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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 intensive-care unit (ICU) scenario 3, task differentiation in healthcare workers (HCWs) (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in ICU scenario 3, task differentiation in HCWs (pandemic period 14 wk).
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Figure 3: A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in intensive-care unit (ICU) scenario 3, task differentiation in healthcare workers (HCWs) (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in ICU scenario 3, task differentiation in HCWs (pandemic period 14 wk).

Mentions: Transfer of tasks to other HCWs than ICU nurses decreases the number of NEMS points needed by 70%. We assume acute-care and ILI patients admitted to the ICU will require the 30% technical ICU-related work of ICU nurses. This decrease in the number of NEMS points needed has a direct effect on the necessary workload in the different AR and length-of-stay models. Figure 3, panels A and B, shows that decreasing the number of required NEMS in the ICU results in sufficient numbers of HCWs being available for care of ILI patients.


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 intensive-care unit (ICU) scenario 3, task differentiation in healthcare workers (HCWs) (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in ICU scenario 3, task differentiation in HCWs (pandemic period 14 wk).
© Copyright Policy
Related In: Results  -  Collection

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

Figure 3: A) Amount of Nine Equivalents of Nursing Manpower use (NEMS) points needed and available by 25% and 50% admission rate in intensive-care unit (ICU) scenario 3, task differentiation in healthcare workers (HCWs) (pandemic period 9 wk). B) Amount of NEMS points needed and available by 25% and 50% admission rate in ICU scenario 3, task differentiation in HCWs (pandemic period 14 wk).
Mentions: Transfer of tasks to other HCWs than ICU nurses decreases the number of NEMS points needed by 70%. We assume acute-care and ILI patients admitted to the ICU will require the 30% technical ICU-related work of ICU nurses. This decrease in the number of NEMS points needed has a direct effect on the necessary workload in the different AR and length-of-stay models. Figure 3, panels A and B, shows that decreasing the number of required NEMS in the ICU results in sufficient numbers of HCWs being available for care of ILI patients.

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