Management of intensive care: guidelines for better use of resources
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Dordrecht u.a.
Kluwer Acad. Publ.
1990
|
| Schriftenreihe: | Developments in critical care medicine and anesthesiology
16 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXIII, 245 S. |
| ISBN: | 0792307542 |
Internformat
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Datensatz im Suchindex
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| adam_text | Contents
Page
Preface xi
by Luciano Gattinoni, President of the European Society of
Intensive Care Medicine
Foreword xm
by Jean Frangois Girard, Directeur General de la Sante (France)
The working group xv
List of abbreviations used in the text xxi
CHAPTER I: INTRODUCTION
Peter F. Hulstaert and Wolf gang Kox
1. Intensive Care Medicine 1
1.1 Fundamentals of Intensive Care Medicine 1
1.2 The facilities 2
1.3 The different interpretations of Intensive Care Medicine 2
1.4 ICM to whom? 3
1.5Ethics 4
2. Guidelines for Intensive Care Medicine 4
2.1 Why guidelines? 4
2.2 The target groups 5
2.3 The guidelines 6
v
VI
Page
CHAPTER II: THE PATIENTS
Jean Roger Le Gall, Philippe Loirat, Daniel Mathieu and
Alan Williams
1. Introduction H
2. Measuring the type of patients 12
2.1 Referral source 12
2.2 The problem of diagnosis 13
3. Measuring the previous health Status and the severity
of illness 16
3.1 Previous Health Status 17
3.2 Severity Indexes 19
4. Measuring the workload 21
4.1 TheTISS System 21
4.2 The Omega System 22
4.3 The PRN System 23
5. Measuring the evolution of severity of illness 24
5.1 The OSF System 24
5.2 The Sickness Scoring (SS) 24
6. Stratification of patient related data 25
6.1 Essential data 25
6.2 Important data 25
6.3 Desirable data 26
6.4 Optional data 26
References 26
Tables 29
CHAPTER III: THE FACILITIES
Ricardo Abizanda
1. Introduction 55
2. ICUs in Europe: The great diversity 56
2.1 Size 56
VII
Page
2.2 Utilization pattern 57
2.3 Education and training 59
2.4 Classification of ICUs 59
3. The type and size of Intensive Care facilities 60
3.1 The type of ICUs 60
3.2 The size of ICUs 63
3.3 The location of ICUs 65
4. General Standard for ICUs 67
4.1 Space and technical conditions 67
4.2 Attendance protocols and procedure manuals 68
4.3 Ancillary Services 69
4.4 Quality assurance 69
5. Staffing 69
6. Comparing facilities 69
Addendum I 70
Addendum II 73
Addendum III 74
Addendum IV 76
References 81
CHAPTER IV: NATIONAL AND REGIONAL ORGANISATION
Dinis Reis Miranda and Dieter Langrehr
1. Introduction 83
2. Estimating the total number of ICU beds required 84
2.1 Rates of occupancy and availability 85
3. Factors influencing regional planning 87
3.1 Hierarchy of IC facilities 88
4. Levels of care 89
4.1 Determinants of levels of care 90
5. Calculating manpower needs 98
6. Conclusions 100
References 101
vni
Page
CHAPTER V: MANAGEMENT CONTROL IN THE ICU
John F.A. Spangenberg, Jan H.R. van de Poel and Gaetano Iapichino
1. Planning and control 103
2. The ICU: Expense or responsibility centre? 104
3. Performance criteria 106
4. Incentives and constraints of ICU Performance 108
4.1 Patient characteristics 109
4.2 Admissions and discharge decisions 110
4.3 ICU inputs 115
4.4 ICU throughputs 117
4.5 Final ICU Outputs 118
5. Conclusions 120
References 121
CHAPTER VI: EDUCATION AND TRAINING
Hilmar Burchardi and Belinda Atkinson
1. Introduction 125
2. The actual education and training of Intensive Care Medicine 126
2.1 Physicians 127
2.2 Nurses 128
2.3 Other personnel 131
3. General recommendations 131
3.1 Physicians 132
3.2 Nurses 137
3.3 Other personnel 140
4. Conclusions 142
Addendum I. Present Situation in European countries 143
Addendum II. Basic education 153
Addendum III. Special education 154
Addendum IV. Catalogue of skills for Special Intensive Care
Medicine training 157
IX
Page
Addendum V. General Intensive Care nur sing for registered
general nurses 160
Addendum VI. Special Intensive Care training for nurses in
West Germany 162
CHAPTER VII: EVALUATION IN INTENSIVE CARE
Philippe Loirat, John Spangenberg and Lis Dragsted
1. What should or could be evaluated 165
1.1 Technologies and interventions 165
1.2 Organisational studies 166
2. Who should evaluate? 168
2.1 Internal audit 168
2.2 External audit 168
2.3 Concensus Conference 169
2.4 Recommendations 169
3 Intensivists should try to adopt common definitions and
classifications 170
3.1 Classification of patients in large series 170
3.2 Classification of patients by specific diagnoses 170
3.3 DRGs and evaluation 171
4. Evaluation studies must have a proper scientific design 171
4.1 Study design 171
4.2 Proper control group 172
4.3 Stratification 172
