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Pandemic influenza and excess intensive-care workload.

Nap RE, Andriessen MP, Meessen NE, Miranda Ddos R, van der Werf TS - Emerging Infect. Dis. (2008)

Bottom Line: Using various published scenarios, we estimate their effect in increasing the availability of healthcare workers for duty during a pandemic.We show that even during the peak of the pandemic, all patients requiring hospital and ICU admission can be served, including those who have non-influenza-related conditions.For this rigorous task differentiation, clear hierarchical management, unambiguous communication, and discipline are essential and we recommend informing and training non-ICU healthcare workers for duties in the ICU.

View Article: PubMed Central - PubMed

Affiliation: University of Groningen, Groningen, The Netherlands. r.e.nap@rvb.umcg.nl

ABSTRACT
In The Netherlands a major part of preparedness planning for an epidemic or pandemic consists of maintaining essential public services, e.g., by the police, fire departments, army personnel, and healthcare workers. We provide estimates for peak demand for healthcare workers, factoring in healthcare worker absenteeism and using estimates from published epidemiologic models on the expected evolution of pandemic influenza in relation to the impact on peak surge capacity of healthcare facilities and intensive care units (ICUs). Using various published scenarios, we estimate their effect in increasing the availability of healthcare workers for duty during a pandemic. We show that even during the peak of the pandemic, all patients requiring hospital and ICU admission can be served, including those who have non-influenza-related conditions. For this rigorous task differentiation, clear hierarchical management, unambiguous communication, and discipline are essential and we recommend informing and training non-ICU healthcare workers for duties in the ICU.

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Related in: MedlinePlus

A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in the intensive care unit (ICU) scenario 2, healthcare worker (HCW) 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in the ICU scenario 2, HCW 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 14 wk).
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Figure 2: A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in the intensive care unit (ICU) scenario 2, healthcare worker (HCW) 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in the ICU scenario 2, HCW 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 14 wk).

Mentions: If the number of HCWs who become ill from ILI is reduced by 80%, a similar increase of deliverable NEMS points is achieved. This increase is irrespective of the number of patients admitted to the hospital and ICU. In Figure 2, panels A and B, results are given for the models with a 15-day length of stay, 25% and 50% ICU admission rate, with and without AVM. In this model, the effect of potential HCW staff shortage is most profound at a 50% ICU admission rate. Even decreasing the number of ill HCWs because of 8 weeks’ prophylactic use of neuraminidase inhibitors (22) does not solve staff shortage when it is most needed.


Pandemic influenza and excess intensive-care workload.

Nap RE, Andriessen MP, Meessen NE, Miranda Ddos R, van der Werf TS - Emerging Infect. Dis. (2008)

A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in the intensive care unit (ICU) scenario 2, healthcare worker (HCW) 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in the ICU scenario 2, HCW 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 14 wk).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2609860&req=5

Figure 2: A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in the intensive care unit (ICU) scenario 2, healthcare worker (HCW) 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in the ICU scenario 2, HCW 8 wk prophylactic use of neuraminidase inhibitors (pandemic period 14 wk).
Mentions: If the number of HCWs who become ill from ILI is reduced by 80%, a similar increase of deliverable NEMS points is achieved. This increase is irrespective of the number of patients admitted to the hospital and ICU. In Figure 2, panels A and B, results are given for the models with a 15-day length of stay, 25% and 50% ICU admission rate, with and without AVM. In this model, the effect of potential HCW staff shortage is most profound at a 50% ICU admission rate. Even decreasing the number of ill HCWs because of 8 weeks’ prophylactic use of neuraminidase inhibitors (22) does not solve staff shortage when it is most needed.

Bottom Line: Using various published scenarios, we estimate their effect in increasing the availability of healthcare workers for duty during a pandemic.We show that even during the peak of the pandemic, all patients requiring hospital and ICU admission can be served, including those who have non-influenza-related conditions.For this rigorous task differentiation, clear hierarchical management, unambiguous communication, and discipline are essential and we recommend informing and training non-ICU healthcare workers for duties in the ICU.

View Article: PubMed Central - PubMed

Affiliation: University of Groningen, Groningen, The Netherlands. r.e.nap@rvb.umcg.nl

ABSTRACT
In The Netherlands a major part of preparedness planning for an epidemic or pandemic consists of maintaining essential public services, e.g., by the police, fire departments, army personnel, and healthcare workers. We provide estimates for peak demand for healthcare workers, factoring in healthcare worker absenteeism and using estimates from published epidemiologic models on the expected evolution of pandemic influenza in relation to the impact on peak surge capacity of healthcare facilities and intensive care units (ICUs). Using various published scenarios, we estimate their effect in increasing the availability of healthcare workers for duty during a pandemic. We show that even during the peak of the pandemic, all patients requiring hospital and ICU admission can be served, including those who have non-influenza-related conditions. For this rigorous task differentiation, clear hierarchical management, unambiguous communication, and discipline are essential and we recommend informing and training non-ICU healthcare workers for duties in the ICU.

Show MeSH
Related in: MedlinePlus