Table 2 Summary of description and definitions for strain indicators across studies
From: Indicators of intensive care unit capacity strain: a systematic review
Quality indicator | description | Definitions used in the literature for exposure, outcome and analysis |
|---|---|---|
ICU census | ICU bed occupancy ICU bed availability | • Total number of patients who spent at least 2 h in the ICU on the calendar day the patient was admitted. • Bed occupancy. • ICU full and not able to admit or discharge any patients. • No available ICU beds |
Queuing | Time delay in patient ICU admission | • Delay in ICU admission. • Delay in ICU admission > 4 h. • Delay in ICU admission > 6 h. • Delay in ICU admission > 8 h. • Mean time from bed request to ICU transfer. |
Nurse-to-patient ratio | Ratio of nurses to patient for a given ICU. | • Ratio of nurses to beds in an ICU. • Ratio > or < 1:2. • Ratio 1:2 vs. 1:2. |
Daily rounds by intensivist | Daily review of patient’s condition and problem list by MRP. | • No definition provided. |
ICU transfer | Transfer of an ICU patient from one ICU to another. | • Inter-hospital transfer of an ICU patient. |
Acuity | Severity of illness of patients in the ICU. | • APACHE II score. • Acute physiology score. • MPM-0 score. |
After-hours discharges | ICU discharge of a patient to the hospital ward outside of regular hours. | • ICU discharge between 1600 and 0800 h. • ICU discharge between 1800 and 0600 h. • ICU discharge between 2000 and 0800 h. • ICU discharge between 2200 and 0700 h. |
Turnover | The number of new admissions to and discharges from an ICU over a given time period. | • Number of new admissions, discharges and transfers. • Number of new admissions per day. • Number of admissions in a given week. |
Workload | Intensity of bedside nurse work required per patient per unit of time. | • Number of new patient admissions and number of patient-care days. • Volume and pressure of work. • TISS score |
Early ICU discharge | Premature ICU discharge. | • Discharged early but would have benefited from longer ICU stay. |
Refusal rate | A measure of the number of patients referred to but not admitted to the ICU. | • Patients who were referred to but not admitted to the ICU. |
ICU readmission | Patients who have been discharged from the ICU and are readmitted within the same hospitalization. | • ICU readmission within 24 h. • ICU readmission within 48 h. • ICU readmission within 72 h. • Unplanned ICU readmission. |
SMR | Ratio between the observed number of deaths in a study population and the number of deaths that would be expected, based on age and sex-specific rates or severity of illness score. | • Not applicable. |
Burnout | Workplace-related psychological stress leading to healthcare providers perception of emotional exhaustion, depersonalization and lack of personal achievement. | • State characterized by physical and/or psychological fatigue, disappointment, underachievement, tiredness and desire to leave work. |
Job satisfaction | Healthcare workers satisfaction with work and workplace environment. | • Nursing self-reports of either being satisfied, unsatisfied or partially satisfied. |
Surgery cancellation | Elective surgeries that is postponed or cancelled due to ICU bed availability. | • Cancellation of surgery due to lack of ICU bed. • Surgery cancelled or rescheduled. |