Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit

<h4>Background</h4> The intensive care unit (ICU) staffing model affects clinical outcomes of critically ill patients. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. <h4>Methods</h4> Th...

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Autores principales:	Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6da64fefe0da4f23b9e323c67bffc419
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spelling	oai:doaj.org-article:6da64fefe0da4f23b9e323c67bffc4192021-11-04T06:49:46ZImpact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit1932-6203https://doaj.org/article/6da64fefe0da4f23b9e323c67bffc4192021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550369/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> The intensive care unit (ICU) staffing model affects clinical outcomes of critically ill patients. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. <h4>Methods</h4> This retrospective before-after study included patients admitted to the medical ICU. Anthropometric data, admission reason, Acute Physiology and Chronic Health Evaluation II score, Eastern Cooperative Oncology Group grade, survival status, length of stay (LOS) in the ICU, duration of mechanical ventilator care, and occurrence of ventilator-associated pneumonia (VAP) were recorded. The staffing model of the medical ICU was changed from a mandatory critical care consultation model to a closed unit model in September 2017, and indices before and after the conversion were compared. <h4>Results</h4> A total of 1,526 patients were included in the analysis. The mean age was 64.5 years, and 954 (62.5%) patients were men. The mean LOS in the ICU among survivors was shorter in the closed unit model than in the mandatory critical care consultation model by multiple regression analysis (5.5 vs. 6.7 days; p = 0.005). Central venous catheter insertion (38.5% vs. 51.9%; p < 0.001) and VAP (3.5% vs. 8.6%; p < 0.001) were less frequent in the closed unit model group than in the mandatory critical care consultation model group. After adjusting for confounders, the closed unit model group had decreased ICU mortality (adjusted odds ratio 0.65; p < 0.001) and shortened LOS in the ICU compared to the mandatory critical care consultation model group. <h4>Conclusion</h4> The closed unit model was superior to the mandatory critical care consultation model in terms of ICU mortality and LOS among ICU survivors.Sung Jun KoJaeyoung ChoSun Mi ChoiYoung Sik ParkChang-Hoon LeeChul-Gyu YooJinwoo LeeSang-Min LeePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sung Jun Ko Jaeyoung Cho Sun Mi Choi Young Sik Park Chang-Hoon Lee Chul-Gyu Yoo Jinwoo Lee Sang-Min Lee Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
description	<h4>Background</h4> The intensive care unit (ICU) staffing model affects clinical outcomes of critically ill patients. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. <h4>Methods</h4> This retrospective before-after study included patients admitted to the medical ICU. Anthropometric data, admission reason, Acute Physiology and Chronic Health Evaluation II score, Eastern Cooperative Oncology Group grade, survival status, length of stay (LOS) in the ICU, duration of mechanical ventilator care, and occurrence of ventilator-associated pneumonia (VAP) were recorded. The staffing model of the medical ICU was changed from a mandatory critical care consultation model to a closed unit model in September 2017, and indices before and after the conversion were compared. <h4>Results</h4> A total of 1,526 patients were included in the analysis. The mean age was 64.5 years, and 954 (62.5%) patients were men. The mean LOS in the ICU among survivors was shorter in the closed unit model than in the mandatory critical care consultation model by multiple regression analysis (5.5 vs. 6.7 days; p = 0.005). Central venous catheter insertion (38.5% vs. 51.9%; p < 0.001) and VAP (3.5% vs. 8.6%; p < 0.001) were less frequent in the closed unit model group than in the mandatory critical care consultation model group. After adjusting for confounders, the closed unit model group had decreased ICU mortality (adjusted odds ratio 0.65; p < 0.001) and shortened LOS in the ICU compared to the mandatory critical care consultation model group. <h4>Conclusion</h4> The closed unit model was superior to the mandatory critical care consultation model in terms of ICU mortality and LOS among ICU survivors.
format	article
author	Sung Jun Ko Jaeyoung Cho Sun Mi Choi Young Sik Park Chang-Hoon Lee Chul-Gyu Yoo Jinwoo Lee Sang-Min Lee
author_facet	Sung Jun Ko Jaeyoung Cho Sun Mi Choi Young Sik Park Chang-Hoon Lee Chul-Gyu Yoo Jinwoo Lee Sang-Min Lee
author_sort	Sung Jun Ko
title	Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
title_short	Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
title_full	Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
title_fullStr	Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
title_full_unstemmed	Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
title_sort	impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/6da64fefe0da4f23b9e323c67bffc419
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Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit

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