5. The proper judgement criteria must be employed 173
6. Long term evaluation of Intensive Care: Health Status and
quality of life 174
6.1 Definitions 174
6.2 Proper scale 175
6.3 General characteristics of the scales 175
6.4 Functional Status scales 176
6.5 Generic measures of health Status 176
X
Page
6.6 Measurements of perceived quality of life 177
6.7 Recommendations 178
7. Economic evaluation of intensive care utilisation 180
7.1 Cost Benefit Analysis (CBA) 181
7.2 Cost Effectiveness Analysis (CEA) 186
7.3 Conclusions and general recommendations 187
References 188
Table 1. Data for Evaluation of ICM 191
Table 2. Components of the Activity of Daily Living 192
Table 3. Elements of the Sickness Impact Profile 193
Table 4. Components of the Quality of Well Being 194
Table 5. Components of the Perceived Quality of Life Index 195
Table 6. Costs and Benefits of Intensive Care 196
Table 7. Cost Accounting in the ICU 197
CHAPTER VIII: EPILOGUE
Gertjan Nooij
1. Introduction 199
2. Quantification 200
3. Regionalisation 201
4. Professionalisation 202
5. Levels of responsibility 203
6. Intensive Care Medicine societies 205
7. Concluding comments 206
Directory of Intensive Care Organisations 209
Subject Index and Abbreviations 224
Nigel Turner
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| indexdate | 2024-07-09T16:12:56Z |
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| isbn | 0792307542 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-002748544 |
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| physical | XXIII, 245 S. |
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| series | Developments in critical care medicine and anesthesiology |
| series2 | Developments in critical care medicine and anesthesiology |
| spelling | Management of intensive care guidelines for better use of resources ed. by D. Reis Miranda ... Dordrecht u.a. Kluwer Acad. Publ. 1990 XXIII, 245 S. txt rdacontent n rdamedia nc rdacarrier Developments in critical care medicine and anesthesiology 16 Health Planning Europe Guideline Intensive Care Units economics Europe Guideline Intensive Care Units organization & administration Europe Guideline Intensive care units Management Gesundheitswesen (DE-588)4020775-4 gnd rswk-swf Intensivmedizin (DE-588)4027263-1 gnd rswk-swf Europa Westeuropa (DE-588)4079215-8 gnd rswk-swf Guideline Westeuropa (DE-588)4079215-8 g Gesundheitswesen (DE-588)4020775-4 s Intensivmedizin (DE-588)4027263-1 s DE-604 Miranda, Dinis R. Sonstige oth Developments in critical care medicine and anesthesiology 16 (DE-604)BV000011020 16 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=002748544&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management of intensive care guidelines for better use of resources Developments in critical care medicine and anesthesiology Health Planning Europe Guideline Intensive Care Units economics Europe Guideline Intensive Care Units organization & administration Europe Guideline Intensive care units Management Gesundheitswesen (DE-588)4020775-4 gnd Intensivmedizin (DE-588)4027263-1 gnd |
| subject_GND | (DE-588)4020775-4 (DE-588)4027263-1 (DE-588)4079215-8 |
| title | Management of intensive care guidelines for better use of resources |
| title_auth | Management of intensive care guidelines for better use of resources |
| title_exact_search | Management of intensive care guidelines for better use of resources |
| title_full | Management of intensive care guidelines for better use of resources ed. by D. Reis Miranda ... |
| title_fullStr | Management of intensive care guidelines for better use of resources ed. by D. Reis Miranda ... |
| title_full_unstemmed | Management of intensive care guidelines for better use of resources ed. by D. Reis Miranda ... |
| title_short | Management of intensive care |
| title_sort | management of intensive care guidelines for better use of resources |
| title_sub | guidelines for better use of resources |
| topic | Health Planning Europe Guideline Intensive Care Units economics Europe Guideline Intensive Care Units organization & administration Europe Guideline Intensive care units Management Gesundheitswesen (DE-588)4020775-4 gnd Intensivmedizin (DE-588)4027263-1 gnd |
| topic_facet | Health Planning Europe Guideline Intensive Care Units economics Europe Guideline Intensive Care Units organization & administration Europe Guideline Intensive care units Management Gesundheitswesen Intensivmedizin Europa Westeuropa Guideline |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=002748544&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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