Department of Intensive Care, Austin Health, 145 Studley Rd, Heidelberg, Melbourne, Victoria, Australia.
School of Nursing and Midwifery, Monash University, Wellington Rd, Clayton, Melbourne, Victoria, Australia.
Aust Crit Care. 2023 Jan;36(1):84-91. doi: 10.1016/j.aucc.2022.12.001. Epub 2022 Dec 12.
BACKGROUND: The COVID-19 pandemic demanded intensive care units (ICUs) globally to expand to meet increasing patient numbers requiring critical care. Critical care nurses were a finite resource in this challenge to meet growing patient numbers, necessitating redeployment of nursing staff to work in ICUs. OBJECTIVE: Our aim was to describe the extent and manner by which the increased demand for ICU care during the COVID-19 pandemic was met by ICU nursing workforce expansion in the late 2021 and early 2022 in Victoria, Australia. METHODS: This is a retrospective cohort study of Victorian ICUs who contributed nursing data to the Critical Health Information System from 1 December 2021 to 11 April 2022. Bedside nursing workforce data, in categories as defined by Safer Care Victoria's pandemic response guidelines, were analysed. The primary outcome was 'insufficient ICU skill mix'-whenever a site had more patients needing 1:1 critical care nursing care than the mean daily number of experienced critical care nursing staff. RESULTS: Overall, data from 24 of the 47 Victorian ICUs were eligible for analysis. Insufficient ICU skill mix occurred on 10.3% (280/2725) days at 66.7% (16/24) of ICUs, most commonly during the peak phase from December to mid-February. The insufficient ICU skill mix was more likely to occur when there were more additional ICU beds open over the 'business-as-usual' number. Counterfactual analysis suggested that had there been no redeployment of staff to the ICU, reduced nursing ratios, with inability to provide 1:1 care, would have occurred on 15.2% (415/2725) days at 91.7% (22/24) ICUs. CONCLUSION: The redeployment of nurses into the ICU was necessary. However, despite this, at times, some ICUs had insufficient staff to cope with the number and acuity of patients. Further research is needed to examine the impact of ICU nursing models of care on patient outcomes and on nurse outcomes.
背景：COVID-19 大流行要求全球的重症监护病房（ICU）扩大规模，以满足对重症护理需求不断增加的患者数量。在满足不断增加的患者数量的挑战中，重症监护护士是一种有限的资源，这需要重新部署护理人员到 ICU 工作。
目的：我们的目的是描述在澳大利亚维多利亚州，2021 年末至 2022 年初 COVID-19 大流行期间，通过 ICU 护理人员的扩充来满足 ICU 护理需求增加的程度和方式。
方法：这是一项对维多利亚州 ICU 的回顾性队列研究，这些 ICU 向 Critical Health Information System 提供了 2021 年 12 月 1 日至 2022 年 4 月 11 日期间的护理数据。根据 Safer Care Victoria 的大流行应对指南的定义，对床边护理人员数据进行了分析。主要结果是“ICU 技能组合不足”-在任何时候，当一个站点的患者需要比平均每日经验丰富的重症护理护理人员数量更多的 1:1 重症护理时。
结果：总体而言，来自维多利亚州 47 个 ICU 中的 24 个符合分析条件。在 24 个 ICU 中的 66.7%（16/24），共有 10.3%（280/2725）的日子出现 ICU 技能组合不足，最常见于 12 月至 2 月中旬的高峰期。当 ICU 开放的额外床位数量超过“正常情况下”时，ICU 技能组合不足的可能性更大。反事实分析表明，如果没有将员工重新部署到 ICU，那么在没有重新部署员工的情况下，护理比例将会降低，无法提供 1:1 的护理，在 91.7%（22/24）的 ICU 中，这种情况将在 15.2%（415/2725）的日子里发生。
结论：将护士重新部署到 ICU 是必要的。然而，尽管如此，有时一些 ICU 的人员不足，无法应对患者的数量和病情的严重程度。需要进一步研究 ICU 护理模式对患者结局和护士结局的影响。
J Nurs Manag. 2022-7
Int J Nurs Stud. 2014-5
Intensive Crit Care Nurs. 2023-8
Rev Bras Enferm. 2025-6-27
Zotero 插件
