SAN ANTONIO – Patients requiring only short periods of ventilator management account for almost 25% of short-stay admissions to surgical-trauma intensive care units (STICU), according to research presented at the 2016 annual meeting of the American Academy of PAs (AAPA).
Over the course of a year, a minimum increase of 0.5 full-time equivalent critical care nursing is needed to provide care to these patients, the presenters said.
The retrospective review looked at STICU admissions of an urban Level 1 county hospital from November 2013 to October 2014. It included patients whose length of stay in the STICU was <12 hours. The presenters recorded demographic data, admission diagnosis, admitting service, documented reason for ICU admission, time of ICU stay, time interval to extubation, patient location prior to ICU admission, and time interval to death.
During the study period, there were 1,244 admissions to the STICU, 106 (8.5%) of which were <12 hours. Of these short-term admissions, 42% were for ventilator management, 17% were for hourly neurologic checks, 7% were for respiratory observation, and 34% were for other reasons.
Out of the patients admitted short-term to the STICU for ventilator management, 23 (52%) were extubated within 4 hours of arrival and then transferred to the ward.
Overall, 21% of patients admitted to the STICU for <12 hours were so-called “ventilator drive-bys” who spent <4 hours on ventilators before being extubated and transferred to the ward.
The presenters said that developing a method to treat these patients without admitting them to the STICU could result in a better use of resources.