU需求评估研究小组基于多样化的技能组合组建。我们旨在就ICU类型、人员配备情况以及对重症护理协议的遵守情况对各机构进行调查。使用谷歌表单创建了一项国际调查“全球ICU需求评估”，并于2020年2月17日至2020年9月23日进行分发。该调查与34个国家的ICU提供者分享。在确保提交方面实施了各种激励医疗保健提供者的方法，包括使用电子邮件、电话、社交媒体应用程序和WhatsApp™。通过完成这项调查，提供者同意将其用于研究目的。本研究被认定符合2类机构审查委员会豁免状态。
来自76个城市34个国家的成人/成人-儿科ICU共收到121份回复。大多数ICU为内科-外科混合类型[92个（76%）]。108个（89%）是仅收治成人的ICU。共有36名受访者（29.8%）年龄在31至40岁之间，男性参与者79名（65%），女性参与者41名（35%）。89名是顾问（74%）。共有71名（59%）受访者报告有一名24小时在岗的重症监护医生。据报告，共有87个（72%）ICU的患者与护士比例为2:1或≥2:1。约44%的ICU是开放式的，76%是混合类型（内科-外科）。ICU经常遵循的协议包括脓毒症护理（82%）、呼吸机相关性肺炎（79%）；营养（76%）、深静脉血栓预防（84%）、应激性溃疡预防（84%）和血糖控制（89%）。
基于这项国际多维度需求评估调查的结果，重症监护设施需要增加招聘和人员配备，并改善患者与护士的比例。该领域未来的研究很有必要，重点是在全球范围内实施适当的卫生标准、协议和资源，以实现重症监护的最佳效率。
