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    Critical care in the emergency department.

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    Authors
    O'Connor, Gabrielle
    Geary, Una
    Moriarty, James
    Affiliation
    Department of Emergency Medicine, St James' Hospital, Dublin, Ireland., gabbyoco@yahoo.com
    Issue Date
    2012-02-01T10:45:15Z
    MeSH
    Adult
    Aged
    Aged, 80 and over
    *Critical Illness
    *Emergency Service, Hospital
    Female
    Health Status Indicators
    Humans
    *Intensive Care
    *Intensive Care Units
    Ireland
    Male
    Middle Aged
    *Nurse's Role
    Retrospective Studies
    Time Factors
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    Citation
    Eur J Emerg Med. 2009 Dec;16(6):296-300.
    Journal
    European journal of emergency medicine : official journal of the European Society, for Emergency Medicine
    URI
    http://hdl.handle.net/10147/207806
    DOI
    10.1097/MEJ.0b013e32831090bd
    PubMed ID
    19829120
    Abstract
    BACKGROUND: The volume and duration of stay of the critically ill in the emergency department (ED) is increasing and is affected by factors including case-mix, overcrowding, lack of available and staffed intensive care beds and an ageing population. The purpose of this study was to describe the clinical activity associated with these high-acuity patients and to quantify resource utilization by this patient group. METHODS: The study was a retrospective review of ED notes from all patients referred directly to the intensive care team over a 6-month period from April to September 2004. We applied a workload measurement tool, Therapeutic Intervention Scoring System (TISS)-28, which has been validated as a surrogate marker of nursing resource input in the intensive care setting. A nurse is considered capable of delivering nursing activities equal to 46 TISS-28 points in each 8-h shift. RESULTS: The median score from our 69 patients was 19 points per patient. Applying TISS-28 methodology, we estimated that 3 h 13 min nursing time would be spent on a single critically ill ED patient, with a TISS score of 19. This is an indicator of the high levels of personnel resources required for these patients in the ED. ED-validated models to quantify nursing and medical staff resources used across the spectrum of ED care is needed, so that staffing resources can be planned and allocated to match service demands.
    Language
    eng
    ISSN
    1473-5695 (Electronic)
    0969-9546 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1097/MEJ.0b013e32831090bd
    Scopus Count
    Collections
    St. James's Hospital

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