Profile of ICU bed requests at Helen Joseph hospital

Abstract

Intensive care units (ICU) in South Africa are resource restricted environments. Of the total number of public hospitals in SA, only 23% have been shown to have ICU facilities. Compounding the limited physical bed status is the scarcity of trained ICU staff. ICU facilitates more intense monitoring and management of patients. The aim of this research was to compile a profile of all the ICU admission requests at Helen Joseph Hospital (HJH). A contextual, prospective, descriptive research design was followed in this study. Data was collected during one winter and one summer month in 2012. A total of 139 patients were included in the study. The median age was 44 years. The majority of patients (79%) were under the age of 60 years. The overall admission rate was 35.25% and the most common reason for admission was mechanical ventilation. Reasons for refusal were 41% assessed as too ill, 30% assessed as too well and 29% were refused due to a lack of resources. Patients admitted to the ICU had a 77.55% survival rate. The relationship between ICU admission and 30 day outcome was statistically significant. This study has described the patients for whom ICU beds were requested at HJH, the reasons for admission or refusal and the 30 day outcome for all patients. The lack of resources has proven to be a significant issue in the ICU. Survival rates correlate with international trends and triage methods appear to be effective.