Resource Allocation in the Intensive Care Unit

2011 ◽  
pp. 1568-1572
Author(s):  
Gordon D. Rubenfeld
Keyword(s):  
Intensive Care Unit ◽  
Resource Allocation ◽  
Intensive Care

scholarly journals Student nurses’ ethical views on responses to the severe acute respiratory syndrome outbreak

2020 ◽  
Vol 27 (4) ◽  
pp. 924-934
Author(s):  
Joseph KM Kam ◽  
Eric Chan ◽  
Albert Lee ◽  
Vivian WI Wei ◽  
Kin On Kwok ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Resource Allocation ◽  
Intensive Care ◽  
Nursing Students ◽  
Severe Acute Respiratory Syndrome ◽  
Infectious Diseases ◽  
Health Workers ◽  
Intensive Care Unit Care ◽  
Central Research ◽  
Collateral Damage

Background Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals. Objective We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work. Research design A questionnaire survey was carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage. Ethical considerations This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education. Findings Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students’ attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients. Conclusion As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress.

scholarly journals Augmenting Resource Allocation Techniques for the Management of ICU Beds During COVID-19 Pandemic

2020 ◽  
Author(s):  
Seyed Mohssen Ghafari ◽  
Richard Nichol ◽  
Richard A. George
Keyword(s):  
Intensive Care Unit ◽  
Resource Allocation ◽  
Intensive Care ◽  
Health Systems ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Stressful Environment ◽  
The World ◽  
Challenging Situation

At the time of writing, more than seventy million people have been infected by COVID19 and more than one and a half million have died from the infection. A major challenge for health systems around the world is to supply ventilators and Intensive Care Unit (ICU) beds for those patients with the most severe symptoms of the infection. Unfortunately, during the COVID-19 pandemic, many countries face ICU bed shortages. In situations of peak-demand, healthcare providers follow predefined strategies to allocate the available ICU beds in the most efficient way. On these occasions, physicians and healthcare workers, who swore an oath to treat the ill to the best of their ability, would have to choose not to save some patients to ensure others survive. This decision puts healthcare professionals in an ethically and emotionally challenging situation in an already stressful environment. In this paper, we propose an automatic approach for managing ICU beds in hospitals to i) create the most effective ICU resource allocation, and ii) relieve physicians of having to make decisions in this regard. The experimental results demonstrate the effectiveness of our approach.

scholarly journals Multi-objective Risk-based Resource Allocation for Urban Pandemic Preparedness: The COVID-19 Case in Bogotá, Colombia

2021 ◽  
Author(s):  
Jeisson Prieto ◽  
Jonatan Gomez
Keyword(s):  
Intensive Care Unit ◽  
Resource Allocation ◽  
Intensive Care ◽  
Social Contact ◽  
Strategic Decision ◽  
Healthcare Facilities ◽  
Scarce Resources ◽  
Multi Objective ◽  
Patient Allocation ◽  
Objective Risk

ABSTRACTDetermining how best to allocate resources to be used during a pandemic is a strategic decision that directly affects the success of pandemic response operations. However, government agencies have finite resources, so they can’t monitor everything all of the time: they have to decide how best to allocate their scarce resources (i.e., budget for antivirals and preventive vaccinations, Intensive Care Unit (ICU), ventilators, non-intensive Care Unit (non-ICU), doctors) across a broad range of risk exposures (i.e., geographic spread, routes of transmission, overall poverty, medical preconditions). This paper establishes a comprehensive risk-based emergency management framework that could be used by decision-makers to determine how best to manage medical resources, as well as suggest patient allocation among hospitals and alternative healthcare facilities. A set of risk indexes are proposed by modeling the randomness and uncertainty of allocating resources in a pandemic. The city understudy is modeled as a Euclidean complex network, where depending on the neighborhood influence of allocating a resource in a demand point (i.e., informing citizens, limit social contact, allocate a new hospital) different network configurations are proposed. Finally, a multi-objective risk-based resource allocation (MoRRA) framework is proposed to optimize the allocation of resources in pandemics. The applicability of the framework is shown by the identification of high-risk areas where to prioritize the resource allocation during the current COVID-19 pandemic in Bogotá, Colombia.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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